Social Security Inspector General Report: Disability Impairments on Cases Most Frequently Denied by Disability Determination Services and Subsequently Allowed by Administrative Law Judges

FOR IMMEDIATE RELEASE
Contact: Jonathan Lasher
Phone: (410) 965-2671
http://oig.ssa.gov
 
The Office of the Inspector General (OIG) for the Social Security Administration (SSA) has issued a report that identifies the four impairments most often denied by Disability Determination Services (DDS) in Calendar Years 2004 through 2006, appealed to the Office of Disability Adjudication and Review (ODAR) hearing level, and subsequently allowed.
 
The four impairments were Disorders of Back; Osteoarthrosis and Allied Disorders; Diabetes Mellitus; and Disorders of Muscle, Ligament, and Fascia. The OIG reports that between 65 percent and 70 percent of appealed denial determinations made by DDSs with these impairments were subsequently allowed at the ALJ hearing level.
 
The OIG's analysis of cases with the four impairments disclosed that:
  • Claimant age affected disability determinations at both the DDS and hearing levels.
  • Determinations of claimants' ability to work resulted in differences at the DDS and hearing levels.
  • Claimant representation was more prevalent in cases allowed at the hearing level than in cases decided at the DDS level.
  • Cases were allowed at the hearing level based on a different impairment than that on which the DDS made its determination.
  • States had both DDS denial rates and hearing level allowance rates above the national averages.
  • ODAR regions, hearing offices, and administrative law judges had wide variations in allowance rates.
Given the wide differences between the DDS and hearing level decisions, the OIG plans to conduct additional work to identify the underlying causes for these differences.
 
To view the full report, click here, or for additional information, contact Jonathan Lasher, Assistant Inspector General for External Relations, at (410) 965-2671. Refer to Common Identification Number A 07-09-19083.