In Monday’s post, we discussed the early stages of the Social Security Disability (SSDI) claims process. In that post, it was mentioned that roughly 75% of claims are denied early on; however, we failed to discuss why this is the case. You may be wondering why so many claims, possibly including your own, are denied early on in the game. It is critical that claimants have an awareness of some of the main reasons such requests are denied, for perhaps this awareness will better your chances when it comes time to seek disability benefits.

These include: evidence of a previous claim for SSDI benefits; a listing of various impairments rather than one major impairment; and a record of having worked after the stated onset date of a claimed condition.

Another wrinkle of the SSDI decision-making process is that in some cases, a judge or adjudicator will simply deny a claim based on some sort of unknown, random basis. Faced with a huge and ongoing workload, the SSA authorities must sometimes act on more of a judicial hunch than a clear cause-and-effect basis. All of which reinforces the need for a claimant to have at their side an experienced and knowledgeable disability attorney!

So if you are denied, don’t feel alone – there are many out there just like you who will have to brace themselves for a long and tedious disability process. Know that the claims process can take on average up to two years or more for a final decision to be rendered, so be ready for a long ride.

Who Makes the SSDI Eligibility Determination?

Before pursuing a claim for Social Security Disability Insurance (SSDI) benefits, an individual must first ensure that they are actually eligible for the process. Federal and state laws governing what constitutes “disability” are the same, and in most states, the agency that makes this crucial initial decision as to whether you can be classified as disabled is known as the Disability Determination Service (DDS).

Generally speaking, about three-quarters of all SSDI eligibility claims are denied at the first stage of the process. The person responsible for rendering the evaluative decision is known as a Disability Examiner, or DE. The DE works closely with a Medical Consultant to review each case, and once the determination has been made, they send the information directly to the Social Security Administration, not the claimant. After reviewing the findings of the state authority, the SSA then contacts the claimant regarding the decision on the claim.

As is the case with an actual SSDI benefits claim hearing, applicants should ensure that they submit to the state authority clear, concise and exhaustive documentation, as well as answer any and all questions to the best of their ability.

Who Makes the SSDI Eligibility Determination?

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