Q Who makes the decision about whether I am eligible for Social Security disability benefits?
Probably not the people you expect.
You may have submitted your initial SSDI (Social Security Disability Insurance) application online, or perhaps you mailed it in. It’s even possible that you handed it over the counter to the pleasant clerk at your local Social Security office. In any case, you naturally assume that somebody from the Social Security Administration will look at all your work carefully, apply her best judgment, and give you an answer in a day or two. Maybe—you hope—a week at the outside.
Many, Many People Will Look At Your Application
Right now, there are many more applications for Social Security disability benefits than personnel to examine them. The result is a long backlog of cases. You can expect it will take a few weeks before anyone begins evaluation of your application. Delays of several months are not uncommon.
During that time, two different groups of people will examine your application for errors, omissions, and disqualifying details. Each group has the independent power to deny your benefits.
The Social Security Administration
Your file will be examined by one or more account caseworkers at a Social Security Administration field office. This review will look only at whether you qualify under the work rules established for disability benefits. That means your application will be checked to make sure:
- You have documented a work history that extends over many years, so you have contributed to the Social Security trust funds.
- You have shown a recent period of work.
- You have supplied proof that you are no longer earning a substantial amount of money from work.
Failure on any of these points means your application will be rejected.
The Disability Determination Service
Your file will also come under review at by a special office set up by your state government but funded by federal money; most states call these offices the Disability Determination Service (DDS).
Caseworkers at the DDS must follow Social Security Administration rules and procedures in deciding whether the information submitted proves the applicant meets the criteria for disability. Examiners perform disability evaluations for both SSDI and Supplemental Security Income (SSI) claims. They can also request that applicants undergo a medical examination to verify details about the person’s health.
In our region, the following DDS offices process all claims originating in their respective states:
- The Disability Determination Services of the Massachusetts Rehabilitation Commission has offices located in Boston and Worcester.
- Rhode Island’s Disability Determination Services has its office in Providence.
- In Vermont, Disability Determination Services is part of the Department for Children and Families, and has its office in Waterbury.
- New Hampshire’s Disability Determination Service is based in Concord.
If your local DDS determines that your medical evidence is not complete or fails to prove you meet the standards for a disability, your application will be rejected.
A Rejected Application Is Not the End
Over two-thirds of all initial SSDI applications are rejected. Many applicants give up at this point; others decide to begin the application process all over again. Most of the time, those decisions are both mistakes. In almost every case, the best answer is to begin the appeals process by requesting your case be reconsidered. You are allowed to supply additional evidence at this point, but your time-frame to respond is very limited.
We’re here to help. We recommend you start by reading our free book, Unlocking the Mystery: The Essential Guide for Navigating the Social Security Disability Claims Process. Then, follow up by using the live chat button on this page to start a conversation with our team to get your specific questions answered. You’ll be glad you did!