Overview of Disability
Disability Back Pay
Requirements for Disability
Applications for disability
Tips and Advice for Disability Claims
How long does Disability take?
Winning Disability Benefits
Common Mistakes after a Denial
Mental Disability Benefits
Denials for Disability
Appeals for denied claims
Disability Benefits from SSA
Child Disability Benefits
Qualifications and How to Qualify
Working and Disability
Disability Awards and Notices
Disability Lawyers, Hiring Attorneys
Social Security List of Conditions
What Social Security considers disabling
Medical Evidence and Disability
Filing for Disability Benefits
Eligibility for Disability Benefits
SSD SSI Definitions
SSDRC authored by Tim Moore
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Who will decide my Social Security disability claim?
If your social security disability or SSI case is at the initial claim level (which is the disability application) or the reconsideration appeal level, it will be decided by a disability examiner who works at a state claim-processing agency. This agency renders decisions on all types of disability claims for the social security administration, including SSI disability, Social Security Disability, and Medicaid for disabled adults. It is usually called DDS, or disability determination services, though in some states it goes by other names such as the Bureau of Disability Determination.
The job of the disability examiner is to gather your medical evidence and review it, looking for evidence of functional limitations that you might have, either mental or physical or both. In the case of adult claimants, the severity of these limitations will be compared to the types of work the person did in the past. In the case of child claimants, the severity of the limitations will be compared to the child's ability to engage in age-appropriate activities, which generally means the ability to perform at grade-level in school.
The examiner does not perform this task strictly on his own, however. The examiner is actually assigned to a case processing team. And this team includes a unit medical consultant, who is a medical doctor, and a pyschological consultant who is a Ph.D.-level psychologist. Both these individuals provide feedback for the disability examiner.
In some sense, these consultants do exactly what the disability examiner does since they read the available medical records in order to gain some idea of how the individual is physically or mentally limited, as well as how long these limitations may persist. Note: for social security disability and SSI purposes, a person's state of disability must be projected to last for at least 12 months, or have already lasted this long by the time the claim is decided, before ongoing disability benefits may be granted.
The medical consultant and the psychological consultant will review the claimant's medical records and will also review the disability examiner's assessment of the case. In some instances, they may offer insight to the examiner regarding the claimant's specific condition and how the severity of the condition may reduce the individual's ability to engage in normal daily activities.
However, it is the disability examiner who fundamentally makes the decision and who, in the end, will decide to approve or deny a disability case--assuming, of course, that the disability examiner's supervisor does not override his or her decision and also assuming that the quality control unit does not have an issue with the examiner's decision-making process.
Continued at: What tools are used by a Social Security Disability Examiner to Make a Claim Decision?
Return to: Social Security Disability Resource Center, or read answers to Questions
How does Social Security Decide if I am Disabled?
How Does Social Security Decide How Much I Get For Social Security Disability or SSI?
How Will Social Security Decide a Disability Case that's filed?
Who will decide my Social Security disability claim?
Does Your Doctor Decide If You Get Disability Benefits from Social Security or SSI?
How does Social Security Disability Decide if you can Work or Not?
How does Social Security use Evidence to Decide an SSDI or SSI Disability Claim and Make a Decision?
What if Social Security Disability does not follow my doctor's assessment of my condition?
Information on the following topics can be found here: Social Security Disability Questions and in these subsections:
Frequently asked questions about getting Denied for Disability Benefits | FAQ on Disability Claim Representation | Info about Social Security Disability Approvals and Being Approved | FAQ on Social Security Disability SSI decisions | The SSD SSI Decision Process and what gets taken into consideration | Disability hearings before Judges | Medical exams for disability claims | Applying for Disability in various states | Selecting and hiring Disability Lawyers | Applying for Disability in North Carolina | Recent articles and answers to questions about SSD and SSI
These pages answer some of the most basic questions for individuals who are considering filing a claim.
Filing for disability - How to file for SSD or SSI and the Information that is needed by Social Security
How to Apply for Disability - What medical conditions can you apply and qualify for?
Applying for Disability - How long does it take to get Social Security Disability or SSI benefits?
What happens if I file a disability application and it is denied by a disability examiner or Judge?
How to Prove you are disabled and qualify to win disability benefits
How do you prove your disability case if you have a mental condition or impairment?
Social Security Disability Back pay and How Long it Takes to Qualify for it and receive it
Social Security Disability SSI - Eligibility Requirements and Qualifications Criteria