Social determinants play into who gets to die prematurely while others get to have healthy productive lives—these are loosely called health disparities. Health disparities are typically understood socially, economically, and politically, but rarely analyzed within the legal system.

The Social Security Administration (SSA)—the federal program for providing Americans with disabilities benefits and resources— recorded that in 2018 approximately ten thousand people died while waiting for the backlogged SSA and SSA administrative law judges (ALJs) to decide on whether they deserved aid for their disability. In regard to this death toll, the president of the association of ALJs expressed frustration about inadequate Congressional funding: “I know that people will die waiting . . . We have decided it’s better for people to die than to adequately fund this program.”

SSA is the primary accessor of the propriety of denials by ALJs that otherwise go unchecked. But studies show that ALJs incorrectly decide SSA benefit applications at high rates without a properly functioning check on ALJ bias. Because an incorrect decision can lead to the worsening health, and even death, of the claimant, it is critical that we understand the factors that impact ALJ decision-making

The legal system is a contributing factor to health disparities. In this Note, I explain this by analyzing a legal aid database of plaintiffside SSA disability cases via a mixed methods study utilizing statistics and content analysis.2 I find that Black claimants are statistically more likely to be rejected for disability aid over their peers—this mirrors what the SSA found in their prior reports. However, SSA reports fail to explore in depth why these results occur. Here, I find that the higher rejection rates for Black claimants is due to two primary factors. First, a minority of judges disproportionately deny Black claimants at significantly higher rates than their ALJ peers. Second, some ALJs rely on medical documentation that does not reflect surrounding factors like implicit bias and cultural context. Low-cost solutions can combat these inconsistent outcomes. For example, the SSA has previously instituted implicit bias training, which although rarely provided, found great success in rooting out ALJ bias. An even more cost-effective method is releasing redacted informative data for independent researchers to analyze. The alternative is the continued perpetuation of a public health crisis caused by courts and judges, not by hospitals and doctors, and the continued deleterious health effects on disabled claimants.