Medical Consultants in the DDS Office

Medical Consultants (MC) at the DDS office are medical doctors or psychologists employed by the DDS offices in each state, either as staff or as independent contractors.

They are trained by the SSA to do a paper review of the medical evidence that is present in a claimant’s file. Because of this special training, MCs have the authority to make disability determinations (i.e. assessments of your functional abilities) based on the evidence in your file which supports your claim for disability benefits.

Generally, MCs will review a case record only after all the medical information that is expected has been received and summarized by the Claims Examiner who manages your disability claim.

It is important that the disability examiner present a complete summary of all the pertinent factors that will be necessary for the Medical Consultant to reach a good determination of your abilities and residual functional capacity based on the evidence in file.

This case summary that the Claims Examiner writes up can be as long as it needs to be, but is generally no longer than one typed page. The summary is placed on a Residual Functioning Capacity Form (RFC) which Claims Examiners complete on the majority of claims alleging a physical impairment. The form is designed as an assessment tool that indicates a claimant’s remaining functional capacity based on their particular limitations.

Once the MC receives the claim record, he will review the completed RFC form which includes the case summary. After which, he will either concur with the assessment of the Claims Examiner or will revise the assessment based on his medical expertise.

MCs may also send the claim back to the claims examiner if they conclude more information or medical testing is needed to support a claims decision.

Medical Consultants work in conjunction with Disability Examiners to make a disability decision on your claim. After they have rendered a decision on how your medical condition affects your ability to function in various areas, the examiner takes these findings and then determines how your limitations affect you vocationally. They look at the functional requirements of your past jobs, jobs in the national economy, your age and education, and use the SSA Grid Rules to determine if you are or are not physically disabled.

A similar process occurs for claims alleging mental impairments, but a different assessment form is used, and the Medical Consultant reviewing the claim will be one trained in the assessment of mental disabilities.

Part 2 ...Consultative Examiners and Examinations in the DDS Adjudication Process

<< Previous    1  2  [3]  4    Next >>