When Applying For Disability Benefits, Who Decides If I Am Disabled?


Posted by: Chris

The Social Security Administration (SSA) rejects thousands of applications for disability benefits every year. The vast majority of these applications are rejected because the SSA decides the applicants are not disabled and therefore not eligible for benefits. But, who makes this decision?

There are four parties that are involved in the process: a disability examiner, medical consultant, psychological consultant, and medical advisor. Here’s what you need to know about their roles:

The Role of the Disability Examiner

The disability examiner is responsible for developing each claimant’s case by gathering the necessary evidence, contacting relevant parties, and requesting consultative examinations if necessary. The disability examiner is also in charge of evaluating the claimant’s ability to work. During this step, the disability examiner will look at the claimant’s work history, education, and skillset to determine if there is any work that he or she can perform. After this information has been gathered, the disability examiner can determine whether or not a claimant is truly disabled.

In some cases, the claim must be presented to the other parties for review before a final decision is made. But, the disability examiner is allowed to make a disability determination on their own under certain circumstances. 

The Role of the Medical Consultant and Psychological Consultant

The medical consultant and psychological consultant play the same role, however the former is involved in physical disability cases, whereas the latter is involved in mental disability cases. Both consultants are responsible for reviewing applicants’ claims to determine if they have provided enough evidence to accurately assess their condition. If the disability examiner has requested a consultative exam, either the medical or psychological consultant will review this request to determine if it’s necessary. If the claimant is examined, these consultants will analyze the results to see how they compare to the evidence provided in the initial claim.

Both of these consultants also help disability examiners interpret medical data sent by claimants. Since they are experts in their respective fields, they can advise disability examiners to ensure they make the right call on whether or not an applicant is disabled.  

The Role of the Medical Advisor

The medical advisor is responsible for helping the other parties understand complex medical issues so they can determine whether or not an applicant is disabled. For example, if there is a claim involving cancer, a cancer pathologist would be able to help the other parties understand the severity of the applicant’s condition.

These four parties work together to evaluate your medical condition and ability to work. This team will ultimately decide whether or not you are entitled to disability benefits. 

Are you applying for disability benefits? If so, contact Armstrong & Vaught, P.L.C. at once. Our experienced attorneys will ensure the SSA has all of the information they need to approve your application. Call us now at 918-582-2500, toll free at (800) 722-8880, or contact us online for a free consultation with a skilled attorney.