An explanation of why DDS Examiners deny so many disability cases

Why does DDS deny so many SSDI and SSI disability claims? Here's my answer: DQB, or the disability quality branch. As all examiners, reps, judges, and CRs know, a percentage of completed dds files are sent off to this unit to see if all the i's are dotted and all the t's are crossed. And, interestingly enough, more cases that were MARKED FOR APPROVAL come back reversed than vice-versa.

When a case is returned from dds, it's like a black mark for the examiner because it directly implies that he or she flubbed up. It's a black mark for the unit supervisor because the return came back to his or her unit. And it's a black mark for the dds administrators because the more DQB returns you get, the worse it makes your agency look.

So, human nature being what it is, what is the outcome at all dds locations in the good old USA?

It means that supervisors tend to exert an iron grip over the examiners in their units. It also means that supervisors will always lean more toward denials rather than approvals And...if a case is one of those cases that is right on the line, you can be sure that the examiner won't stick his or her butt on the line because the likelihood is that the unit supervisor will "have to talk to the examiner about his or her decision-making ability".

I am not saying that we need to dispense with quality review. But, I think it's pretty plain that external quality review has had an insidious effect on dds claims processing-----with disability claimants coming out the clear loser.

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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