DISABILITY BENEFIT RECOVERY

When you apply for Social Security disability benefits (SSDB), the case is sent to a state agency, usually called the "Disability Determination Service" or DDS.  DDS is a state run agency operating under contract with the Social Security Administration. The role of the DDS is to gather all the relevant medical records, evaluate the work history and vocational skills of the claimant, and make an initial determination as to whether the claimant meets Social Security's rules for disability. The person who handles the claim at DDS is called a "disability specialist."  After this specialist has worked up the file, he/she has it reviewed by a contracted, or sometimes employed, medical doctor. When a decision is made, the file is sent back to the local Social Security office from where it came and Social Security sends a determination letter to the claimant.  About 70 percent of cases are denied at the DDS level (often referred to as "the state level").

The mandatory process to appeal an unfavorable decision by a hearing judge in a Social Security disability case is to file an appeal with the Appeals Council.  This is a group of judges in Falls Church, VA. (and some are located in Washington, DC, also).  See Our Website for Details. The time frame for getting a review by the Appeals Council is 12 to 18 months.  Neither the claimant or representative appears at this stage of appeal. Here are the typical results of the Appeals Council actions based on national averages: 74 percent of cases are either denied or dismissed, so the hearing judge's decision remains in place. 24% of cases are remanded ( sent back to the hearing judge for another hearing or additional development). 2 percent are awarded directly by the Appeals Council. If the Appeals Council does not award or remand your case, the next and final appeal is to file a suit against the Commissioner of Social Security in a US District Court.  You cannot