Topic Categories:


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

SSI Benefits

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



Ask a question, get an answer

Should your Doctor determine if you get Social Security Disability or SSI in Texas?




 
Ideally, a social security disability or SSI claimant's doctor (treating physician) should determine whether or not a claimant is awarded disability benefits. After all, this is the same individual who is responsible for monitoring and treating the patient and who is in the best possible position to determine the prognosis and functional outlook (social security disability eligibility always hinges on functionality, i.e. whether or not a person can perform work activity) of the patient.

However, if this was the case, then the social security administration would no longer need nearly as many disability examiners who work on reconsideration appeals nor as many judges who render decisions at the hearing level. Because so many more correct decisions would be rendered at the disability application level, making the need for appeals far less.

Here's why it will never be the case that social security disability decisions in Texas will rest on the opinions of treating physicians.

A. The social security administration has an inherent distrust of personal doctors.

B. The social security administration has the unstated goal of keeping the number of disability approvals down.

Regarding A, I speak from the position of being a former examiner and as someone involved in disability representation. The simple truth is that a detailed supportive statement from a doctor at a disability hearing can make or break a case, while the same letter when viewed at the disability application or request for reconsideration appeal level may be all but ignored.

Why the difference between the two? Because decisions that are made at the first two levels of the system are made by disability examiners and examiners are tightly controlled by their supervisors. In other words, the social security disability and SSI system keeps a close rein on how many approvals these examiners make (chiefly through the threat of external quality control, which tends to focus on approved cases, not denied cases).

Hearing level decisions in Texas, by contrast, are made by independent federal administrative law judges. I've actually heard disability examiners and field office claims reps complain about the number of approvals made by these judges and make statements along the lines of "that decision would never have been made by an examiner" or "those judges make crazy decisions".

However, the decisions issued by judges tend to be better, because judges do not have supervisors and are free to render decisions as they personally see fit. And, perhaps, because they do function independently, disability judges give far more credence to the opinions of treating physicians.

Regarding B, does the social security administration attempt to keep approvals on cases down? I think the numbers speak for themselves. Seventy percent of disability applications are denied by disability examiners. Of those individuals who are denied and decide to file a request for reconsideration an even higher percentage of 85 percent are denied. Yet, of those who persist and go to the hearing level, more than half are eventually approved.

Why weren't these cases approved at the very beginning of the disability process? Because the disability system is, sadly and unfortunately, set up to discourage claimants. And, yes, this does work. Thousands of individuals who are denied never appeal. They give up. This, of course, is something a claimant should never do. Because the odds of being approved lie in the claimant's favor...if they simply refuse to give up and follow the appeals process.















Return to:  Social Security Disability Resource Center, or read answers to Questions





























Related pages:

Can You Collect Social Security and Disability At the Same Time in Texas?
How to Get Disability with a Back Injury in Texas
Is there a short term Social Security Disability Benefit in Texas?
What is SSI Disability Pay Based On in Texas?
What Should you say to the Social Security Disability Doctor at a CE in Texas?
Reasons for Social Security Disability Cases Being Denied in Texas
Mental Disorders and SSD (Social Security Disability) and SSI in Texas
How long after you are approved for disability do you have to sign up for medicare in Texas?
What does Social Security Disability consider a Mental Impairment in Texas?
Should your Doctor determine if you get Social Security Disability or SSI in Texas?
Doctor Records and the Texas Social Security Disability Hearing
Who is eligible for Social Security Disability or SSI Disability in Texas?



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 provide answers to basic questions about pursuing disability benefits

What to Prove to Qualify for Disability Benefits
Applying for disability benefits, SSI and SSDI
What Disabilities Qualify for SSI and Social Security Disability?
How does back pay for Social Security disability work?
Social Security Disability And SSI Qualifications
Permanent Disability Qualifications for SSD and SSI
Status of your social security disability or SSI case
Disability lawyer representation, finding lawyers
What is qualifying for disability based on?
How to qualify for disability, qualifying for Benefits
Qualifications for Disability Benefits
How long does it take to get disability after applying?
Disability application, how to file in Texas
Texas disability requirements
Eligibility and qualifying for disability in Texas
What are the qualifications for disability in Texas?
Will I Qualify For Disability Benefits in Texas?
Getting a Texas disability lawyer, attorney, or advocate