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When you are applying for SSDI or SSI benefits, you need to include as much information about your diagnosis, symptoms, and limitations as you can. The people who examine your claim in the initial phase are known as Disability Determination Services (DDS). Their denial of your claim does not mean the end of the road but it is in your best interests to provide as much detail as you can up front so you have a better chance of getting approved without delay.
One of our Charleston lawyers can assist you with setting expectations and crafting the claim for the benefit of DDS.
DDS is responsible for deciding to grant or deny the SSDI application at the initial and reconsideration levels. They can request medical records and gather any written testimony to support a claim, including clarifications on the applicant’s daily activities, work history, pain locations, and what makes their pain better or worse.
Some specific medical conditions, like seizures, might prompt DDS to send an extra form, or they might send someone to receive what is called a consultative exam, which might be a physical, psychological evaluation, breathing test, or an X-ray. They are looking for information that they cannot find within the applicant’s own medical records. Notably, the DDS office will pay for this exam.
This exam should give them more information that they cannot find in the medical records, to determine if the applicant is properly disabled or not. It is important to keep those appointments, because without that information, the application will likely be denied.
DDS examiners look into medical records for an applicant’s limitations, diagnoses, reported issues, and the severity of the problem. A person cannot get benefits from simply saying, “My back hurts.” He or she needs to say that their injured back prevents them from standing or sitting for a certain number of minutes, or that they need to lie down with their legs elevated for a certain amount of time each day.
If they have depression, they need to talk about how it affects them; for example: not attending family functions anymore, feelings of isolation, the lack of motivation to stay hygienic, problems with concentration, or oversleeping. They must be very detailed with their doctor, but their doctor must also include those details within their medical record.
DDS may require a consultative exam if the medical records do not contain enough detailed information to allow them to make a fair decision. This can happen if the person is not being treated for their disability or has not been treated in a long time.
At the initial claim determination level, approval falls to DDS examiners and doctors, not with judges. The claim must be very black and white to get approval at this level, which is why we see a lot of initial claims being denied. If they need any kind of additional testimony from a medical or vocational expert, or there is a gray area to the claims, the application will likely be denied and need to go before an administrative law judge.
The people at DDS are not judges, so they have a lot of limitations on the decisions that they can make. Administrative law judges have more authority to make decisions when there is a gray area in the person’s disability.
Putting in the work of a full application up front can save you months of delays and appeals for your SSDI benefits. It all comes down to what you submit to Disability Determination Services (DDS), the first people to examine your application and either approve or deny it. Call our Charleston office for more information on how we can help. Our consultations are completely free.
To Schedule an Appointment, Call Us Toll Free at 1.877.873.8208 or Email Us for a Prompt Response.
Jan Dils, Attorneys at Law
