Processing Disability Claims and Benefits

Disability entails physical and financial hardships. To alleviate the pain and suffering of a disabled individual, social security benefits are provided. As a prerequisite, applicants must pass the disability claims evaluation. First, they must be disabled as defined by the Social Security Administration and second, they must prove their disability by submitting pertinent documents or medical records.

The SSA defined disability as one where an individual no longer able to perform substantial gainful activity as a result of a physical or mental impairment that is expected to last for at least 12 months.

However, claimant’s determination of disability is just a start of a lengthy and complicated claims process.

Processing of Disability Claims

Claimants must fill out forms to show intent to avail of the benefits. Application may be done personally or through telephone, mail or internet.  The applicant must provide information as to the impairment, treatment sources and pertinent data regarding the disability.

Initially, disability claims are processed through a network of local SSA field offices called Disability Determination Services (DDS). Upon filing of the forms, a field office will be responsible for verifying the non-medical eligibility of the application including age, marital status, employment and coverage information. Thereafter, the office will forward the case to DDS for disability evaluation.

The DDS are state agencies fully funded by the Federal Government that is tasked to develop medical evidence and render initial determination on the qualification of the claimant. Moreover, DDS may obtain evidence from the claimant’s own medical sources or conduct a consultative examination in case evidence is unavailable or insufficient.

After consultative examination, DDS will make its initial determination. If claimant is found to be disabled, SSA will complete any outstanding non-disability development, compute the amount of benefit and pay the benefits.

On the other hand, if claimant is found not to be disabled, the file is archived with the field office. The file will only be re-opened if the claimant decides to appeal the determination. In case of unfavorable determination of disability, appeal may be done with the DDS itself or with the administrative law judge in SSA’s Office of Disability Adjudication and Review.

It is advised, however, to seek the assistance of a disability lawyer. In this way, errors may be avoided and denial may be minimized. Denial of the claim will only lengthen the already tedious disability claim process.