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
Ask a question, get an answer
What does a Social Security Disability Examiner do?
The answer to this question depends on what level of the social security appeal system your particular claim happens to be at. If you have filed a disability application, then the decision on your claim will be made, principally, by a disability examiner.
What is a disability examiner? A disability examiner is a specialist who works at a state agency whose function is to evaluate disablity claims (both social security disability and SSI disability) for the social security administration. These state agencies are disability determination services. Each state has at least one DDS and some have several (North Carolina, for example, has a centralized system that uses one DDS, while South Carolina has a decentralized system that uses multiple DDS facilities).
What happens at DDS and what does the disability examiner do? DDS is where claims go after they have been opened in local social security offices. There at DDS, cases are assigned to disability examiners who have caseloads of pending claims.
Disability examiners are responsible for requesting a claimant's medical records from all the various medical treatment sources listed on the claimant's disability application. Getting the records, of course, can take quite some time in many instances.
However, once the records are received, the disability examiner will be responsible for evaluating them. This usually entails reading them and taking notes to ascertain whether or not the claimant meets the necessary qualifications to satisfy a listing in the blue book (the social security disability list of impairments).
The claimant's remaining physical and mental capabilities (in light of their various physical and mental conditions) is known as their RFC, or residual functional capacity. Residual functional capacity is expressed in terms of a rating, either physical or mental.
How does a disability examiner determine a claimant's functional limitations?
Disability examiners begin the process by requesting medical treatment records from all the medical sources provided by the person at their disability interview (conducted by a CR, or claims representative, at a Social Security office).
When filing for disability, claimants do not have to provide their actual medical records themselves (though it is possible for a claimant to personally deliver their medical records at the time of application--which can have the effect of speeding up the disability case) just the names of their treating medical sources, i.e. the various clinics, hospitals, and doctor's offices where they have received treatment.
For more on the topic of how an determines what a person can and cannot do (functional limitations), visit this page: Examiners must decide an individualís currently level of physical and/or mental functioning.
Can you speak to your disability examiner?
Yes, you can speak to the examiner handling your case. You can contact Social Security (the office you applied at) and get the number for your state's DDS agency. When you call DDS, they will confirm your identity and then put you in touch with the examiner. For more on this topic: Can I Talk To the Disability Examiner Working On My Case?
What if the examiner cannot locate all the medical records?
Answer A): If the examiner cannot find medical records that show treatment for a particular condition, the examiner will probably have to schedule a CE, otherwise known as a consultative examination, and often referrred to as a social security medical exam.
Answer B): If the examiner cannot find current medical records, the examiner will also probably have to schedule a CE. This is because the social security administration requires that the decision on the disability claim is based on at least some current information. Current information is defined as information that is not older than 90 days. Why is current medical information important? Because to establish disability benefits, there must be sufficient proof that the claimant currently has limitations that are significant enough to prevent work activity.
For more on this specific topic: What if the examiner can't get all my medical records?
How long does it take a disability examiner to work on a case
SSA usually quotes 90-120 days as the average amount of time for a decision on a disability claim. Most cases get decided in that time frame. However, some cases take longer due to a number of factors, including how long it may take to get medical records gathered and whether or not a person has to go to consultative medical exams for their claim. Some applications will only take several weeks. Some can actually take half a year or longer, though this is usually not true.
However, to avoid unnecessary slowdowns, you may wish to view some of these tips: Social Security application tips.
The main topic of this page is continued here: How does Social Security Disability decide that you cannot work?
Return to: Social Security Disability Resource Center, or read answers to Questions
What happens if the Social Security disability examiner cannot find all the needed medical records?
How long does it take for an examiner to review a disability case?
Will the the SSA Examiner Call or Contact me about my Social Security Disability or SSI Claim?
What tools are used by a Social Security Disability Examiner to Make a Claim Decision?
After you file for SSD, the Disability Examiner may contact you for additional information
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