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SSDI examiners inconsistent in initial determinations

Despite agency efforts to introduce consistency in Social Security Disability Insurance determinations, outcomes in SSDI applications and appeals still appear to depend on the particular officer reviewing the case. In other words, if two New Jersey applicants with nearly identical cases applied for disability benefits, which officer considered their claim may be as important as the facts in their application.

Research completed by the RAND Corporation was presented at a recent hearing before the House Committee on Ways and Means. The research showed that up to 60 percent of initial applicants could have had a different result in their initial determinations had they been assigned a different officer in the same Disability Determination Service office.

DDS offices have average allowance rates, which most examiners stay within. However, certain examiners approve applications at a rate that diverges significantly from their office average.

If, in an attempt to address inconsistencies, the SSA introduces new policies and procedures, the data indicates that people who truly need help would have a better chance of receiving benefits.

The research also showed that the appeals process seems to address the inconsistencies within DDS offices. Data shows that 75 percent of appealed denials are overturned.

However, appealing an SSDI denial is complex. A decision can take an average of two years, during which time an applicant must comply with strict income limits. This long wait represents a real hardship to applicants and their families.

Navigating an inconsistent system is difficult. However, an experienced attorney can assist an individual in every step of the SSDI process, from the initial application to the appeal.

Source: House Committee on Ways and Means, Subcommittee on Social Security, "Securing the Future of the Social Security Disability Insurance Program," Nicole Maestas, March 20, 2012

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