• Menu
  • Skip to right header navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

Before Header

Has your disability claim been wrongfully denied or terminated? Call us today for help!  (888) 321-8131

  • Facebook
  • Instagram
  • LinkedIn
  • Twitter
  • YouTube

OLF Ortiz Law Firm National Disability Attorneys

We appeal wrongful long term disability insurance and Social Security Disability denials.

  • ABOUT US
    • Our Team
    • Our Results
    • Areas We Serve
    • Core Values
  • PRACTICE AREAS
    • Initial Application
    • Request for Reconsideration
    • Hearing Before an Administrative Law Judge
  • RESOURCES
    • Top 10 Mistakes That Will Destroy Your Social Security Disability Claim
    • SSD Training Webinar: Knowing What Wins
    • Physical RFC Form
    • Mental RFC Form
  • BLOG
  • Search
  • CONTACT
  • ABOUT US
    • Areas We Serve
    • Testimonials
    • Our Team
      • Nick Ortiz
    • Our Office
    • Core Values
    • Referring Attorney Program
  • PRACTICE AREAS
    • Long Term Disability Claims
      • Administrative Appeals
      • Lawsuits
      • Lump-Sum Buyout Offers
    • Social Security Disability Claims
      • Initial Applications
      • Request for Reconsideration
      • Hearing Before an Administrative Law Judge
    • Personal Injury Claims
  • DISABLING CONDITIONS
    • Long Term Disability
    • Social Security Disability
  • INSURANCE CARRIERS
    • Cigna
    • Guardian
    • Hartford
    • Lincoln Financial
    • Matrix Absence Management
    • MetLife
    • Mutual of Omaha
    • Northwestern Mutual
    • New York Life
    • Principal
    • Prudential
    • Reliance Standard
    • Standard
    • Unum
  • RESOURCES
    • Blog
    • Free Downloads
      • Residual Functional Capacity (RFC) Form
      • Mental Residual Functional Capacity (RFC) Form
      • eBook: Top 10 Mistakes That Will Destroy Your LTD Claim
      • eBook: Top 10 Mistakes That Will Destroy Your SSD Claim
      • Cancer Case Study
      • Fibromyalgia Case Study
      • Doctors Guide to ERISA Disability
      • Doctors Visit Record
      • Ultimate Appeal Checklist
      • Medication Log
      • Migraine Diary
    • Lump Sum Disability Buyout Calculator
    • FAQ: Long Term Disability
    • FAQ: Social Security Disability
    • Abbreviations in Social Security Disability Claims
  • Search
  • CONTACT

Mobile Menu

Schedule A Free Consultation Now!

Find out how our law firm can help you win your case or you don’t pay a cent.

(888) 321-8131

  • ABOUT US
    • Areas We Serve
    • Testimonials
    • Our Team
      • Nick Ortiz
    • Our Office
    • Core Values
    • Referring Attorney Program
  • PRACTICE AREAS
    • Long Term Disability Claims
      • Administrative Appeals
      • Lawsuits
      • Lump-Sum Buyout Offers
    • Social Security Disability Claims
      • Initial Applications
      • Request for Reconsideration
      • Hearing Before an Administrative Law Judge
    • Personal Injury Claims
  • DISABLING CONDITIONS
    • Long Term Disability
    • Social Security Disability
  • INSURANCE CARRIERS
    • Cigna
    • Guardian
    • Hartford
    • Lincoln Financial
    • Matrix Absence Management
    • MetLife
    • Mutual of Omaha
    • Northwestern Mutual
    • New York Life
    • Principal
    • Prudential
    • Reliance Standard
    • Standard
    • Unum
  • RESOURCES
    • Blog
    • Free Downloads
      • Residual Functional Capacity (RFC) Form
      • Mental Residual Functional Capacity (RFC) Form
      • eBook: Top 10 Mistakes That Will Destroy Your LTD Claim
      • eBook: Top 10 Mistakes That Will Destroy Your SSD Claim
      • Cancer Case Study
      • Fibromyalgia Case Study
      • Doctors Guide to ERISA Disability
      • Doctors Visit Record
      • Ultimate Appeal Checklist
      • Medication Log
      • Migraine Diary
    • Lump Sum Disability Buyout Calculator
    • FAQ: Long Term Disability
    • FAQ: Social Security Disability
    • Abbreviations in Social Security Disability Claims
  • Search
  • CONTACT
  • Facebook
  • LinkedIn
  • Twitter
  • YouTube
You are here: Home / Social Security Disability Frequently Asked Questions / Who is The Social Security Disability Examiner?

Who is The Social Security Disability Examiner?

The Social Security Disability Examiner Evaluates Your Claim

Social Security disability claims examiners make the initial determination (decision) on an applicant’s medical eligibility for Social Security disability Insurance (SSDI or SSD) and Supplemental Security Income (SSI) claims. In Florida, disability claims examiners work at the state agency called Disability Determination Services, or DDS. Although DDS is fully funded by the Federal Government, it is still a State agency responsible for developing medical evidence and issuing the initial determination as to whether the claimant is disabled under the law. Given the size of the State of Florida, our DDS office has several hundred disability examiners. The following provides a basic outline of what the DDS claims examiner does in evaluating a claim.

