My Application for Disability was given a Denial by the Examiner



 
Someone wrote in and said (paraphrased): "I learned my application for disability was given a denial by the examiner. I did not receive the notice of denial, but when I called the examiner she told me it had been sent again to her from the local office requesting that take another look at it. She stated that the claim is looking more favorable due to this. It was not pulled by quality review, but was sent immediatly back to her? Does this happen often?"

Answer:

If she denied you at the initial claim level, it should not have come back to the examiner unless it was flagged by DQB, the disability Quality Branch, which is external quality control. When cases are returned from DQB, this means that there is an issue with the examiner's decision. It may be a technical issue, or it may be that there is a significant issue having to do with the examiner's decision.

If it was not external quality control, then I don't know how it would have come back to her. It should not have been sent back by the local social security office where it originated because social security offices do not have anything to do with the processing of claims. They just do the intake, send it off for a decision from the DDS, and wait for it to come back. Maybe if there was more clarification on what she meant by "local office".



Also, if it was sent back to her "immediately", this does not sound like a DQB pull. It sounds like internal quality control at DDS. However, if that was the case she should not have told you that it was denied. DDS examiners are prohibited from informing you of their decision BECAUSE THE BUCK DOES NOT STOP WITH THEM. Their decisions are alterable by others, including their own management and DQB.







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