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Who Decides to Approve or Deny SSDI Claims in Virginia?

Filing for social security disability benefits is a daunting task. With nearly two-thirds of SSDI claims getting denied after the first application, many claimants wonder who decides to approve or deny SSDI Claims in Virginia?

The state agency decides on disability claims, not a federal office. The Social Security Administration (SSA) specifies rulings about the disability benefits application process, eligibility criteria, calculation of benefits if approved, and others. At the same time, Disability Determination Services (DDS) is the State Agency that makes decisions on disability applications for the SSA under federal guidelines.

In this article, Virginia's trusted Social Security Disability lawyers at Kalfus & Nachman explain DDS and its role in deciding disability claims.

Virginia DDS and its Role in SSDI claims

In Virginia, the Disability Determination Services (DDS) is a division within the Virginia Department of Rehabilitative Services (DRS). This state agency processes SSDI claims based on medical and psychological evidence, vocational criteria, consultative evaluation, and continuing disability review. It works in partnership with the Social Security Administration and follows federal regulations in making its decisions.

A claimant can file a disability benefits application online, by phone, or in local SSA field offices. The field office verifies basic requirements like age, employment, or marital status. After the verification, if the application is complete, they forward the disability application to the Disability Determination Services office. The DDS then completes the disability determination for Social Security. However, it is responsible only for the medical eligibility portion of the disability claim.

Types of disability claims handled by DDS:

  • Initial applications for disability benefits.
  • Subsequent initial applications for disability benefits
  • Reconsideration requests
  • Continuing disability reviews (CDRs)
  • Medicaid claims based on disability status

Basic Steps DDS follows in the Disability Determination Process

The DDS staff usually begins by gathering medical information from the claimant's listed medical sources. The agency evaluates that evidence against SSA's specific Social Security Disability criteria. If that evidence is unavailable or insufficient, they will schedule a consultative examination (CE) to gather more information about the applicant's medical condition. The CE can be performed by an independent source or the claimant's treating medical provider. After reviewing the medical report from the examining physician, DDS decides if you are disabled under the rules of Social Security. They then send your claim back to SSA, which performs a quality assurance review of initial DDS disability decisions to determine eligibility for benefits. However, if the DDS is considered a "single decision-maker," it may decide to approve or deny SSDI claims without going through the SSA's review process.

What Happens After DDS Makes a Disability Decision

After initial determination, the state agency (DDS) returns the case to the SSA field office for appropriate action on your SSD claim. If the DDS determines the claimant is disabled, the Social Security Administration completes any outstanding non-disability development, computes the benefit amount, and begins making payment of SSDI benefits to the claimant. If DDS finds the claimant is not disabled, the file is kept in the local SSA field office, and claimants can appeal the decision.

DDS denies the majority of Social Security disability claims at the initial and reconsideration levels, compelling applicants to request a hearing before an administrative law judge before being approved for Social Security disability benefits. Thus, seeking legal help before even filing a disability claim will ensure that your case receives the consideration that it deserves. A qualified and competent SSDI attorney will thoroughly analyze your case and recommend any extra documentation that may be beneficial to your case.

How Long Does it Take to Decide on an SSDI application?

It takes DDS about three to four months from the application date to make an initial disability determination. Reconsideration appeal takes about the same time, and ALJ hearing decision from six months to two years. However, with no deadlines for applications or appeals in the federal disability program, it is hard to forecast how long a case will take. Kalfus & Nachman's experienced social security attorneys may help you expedite your SSDI claim with their extensive knowledge in filing Social Security claims in Virginia.

SSDI Claim Denied in Virginia? Call Kalfus & Nachman for a free consultation

Unfortunately, 70% of disability claims filled in Virginia get initially denied, and many applicants give up at this point, almost always. It is crucial to submit proofs that demonstrate overwhelming evidence of your disability. Claimants should consult with skilled Social Security disability lawyers specializing in assisting clients with SSD claims. They can walk you through the application process, focusing on gathering the necessary medical evidence. If the SSA denies your claim, your SSD lawyer may assist you in filing a reconsideration appeal or any subsequent appeals with the DDS. Although the claim process can take months, your Social Security lawyer may be able to expedite the process by maintaining regular contact with the SSA and timely submission of all documents and appeals.

At Kalfus & Nachman, our SSD lawyers understand what you are going through. We also know how to deal with the SSA bureaucracy for our clients. If you were denied Social Security benefits, or need assistance with an SSDI claim, speak to our aggressive Social Security Disability attorneys serving Virginia. We are committed to helping you get the benefits you are entitled to and need. Call us for a free consultation today at 855-880-8163

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