In most states, the majority of Social Security disability cases are denied twice, which results in the need to request a hearing before an Administrative Law Judge (ALJ). Obviously the ALJ makes the disability determination after the hearing, but who makes disability determinations prior to this level?
Most people who are applying for either Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits might be surprised to learn that Social Security doesn’t make a disability determination prior to the hearing level. Those decisions are made by a state agency known as either Disability Determination Services (DDS) or the Disability Determination Bureau (DDB) depending on which state you live in. This agency is part of a state’s vocational rehabilitation services.
An SSDI or SSI initial application or Request for Reconsideration claim is sent to DDS or DDB, where a disability examiner is assigned. The disability examiner will request a claimant’s medical records and possibly setup up medical appointments for exams paid for by Social Security if the disability examiner feels there is insufficient medical information to make a determination.
The disability examiner will evaluate your claim based on your medical condition and vocational information, such as age, education and past work, and a medical doctor will review evidence and determine how your disability impacts your ability to work. These disability determinations, according to Social Security, are based on laws, regulations and court rulings. Once a case is medically reviewed the disability examiner will make a determination of whether the claimant is disabled and whether the disabilities meet Social Security’s requirements for disability benefits.
After the disability determination is made the file is returned to the claimant’s local Social Security office and notice of either a denied claim or an approved status is sent to the claimant. As was indicated earlier, most cases are denied at the initial application level (75 percent) and the Reconsideration level (90 percent).
For more information about how determinations are made on Social Security disability cases prior to the hearing level visit this link.
