The Social Security Disability Program is Non-Adversarial

Contrary to the beliefs of many who have been denied their Social Security disability insurance (SSDI) or Supplemental Security Income (SSI) benefits, it is important to understand that the Social Security disability program set up to administer the review of disability claims is a non-adversarial process.   The rules are set up in such a way as to provide a neutral review of one’s disability claim.

The initial application process requires that an individual claimant first submit information to the Social Security Administration (SSA) which will allow the agency to not only obtain all of the necessary medical documentation from one’s treatment providers but also review information as to how the claimant’s daily activities and ability to work is hindered.  The application forms likewise allows the Agency to determine one’s educational and work background as these areas of information are critical to the ultimate determination as to whether one may meet a medical listing of impairment and two, if not, if the individual remains incapable of returning to any of one’s past relevant work (work performed during the 15 year period prior to becoming disabled) or any other work that exists in significant numbers in the national economy.

The initial material that is gathered on the application form, along with a signed medical authorization from the claimant, is then transferred to the state agency responsible for making the actual disability determination for the Federal Government in each state.  In Maine, Massachusetts and New Hampshire, this is referred to as the Disability Determination Services (DDS).  In Maine, the office is located in the capital of Augusta, in New Hampshire, the office is located in Concord and in Massachusetts, there are offices in Boston and Worcester.    Once the case is transferred from one’s local Social Security Administration office (referred to as the District Office) to DDS, a disability claims examiner (or adjudicator) is then assigned to work on the case.  They are given the task of  ensuring that all of the relevant treatment records are obtained that are both listed in your application or that are subsequently pointed out to DDS by the claimant or their representative.   The DDS adjudicator is not, however, provided with the responsibility of obtaining helpful documentation from one’s treatment providers that might support a finding that one either meets a medical listing of impairment or remains disabled from performing one’s past relevant work or other work.

Simply because DDS is working in a neutral manner to gather evidence does not mean they are working against you.  As a Social Security lawyer practicing throughout Maine, Massachusetts and New Hampshire for 27 years, we understand it’s our job to work with you and with DDS to ensure all of the medical documentation is being obtained (including supportive reports from your doctors that not only address the medical listings of impairments but also the extent to which you remain functionally disabled from performing tasks that would be necessary in a work environment).  Assuming one is denied at the initial level in Maine and Massachusetts, then a reconsideration takes place that once again involves DDS’s involvement in obtaining the updated medical documentation from those providers listed in the Disability Report Appeal filed with SSA.

With the understanding that the process is non-adversarial, it’s important to recognize that Social Security’s rules expect all parties (both the claimant and their representative) to be both forthright in the claims made before the Agency.   The individual claimant face very serious penalties associated with making false statements or representations on their application materials, and representatives are required to submit all evidence that relates to whether a claimant is disabled or not.

In the event one is denied on reconsideration in Maine or Massachusetts, or even on their initial application in New Hampshire, it then becomes necessary to appeal for a hearing before an Administrative Law Judge (ALJ).    As this may require a hearing before a judge, it’s understandable that this could cause great concern.  It is important to remember, however, that the process is taking place before a neutral judge, and there is no party that is on the other side arguing against you.  One of the first things an ALJ will inform you is that he is a neutral fact finder who has been assigned by SSA to hear your case,  he is not bound by prior decision, and he will make a new decision based on the evidence that has been submitted (both medical and supporting application materials included), the testimony that day and any arguments that may be made by your counsel (or yourself, if self-represented).

If you or someone you love feels as though they have been unfairly treated by SSA, or want to ensure that you receive a fair and detailed review of your claim, contact the Law Offices of Russell J. Goldsmith at 1-800-773-8622 for a no cost consultation.