Who is making the disability decision?According to the SSA, the claimants SSDI or SSI application is first processed through, a network of local Social Security Administration (SSA) field offices and State agencies (usually called Disability Determination Services or DDS).
These DDS state offices are fully funded by the Federal Government. The state agencies are responsible for developing medical evidence and evaluating whether a claimant is disabled or blind according to the Social Security Administrations definition of disability. These DDS offices are generally located within the states vocational rehabilitation agency.
Critics of this system have noted how difficult it is for a state agency to follow federal regulations and to determine who qualifies for federal benefits while at the same time experiencing differing state political pressures and to standards set by different federal courts and specific claims processing procedures (Mashaw, 1983, p. 156).
Who is on the Disability Determination Services Team (DDS)?
Disability determination teams consist of a disability examiner, a medical consultant and a psychological consultant. According to the SSA, all members of the team are trained in the disability evaluation process and must collaborate together.
Medical consultants are licensed physicians (medical or osteopathic doctors), licensed or certified psychologists, licensed optometrists (for purposes of establishing visual disorders only), licensed podiatrists, and qualified speech-language pathologists (SLPs).
What is the role of each DDS Team Member?
Whether it is the disability examiner, medical consultant or the psychological consultant, each team member has a different role.
Role of the disability examiner
- Identify sources of evidence
- Send and request information for medical and nonmedical evidence
- Prepare the cases for the medical and psychological consultant
- Schedule appointments for the claimant with the consultative examiner
- Prepare residual functional assessment capacity forms (RFC Forms)
- Prepare determinations, including forms SSA-831 (Disability Determination and Transmittal) or SSA-832 and SSA-833 (Cessation or Continuance of Disability or Blindness Determination and Transmittal) determination rationales, and disability determination notices
There are a limited number of cases where the DE is allowed to make the disability determination on their own: no medical evidence is present in the file and the claimant does not attend their scheduled consultative examination, the DE has the authority as outlined in SSA documentation to be a single decision maker, or the claimant meets the requirements outlined in the compassionate allowance program.
Role of the Medical and Psychological Consultant
- Resolving problems in obtaining medical evidence of record (MER) through discussions with DEs and other staff members
- Determining if the request for the consultative examiner is necessary
- Identifying alternatives to requesting a consultative examination
- Reviewing CE reports
- Evaluating medical questions
- Improving the disability examiners understanding of the medical evidence of record
- Reviewing and approving disability determinations.
Keep in mind, the psychologist consultant is limited to evaluating mental impairments and according to the SSA they take responsibility for the medical portion of the determination when a mental impairment is the only impairment in the claim, or when there is a combination of a mental impairment with another impairment, but the mental impairment alone would justify a finding of disability.
If you have more questions about how your SSI or SSDI case may be evaluated by the Disability Determination Services office in your state, contact a disability lawyer.
- SSA Medical Vocational Allowance (disabilitybenefitshome.com)
- SSI and SSDI - Medical Disability Denials (disabilitybenefitshome.com)
- How to Win a SSDI or SSI Case Fast (disabilitybenefitshome.com)