What is a Disability Adjudicator?

disability adjudicatorBecause of the volume of disability claims it processes, Social Security uses a very structured procedure to evaluate every SSDI or SSI application it receives.

When you file your claim, an SSA intake clerk opens an electronic claims folder in your name.  Thereafter your claim will be assigned to a claims representative located in your state.  These claims representatives are called adjudicators and they are employed by your state government (in Georgia, the Disability Adjudication Services office is part of the Georgia Vocational Rehabilitation Agency).  100% of the cost of the adjudication program is borne by the federal government (Social Security Administration).

The adjudicator in your case will gather medical and vocational evidence and has the authority to approve or deny your claim based on very specific guidelines.  Adjudicators work directly with medical and psychological consultants to better understand the documentation in your claims file.

Your adjudicator can also refer you out to a consultative evaluation with a medical doctor or psychologist in an effort to further develop your file.

Generally the initial application adjudication process takes between three and six months.  If the adjudicator denies your claim, she will mail out a denial notice along with an explanation of what factors went into her decision.  If you disagree with the adjudicator’s conclusion that you are not disabled, you must file an appeal called a request for reconsideration within 60 days from the denial notice date.

The reconsideration appeal goes back to the adjudicator for an updated look at the evidence. This re-evaluation process will take between three and six months  Statistically very few denied claims are reversed at reconsideration.

If the adjudicator denies your claim at reconsideration, she will send out a reconsideration denial notice and brief explanation.  At that point, you have the right to appeal and request a hearing before an administrative law judge.  This request for hearing must be filed within 60 days from the reconsideration denial date.

Once you file your request for hearing, your adjudicator’s job is over and your electronic file will be transferred to a local hearing office called an ODAR (Office of Disability Adjudication and Review). The ODAR is staffed by federal (not state) employees and your case will be assigned a federal administrative law judge.

One important point about the transfer from the state to the federal government.  Your adjudicator has the responsibility of developing your record by requesting and obtaining medical records.  The ODAR does not have personnel to do this, so once you request a hearing you and your lawyer are solely responsible for updating your claims file.  Since the delay in getting your hearing scheduled can be a year or longer, it is essential that you and your lawyer make an ongoing effort to update the records in your file – you do not want to appear before a judge with the last record in the file dating back 12 months or longer.

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Jonathan Ginsberg

Jonathan Ginsberg represents deserving men and women seeking disability benefits from the Social Security Administration. You can reach Jonathan directly at 770-393-4985
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Published by Jonathan Ginsberg

Jonathan Ginsberg represents deserving men and women seeking disability benefits from the Social Security Administration. You can reach Jonathan directly at 770-393-4985

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1 Comment

  1. What a cushy job! First of all, they apparently don’t conduct thorough reviews of claims because I can’t count how many claims were eventually approved after a hearing even when NO new evidence was submitted. Why would ANY adjudicator take this job seriously? Is their job accuracy measured, documented, or even reviewed? What happens when a claimant’s file suffers because of the lack of diligence from these people? I can tell you, nothing! They are responsible for screwing up the foundation of your claim in which everyone else bases their decisions. I can’t imagine these people even bother to read the entire medical record before making a decision; it’s just impossible with their rate of improper decisions that are consistently overturned at the next level.

    Where do I sign up for this job!

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