State agencies make the initial determination whether to approve Social Security Disability (“SSD”) benefits. Periodically, the Social Security Administration (“SSA”) has always conducted "Quality Assurance" reviews to make sure each State agency is making disability determinations that are in line with federal policies and standards. The frequency of those reviews has greatly increased in recent years, which has added to the already unacceptable delays in paying SSD benefits.
The reviewed cases are supposed to be selected randomly from all of the cases that were decided by the State agency, including decisions awarding benefits and decisions denying benefits. However, while I have had many approved applications reviewed, I have never had a denied application selected for review. The SSA claims that only about 1% of claims are chosen for review. While that may have been true once, during the last couple of years I have had four or five times that number “randomly” pulled, and all those claims were ones that the State agency had approved.
Since the only cases that are being randomly selected are approvals, the true reason for the reviews cannot be to make sure the State agency is making disability determinations in line with federal policies and standards. The true reason must be that the SSA is trying to ferret out claims that can be rejected, and to delay the payment of SSD benefits.