When does a case go to the Social Security Disability review board?

Someone recently submitted the following question: "My case has been approved by DDS, but has been sent to the Quality review board. Is this social security's way of making sure that DDS did their job correct?".

The quality review board being referred to is something known as DQB, or disability quality branch. This is a facet of the social security administration that reviews cases that have been processed by disability examiners.

Officially, the purpose of a DQB review is to ensure that the decisions made by disability examiners on Social Security Disability claims and SSI disability claims are correct and proper.

However, it's the opinion of many disability examiners that there's more to it than that. Specifically what I mean is this: as a disability examiner, the returns (cases that are intercepted by DQB, reviewed, and then sent back to DDS, or disability determination services, to be worked on again) noticed by myself and other examiners tended to be cases that had been marked for approval, not cases that had been marked for denial.

In other words, there seemed to be a clear pattern that indicated that the social security administration was looking far more closely at cases that examiners had determined should be approved, and not as closely at cases that disability examiners had determined should be denied. And the only plausible reason for that seemed to be an agency slant toward saving money...which is another way of saying holding down the number of approved cases...which is another way of saying trying to deny more cases.

Should it surprise anyone that the Social security administration might have a bias against approving claims? Not at all. In my own opinion, it is the manner in which the "Social Security Disability quality review board" works that has a direct and immediate influence on how cases are decided in the various state DDS agencies.

And, of course, there is the uncomfortable fact that higher-ups within the Social security administration have actually advocated that the disability hearing appeal should include an SSA attorney, effectively turning the hearing level into something far less than an objective process and into an interest-based adversarial process.

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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