Most people know that Social Security is a federal program for retirement and disability benefits, but few people probably know that Social Security does not make medical decisions on disability claims at the lower levels of the Social Security disability process. These are made by specified state agencies know as either Disability Determination Services or the Disability Determination Bureau.
When a claim for Social Security disability is filed, it is sent to a local Social Security office. This office’s representatives will determine whether the applicant meets the technical requirements of either the Social Security Disability Insurance (SSDI) program or the Supplemental Security Income (SSI) program. Social Security will look at a variety of things to determine eligibility like work income, how recent and how long the applicant spent working, as well as household income and assets.
If the applicant meets the technical requirements of at least one of the two disability programs, the claim is sent the state disability determination agency. It is this agency that will determine whether the applicant is disabled or not disabled during the initial application and Request for Reconsideration phase of the process. Social Security does not make the medical determination.
The disability determination agency will use a variety of methods to make its disability determination. Most of the time this includes looking at medical records and medical opinions of the applicant’s doctors, examination of work history, the applicant’s ability function on a daily basis and possible exams set up by the agency for an independent medical evaluation.
If an applicant is medically denied at the initial and Reconsideration phases of the process, the applicant can request a hearing before an Administrative Law Judge. This judge will make the ultimate decision, which comes from the Social Security Administration.
For more information about the disability determination agencies click here.
