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Local Social Security employees don’t make medical evaluations

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Q: Do Social Security employees have medical training so they can evaluate medical information for disability application decisions?

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A: Local Social Security employees do not make medical decisions for disability applications and do not evaluate medical evidence for Social Security or Supplemental Security Income (SSI) applications.

Whether a person files online or by personal interview, when a disability application is received, Social Security representatives review it to verify that non-medical eligibility requirements are met.

For example, SSA employees will verify that an applicant for Social Security disability meets the work requirement or that a person filing for Supplemental Security Income (SSI) meets the income and resource requirements of that need-based program.

If non-medical requirements are not met, applications are denied and a medical decision is not required.

When non-medical requirements are met, SSA representatives review applications for completeness, including details describing the disabling impairments, medical treatment, medical releases and related employment and vocational information.

They start other development and prepare the application for further processing.

For the actual medical decision, the disability application is electronically transmitted to a State agency, usually called a Disability Determination Service (DDS).

These state agencies, fully funded by the Federal Government, are responsible for developing medical evidence and making the initial determination on whether or not a claimant is disabled or blind under the law.

Samples of DDS decisions from all States are reviewed within Social Security to maintain national consistency with program requirements.

Following a national, step-by-step disability evaluation process, DDS employees make the disability decision and return the application to the local Social Security office for completion. 

Depending on the decision, this could be final development before payment begins or, if a denial, holding a file for the appeal period.

Learn more about filing for disability in the Social Security disability planner at www.socialsecurity.gov/dibplan.

Based in Grand Forks, Howard I. Kossover is the Social Security Public Affairs Specialist for North Dakota and western Minnesota.  Send general interest questions to him at howard.kossover@ssa.gov. Read his online articles at http://socialsecurityinfo.areavoices.com.

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