When you file for Social Security disability in North Carolina, a state agency decides whether you are disabled, even though Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) are federal programs. North Carolina's Disability Determination Services (DDS) is the agency that makes the initial approval or denial of benefits (contact information below). North Carolina's DDS approves fewer disability applications (25.7%) than the national average.
North Carolina also differs from other states in that it allows a "single-decision maker" at DDS to make disability decisions and it pays a substantial additional payment to SSI recipients. We'll discuss these issues below.
To appeal a denial in North Carolina, you first request that DDS reconsider its decision by filing a Request for Reconsideration. If DDS denies your claim a second time, you file a Request for Hearing form.
Administrative law judges (ALJs) hold hearings at the hearing office (called the Office of Disability Adjudication and Review, or ODAR) located nearest to your local Social Security field office. (Contact information for North Carolina's four ODAR offices is below.) Occasionally, a hearing is held by videoconference; however, you can ask that the hearing be held in person. Unfortunately, it takes a long time to get a hearing date. In 2011, it took, on average, 376 days from the time the request for hearing was filed to the date the case was decided by an ALJ.
In 2011, North Carolina ALJs awarded disability benefits in 63% of the cases they heard. Of those approvals, 59.4% were fully favorable, and 3.5% were partially favorable.
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North Carolina is taking part in a Social Security redesign project that allows a disability determination to be made without a doctor in some situations. This model uses one disability examiner, instead of a disability examiner and a medical consultant, to make medical assessments about an applicant's physical ability to work. This is known as the single decision-maker (SDM) model. Federal law prevents the "single decision-maker" model from being used when deciding claims that involve mental impairments. A psychologist or psychiatrist must always be involved in a disability decision involving emotional, psychiatric, or mental problems.
Although single-decision makers at DDS can make decisions about your physical ability to work (including your residual functional capacity) when making initial disability determinations, those opinions cannot be considered by an ALJ when deciding your claim at the hearing level. It is important that you review the exhibit file before your hearing to ensure that any opinions created by an SDM are clearly noted. If the ALJ has erroneously included the opinion of an SDM when deciding your claim, and you were denied benefits, you may have grounds for an appeal to the Appeals Council.
For most SSI recipients, the federal government funds the entire SSI payment (up to $733 per month), but for those who live in an adult care home, North Carolina provides a state supplementary payment on top of the federal payment. North Carolina pays those in a basic adult care home or assisted living arrangement an additional $554; qualified individuals living in a special care unit or in hospice may receive an additional $887.
The North Carolina Department of Health and Human Resources, Division of Aging and Adult Services administers the SSI supplement. You can apply for the supplement at your county's Department of Social Services office. Use North Carolina's DSS locator to find the office closest to you.
North Carolina law places a limit on how much a doctor’s office or hospital can charge you for your medical records. In North Carolina, medical providers can charge a $0.75 for the first 25 pages, $0.50 for pages 21-100, and $0.25 for each page copied over 100. A doctor can also charge a reasonable fee to review your records and write a short description of your treatment and condition based on the records.
The North Carolina Department of Health and Human Services (DHHS) administers the state's Disability Determination Services (DDS) program. Unlike many states, North Carolina does not have individual DDS locations. Here is the contact information for North Carolina’s DDS headquarters:
DDS Mailing Address
P.O. Box 243
Raleigh, NC 27602
3301 Terminal Dr.
For more information, visit the website of the Department of Health and Human Services.
North Carolina has Office of Disability Adjudication and Review (ODAR) hearing offices located throughout the state. Below is the contact information for each office.
6701 Carmel Rd., Suite 300
Charlotte, North Carolina 28226
421 Maiden Lane, 2nd Floor
Fayetteville, NC 28301
101 South Edgeworth St.
Greensboro, North Carolina 27401
4800 Falls of Neuse Rd.
Raleigh, North Carolina 27609
North Carolina offers vocational rehabilitation and retraining services through the Division of Vocational Rehabilitation Services (DVRS). DVRS provides assistance to disabled individuals with job placement, self care skills, and help to achieve independent living. For more information, see the DVRS website.
You can visit our North Carolina disability lawyer page if you decide to hire an attorney to represent you in your appeal.
by: Melissa Linebaugh, Contributing Author