Disability denials issued at the initial application level and the first appeal level are sent out by Social Security, but many people do not understand that Social Security does not make the decision of whether or not someone is disabled, that is decided by a state agency known as Disability Determination Services (DDS). Understanding who DDS is and what they do is important in understanding a disability claim.
State Disability Determination Services
The DDSs are State agencies responsible for developing medical evidence and making the initial determination about whether the claimant is or is not disabled or blind under the law. These State agencies are fully funded by the Federal Government.
Usually, the DDS obtains evidence from the claimant’s own medical sources first. When the evidence is unavailable or insufficient to make a determination, the DDS may arrange a consultative examination (CE) to obtain additional evidence. The individual’s own medical source(s) is the preferred source for the CE; however, the DDS may also obtain the CE from an independent source. (See Part II, Evidentiary Requirements, for more information about CEs.)
After completing its development, the DDS makes the disability determination. An adjudicative team consisting of a medical or psychological consultant and a disability examiner usually makes the determination. If the adjudicative team finds that additional evidence is still needed, the consultant or examiner may re-contact a medical source and ask for additional information.
The DDS will refer the case to the State vocational rehabilitation (VR) agency if the claimant is a candidate for VR.
The DDS returns the case to the field office after making a disability determination. The field office takes appropriate action depending on whether the claim is allowed or denied. If the DDS finds the claimant to be disabled, SSA will complete any outstanding non-disability development, compute the benefit amount, and begin paying benefits. If the claimant is found to be not disabled, the file is retained in the field office in case he or she decides to appeal the determination.
If the claimant appeals an initial determination, the appeal is usually handled much the same as the initial claim with the exception that a different adjudicative team in the DDS than the one that handled the original case makes the reconsideration determination.
