Disability Determination Services

Last updated

Disability Determination Services, commonly called DDS, are state agencies that are funded by the US federal government. [1] Their purpose is to make disability findings for the Social Security Administration.

Contents

Applicants for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) file applications for disability benefits at local Social Security field offices.

If the application is accepted, it is sent to the DDS in the state that the applicant lives to have the claim of disability assessed.

The claim is either approved or denied at the DDS for disability qualification. The claim is then returned to the originating SSA office to finish its processing.

Methods used

The following methods are used in determining a disability.

Applicant's own statement

The applicant is requested to provide information on the disability. During the application process, it is requested for the applicant to list all conditions that contribute the disability and how they prevent employment.

Also, the applicant is mailed a questionnaire that contains questions pertaining to the applicant's activity before and after the applicant's disability, including daily activities and how the disability has affected the ability to perform them. Such activities include activities like dressing, bathing, grooming, food shopping, meal preparation, housekeeping, laundry, and transportation.

Approval is based on how the applicant's medical conditions impact the ability to earn an income. While an applicant's own words alone are usually not sufficient to qualify for approval, they can play an important role.

Personal statements can be of questionable validity. Applicants who have expertise in the system or can obtain help from an expert may be able to influence the decision by the use of particular words and phrases.

Medical records

The applicant's medical records are obtained from physicians involved in the current treatment of the applicant. The physicians provide information on the conditions for which the applicant is being treated and how they impede the applicant's ability to work.

In many cases, DDS will send the applicant to one or more physicians for a medical examination, which is paid by DDS. That most often occurs in the absence of a physician with an existing treating relationship with the applicant who can verify an impairment that is alleged by the applicant.

The examination verifies the information provided by other sources and provides a more up-to-date record in making a determination.

Study of applicant's life

Staff of the DDS will often contact the applicant or other people who know the applicant to obtain descriptions of "Activities of Daily Living" (ADLs). They can be combined with the objective medical opinion and the opinions of medical sources to build an assessment of what the applicant can or cannot do in a typical day.

Rarely, in only a limited number of locations, an external investigation can referred to a "Cooperative Disability Investigations" (CDI) unit. Such a referral is made only when fraud is suspected. The purpose is to corroborate that the applicant's statements reflect real-life activities. For example, there are cases of those filing for disability and falsely claiming to be unable to engage in various forms of physical activity. The fraudulent applicants are then observed performing tasks outside of a work setting that require the same skills. Such information could be used to then deny benefits.

The examiner and representatives may also call or otherwise obtain statements from those who are known to the applicant like relatives, friends, acquaintances, neighbors, co-workers, and teachers. The questions will be asked in a manner in which evidence may be corroborated.

Decision made

The decision is made, based on whether or not the applicant is able to perform work that used to be done in the past or that the applicant is trained to do and is likely to be able to perform and find employment in the disability. It is for that reason that two people with identical disabilities may have very differing outcomes in their applications.

The legal definition of a disability that qualifies an applicant for benefits is "inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months." [2] For adult applicants, Social Security Administration regulations specify a five-step process for making the decision. [3] A modified process is used in the case of children for whom Supplemental Security Income benefits are being claimed [4] (as children are not expected to work).

For adults, part of the disability-determination process involves assessing the applicant's "residual functional capacity": what the applicant can do in spite of the disability. [5] Factors that may be considered in determining the "residual functional capacity" [6] may include the following:

Contrary to what many think, simply "being disabled" by any definition does not alone qualify one to automatically be approved. While one who is able to walk, talk, and manage one's own life may be considered disabled if there is no suitable employment for one's abilities, one with diminished mobility or mental capacity may not qualify if there is plentiful employment available with one's abilities.

One or more diagnosed medical conditions may not automatically qualify an applicant, and the lack of one or more may not disqualify the applicant. In some cases, an applicant may qualify based on symptoms alone.

