Tuesday, June 13, 2006

Disability Denied

I've been around social security disability and SSI disability claimants in several capacities over a number of years (caseworker, disability examiner, advocacy) and the conclusion I've reached is that the majority of disability applicants do not want to file for disability benefits. They file for disability benefits because they have to. In other words, because their medical or mental condition has made it impossible for them to work and earn enough money to support themselves.

Individuals who file for SSD and SSI benefits and enter the disability evaluation process do so with a fair amount of despondency and anxiety. And, unfortunately, most have their disability denied, and their trepidation validated. Depending on the state in which you live, the rates of denial at the initial claim level can be as high as seventy percent or more.

Why does this happen? Why do so many individuals with valid claims have their disability denied, particularly when so many of them stand a greater chance of being approved for benefits at a later point in the process (that is, if they follow the appeal process -- for more information, visit this page: Social Security Disability Appeals) ?

The answer is multifaceted, without a doubt; however, part of the reason for such large denial rates has to do with the "culture of denial" that exists at the various state agencies that process social security disability and SSI disability claims for the social security administration. These are the agencies (normally referred to as disability determination services or the bureau of disability determination) in which disability examiners gather the medical records of applicants and render decisions on their claims. These are also the agencies in which disability examiners work under a subtle (and sometimes not so subtle) pressure to deny more disability claims than they approve.

In these agencies, the quality-control focus on continually analyzing whether a disability determination should have been a denial instead of an approval has led to certain patterns of behavior that have long since become SOP, and virtually etched in granite.

Put another way, the ranks of unit supervisors at the various disability determination services (each state has at least one DDS, some states have several) have been inclined, and motivated, for many years to deny many good claims for disability benefits. And this inclination is so pervasive (and, let's be honest, twisted) that it is not unheard of for DDS unit supervisors (who, incidentally, have no medical training whatsoever) to challenge the very physicians who are assigned to their units as medical consultants.

Some would categorize this as outrageous chutzpah, that a DDS unit supervisor (i.e. a state employees with zero medical expertise) would challenge and override a physician whose job is to assist and validate the decisions of disability examiners. But it happens all the time (not by actual order, but definitely via pressure and coercion, i.e. strongarming).

And it is clear evidence as to why "social security disability reform" may not be nearly so effective as its architects project and anticipate. Because as long as the culture of denial remains rooted at disability determination services, no shell games (substituting federal review for DDS reconsiderations) or wishful-thinking-alterations to the system (quick disability decision units, which, under current supervisors, are not likely to move disability cases any faster than they currently move) will have any substantial impact.

Unfortunately, this is where SSA's top level management falls shortest, simply because for all they do know, at a very basic level (the level at which initial disability claims are received and processed), you have to wonder if they really know much about how the disability system actually works.

Return to the Social Security Disability SSI Benefits Blog

Other Posts

Attorney for a disability Claim
Application for social security disability
Social security appeal
Disability Carpal Tunnel


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