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My Application for Disability was given a Denial by the Examiner



 
Someone wrote in and said (paraphrased): "I learned my application for disability was given a denial by the examiner. I did not receive the notice of denial, but when I called the examiner she told me it had been sent again to her from the local office requesting that take another look at it. She stated that the claim is looking more favorable due to this. It was not pulled by quality review, but was sent immediatly back to her? Does this happen often?"

Answer:

If she denied you at the initial claim level, it should not have come back to the examiner unless it was flagged by DQB, the disability Quality Branch, which is external quality control. When cases are returned from DQB, this means that there is an issue with the examiner's decision. It may be a technical issue, or it may be that there is a significant issue having to do with the examiner's decision.

If it was not external quality control, then I don't know how it would have come back to her. It should not have been sent back by the local social security office where it originated because social security offices do not have anything to do with the processing of claims. They just do the intake, send it off for a decision from the DDS, and wait for it to come back. Maybe if there was more clarification on what she meant by "local office".



Also, if it was sent back to her "immediately", this does not sound like a DQB pull. It sounds like internal quality control at DDS. However, if that was the case she should not have told you that it was denied. DDS examiners are prohibited from informing you of their decision BECAUSE THE BUCK DOES NOT STOP WITH THEM. Their decisions are alterable by others, including their own management and DQB.








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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.