In determining a physical disability, common factors are the ability to sit, stand, lift, bend, and stoop. Mental disabilities are determined based on the ability to communicate with others, understand oral and/or written instructions from others, and get along with others. One who is able to sit for prolonged periods of time but not stand, lift, bend, or stoop may be disqualified by being able to perform some type of desk work, and one may qualify without such an ability because of intellectual capacity, education level, or previous work experience. Likewise, a person with limited mental capacity who has the ability to perform physical labor may not qualify as "disabled."

Such skills are also used for applicants who have never worked and for whom the claim is that they can never work.

See also

Related Research Articles

Supplemental Security Income (SSI) is a means-tested program that provides cash payments to disabled children, disabled adults, and individuals aged 65 or older who are citizens or nationals of the United States. SSI was created by the Social Security Amendments of 1972 and is incorporated in Title 16 of the Social Security Act. The program is administered by the Social Security Administration (SSA) and began operations in 1974.

A disability pension is a form of pension given to those people who are permanently or temporarily unable to work due to a disability.

A background check is a process used by an organisation or person to verify that an individual is who they claim to be, and check their past record to confirm education, employment history, and other activities, and for a criminal record. The frequency, purpose, and legitimacy of background checks vary among countries, industries, and individuals. An employment background check typically takes place when someone applies for a job, but it can also happen at any time the employer deems necessary. A variety of methods are used to complete these checks, including comprehensive database search and letters of reference.

Social Security Disability Insurance is a payroll tax-funded federal insurance program of the United States government. It is managed by the Social Security Administration and designed to provide monthly benefits to people who have a medically determinable disability that restricts their ability to be employed. SSDI does not provide partial or temporary benefits but rather pays only full benefits and only pays benefits in cases in which the disability is "expected to last at least one year or result in death." Relative to disability programs in other countries in the Organisation for Economic Co-operation and Development (OECD), the SSDI program in the United States has strict requirements regarding eligibility.

Transferable skills analysis is a set of tests or logic to determine what positions a person may fill if their previous position(s) no longer exists in the local job market, or they can no longer perform their last position(s). An informal transferable skills analysis can be performed with the help of a career counselor, career portfolio or a career planning article or book. Transferable skills are determined by analyzing past accomplishments or experience. For instance, a stay-at-home parent and homemaker might find they have skills in budgeting, child development, food services, property management, and so on.

Richardson v. Perales, 402 U.S. 389 (1971), was a case heard by the United States Supreme Court to determine and delineate several questions concerning administrative procedure in Social Security disability cases. Among the questions considered was the propriety of using physicians' written reports generated from medical examinations of a disability claimant, and whether these could constitute "substantial evidence" supportive of finding nondisability under the Social Security Act.

The United States Social Security Administration's Ticket to Work and Self-Sufficiency Program is the centerpiece of the Ticket to Work and Work Incentives Improvement Act of 1999.

Disability fraud is the receipt of payment(s) intended for disabled people from a government agency or private insurance company by one who should not be receiving them, or the receipt of a higher amount than one is entitled to. There are various acts that may constitute disability fraud. These include feigning a medical problem in order to be declared disabled, exaggeration of an existing medical problem that potentially can but in reality does not render the person disabled, continuing to receive payments after having recovered from a medical problem, or continuing to receive payments while working above the allowable level for those receiving the payments.

The EB-1 visa is a preference category for United States employment-based permanent residency. It is intended for "priority workers". Those are foreign nationals who either have "extraordinary abilities", or are "outstanding professors or researchers", and also includes "some executives and managers of foreign companies who are transferred to the US". It allows them to remain permanently in the US.

Disability benefits are a form of financial assistance or welfare designed to support disabled individuals who cannot work due to a chronic illness, disease or injury. Disability benefits are typically provided through various sources, including government programs, group disability insurance provided by employers or associations or private insurance policies typically purchased through a licensed insurance agent or broker, or directly from an insurance company.

EB-2 is an immigrant visa preference category for United States employment-based permanent residency, created by the Immigration Act of 1990. The category includes "members of the professions holding advanced degrees or their equivalent", and "individuals who because of their exceptional ability in the sciences, arts, or business will substantially benefit prospectively the national economy, cultural or educational interests, or welfare of the United States, and whose services in the sciences, arts, professions, or business are sought by an employer in the United States". Applicants must generally have an approved Permanent Labor Certification, a job offer, and their employer must have filed an Immigrant Petition for Alien Worker with the USCIS.

