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Who makes the decision on your Social Security Disability claim?

Do you know who actually makes the decision on your Social Security Disability (SSD) or Supplemental Security Income (SSI) claim?

Most people don’t. Knowing that information, however, can make it easier to understand the entire claims process — and help you understand where to focus your energies.

When you file an application for either SSD benefits or SSI, the claims representative in the local office who assists you does not actually make the decision on your case. That representative’s job is to handle the initial screening — to make sure that you seem to meet all of the technical, nondisability requirements for benefits under one or both programs. That representative will also facilitate your claim for payment if you are eventually found to be disabled under Social Security’s rules.

Once your claim is taken, all of the information you provide is sent to a state agency, known as the Disability Determination Services (DDS). That’s where your claim is assigned to a Disability Examiner (DE) for assessment. The DE’s job is to gather the information necessary to make a decision on your claim. That may mean simply gathering more medical records for evaluation. It may mean sending you to a consultative exam (especially if your relevant medical records are sparse). It may also mean contacting the friend or relative you listed on your application as someone familiar with your condition.

If your claim is denied, you can file a Request for Reconsideration at the local field office. At that point, your claim will be routed back to the same DDS — but to a different DE and different medical expert — for a second evaluation. If your claim is denied a second time, you can then file a request for a hearing in front of an administrative law judge.

Are you struggling to gain approval for your SSD claim? If so, you don’t have to struggle alone. An attorney with experience handling disability claims may be able to help.