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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

Should your Doctor determine if you get Social Security Disability or SSI in Texas?



 
Ideally, a Social Security Disability or SSI claimant's doctor (treating physician) should determine whether or not a claimant is awarded disability benefits. After all, this is the same individual who is responsible for monitoring and treating the patient and who is in the best possible position to determine the prognosis and functional outlook (Social Security Disability eligibility always hinges on functionality, i.e. whether or not a person can perform work activity) of the patient.

However, if this was the case, then the social security administration would no longer need nearly as many disability examiners who work on reconsideration appeals nor as many judges who render decisions at the hearing level. Because so many more correct decisions would be rendered at the disability application level, making the need for appeals far less.

Here's why it will never be the case that Social Security Disability decisions in Texas will rest on the opinions of treating physicians.

A. The social security administration has an inherent distrust of personal doctors.

B. The social security administration has the unstated goal of keeping the number of disability approvals down.

Regarding A, I speak from the position of being a former examiner and as someone involved in disability representation. The simple truth is that a detailed supportive statement from a doctor at a disability hearing can make or break a case, while the same letter when viewed at the disability application or request for reconsideration appeal level may be all but ignored.

Why the difference between the two? Because decisions that are made at the first two levels of the system are made by disability examiners and examiners are tightly controlled by their supervisors. In other words, the Social Security Disability and SSI system keeps a close rein on how many approvals these examiners make (chiefly through the threat of external quality control, which tends to focus on approved cases, not denied cases).

Hearing level decisions in Texas, by contrast, are made by independent federal administrative law judges. I've actually heard disability examiners and field office claims reps complain about the number of approvals made by these judges and make statements along the lines of "that decision would never have been made by an examiner" or "those judges make crazy decisions".

However, the decisions issued by judges tend to be better, because judges do not have supervisors and are free to render decisions as they personally see fit. And, perhaps, because they do function independently, disability judges give far more credence to the opinions of treating physicians.

Regarding B, does the social security administration attempt to keep approvals on cases down? I think the numbers speak for themselves. Seventy percent of disability applications are denied by disability examiners. Of those individuals who are denied and decide to file a request for reconsideration an even higher percentage of 85 percent are denied. Yet, of those who persist and go to the hearing level, more than half are eventually approved.

Why weren't these cases approved at the very beginning of the disability process? Because the disability system is, sadly and unfortunately, set up to discourage claimants. And, yes, this does work. Thousands of individuals who are denied never appeal. They give up. This, of course, is something a claimant should never do. Because the odds of being approved lie in the claimant's favor...if they simply refuse to give up and follow the appeals process.








Essential Questions

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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

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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



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Related pages:

Can You Collect Social Security and Disability At the Same Time in Texas?
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Should your Doctor determine if you get Social Security Disability or SSI in Texas?
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These pages provide answers to basic questions about pursuing disability benefits

What to Prove to Qualify for Disability Benefits
Applying for disability benefits, SSI and SSDI
What Disabilities Qualify for SSI and Social Security Disability?
How does back pay for Social Security Disability work?
Social Security Disability And SSI Qualifications
Permanent Disability Qualifications for SSD and SSI
Status of your Social Security Disability or SSI case
Disability lawyer representation, finding lawyers
What is qualifying for disability based on?
How to qualify for disability, qualifying for Benefits
Qualifications for Disability Benefits
How long does it take to get disability after applying?
Disability application, how to file in Texas
Texas disability requirements
Eligibility and qualifying for disability in Texas
What are the qualifications for disability in Texas?
Will I Qualify For Disability Benefits in Texas?
Getting a Texas disability lawyer, attorney, or advocate








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.