Nolo’s Guide to Social Security Disability by David A. Morton III M.D

Author:David A. Morton III, M.D.
Language: eng
Format: epub
Publisher: NOLO

F. If Your Claim Is Denied

If the DDS denies your claim, you might want to find out the details behind that decision. This information may be important to you if you plan to appeal. The SSA keeps disability information in an “electronic folder” (EF), and much of that information is avail able to you. (Electronic folders are discussed in more detail in Chapter 12.)

If you get your folder, look for Form SSA-831, Disability Determination and Transmittal—it’s usually at the front of the folder. The DDS claims examiner and the medical consultant must complete this form in every initial and reconsideration application. If you have applied more than once, your folder (also called your disability file) will contain multiple forms.

Even if the form was signed by a medical consultant, it may not have been reviewed by a doctor. To see if the medical consultant who signed the form reviewed your disability file, look for medical notes or a residual functional capacity (RFC) rating form completed by the medical consultant. If you can’t find notes or an RFC form, it’s quite possible that your claim was not reviewed by the medical consultant. (Children don’t receive RFCs, so no such form would be expected in their disability file, but you would still expect to find the medical consultant’s notes.)

If it appears that your file was not reviewed by a medical consultant, write and call the DDS director. State that your file contains no evidence that your claim was reviewed by a doctor, except for a signature on the Disability Determination and Transmittal Form. Demand that your claim be recalled and reviewed by a medical consultant. If the director won’t help you, contact your senator or congressional representative, as well as your governor and local state legislator. You have a right to have your medical records reviewed by a medical consultant.

Of course, your claim may be denied whether or not it is reviewed by a DDS medical consultant. (Chapter 11 contains a discussion of the different ways claims can be denied. Chapter 12 discusses the various types of appeal available to you.)

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