When a claimant files a Social Security Disability and/or SSI claim, the Social Security Administration will send the case to Disability Determination Services (DDS). This is a state entity separate from the Social Security Administration, which of course is a federal entity. Social Security contracts with DDS to assist them in making a medical determination of the case. DDS in turn assigns the claimant’s case to an examiner. Qualified medical professionals examine the medical evidence in order to determine whether or not a favorable decision can be made.
If the case is not won after the initial decision then a claimant has the opportunity to appeal. We always help our clients with the appeal. The first appeal is called a “reconsideration request.”
After the reconsideration request, the case goes again to DDS, but this time it is assigned to a different examiner, to be reviewed by a fresh set of eyes. Any new evidence of disability should be submitted.
If DDS again returns an unfavorable decision, the claimant has the opportunity to again appeal by requesting a hearing before an Administrative Law Judge (ALJ). We always help our clients prepare the request for hearing by an ALJ when there is a denial at the reconsideration stage. Again, any new evidence of disability will be submitted along with the appeal.
The ALJ is not bound by DDS’ prior determinations. He or she will make a decision de novo, or in other words, an entirely new decision on the case.
One nice thing about a hearing with an ALJ is the opportunity for the claimant to appear in person and explain his or her case to the ALJ. It is like having your “day in court”, to use a well-worn but appropriate cliché.
This material should not be construed as legal advice for any particular fact situation, but is intended for general informational purposes only. For advice specific to any individual situation, an experienced attorney should be contacted.