How the Disability Determination Process Works

How the Disability Determination Process Works

If you recently became disabled and your condition is expected to last at least a year, or result in death, you may qualify for Social Security Disability benefits. So, how does the disability determination process work?

Most Social Security Disability claims are processed at local Social Security Administration (SSA) field offices and through state agencies, which are usually called Disability Determination Services or DDS.

What if an application is initially denied? If the applicant chooses to file an appeal, the appeal would be decided by one of two entities, either the DDS, or by an administrative law judge from the SSA’s Office of Disability Adjudication and Review.

Initializing the Process

As the person applying for SSDI benefits, you are considered the “claimant.” To begin the application process, the claimant files in person, by phone, mail, or online. These applications are handled by Social Security representatives in the field offices.

The application and related forms asks the claimant about:

  • The claimant’s medical condition (impairments)
  • The claimant’s treatment sources
  • Other information that relates to their disability

The field office verifies the claimant’s nonmedical eligibility requirements, including their age, employment, marital status, and their Social Security coverage.

Once the field office has evaluated all of the above information, they forward the case to DDS to evaluate the claimant’s disability.

About DDS Agencies

The DDSs are state agencies funded by the federal government. The DDSs are the agencies that develop medical evidence and make the initial determination whether a claimant is blind or disabled under SSA’s guidelines.

Usually, the DDS attempts to obtain the necessary evidence from the claimant’s medical sources first. However, if that evidence is insufficient or unavailable for them to make a determination, the DDS will arrange for a consultative determination (CE) in an effort to obtain the information needed.

While the claimant’s medical doctor(s) is the preferred source for the CE, the DDS may decide to obtain the CE from another source. Once the staff at the DDS has reviewed all of the information, they issue their initial disability determination.

The DDS then returns the case to the field office to take the appropriate action. If the DDS decides that the claimant is disabled, the SSA completes the case, computes the benefit amount, and starts paying the benefits.

If the claim was denied, the field office keeps the file and if they desire to, the claimant can file an appeal.

Let us streamline the application process for you. Contact us to work with an experienced Dallas Social Security Disability lawyer!