To determine whether you are disabled when you apply for Social Security disability or SSI (Supplemental Security Income), the Social Security Administration will send your claim to a state agency that's often called Disability Determination Services (DDS). (To learn other common names for the agency, see our article on the state disability determination agency.)
DDS, rather than the Social Security Administration, assesses whether you are doing a certain minimal amount of work (in which case you aren't eligible for benefits) and whether you are medically disabled (physically or mentally unable to perform any job).
This is what happens at DDS: Your file arrives from a Social Security office and is assigned to a disability claims examiner. The examiner immediately begins to order medical records from all of the doctors' offices, hospitals, and other medical providers that you listed on your application.
The disability examiner may call you for more information about your work or medical history. If your examiner leaves you a message, be sure to call back promptly. Alternatively, the examiner may send you a questionnaire form that you need to fill out and return. The examiner will usually ask you questions to clarify the details of what you put on your disability application.
Once most of your medical records arrive at DDS, the examiner can begin to go about the task of deciding whether you will qualify for disability. These are the questions the claims examiner will try to answer as he or she looks at your file.
The first test the examiner will apply to your file has nothing to do with your condition, but whether you are working, and how much you're working. For both the SSDI program and the SSI program, a disability claimant cannot work and earn more than an amount equal to or greater than what is known as "SGA," or substantial gainful activity. In 2021, the SGA amount is $2,190 for blind applicants and $1,310 for applicants with other disabilities. If you are currently working and are making this amount or more, the DDS examiner, and Social Security policy, assumes you can't really be disabled. (There are specific rules for the self-employed, however, who may not bring home a set paycheck every month. For more information, see our article on SGA.)
As the second step of the evaluation process, the DDS examiner will assess the severity of your condition and how it limits you. For instance, if you have moderate hearing loss, but with hearing aids you are able to hear 95% of what people are saying, the DDS is not likely to consider your condition severe, and your claim will not move on to the next level of the evaluation process.
Next, the examiner will determine, with the help of a doctor who works at DDS, whether your condition meets the requirements of any of the official disability listings in its "blue book" of disability listings. If your medical records indicate that you have a severe medical condition that matches the requirements of a disability listing, you will automatically qualify for disability and the claims examiner will immediately put you on "benefit receipt" status. The examiner will forward your file back to the SSA for further processing.
Only the most severe medical conditions will meet a disability listing. For details on this part of the evaluation process, see our section on the medical disability listings.
Next, the examiner will review your physical and/or mental limitations in your medical records and files to see if there is work you can do. This stage of the process has to do with exactly how your medical, psychological, or psychiatric condition limits your ability to work. If you have a medical impairment or disability that makes it impossible for you to work your prior job full time, or another type of work full time, you can get benefits. For the details on this part of the evaluation process, see our section on the medical-vocational assessment.
If the examiner receives your medical records quickly, it may only take the examiner two to three months to make a decision in your case. But a delay in getting the records can make the DDS decision take much longer. If you haven't received a decision after three or four months, it can help move your case along to call DDS.
Updated February 10, 2021