Disability Determination Process
As an attorney who specializes in Social Security disability claims in San Diego and Temecula, I find it helpful for clients to have information about the disability determination process. Most Social Security disability claims are first processed through a network of local Social Security Administration (SSA) field offices and State agencies (usually called Disability Determination Services or DDSs). Additional appeals of unfavorable determinations may be determined in a DDS or by an administrative law judge in SSA’s Office of Disability Adjudication and Review.
Social Security delegates in the field offices usually acquire applications for disability benefits in person, by telephone, by mail, or by filing online. The application and accompanying forms ask for a description of the claimant’s impairment (s), treatment sources, and other information that relates to the alleged disability. (The “claimant” is the person who is requesting disability benefits.)
The field office is responsible for confirming non-medical eligibility requirements, which may include age, employment, marital status, or Social Security coverage information. The field office then sends the case to a DDS for evaluation of disability.
The DDSs, which are fully funded by the Federal Government, are State agencies responsible for developing medical evidence and rendering the initial determination on whether or not a claimant is disabled or blind under the law.
Most often, the DDS tries to access evidence from the claimant’s own medical sources first. If that evidence is unavailable or insufficient to make a decision, the DDS will arrange for a consultative examination (CE) to gather the additional information needed. The claimant’s treating source is the preferred source for the CE, but the DDS may obtain the CE from an independent source. After completing its development of the evidence, trained staff at the DDS makes the initial disability determination. Then, the DDS returns the case to the field office for appropriate action. If the DDS found that the claimant is disabled, SSA completes any outstanding non-disability development, computes the benefit amount, and begins paying benefits. If the claimant was found not to be disabled, the file is kept in the field office in case the claimant decides to appeal the determination.
If you have further questions regarding your case or your ability to qualify for Social Security Disability in San Diego or anywhere in California, please feel free to contact our office.
