Do Disability Examiners make bad decisions, or do Social Security Judges?

In answer to this question, my own opinion is that the real problem is disability examiners and the system they work in. The Social Security Disability and SSI disability system is federal, but every DDS operates independently. And decision-making is not uniform, not even between units in a DDS.

I think the real problem is that DDS examiners have a disinclination to approve too many cases. This is because external quality control (in the Atlanta region, this was known as DQB, or disability quality branch) tended to send back as "returns", cases for which DQB found errors in decision-making on the part of disability examiners) and usually cases that had been marked for approval by disability examiners. Very seldom was a return a case that had been denied by an examiner. The effect was that approvals were suppressed.

I remember one case in which a person suffered second and third degree burns to 25 percent of their body. They had been discharged at one point by UNC hospital but had been readmitted because of renal failure subsequent to their injuries. Our unit manager forced the case to be denied. The unit medical consultant went along with the unit supervisor (how independent does this make the unit medical consultant then?) and the rationalization was that the level of stricture from the burns was not significant enough that it couldn't resolve within 12 months.

Completely wrong. That was a good example of unit supervisors exercising their influence on decision-making simply because they want to suppress approvals and reduce the potential for returns from external quality control, which makes them look bad to upper DDS agency management. In other words, state government employees subverting the system for their perceived career goals.

Given this, it is not surprising that Social Security judges reverse so many of these bad decisions. Judges do not answer to management. They are autonomous. And in being so, they re-introduce a level of fairness into the system since the state-run DDS agencies have the opposite effect. Which is why it is so disheartening to see attempts to paint all judges as being too lenient.

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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