One lightly discussed topic in the area of Social Security disability law is something known as Quality Assurance Reviews.
When an applicant applies for Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) that claim is processed and sent to a state agency for a medical determination. A person at the disability determination agency is in charge of deciding whether the applicant is disabled according to a set of standards issued by the federal government. This person is not an employee of Social Security.
Because this person is not an employee of Social Security, periodically Social Security conducts Quality Assurance reviews of decisions made by the disability determination agency.
These Quality Assurance reviews are done to make sure the disability determination agency is making decisions consistent with federal policy and standards. This provides better assurance that Social Security applications, regardless of where the applicant lives, are evaluated with consistent standards.
All Social Security applications are not chosen for Quality Review, Social Security only looks at a random sample of all claims. The applications chosen for review include favorable decisions in which the claimant is found disabled and unfavorable decisions, where the claimant is not found to be disabled. About one out of every 100 Social Security disability applications are chosen for Quality Review.
Basically, the Quality Review is supposed to ensure the correct disability determination was made.
The Disability Quality Branch has the power to overturn the disability determination agency’s decision, or it can agree with the decision, but there is no certainty what decision will be made. The only certainty is that if your claim is chosen for a Quality Assurance review, it will increase the amount of time you are waiting for a decision from Social Security.
For more information about Quality Assurance reviews click here.
