How to file for disability, Filing for SSI
Disability Requirements, Disability Status
How long is the wait?, Disability Application
The Social Security List of Impairments
Qualifying for Disability, Mental Disability
Disability Lawyer Info, Disability Back Pay
Who makes the Determination of a Social Security Disability Claim?
There are various decision-makers for Social Security Disability and SSI claims. Who decides whether or not a claim meets the SSA disability qualifications depends upon what level of the disability process the claim is at.
The Social Security Disability, SSI system has the initial disability claim level (this is the disability application), the reconsideration appeal level (the appeal is known as a "request for reconsideration"), administrative law judge hearing level (the appeal is known as a "request for hearing before an administrative law judge), the Appeal Council review level, and finally the Federal district court level. Each level of the disability process has individuals who are responsible for making disability determinations.
The first two levels of the Social Security Disability, SSI system
At the initial disability claim and reconsideration appeal levels, the disability determination will be made by a team of sorts. Once a case has been transmitted from a local Social Security office to the state disability agency (see Disability Determination Services), the disability claim is assigned to a disability examiner. The examiner is a case processing specialist who will be responsible for gathering your medical evidence and making a disability determination.
Generally, after gathering the medical evidence, reviewing it, and also reviewing the claimant's work history (academic history if the claimant is a school-age minor child), the disability examiner writes up the determination for the case.
In some cases, the examiner will have complete authority as to whether her or she will issue a disability denial or an approval of the claim. Social Security does have SDN, or single-decision-maker disability examiners. These examiners have the freedom to make disability determinations without consultation and review (by medical consultants who are attached to their case-processing units) provided, of course, that the case is not complex and does involve significant mental health allegations.
Most claims, however, will not involve just a disability examiner, but a disability examiner who receives consultation from a medical doctor and a psychologist who both work in the disability examiner's unit.
Additionally, there are times at most state disability agencies when unit managers become involved in the disability determination process themselves. Often, managers have to worry about statistical information that may say they are approving or denying too many disability claims. And unfortunately, there seems to be more concentration on whether or not their unit make too many disability approvals.
If the disability claim is not approved at either of these levels (disability application and reconsideration appeal), it will move to the administrative law judge hearing appeal level.
The hearing level
At the disability hearing level, an administrative law judge will make the actual determination on the disability claim. Although the judge makes the final disability determination, they may use a medical or vocational expert to help them make their determination.
If the disability claim is not approved by the administrative law judge, it may move to the Appeals Council Review appeal level. The Appeals Council reviews disability determinations that are made by judges.
Most Appeals council reviews are denied without much of a "review" actually happening. If they are not denied, most are simply remanded back to the administrative law judge who made the original disability hearing decision for a second hearing, or "remand hearing". Appeals Council judges do approve a very small percentage of the appeals, but this is somewhat rare.
The last level of the Social Security Disability process is Federal district court. Of course, the disability determination at this level will be made by a federal judge. This level of the disability process is rarely used because of the time it takes and the expense of trying the case in federal court.
What is the Social Security Disability SSI list of impairments?
Can you work while getting or applying for Disability?
How Often Does Social Security Approve Disability The First Time You Apply?
Tips for getting Social Security Disability or SSI benefits approved
What medical conditions will get you approved for disability?
What kind of Mental Problems Qualify for Disability?
Receiving a Disability Award Letter
Conditions Social Security will recognize as a disability
Previously answered questions regarding SSD and SSI
Applying for disability in your state
Most popular topics on SSDRC.com
Social Security Disability SSI Questions
The listings, list of disabling impairments
Can a mental illness qualify you for disability?
Disability Lawyers prevent unnecessary denials
How much Social Security Disability SSI back pay?
How to apply for disability for a child or children
Filing a Social Security Disability SSI application
Filing for disability - when to file
How to apply for disability - where to apply
Qualifications for disability benefits
How to Prove you are disabled and Win your Disability Benefits
Qualifying for Disability - The Process
How to get disability for depression
Getting disability for fibromyalgia
SSI disability for children with ADHD
What is the Application Process for Social Security Disability and SSI?
Common Mistakes to avoid after being denied for Disability
Social Security Disability SSI Exam tips
More Social Security Disability SSI Questions
Social Security Disability SSI definitions
What makes you eligible for Social Security Disability or SSI?
New and featured pages on SSDRC.com
Who can help me file for disability?
The Steps of The Social Security Disability Determination Process
How is the Determination for Disability made by Social Security?
Appealing A Social Security Disability Determination
Who makes the Determination of a Social Security Disability Claim?
Getting a Social Security Disability Determination After Seeing a Psychologist at a Mental Evaluation
Disability determination services in North Carolina
How does the North Carolina Social Security Disability determination process work?
Can I work if I have not received my disability award letter?
How does age affect a Social Security Disability or SSI case?
What conditions qualify for disability in Kentucky?
How much SSI will I get in Kentucky?
Permanent Disability Benefits in Kentucky
These pages answer some of the most basic questions for individuals who are considering filing a claim.
Can you get temporary Social Security Disability or SSI benefits?
Permanent Social Security Disability
What is the difference between Social Security Disability and SSI?
Who is eligible for SSI disability?
Can I Be Eligible For SSI And Social Security Disability At The Same Time?
What makes a person eligible to receive disability benefits?
Applying for Disability - How long does it take to get Social Security Disability or SSI benefits?
What happens if I file a disability application and it is denied by a disability examiner or Judge?
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.