What is the Application Process for Social Security Disability and SSI?
How do you Win Benefits under Social Security Disability or SSI?
If I am determined disabled, how far back will Social Security pay benefits?
How do you prove your disability case if you have a mental condition?
What Can I Do to Improve My Chances of Winning Disability Benefits
Common Mistakes after Receiving a Denial of Social Security Disability or SSI Benefits
How to File for Disability - Tips for Filing
If You Get Approved For SSDI Will You Also Get Medicare?
How much does a Social Security disability attorney get paid?
Social Security Disability SSI Criteria and the Evaluation Process
How long does it take to be approved for SSI or Social Security disability?
What do you Need to Prove to Qualify for Disability Benefits?
Social Security Disability SSI and Fibromyalgia
Social Security Disability SSI and Degenerative Disc Disease
Can I Qualify For Disability and Receive Benefits based on Depression?
Answers to questions about SSD and SSI disability
What Disabilities Qualify for SSI and Social Security Disability Benefits?
Social Security Disability Status
Social Security Disability Tips — how a claim gets worked on
Social Security Disability, SSI Disability - Terms, Definitions, Concepts
Who Makes The Social Security Disability Decision, A Judge Or A Caseworker?
How to prove you are disabled
and win disability benefits
The Social Security Administration does not actually use caseworkers. Caseworkers are typically employed at various departments of mental health and departments of Social Services. Social Security uses claims representatives (CRs) to take the actual disability application or appeal in a local social security field office. Once the claims representative has gathered all of the needed information (at, and after, the disability application interview), they send the disability claim to a state agency (Disability Determination Services, or DDS) for a medical decision.
Once at the state agency, disability examiners, physicians, and vocational staff are involved in making Social Security disability decisions. If an individual’s disability claim is denied, they will have to begin an appeal process that might end with an administrative law judge making their Social Security disability decision.
Prior to going to a disability hearing, an individual must first file a reconsideration appeal that is sent to the same state disability agency that made their initial disability claim decision. The "request for reconsideration" is the first appeal that is available to claimants who have been denied on their application for disability.
It should be no surprise that, at level of a reconsideration appeal, very few initial disability claim denials are reversed to an allowance, especially since the disability decision is being made at the same state disability agency using the same strict decisional guidelines. The only real difference is that a different disability examiner will make the reconsideration disability decision. Unless the first disability examiner made a clear error in the medical determination, or there is new material evidence that allows the reconsideration appeal to be approved, the outcome can almost be guaranteed to be the same.
For most, the only encouraging thing about a reconsideration appeal is that the denial allows an individual to appeal their disability case to an administrative law judge. Although judges have to use the same disability guidelines to make their decisions, they have more flexibility in their interpretation of the medical evidence and the application of the Social Security disability vocational guidelines. Perhaps this is why more disability claims are approved when a judge makes the disability decision.
The national approval rate for administrative law judges is about sixty six percent, which makes it the most favorable level of the disability process. In a nutshell, Social Security medical decisions are made both by disability examiners and administrative law judges. There are no “caseworkers” in Social Security.
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Individual Questions and Answers
SSD and SSI are Federal Programs
The title II Social Security Disability and title 16 SSI Disability programs operate under federal guidelines and, therefore, the program requirements--medical and non-medical--apply to all states:
Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Indiana, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming
Recent approval and denial statistics for various states can be viewed here:
Social Security Disability, SSI Approval and Denial Statistics by state
Special Section: Disability Lawyers and unnecessary claim denials