Does The Social Security Judge Use The Same Rules As The Disability Examiner?

In theory, all Social Security Disability medical determinations are based upon the same disability rules and guidelines. To that end, Social Security Disability examiners are strictly bound by the disability criteria contained in the Social Security impairment listings and established vocational rules (sometimes called the vocational grid).

Disability examiners have very little leeway when making their medical determinations. This could account for the low approval rates for initial disability claims and reconsideration appeals. The national average approval rate for initial disability claims is about thirty five percent and the average approval rate for reconsideration appeals is only about ten to fifteen percent.

It is only when an individual appeals their disability claim to an administrative law judge hearing that their chances of being approved for disability dramatically improve. Now comes the big question as to why this is so if both disability examiners and administrative law judges have the same rules and guidelines to make their disability determinations.

The simple truth is that administrative law judges have more flexibility in interpreting medical evidence and in applying vocational guidelines. For example, administrative law judges have vocational and medical experts to help them with their decisions.

Vocational experts are generally local and are able to interpret the lack or availability of other types of work in the area that might be appropriate for an individual considering their residual functional capacity (what an individual is able to do in spite of the limitations impose upon them by their disabling impairment).

Disability examiners, on the other hand, must look at the national general economy when they make their determinations. Whatever the reason--more flexibility in applying the guidelines, medical experts, or vocational experts--the approval rate for administrative law judge disability hearings is the highest of all levels of the disability process.

National statistics indicate that about sixty-six percent of all disability claimants who attend a disability hearing are approved.

About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.

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