Who Makes the Decisions in my Social Security Disability Case?

A ruling as to whether or not you qualify for Social Security disability benefits will be made by one of two types of decision-maker.  At the initial application and reconsideration appeal stage, the decision is made by someone called an “adjudicator.”  Should your case go to a hearing, the decision will be made by a federal administrative law judge.

Who Are the State Agency Adjudicators?

In Georgia, disability adjudicators work for an agency called the Disability Adjudication Section, or D.A.S.  The D.A.S. is also sometimes referred to as the “State Agency.”  The D.A.S. is managed by the State of Georgia, although its operations are funded by the Social Security Administration (federal government) and the rules used in D.A.S. decisions are uniform federal Social Security rules. Click on the link to read how the Georgia Department of Labor describes the adjudicator’s job functions.

State Agency adjudicators are generally non-lawyers and they are trained to apply Social Security rules to evaluate cases.  When you file your case, an adjudicator is assigned to develop the record.  Adjudicators use the Form 827 medical release forms that you have signed to request medical records from your treating doctors and hospitals.  Your adjudicator will gather medical and vocational records, then submit your case for review with medical, mental health and vocational experts who work under contract with the D.A.S.

If the relevant expert recommends approval of your case, the adjudicator will process an approval.  The adjudicators and non-examining “experts” employed at the D.A.S. do not have much discretion when making a decision about a case.  Generally, in order to win an approval at the initial application or reconsideration, your medical condition generally must meet a “listing.”

The State Agency adjudicators are very busy and rarely have time to take special interest in any particular case.  Further, the adjudicators usually have very little direct interaction with you.  Most of their time is involved with collecting medical records and managing dozens of files, while under pressure from D.A.S. supervisors to process files quickly. 

An adjudicator will be assigned to your claim when you first file, and a different adjudicator will be assigned to consider your reconsideration appeal.  Not surprisingly, very few cases are approved at reconsideration, because adjudicator #2 is applying the same rules and procedure as adjudicator #1.

Who are Social Security Administrative Law Judges?

In contrast to State Agency adjudicators, administrative law judges (known as an ALJ) have significantly more authority and discretion when making decisions.  Since every case heard by an ALJ has previously been turned down by two adjudicators, it may surprise you to learn that around half of all hearing cases are approved by ALJ’s.

Judges can consider a wider variety of arguments for disability than can adjudicators.  Further, judges are interacting directly with you at a hearing and thus can consider your credibility as well as the medical evidence.

ALJ’s are assigned at random from a pool of judges in a particular hearing office (called the ODAR - Office of Disability and Review).  My experience has been that most judges want to make fair and reasonable decision, although there can be a wide range of approval percentages within the judges who work at a particular ODAR.

A recent Freedom of Information Act lawsuit resulted in a finding that Social Security must make available statistical information about its judges.  You can review your disability judge’s approval percentage at a handy web site.

Whether your case is before a State Agency adjudicator or a Social Security Administrative Law judge, you and your lawyer should make every effort to help the decision-maker by providing up to date information about medical or mental health treatment and by writing or testifying clearly and logically about your disabling condition and how it affects your capacity to perform work.

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