When an individual files an application for Social Security disability benefits, there are essentially four levels an application may progress through. This post discusses the first stage of the process, the initial level. The remaining stages will be discussed in future posts.
The Initial Level
The first level of the disability process is commonly referred to as the “initial level.” After an individual (the claimant) files an initial application the Social Security Administration (SSA) will obtain and consider relevant medical documentation.
These tasks, obtaining and considering relevant medical documentation, are conducted by the State’s Disability Determination Services, or “DDS.” The DDSs are state agencies which are fully funded by the Federal Government and are responsible for developing and considering the medical evidence. Additionally, the DDSs are responsible for rendering the initial determination on whether the claimant is, or is not, disabled under the law.
The DDS will attempt to obtain evidence from the claimant’s health care providers. If it is determined that sufficient evidence does not exist, the DDS will schedule a consultative examination (CE). This is an examination the claimant will attend with a health care provider at the cost of the SSA. Following the CE, the DDS will consider the CE report as evidence.
Once all relevant evidence has been obtained and considered, the DDS will make a disability determination. This determination is made by a two-person adjudicative team consisting of a medical consultant and a disability examiner.
The DDS will make the initial determination of whether a case should be allowed or denied. Claimants can typically expect to receive a response at this level within two to four months from the time the initial application is filed. If the DDS determines the case should be denied, the claimant will be afforded the opportunity to appeal this decision. This step will be discussed in a future post, entitled The Reconsideration Level.