Gathering Medical Evidence

First, the disability examiner gathers all of your medical records and reviews any additional information from you, your representative, or your doctor. In other words, the DDS tries to obtain evidence from the claimant’s own medical sources first. In the alternative, the disability examiner may schedule you for a consultative examination (C.E.) under any of the following circumstances:

  • the records are unavailable,
  • your medical records are insufficient to adequately evaluate the claim, or
  • you have not seen any doctors (also called “medical treating sources”) within the recent past (typically the past three months).

The claimant’s own treating source is the preferred source for the CE; however, the DDS may also obtain the CE from an independent source.

The disability examiner should maintain contact with you to coordinate the proper gathering of medical evidence in your claim.

Adding Vocational Information

The disability examiner will then gather together your:

  • medical treatment records and notes;
  • residual functional capacity opinions from your treating medical providers;
  • consultative examination results;
  • your relevant past work history (jobs that you performed in the fifteen (15) years prior to the onset of your disability); and
  • your educational background.

Making the Disability Determination

After completing its initial development, the DDS makes the disability determination. The determination is made by a two-person adjudicative team consisting of a medical or psychological consultant and a disability examiner. If the adjudicative team finds that additional evidence is still needed, the consultant or examiner may recontact a medical source(s) and ask for additional/supplemental information.The DDS also makes a determination whether the claimant is a candidate for vocational rehabilitation (VR). If so, the DDS makes a referral to the State VR agency.

In most cases, the disability examiner completes a medical decision write-up for the state disability physician to review. In writing the medical decision, the examiner will discuss whether your impairment meets the requirements of a disability Listing of Impairment, and if not, whether your residual functional capacity (RFC) is enough to allow you to work any other type of job. The medical consultant, or unit physician, is typically called upon to develop the RFC, but it does not always happen that way.

The examiner is expected to consult the doctor on the nature and severity of the claimant’s medical impairments as well as what kind of additional medical evidence is required to decide the claim. The examiner is not permitted to make decisions on medical eligibility without consulting the doctor, except in quick disability determination cases (QDD). (QDD cases are those with very straightforward facts that warrant obvious outcomes. In QDD cases, a single decision maker (the examiner) can only approve a case (and cannot deny a case) without a unit physician review.

After the DDS makes the disability determination, it returns the case to the field office for appropriate action depending on whether the claim is allowed or denied. If the DDS finds the claimant disabled, SSA will complete any outstanding non-disability development, compute the benefit amount, and begin paying benefits. If the claimant is found not disabled, the file is retained in the field office in case the claimant decides to appeal the determination.

If the claimant files an appeal of an initial unfavorable determination, the appeal is usually handled much the same as the initial claim, except that the disability determination is made by a different adjudicative team in the DDS than the one that handled the original case.

FacebookTweetPinLinkedInPrintEmail

Primary Sidebar

Disability Academy

Watch the Knowing What Wins Training Webinar

Top Ten Mistakes That Will Destroy Your Social Security Disability Claim

View All Social Security Disability Resources


Tim Anderson

My only regret is that this review is about seven years overdue. I rarely write reviews and did the firm a disservice by not submitting any reviews of the great service I received from the Ortiz Law Firm back in 2013. If I recall correctly, he was the only attorney with the firm then. He and his staff were very deserving of a positive review. Today I was reminded of the EXCELLENT service received from Nick Ortiz while looking for an attorney for my VA disability claim, and decided to write the belated review that I should have at the time.

Nick succeeded in getting my Social Security Disability claim approved the first time through. I wasn't getting very far in the initial filing of my claim for SSDI benefits, just spinning my wheels trying to navigate SSA's requirements and gathering the necessary records. My physical and mental health had me really stressed out, and I was overwhelmed with just getting by day-to-day. I met with Nick O for a free consultation. He impressed me with his ability to listen and understand my issues and with his track record dealing with the SSA. He had a very pleasant personality, and was easy to talk to. He accepted my case, and handled everything involving my claim.

About four to five months later, my claim was approved! No need to file an appeal or anything else. I was/am extremely pleased with the outcome. His fee was some of the best money I ever spent. He earned every penny of it and then some!

I would definitely recommend Nick Ortiz for any of his practice areas and have done so numerous times to friends and others dealing with the SSA.

https://youtu.be/3_sfwSkG0pI

View All Testimonials

Learn More About Social Security Disability

  • Areas We Serve
  • Frequently Asked Questions
  • Denials and Appeals
  • Common Mistakes
  • Insider Tips
  • Non-Medical Eligibility
  • Conditions That May Qualify
  • Social Security Disability Blog

Complete This CONFIDENTIAL Form for a FREE Social Security Disability Case Evaluation

  • This field is for validation purposes and should be left unchanged.

Footer

Location

ORTIZ LAW FIRM
(888) 321-8131

316 S Baylen St
Ste 590
Pensacola, FL 32502
Monday - Thursday: 9:00 AM - 5:00 PM Friday: 9:00 AM - 2:00 PM
Saturday - Sunday: Closed

View Site

Our Team

  • Nick Ortiz
  • Jessica Ortiz
  • Dawn Keller
  • Tory Nelson
  • Sarah Peak

Practice Areas

  • Pensacola Long Term Disability Lawyer
  • Pensacola Social Security Disability Lawyer
  • Personal Injury Claims
  • Facebook
  • LinkedIn
  • Twitter
  • YouTube

Site Footer

©2020 Ortiz Law Firm, All Rights Reserved. Reproduced with Permission | Disclaimer | Privacy Policy

Share this ArticleLike this article? Email it to a friend!

Email sent!