Social Security Administration (SSA) manages two programs that offer benefits based on disability: Social Security Disability Insurance Program (Title II of the Law of Social Security (Law) and additional security mechanisms Income (SSI) program (Title XVI of the Act). Title II provides for payment of benefits for disabled people are “insured” under the law with their contributions to the Social Security Trust Fund through the Social Security tax their profits, and to certain disabled members of the insured person. Title XVI SSI provides payments to individuals (including children under 18 years) with disabilities and have limited income and resources. The law and its implementing regulations require the SSA, the rules for determining whether an individual is disabled. “SSA criteria for deciding whether someone is disabled does not have to apply the same criteria other public and private disability programs. Definition of disability To all the people applying for disability under Title II and the application for adults under the title XVI, the definition of disability is the same. The law defines disability as the inability, in any substantial gainful activity (SGA) to participate, by reason of a medically determined physical or mental disorder (s) which can be expected to result in death or has lasted or can be expected to continue for the final period of not less than 12 months. Children with disabilities under Title XVI, a child under 18 years will be considered disabled if she has a medically determined physical or mental damage, or a combination of damage, which causes marked and severe functional limitations, and that can be expected to result in death or has lasted or can be expected to continue a period of not less than 12 months continue. What is meant by “medically defined disorder” a medically determined physical or mental disability is the result of anatomical, physiological and psychological changes that can be shown by medically acceptable clinical and laboratory diagnostic techniques. A physical or mental disorder should be established by medical evidence consisting of signs and symptoms and laboratory findings – not only by the declaration of individual symptoms. The Disability Determination Process Social Security Office Most disability claims are initially through a local network of social security field offices and authorities to be processed (usually as a disability determination services or DDSS). Next appeal from unfavorable determinations may be detained in the office of hearings SSA administrative law judge and Appeals (OHA) in DDSS or. SSA representatives in the field offices usually obtain applications received on disability retirement, whether in person, by phone or by mail. Applications and related forms ask for information about the loss of the applicant (s), name, address and phone number care resources, and other information about the alleged defects. (The “applicant” means the person being sought disability benefits.) Branch is not responsible for the review of the medical eligibility criteria, age, occupation, marital status may include social security, and much more. Field offices to send the case to a DDS for evaluation of disabilities. Disability Determination Services The DDSS is fully funded by the federal government, state agencies responsible for developing medical evidence and rendering initial determination whether or not the applicant is blind or disabled under the law. Usually, the DDS tries to obtain the applicant own medical knowledge from primary sources. If the evidence is not available or not enough to make a discovery is set DDS CE to obtain additional information needed. Plaintiff is a preferred source of treatment of the source of CE, but the DDS may also obtain CE from an independent source. (See Section III for more information about CES.) After completing the initial development, the DDS makes the disability finding. Determination made by two teams of judges, consisting of medical or psychological consultant (what a doctor or psychologist) and a disability examiner. If the judicial team noted that further evidence was needed, the consultant or examiner may contact the medical source (s) and request additional information again. The DDS is also a decision about whether an applicant) is a candidate for vocational rehabilitation (VR. If so, the DDS makes reference to the State VR agency. After making the discovery of defects, DDS, there is the case with the field office for appropriate action, depending on whether the request is allowed or denied. If the DDS found the claimant disabled, SSA of all non-construction defect is complete, calculate the amount of unemployment benefits and began paying benefits. If the applicant is found not disabled, will receive the file in the office, if decided by the applicant, the determination of the complaint. If the applicant files an appeal from the initial adverse determination appeal can generally be treated the same as the original claim, except that this is the definition of disability by another team in the DDS test than what the early cases treated. Office of Inspection and Appeals Petitioner was not satisfied with the first appeal the subsequent decision may appeal. Hearings at the Office of Hearings and Appeals (OHA) second appeal process. Administrative law judge is the second appeal decision, usually after a trial and get more evidence from medical sources or other sources Applicant. OHA medical development is often done by the DDS. However, it can also directly to the medical source consulting office. In rare cases, the administrative law judge may issue a subpoena requiring the production of evidence or testimony at trial. Role of Health Professionals Health professionals play an important role in determining the disability process and in the process in various ways: as a source of treatment or medical sources other medical evidence of their patients; As CE sources to perform to the cost, examination and / or tests required; Reviewing full-time or part-time medical or psychological consultant, claims in a DDS, in one of the offices, SSA, or in SSA central office or As a medical expert who testified at the hearing the administrative law judge. Treatment sources One source is the applicant’s own medical doctor, psychologist or other medical resources that can be accepted that the plaintiff is a medical treatment or evaluation is made available and has or had a need for ongoing treatment relationship with the plaintiff. The treating source is usually the best source of medical knowledge about the nature and severity of disability a person (s). If the examination or further testing is needed, SSA usually considers treatment options to the source resources to carry out checks or tests for the patients themselves. Sources who took care not required or expected that the decision whether applicants with disabilities. However, a treating source will usually be asked to give a statement about the applicant’s ability, despite its limitations, do work, physical or mental activity. Program Medical Professionals Doctors almost all specialties and psychologists at the national, regional or national levels review claims for disability benefits. Review of work in the State or DDSS SSA regional offices or headquarters running. This is really a paper check, the program physician or psychologist usually has contact with the plaintiff. Medical Expert Because there is no direct involvement of medical professionals, complex decisions in the administrative law judge’s disability at the Office of Hearings and appeals, administrative law judges sometimes request expert testimony on medical matters. Each office maintains a list of medical experts meeting was called to testify as an expert in the trial. The experts are paid fees for their services. Confidentiality note Two laws are separate, “Freedom of Information Act and Privacy Act, have special significance for the federal government. Under the Freedom of Information Act, federal agencies must provide public access to records and documents. That is, public law, with certain exceptions, to examine records relating to the functions, procedures, and final opinion of this policy the federal government. Privacy Act allows an individual or his representative to examine records relating to him or her in a federal agent. For disability applicants, this means that a person may request that use of medical or other evidence to see / request disability payments under Social Security or SSI-program level. (Evidence of this is not for the general public.) Identify SSA screens all requests to see medical evidence in the claim file to determine whether evidence of a direct discharge to the individual may have an effect on the individual. If so, the report only to an authorized representative of the designated individuals will be released.
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