We are always interested in reviewing the approval rates at various levels of adjudication.
For fiscal year 2020, the initial application approval rate rose from 37% to 39%. The reconsideration appeal rate increased from 13% to 14%. The hearing level approval rate rose from 45% to 49%.
In the past, the grant rate at the hearing level was as high as 60%, and I have even seen references to 70%. There was at least one high profile fraud case involving an attorney, a judge, and some medical providers that has been referenced as a major factor in the declining grant rate.
The backlog at the initial application level rose by 30% for fiscal year 2020. The pandemic and high turnover have caused significant delays in the adjudication of these claims.