Disability Determination Specialist
Disability determination specialists are state government employees who evaluate medical evidence to decide whether someone applying for Social Security disability benefits meets eligibility criteria. They gather evidence, analyze it and apply it to Social Security rules. It is essential for specialists to be good investigators and have a firm grasp of medical terminology.
The US Social Security Administration funds disability determination services operated by state governments.
These state programs hire staff to determine whether applicants for Social Security disability benefits are in fact disabled such that they are eligible for benefits under the Social Security Disability Insurance (SSDI) or (SSI) programs. The SSA uses the term claimants when they discuss those applying for benefits. Federal employees make decisions about the other aspects of claimants’ situations like age, work history, and marital status.
Procedures vary by state, but in general, disability determinations specialists are hired using the normal government hiring process. Some states administer a written exam during the hiring process. While the funding for their positions comes from the federal government, disability determination specialists are state government employees.
Education and Experience
Job postings for disability determination specialist positions require applicants to hold a bachelor’s degree.
They often do not require any experience since some states start new disability determination specialists with a trainee designation.
Disability Determination Specialist Duties
Disability determination specialists gather and analyze evidence to determine whether an applicant for Social Security disability benefits meets eligibility criteria specifically related to that person’s disabilities.
Specialists compare what they find to what Social Security rules prescribe. They decide whether a claimant meets criteria and notifies the SSA and claimant of the decision in writing. The specialist explains how the evidence supports the decision. The claimant may appeal this decision to the local SSA office.
Claimants may not have all the evidence a specialist needs to make a determination. Specialists advise claimants on providing the necessary evidence. If a claimant’s medical documentation is insufficient, a specialist will work with the claimant’s physician to find the needed medical records or may ask the claimant to visit the doctor so that the doctor can evaluate the claimant and provide expert testimony. If the claimant does not have a primary care physician, the specialist may help the claimant arrange an appointment with a doctor. Specialists may also ask claimants to have medical tests performed in order to substantiate the existence or severity of a disabling condition.
One of the first things disability determination specialists are trained on is medical terminology. Of course, specialists do not take it upon themselves to diagnose claimants, but they must be able to understand what medical professionals write and apply diagnoses, prescriptions and expert statements to Social Security rules.
Like many other frontline workers in human services, disability determination specialists carry a caseload. At any given time, specialists have a set of cases they are working. As long as they close a case at about the same time they receive a new one, they can maintain a manageable workload. Some cases take much more work than others, but over the long haul, workload balances out among specialists in the same geographical area within a state.
Specialists have access to very sensitive personal information. They take precautions to safeguard this information ensuring that only people who have a legitimate need for information receive it. Even when someone is entitled to information, specialists are careful to disclose only what is necessary.
What You'll Earn
The standard of living varies across the US, so state governments have slightly different salary rates for new disability determination specialists.
However, new hires can expect to start somewhere in the low to mid-$30,000’s. As specialists gain experience, they can expect regular salary increases because of career ladders established by state agencies administering disability determination programs.