Who Decides If You Are Disabled?

Legal Representation for Social Security Disability Insurance (SSDI) Claimants

The Massachusetts disability lawyers at Kantrovitz & Associates have over 25 years of experience recovering SSDI benefits for workers throughout Massachusetts, Rhode Island, and New Hampshire. We have an in-depth knowledge of the claims process and handling by the Disability Determination Services (DDS). Our established reputation among disability examiners is crucial to helping clients obtain the compensation they deserve, and we are dedicating to fighting for all benefits to which disabled workers are legally entitled.

SSDI Eligibility

Chapter 6, Section 74 of the Massachusetts General Laws (MGL) established the Massachusetts Rehabilitation Commission to operate DDS, the state agency responsible for determining initial and continued eligibility for federal SSDI benefits. Although claims are filed at local Social Security Administration (SSA) offices, these offices only make financial determinations of eligibility based on earned income credits from covered employment. Once this has been satisfied, the SSA sends the case file to DDS for a medical determination of eligibility. Each case is assigned to a DDS examiner who begins to develop the medical evidence required to approve or deny a claim. This often involves reviewing medical records and scheduling an exam, if necessary, to evaluate whether the condition meets the SSA’s criteria for listed disabilities.

DDS Decision-Making

In what is known as a “sequential” evaluation process, DDS makes the first medical decision by looking at evidence to answer a series of questions based on the facts of each case. The need to provide sufficient documentation of the disability will clearly speed up the process; extra steps to procure further medical records and another consultative exam can cause delays. Factors that DDS considers before approving a claim may include:

  • Current work
    • Cannot do more than “substantial gainful activity” (SGA) - $1070/month in 2014
    • Impairment’s effect on ability to work prior job or another full-time job
    • Job duties, necessary skills, exertion level of all jobs in past 15 years
  • Medical condition
    • Immediate “benefit receipt” status if severe condition matches disability listing
    • In some cases, DDS may request another exam by independent physician
    • Documentation must include all treating doctors, therapists, hospitals
  • Severity of condition
    • Medical-vocational assessment determines residual functional capacity
    • Medical condition must severely limit ability to engage in SGA

According to recent audits in accordance with MGL Chapter 11, Section 12, DDS and vocational rehabilitation programs receive nearly $100 million in appropriations each year, almost $80 million of which consists of federal funds. As such, DDS must comply with regulations requiring an eligibility determination within 60 days. Once DDS finds a medical disability, it returns the case to SSA for payment or appeal.

Obtaining DDS Approval

If you are applying for SSDI benefits in Massachusetts, contact the Massachusetts social security disability attorneys of Kantrovitz & Associates today. We concentrate on filing claims thoroughly supported by evidence of listed disabilities and other impairments that qualify for payment. After over 25 years of experience dealing with DDS examiners, our firm has recovered SSDI benefits for disabled claimants in Middlesex, Essex, Suffolk, and other counties throughout the Commonwealth. Call (800) 367-0871 today for a free consultation or contact us online.