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Examining Your Adult Social Security Disability and Supplemental Security Income Initial Disability Claim: From Disability Determination Service Case Receipt to Claims Decision

(draft only) 

Welcome!

When I initially left my position as a claims examiner for the Disability Determination Services unit -- the state contractual arm of the Social Security Administration charged with adjudicating disability claims -- my intent was to write this book immediately while everything was still fresh in my mind.

But then life and making a living interjected itself and got in the way. And so I decided the next best thing would be to create a website so that I could place articles there as I wrote them, with the expectation that these articles would eventually be placed in this book. And, after three years, albeit with some downtime, here we are.

About the Author
Just a little about me, before we jump into this thing head first. Since graduating college in the late 70's, I've worked professionally in several different areas, including handling social, economic and legal services for the economically disadvantaged and the disabled. I've also been a journalist and an editorial assistant, both stateside and abroad.

In the late 1980s I accepted a position with a Legal Services non-profit agency where my job was to help low income individuals to get and keep their public benefits, including welfare, Supplemental Security Income and Social Security Disability. Serving as a paralegal was an interesting position and one I thoroughly enjoyed. I had a chance to use analytical skills and interviewing skills, as well as skills in federal policy interpretation.

My first Social Security Disability case involved a young lady in her early twenties who was trying to get benefits based on having asthma. And though I knew very little about SSA at the time, I did know that this was going to be a hard case to get approved for benefits. So the managing attorney who I was working under gave me this big book called the Federal Registry and told me which section of the manual to look in to find SSA policies and regulations.

The language was Greek to me at the time, and I remember thinking, “wouldn't it be nice if I could go to work for the SSA first, learn all I can and then come out and help people get the benefits they are seeking?” After all, I did have that advantage in handing the social services cases. Having worked prior with the local and state department of social services had prepared me to handle those welfare, medicaid and food stamp cases, but nothing had prepared me for SS Disability cases, so I was almost lost.

Luckily, my Managing Attorney was a good trainer and taught all the paralegals in the office the skill of legal analysis, and how to write up case summaries that focused on presenting all the pertinent facts that could prove applicants were disabled before an Administrative Law Judge (ALJ).

Somehow, we did win benefits for this young lady, but of course we uncovered in the interim that her real disability stemmed from the fact that she had mental impairments that SSA had failed to consider in her original and subsequent reconsideration applications.

And after getting a favorable decision on this claim, I was hooked. Because of my analytical approach to things and my prior experience with having to interpret and apply policy from state, local and federal programs, I took to being a public benefits and social security disability paralegal like a fish to water.

About a year later, I relocated and accepted a position as a child protective services caseworker, then worked as a newspaper journalist covering health, education, welfare and religion news, prior to traveling overseas to serve my faith for five years. It was when I returned that I began my career with the Disability Determination Services as a claims examiner.

So I can say unreservedly that most of my professional career has been devoted to being a public servant, assisting applicants with claiming benefits for various local, state and federal programs.

Working as a Disability Claims Examiner

The job of a disability claims examiner is not an easy one, and the preparation required to get acclimated to the system is extensive. One does not even begin to feel comfortable in managing a caseload until perhaps 18 months into the position. After about 28 months into my career, I was granted the designation of being a “Single Decision Maker”, indicating that I could decide claims that did not have a mental allegation without the input of a DDS staff medical doctor or psychologist.

Having such a designation allowed me to approve and deny claims more rapidly because it eliminated one additional step in the process, a process which will be explained in detail in this guide.

Of course, from a claimant perspective, I would much rather have a medical consultant, a doctor or psychologist complete my case review and writeup because despite any training or work experience on the part of the examiner, most are not medical doctors and don't have the extensive training doctors undergo. So, I imagine that for cost reasons, ie the time of a disability examiner is less expensive than the time of a medical doctor's, so most of the work on your claim is done by the examiner, and sometimes includes a review by the staff medical consultants.

So... this disability guide is written from the perspective of a former disability claims examiner with the goal of helping you to understand the disability claims process, the tools the examiner uses to assess and adjudicate your claim, and the ways that you can assist the examiner so that you receive and accurate decision in the least amount of time.

So let's get started...

• DDS Staff--Who Does What in the Process
  
  Find out which Disability Determination Services staff does what when it comes to making a decision on your disability claim.
• Instant Approvals for these Medical Conditions that Meet A Listing
  
  When you have one of these medical conditions, and you qualify for SSI (Title XVI), you may be eligible for an instant approval on your claim--PD Decisions.
• Denials for these Non Severe Medical Conditions
  
  These conditions almost always are considered non-severe by the SSA and your claim will likely be denied if you apply for benefits based on them.
• Medical Evidence is Sufficient to Make a Decision
• More Medical Evidence is Required to Make a Decision on Your Claim--CE Examinations
• Getting Benefits the Second or Third Time Around
• Flaws in the System
• Changing Face of Social Security Disability System
• Appendix