How It Works
The claim evaluation process conducted by Disability Determination Services can take up to six months (sometimes longer) before making a decision. But if your initial claim’s denied, don’t give up! Approximately 60% of initial applications submitted are denied for a variety of different reasons, such as inadequate medical documentation, technicalities, inadequately presenting your disability and other mistakes that commonly occur with claimants who file independently.
Getting help from an experienced advocate or attorney who knows how to properly prepare and submit your claim can potentially reduce your initial application’s evaluation time and increase the odds of approval. After receiving your initial application, a Social Security Administration representative will evaluate your claim to determine if you meet the basic requirements to be eligible for SSD benefits, including your current monthly income. While you don’t need to be unemployed to qualify, you may be determined ineligible for benefits if your monthly income exceeds the maximum limit that’s allowed.
Once the SSA representative determines that you’ve met these basic eligibility requirements, your application advances to the second evaluation level. A second evaluation is then conducted by the DDS, which consists of a team of evaluators that may include disability specialists, such as physicians or psychologists. An examiner will review your information and ensure that all required documents have been submitted with your claim. If further documentation is needed before making a decision, the examiner will submit a request to you or your health care provider(s) for any information believed to be necessary for evaluating your claim. Rapid communication with the SSA is essential to expedite this process, so be sure to include your current contact information as well as a fax number that’s easily accessible for sending and receiving these documents.
If your claim isn’t approved based on the information and documents submitted with your initial application, the DDS will request that you undergo a consultative examination. This may be performed by a doctor other than your primary physician, but since yours will be most familiar with your condition, you may ask the DDS to allow your primary care provider to conduct the consultative examination. If your doctor is determined to be qualified to conduct the examination and has the resources required to do so, the DDS will approve your request.
During this stage, the DDS will consider your health problems and how they may affect your ability to perform based on your previous work experience, level of education and age. They’ll also review your physician’s diagnosis, severity and the length of time you’ve suffered from your condition, and most importantly, how it limits your daily routine and ability to perform work-related activities. Debilitating factors like chronic pain, physical and mental limitations and the medication you’re being prescribed for your condition are also taken into consideration before issuing a denial or approval of your claim.