Who decides whether I will get disability in Florida?

"Does A Doctor Make The Decision On My Florida Social Security Disability Claim Or A Case Worker?"

The Social Security Administration does not have caseworkers; it is not a Social Services agency. When you file a disability claim, a Social Security Claims Representative takes your disability information and forwards your claim to the state disability agency for a medical decision (usually called DDS).

At that point, the Social Security claims representative no longer controls the development of your disability claim. Once in the state agency, your disability claim is assigned to a disability examiner for medical development. The disability examiner is responsible for gathering the medical records from the medical source information you provided at your initial disability interview or your online disability application.

Once the disability examiner in Florida gets your medical records, they must determine if a consultative medical examination is needed to make a decision (consultative medical examinations are used when an individual has old medical information, very little information, or no medical information). If a consultative examination is required, the disability examiner will wait for the medical report from the examining physician prior to making their medical disability determination.

Now does a doctor make the decision or does the disability examiner? All disability decisions or determinations are 'written up' by disability examiners. Disability examiners have to have their decision reviewed by a unit medical professional (medical physician, psychologist, or psychiatrist).

In other words, disability claims in Florida are reviewed by a medical professional before a final medical decision is made. Social Security medical consultants and psychological consultants and disability examiners alike must follow the criteria outlined in the impairment listing book ' Disability Evaluation Under Social Security' or as it is more commonly known, the blue book.

All this said, however, there are situations in which decisions made by examiners (and their consultants) are overturned by quality control personnel. This happens as a result of the fact that all determinations made by examiners at all state-level DDS offices (disability determination services) are subject to quality control review.

When the disability quality branch decides that a decisional error has been made, that case is returned to the examiner's unit for further development which may result in a new, and different, decision. It is for this reason among others that disability examiners are not allowed to reveal decisions about their cases to claimants; those decisions that they make are not set in stone and may be changed as a result of the quality control review process.

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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