The Steps to your Initial Disability Determination
Once your application arrives at the Disability Determination Services (DDS), your case is assigned to an examiner. The DDS examiners job is to use the information provided in your application to see if you meet the criteria for disability benefits. These criteria are:
- Are you working at Substantial Gainful Activity (SGA)? Even being able to work a small amount does not disqualify you from claiming disability. If you are found to be able to support yourself by working, you will be denied benefits. If your impairment keeps you from earning enough money to support yourself, then you pass this step.
- Is your condition(s) severe enough to prevent you from doing basic work?
- Does your condition(s) “meet or medically equal” the definition in the list of impairments? If you can prove that you have met a listing, or if your conditions combined create problems which equal the listed conditions, then you will continue on to the next step. If your condition does not meet or equal a listing, you could be denied.
- Are you able to perform your past line of work? If you can return to your line of work, you will not be given benefits. If you are found unable to return to your previous line of work, you will go to the last step.
- Do your condition(s) and abilities allow you to do a different line of work? This is somewhat up to the SSA and their experts to determine whether there is another line of work that you are able to do. Rather than only going on your medical records, they must speculate about other jobs you can perform.
If more medical information is needed before a decision can be reached, you may be asked to have a Consultative Exam (CE). This is an exam performed by a doctor assigned by the state which is intended to fill in any gaps in your medical information. The Social Security Administration (SSA) pays for this exam. Once enough medical information is gathered your initial application will either be approved or denied.
Your application will be returned to the SSA who will continue with the appropriate action. If you have been found to be disabled, then the SSA will calculate the benefit amount and pay benefits. If you are found not to be disabled, your file will be kept in the field office in case you decide to appeal your claim. This is called a Reconsideration Appeal.
Every day, people across the United States are applying for disability benefits from the US government and specifically from the Social Security Administration (SSA). The process can be a long, involved one as there are several steps that must be completed. For many, this can be a trying experience in getting the benefits that you deserve, but if you understand and follow the guidelines, then you can get through it and start receiving the benefits that are owed to you.
Before you start the application process, it is important to fully understand your current condition, the previous employment you held, and any outstanding information about your case that applies to the process of receiving disability benefits from the SSA. Usually, this starts with a recommendation from your doctor which will offer the foundation for applying if needed.
At this point, you may need outside assistance to ensure that your experience through the process is one that you fully understand. Too many people who have applied for disability benefits have been rejected for reasons that they did not understand or simple mistakes that delayed approval by weeks, months, or even longer.
You will need to fill out the application for receiving benefits to the Disability Determination Center (DDS). The application will be assigned to an examiner who will use the information that you provided and compare it to the standards for receiving disability benefits. The form itself is straightforward and requires additional information in the form of medical records that back up the claim. The standards for qualification are as follows;
Substantial Gainful Activity (SGA): Although being able to work a small amount does not disqualify you from receiving benefits, if you are working at SGA or able to support yourself through work, then you will be denied benefits.
Qualification: Does the disability you suffer from meet or exceed the definition of the impairment? If so, you will need to demonstrate that your condition or set of conditions is equal to or exceeds what is considered the minimum standard for the disability. It’s possible that if your condition does not meet the standard, you will be denied benefits.
Return to Work: Can you return to your previous employment and carry out the duties as they were defined just like before you were disabled? If so, then you will be denied benefits. If you cannot go back to your previous work, then you can skip to the last step in this initial process.
Severity: Is the severity of your disability enough to keep you from doing basic work, which does include skilled and unskilled labor? The work must be substantial enough for you to support yourself.
Performing Other Jobs: If you cannot perform at your previous job, can you do a different line of work. This will be determined by the SSA and the experts they employ to see if you can perform other types of substantial work apart from your previous employment. This will be more about speculation on their part rather than relying on medical records alone.
If a decision cannot be reached by the SSA during this initial stage, then you might have to undergo a Consultative Exam (CE). This is an exam performed by a doctor which is assign by the state to fill out the gaps in the medical information that you provided and offer a clearer picture of your capabilities. The SSA will pay for this exam and will use it along with existing medical records to determine if you are capable of holding substantial work.
At this point, one of two things will happen. Either you will be found disabled which means incapable of performing work that provides adequate financial support or your application will be rejected because you are found to be physically and mentally able to support yourself through work. If the ruling is on the former, then the SSA will calculate the amount of benefits you receive and pay them on a monthly basis.
However, if you are found to be able to work, then your application will be kept on file at the local SSA field office and you can then decide if you want to appeal. This is known as a Reconsideration Appeal.
Reconsideration Appeal (RA)
An RA occurs when your initial application for disability benefits has been denied by the SSA. You will need to start by examining the reasons given by the SSA and DDS and start the process from there. This means that you will need to add new information that counters the contentions of the DDS, so you can successfully challenge their findings.
If successful, the RA will overturn the findings of the DDS and your disability payments will be assessed and paid every month. However, you may also be rejected and unable to qualify for SSA disability benefits because you do not meet the criteria.
How the Disability Help Center San Diego Can Help
For those who are not familiar with the application and determination process, getting assistance from the Disability Help Center San Diego can be most beneficial. We offer complete services that help you in filling out the initial application, responding to the Consultative Exam, and filing a Reconsideration Appeal if needed.
If you need assistance in filling out your application, have questions about how Disability Determination Services (DDS) works, or want representation during this crucial stage of the process, please call the Disability Help Center San Diego. Our friendly, courteous staff will explain our services, answer your questions, and provide the assistance you need when applying for disability benefits.
We are located at 1833 Fourth Avenue, San Diego, CA 92101 and you can call us at (619) 282-1761. Call today and find out more about our services and let us help you when applying for disability benefits.