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Why Can't the Examiner Tell me What the Decision on my Disability Case was?



 
Someone recently described the following (paraphrased) scenario with regard to their Social Security Disability case:

I filed for disability, was denied, and then filed for reconsideration. I didn't hear back on my case for a long time and for that reason I called the disability examiner. I was told that a decision had already been made on my case and they couldn't tell me anything more. I don't get it. Was I denied. If so, why can't they tell me?.

This is a fairly easy question to answer. If, after filing for disability you learn that a decision has been made on your SSD or SSI disability claim and you contact the disability examiner who processed your case to learn what the decision was, they simply will not be able to tell you. Why? As a matter of policy they are prohibited from doing so. But this is for a reason that most applicants for disability might never guess which is this: between the time that the disability decision has been made by an examiner and the time that a claimant receives their actual notice of decision...the decision could change.

How is this? Here's how. A small percentage of cases that are decided by disability examiners are selected for external quality control review by something known as DQB, or disability quality branch. When a case gets sent to DQB it can remain there for quite a while. It can also coming back as something other than what it was when it arrived there. In other words, the disability quality branch might determine that the case that was approved by the disability examiner should have been a Social Security Disability denial. Or, vice-versa (though, it is no secret that DQB very seldom takes a case that was denied by a disability examiner and overturns it, making it an approval).

So, therefore, the reason why an examiner is prohibited from telling any claimant what the decision on their case was is simply due to the fact that, ultimately, because external quality control may change the decision, the examiner does not have the final say on the claim. And, thus, the answer they give to the claimant over the phone may turn out to be wrong.








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For the sake of clarity, SSDRC.com is not the Social Security Administration, nor is it associated or affiliated with SSA. This site is a personal, private website that is published, edited, and maintained by former caseworker and former disability claims examiner, Tim Moore, who was interviewed by the New York Times on the topic of Social Security Disability and SSI benefits in an article entitled "The Disability Mess" and also by the Los Angeles Times on the subject of political attempts to weaken the Social Security Disability system.

The goal of the site is to provide information about how Social Security Disability and SSI work, the idea being that qualified information may help claimants pursue their claims and appeals, potentially avoiding time-consuming mistakes. If you find the information on this site helpful and believe it would be helpful to others, feel free to share links to its homepage or other pages on website resource pages, blogs, or social media. Copying of this material, however, is prohibited.

To learn more about the author, please visit the SSDRC.com homepage and view the "about this site" link near the bottom of the page.