The Social Security Disability and SSI decision process in Illinois
Disability examiners, the individuals who, in theory, render disability claim decisions in Illinois at the application and reconsideration levels do not actually make the decisions themselves. That is to say, they do not have unilateral authority to stamp an approval or denial on a Social Security Disability or SSI case (aside from a minority of single decision makers).
In actuality, the decision is initially made by an examiner, agreed upon (or not) by a medical or psychological consultant who is attached to the examiner's unit, and then finally signed off on, or overruled by, the examiner's unit supervisor.
This, of course, is simply the long way to state that decisional authority for the outcome of a case rests not with the examiner, but with the examiner's supervisor. Why is this fact significant? Because unit supervisors at state processing agencies are extremely concerned with the statistics of the units they supervise.
Specifically, the number of returns they receive from quality control units. Returns are viewed by supervisors, as Joseph Heller (author of Catch-22) might say, as "blackeyes". No supervisor wants blackeyes, particularly when upper management has the tendency of comparing one's unit's statistics against all the others. Returns also tend to be...drumroll please...cases that were approved, not cases that were denied.
Now you see the rub. But's lets review the facts.
1. Unit supervisors, not disability examiners, have the final say-so on claims (at least before they leave their units).
2. Unit supervisors hate to receive blackeyes, otherwise known as returns.
3. Returns tend to be cases that were approved, not cases that were denied.
It doesn't take Sherlock Holmes to figure out where this all leads, does it? Human nature being what it is, it simply means that as long as A) unit supervisors are reviewed according to the number of "returns" their units receive and B) returns tend to be "cases that were approved", then the following will always tend to be true, which is C) unit supervisors will always tend to discourage the disability examiners who work in their respective units from making too many approvals. Because "too many approvals" may potentially mean more returns, and returns, which are viewed as errors, do not make supervisors look good in the eyes of their superiors.
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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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