Disability Determination Services (DDS) is a state-level agency responsible for making the initial decision on your Social Security Disability (SSD) or Supplemental Security Income (SSI) claim. While SSA manages the overall disability program, DDS handles the medical evaluation portion. Understanding how DDS works can help you navigate the disability application process and ensure your claim is processed smoothly.
How DDS Evaluates Your Claim
When you file your disability claim, SSA sends it to DDS for a medical evaluation. The role of DDS is to determine whether your medical condition meets the SSA’s definition of disability. DDS is staffed by medical and psychological experts who review your medical records, assess your functional limitations, and determine if you are capable of working.
Here’s a breakdown of what happens once DDS receives your claim:
- Review of Medical Records: DDS collects your medical records from the healthcare providers you listed in your application. They may also request additional records or schedule a Consultative Exam (CE) if more information is needed.
- Functional Capacity Evaluation: The DDS medical team will evaluate your physical and mental limitations, such as your ability to lift, walk, concentrate, or handle stress. This assessment helps determine if you can perform your previous work or adjust to a different type of work.
- Decision Making: Based on the medical evidence and functional capacity evaluation, DDS will decide whether you qualify for disability benefits. If your condition meets the criteria, DDS will approve your claim. If not, they will issue a denial, and you’ll have the option to appeal.
Common Reasons for DDS Denials
DDS denies many claims, often for reasons related to insufficient medical evidence or a lack of detailed functional limitations. Here are a few common reasons claims are denied at the DDS level:
- Lack of medical records: If your medical records don’t fully document the severity of your condition, DDS may deny your claim. It’s important to ensure that all relevant records are submitted.
- Failure to attend a Consultative Exam (CE): If DDS schedules a CE and you don’t attend, they may deny your claim for non-cooperation.
- Medical condition isn’t severe enough: If DDS determines that your condition doesn’t significantly limit your ability to perform work-related tasks, they may deny your claim.
A common mistake claimants make is assuming that DDS will automatically contact all of their healthcare providers. To avoid delays or denials, make sure you provide complete and accurate contact information for all your doctors, and follow up to ensure DDS receives your records.
How to Strengthen Your Claim at the DDS Stage
While DDS has the responsibility of evaluating your medical evidence, there are steps you can take to strengthen your claim:
- Submit thorough medical records: Ensure your application includes all relevant medical records from every healthcare provider involved in your care. This includes specialists, hospitals, and mental health professionals if applicable.
- Provide a detailed work history: Submit a complete work history that explains how your condition affects your ability to perform tasks related to your previous jobs. This helps DDS understand the specific challenges you face in the workplace.
- Keep your doctors informed: Make sure your doctors know that DDS might request additional information. Having your healthcare providers prepared can ensure that DDS gets the records they need quickly.
Appealing a DDS Denial
If DDS denies your claim, you have the right to appeal the decision. The first step is to request a reconsideration, where a different DDS team will review your case. If you’re denied again, you can request a hearing before an Administrative Law Judge (ALJ).
The appeal process can be complex, which is why many claimants turn to an experienced attorney for help. Attorneys who specialize in disability claims, like those at Disability Law Group, know how to gather additional medical evidence, present a compelling case, and avoid the common pitfalls that lead to denials at the DDS level.
How an Attorney Can Help
An experienced attorney can make a significant difference in how your case is handled at the DDS stage. Here’s how:
- Gathering and submitting evidence: Attorneys can help ensure that DDS receives all necessary medical records and documentation, reducing the chance of denial due to missing information.
- Communication with DDS: Your attorney can communicate directly with DDS to clarify any misunderstandings, provide additional evidence, and ensure your claim is being processed correctly.
- Appealing denials: If your claim is denied, an attorney can guide you through the appeals process, helping to strengthen your case at every stage.
Understanding how DDS works and what they’re looking for in your application can help you better prepare your disability claim. If you need assistance with submitting your claim, gathering medical records, or appealing a denial, Disability Law Group is here to help. Contact their experienced team today to learn how they can support you through the disability determination process.
