QC Reviews

The Social Security Administration (“SSA”) routinely conducts “quality reviews” of decisions from the State agency.  The SSA insists that the reviews are random.  However, since the last Century, every time one of my client’s decisions has been pulled for review, the State agency decision was an approval of Social Security Disability (“SSD”) benefits.  Moreover, every colleague I know has also expressed that their clients have never had a disapproved decision reviewed.

We represent a 54 year old teacher from Port Jefferson Station with diabetes and mental impairments.  The State agency approved SSD benefits three days after we submitted very supportive reports from the claimant’s psychiatrist and therapist.  Nonetheless, it took a month and a half to obtain the approval because the decision had been pulled for quality review. 

 There is zero justification for quality reviews.  The fact that only awards are reviewed reveals that their purpose is not to attempt to improve that quality of the State agency decisions.  Rather, their purpose is to try to find some means to reverse the approval.  Just as the SSA is being called upon to eliminate the reconsideration stage of the hearing process, the SSA should also eliminate so-called quality reviews.