<span class="mw-page-title-main">Veterans benefits for post-traumatic stress disorder in the United States</span> VA disability compensation for PTSD

The United States has compensated military veterans for service-related injuries since the Revolutionary War, with the current indemnity model established near the end of World War I. The Department of Veterans Affairs (VA) began to provide disability benefits for post-traumatic stress disorder (PTSD) in the 1980s after the diagnosis became part of official psychiatric nosology.

A functional capacity evaluation (FCE) is a set of tests, practices and observations that are combined to determine the ability of the evaluated person to function in a variety of circumstances, most often employment, in an objective manner. Physicians change diagnoses based on FCEs. They are also required by insurers in when an insured person applies for disability payments or a disability pension in the case of permanent disability.

<span class="mw-page-title-main">Vocational rehabilitation</span> Occupation rehabilitation processes

Vocational rehabilitation, also abbreviated VR or voc rehab, is a process which enables persons with functional, psychological, developmental, cognitive, and emotional disabilities, impairments or health disabilities to overcome barriers to accessing, maintaining, or returning to employment or other useful occupations.

The Disability Tax Credit (DTC) is a non-refundable tax credit in Canada for individuals who have a severe and prolonged impairment in physical or mental function. An impairment qualifies as prolonged if it is expected to or has lasted at least 12 months. The DTC is required in order to qualify for the Registered Disability Savings Plan, the working income tax benefit, and the child disability benefit. Families using a Henson trust, the Canada Disability Child Benefit other estate planning methods for children with Disabilities are not excluded from the DTC. While the credit is valuable, many have found qualifying for it challenging.

The Social Security Disability Benefits Reform Act of 1984 was signed into law by then-U.S. President Ronald Reagan on 9 October 1984. Its purpose was to ensure more accurate, consistent and uniform disability determination decisions under the Social Security Disability Insurance (SSDI) program, and to ensure that applicants were treated fairly and humanely. It has been described as "one of the key pieces of social welfare legislation" enacted toward the end of Reagan's first term in office.

Substantial gainful activity is a term used in the United States by the Social Security Administration (SSA). Being incapable of substantial gainful employment is one of the criteria for eligibility for Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) benefits. It is known as the "SGA requirement," and is defined in Section 520 of the Social Security Act.

The U visa is a United States nonimmigrant visa which is set aside for victims of crimes who have suffered substantial mental or physical abuse while in the U.S. and who are willing to assist law enforcement and government officials in the investigation or prosecution of the criminal activity. It permits such victims to enter or remain in the US when they might not otherwise be able to do so. An advantage that comes along with the acceptance of a U-visa is the individual will have deportation protection which is important when they are collaborating with law enforcement.

<i>Meyer v. Astrue</i>

Meyer v. Astrue, 662 F.3d 700, was a landmark Social Security Disability Insurance case argued in federal court, resolving a conflict within the circuit over the summary denial of requests for review when new evidence is submitted to the Appeals Council.

A National Interest Waiver is an exemption from the labor certification process and job offer requirement for advanced degree/exceptional ability workers applying for an EB-2 Visa for Immigration into the United States.

References

  1. ↑ "Disability Determination Process".
  2. ↑ 42 U.S.C. § 423(d).
  3. ↑ 20 C.F.R. § 404.1520 Archived June 12, 2011, at the Wayback Machine ; 20 C.F.R. § 416.920 Archived June 12, 2011, at the Wayback Machine .
  4. ↑ See 20 C.F.R. § 416.924. Archived June 12, 2011, at the Wayback Machine
  5. ↑ 20 C.F.R. 404.1545 Archived June 12, 2011, at the Wayback Machine ; 20 C.F.R. 416.945 Archived June 12, 2011, at the Wayback Machine .
  6. ↑ "Residual Functioning Capacity". Disability Determination. 20 September 2017.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.