Ron, you don't seem to be considering that
many people have their claims initially denied because they don't meet the legal requirements to qualify for disability.
Of that 63% who are denied initially, I read that chart as saying another 3% out of that group get allowed at recon, another 12% at hearings, and 1% at the appeals council. To me that looks like 37 out of the 53 people that are allowed (which is the number in the the paragraph right above the chart) or about 70% of the claimants, get allowed at the initial determination, or that 16 out of the 63 that are initially denied (about 25%) get allowed at a later point.
So about 54% of the people who file a claim eventually get allowed as meeting the legal requirements for Title II Disability. In any event "as they always do, the first time around" is an incorrect statement on your part, and my previous post was meant to correct the misinformation that you posted.
Many people who file can be denied just on the basis of their allegations on the claim, as they don't meet even minimal standards for eligibility on either disability or non-disability factors. Other people can screw themselves up by being poor historians - if they can't tell the CR who their doctors are, the DDS can't contact those doctors to get their medical records. Some consultative examinations are ordered by the DDS (and paid for by the agency) if it appears they might be needed, but there's a certain burden of proof that falls upon the claimant.
nomo-aloha, I'm not clear on what you are getting at. Most of the people I worked with were interested in doing an accurate job (and I was in the quality review organization - we were the ones who checked up on the work done by the field offices) and in seeing that claimants got what they were entitled to - whether that was an allowance, back payments when they came up with something that supported that, or a referral to the US Attorney's office for fraud if that was appropriate.
The idea behind having a bureaucracy is to treat people as equally before the law as possible. Compassion shouldn't come into the process. I've felt good for getting tangled cases sorted out and people paid the money they were due, and I've felt good about referring people for fraud. I've felt sorry when denying people who seemed like they could use some help, but they didn't meet the legal requirements for help from SSA (though a standard part of the CR job is to make referrals of people to the local Social Services who might be able to help them, and if it appears that the claimant might qualify for SSI, a concurrent DIB claim will be taken). But the employee's job is to administer the laws and regulations, not to say "my you seem like such a pleasant person, I'm going to give you an extra helping of money today, just because the sun is shining and I'm feeling good about things" or "my, you've been really nasty to me, I'm going to stop the payments you are legally entitled to, how do you like that?"
edited to add: anyone who feels they may be eligible for benefits SHOULD FILE IMMEDIATELY. If you aren't eligible at this time, it may be possible (depending upon circumstances) for the denied claim to serve at a later time as a protective filing date, and it may extend the period for which benefits can be paid.
Also, Ron, I apologize for being peeved enough to use the term "BS" instead of just pointing out your error, as generally I try to watch that I keep things civil. But three decades of listening to people unjustly slam members of the Federal civil service makes me a bit sensitive on that subject. However, I'll be glad to back you on slamming people when you can do it justly.
cheers,
Michael