The Disability Claims Determination Process

Generally, social security disability claims are processed through a network of local Social Security Administration (SSA) field offices and state agencies usually called Disability Determination Services (DDSs).

Determining claims in a disability case involves not only the necessary preparation and filing for benefits. As part of the whole process, decisions and subsequent appeals of claims are often made in a DDS or by an administrative law judge in agency’s Office of Hearings and Appeals.

The process of determining a disability claim has several steps.

1. The initial process begins in the field offices where social security representatives usually obtain applications for disability benefits in person, by telephone, by mail, or by filing online.

   The application and related forms include the following information:

   • a description of the claimant’s impairment
   
   
   • treatment sources
   
   
   • other information related to the alleged disability.


2. The field office is responsible for verifying 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.


3. 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.

   First, the DDS is usually tasked to obtain evidence from the claimant's own medical sources. If that evidence is unavailable or insufficient to make a determination, the DDS will arrange for a consultative examination (CE) to obtain the additional information needed.

   Usually, the claimant's treatment facility 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.

4. 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.

How A Lawyer Can Help You

A social security disability lawyer will handle your claim at any stage in the process including application and appeals. Generally, a lawyer will be helpful in the following instances:

• Provide you with a thorough evaluation of your social security disability or SSI claim


• Obtain the benefit amount you can expect to collect


• Act as your liaison with the Social Security Administration


• Help you complete and process all paperwork and applications for your disability claim


• Investigate all medical documentation and obtain additional reports for your Disability or SSI Disability Claim


• Represent you in all courts and legal proceedings related to your claim


• Prepare you for any Social Security required hearings


• Make sure you receive all the Social Security Disability and/or SSI Disability benefits that you are entitled to.

Pursuing a disability claim often involves complicated paperwork which require the skills of an experienced lawyer. A social security lawyer who specializes in disability claims can improve your chances of getting your due.

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