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Quality Assurance Review Board and my SSDI case

Periodically, the Quality Assurance Review Board will randomly choose a disability claim to review. This is done to ensure that the Disability Determination Services Offices are reviewing claims according to regulations and standards accepted by the Social Security Administration and the United States federal government.


Recently on our disability forum a user asked, “If I have been notified that my SSDI case is under review by the Quality Assurance Review Board how will this affect my claim and will it take longer to process?”

Disability Determination Services and the Quality Assurance Review Board

After a claimant has filed a Social Security Disability application the local SSA office will review the claim to ensure the claimant meets the nonmedical requirements for disability benefits. If they do, the SSA will send their claim to the Disability Determination Services office (DDS) for further review.

The DDS will review the SSDI application to determine whether the claimant is medically disabled, according to the standards defined by the SSA. The DDS examiners are not considered actual employees of the SSA. In fact, different states have established their own DDS offices.

Because the SSA understands that it can be challenge for different offices not under their direct supervision to maintain the same standards and follow the same federal policies, the Quality Assurance Review Board will periodically review cases at different DDS offices to ensure the procedures are similar and the DDS is reviewing SSDI claims consistently and accurately.

How does the Quality Assurance Review Board decide what cases to review?

The Quality Assurance Review Board will audit approximately one disability claim per one hundred. They will review both approved and denied claims. They will take their samples from each DDS regional office, which is referred to as Disability Quality Branches (DQB). If your claim has been randomly chosen for review you will be notified via mail.

What will the Quality Assurance Review Board review?

After choosing which cases to review the Quality Assurance Review Board will analyze the processes and procedures used by the DDS officer to deny and approve claims. They will ensure the examiner gathered the proper medical evidence, reviewed the proper forms, and applied the medical evidence correctly. If the claimant was not approved by meeting or exceeding a listing on the SSA Listing of Impairments, the SSA will ensure that the examiner assigned the correct RFC (residual functional capacity rating) to the claimant.

What will happen following the Quality Assurance Review?

So what can you expect after the Quality Assurance Review Board reviews your SSDI case? The news can be good or bad. For example, if your case was approved and they agree with the decisions- case closed, you will receive benefits. If they disagree with the approval you can have your benefits denied. They also have the power to award you benefits even if the DDS originally denied benefits. Some cases which are incomplete or need additional work will simply be sent back to the DDS as a “return.”

Unfortunately, regardless of the outcome for your particular case, the length of time it will take to process your claim will definitely increase.
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