Proposed Rules Allow DDD to Approve QDD Cases

March 10, 2010

Author: Catherine M. Callery (Kate) | Louise M. Tarantino

SSA proposes “to amend our rules to permit disability examiners in the State agencies to make fully favorable determinations in certain claims for disability benefits under Titles II and XVI of the Social Security Act (Act) without the approval of a medical or psychological consultant.  The proposed changes would apply on a temporary basis only to claims we consider under our rules for Quick Disability Determinations (QDD) or under our compassionate allowance initiative.”  75 Fed. Reg. 9821 (March 4, 2010).  In New York, the state agency, the Division of Disability Determination (DDD), would be able to make these fully favorable decisions. Comments are due by April 5, 2010.

The proposed permission would not apply in childhood disability SSI claims.  The sunset provision is three years, subject to extension.

The announcement reminds us, “Under our current rules, a State agency disability examiner and a State agency medical or psychological consultant generally work together to make disability determinations at the first two levels of the administrative review process for adjudicating disability claims under titles II and XVI of the Act. The members of the team are jointly responsible for the determination.  A State agency disability examiner can make the disability determination alone only when there is no medical evidence to evaluate and the claimant fails or refuses, without a good reason, to go to a consultative examination.”

Remember, these rules would only allow a DDD analyst to make a fully favorable decision in adult cases.