The Life of a Social Security Disability Examiner
When I first became a disability examiner, I had a general idea of what I was going to be doing. However, I didn't have a true understanding of what I actually signed up for. I didn't understand the gravity of what I was actually hired to do. I would be making disability decisions for adults and children that lived in and around my community. Little did I know, I was hired to change the lives of people I knew very little about outside of the reports and records I was able to obtain about them.
During the first few months, I spent all my time training. Prior to this, the longest training I had been apart of to get ready for a position was about a month. This training officially lasted for 3 months, but that was only enough training to actually learn the process of working a disability claim. Training primarily consisted of reading The Blue Book, reading POMS, and shadowing more experienced disability examiners. During that time, I was sparingly assigned cases to see if any of the information that was being thrown at me actually caught on.
After training, I was assigned to a unit. From that point on, I was in regular rotation. I was assigned 3 new cases per day. While the circumstances of each case were different, the process we followed in processing those claims were basically the same. Send an introduction letter; make an initial contact phone call to the claimant; send out questionnaires, request medical records from all the sources listed on the application, contact the Social Security field offices to clear up any discrepancies on the application, and so forth. These steps are discussed in more detail in The Process section of this site. For the average disability claim, the claimant, an individual filing whose Social Security disability claim you're working, would have at least 3 medical sources that I would have to request medical records for. This is the part of the job that seasoned disability examiners would hint about but wouldn't outright tell you. The true work of a disability examiner is the one who can manage, read, and analyze the enormous amount of reports that will be headed their way.
Being in full rotation meant that we were receiving 3 new cases with at least 3 medical sources per case. The numbers began to pile up from there. For a full week's worth of intake, a disability examiner will inherit about 40 medical reports of varying sizes from a few pages to a few hundred pages. After a month, those 40 medical reports would blossom to 160-200. Your caseload would have at least 50 cases in it. For an inexperienced disability examiner, it is very difficult to figure out what's relevant and what's not in the mountain of medical reports in front of them. You don't want to spend too much time one medical report because you have hundreds more waiting for you to review. You don't want to go too fast and miss the essence of the claimant's condition and the few pages you skimmed over and didn't fully analyze were the few pages that could have gotten that claim off of your desk in a few hours as opposed to a few months. This is the hardest part of an examiner's job to master. I know examiners who have been working cases for years that still haven't mastered this skill. In order to be efficient and keep your sanity, this is a skill that must be learned as soon as possible.
On top of reviewing, analyzing, and summarizing medical records, disability examiners have to review claimant's work history and daily activity questionnaires. Some claimants do not understand the importance of these forms and will give you one word answers when the question clearly asks for detail, so you have to stop and make a phone call to get additional details or clarification. Unfortunately, the same claimant that didn't care too much about completing that form correctly is also the claimant that refuses to answer your calls. The secondary contacts they provided on the application do not answer their calls either, so you're forced to calendar a call back for this claimant. Next thing you know, a week has passed an after multiple phone calls you haven't been able to get anyone on the phone. Now, you're forced to send a call in letter and wait another 5-10 days for a response. After multiple attempts to get in contact with the claimant, you discuss the case with your specialist as you feel you've made sufficient attempts to get in contact with the claimant to no avail. Your specialist advises you to make one more attempt, you do so and to your surprise the claimant answers. You attempt to get everything you need from the claimant so that you have no need to call back. You hang up and go back to processing the claim. You come back from lunch and you receive the claimant's last piece of medical. On the first page, the history notes say the claimant has gone back to work. You look through the rest of the file to make sure you didn't overlook this. You didn't, but now you have to find out everything you can about this work before you can finish processing the claim. You call back and you have hearing the following message "The number you have called is unavailable." I give up!
That situation happens all too often. It is one that will spoil a day's worth or productivity and it takes away from cases that could have been closed. Most disability examiners work an 8-hour shift. During that time, the examiner will get to look at about 30 of the 150 cases that are in their caseload. On average, a disability examiner will spend between 3-4 hours in total gathering all of your evidence, reviewing your medical records, analyzing your medical conditions, and generating your decision notices. Time is a luxury disability examiners do not have.
So where's the silver lining? Unfortunately by the time an examiner has figured out a system that somewhat works for them, a year has passed, their caseload is sitting around 160 claims, and the powers that be are breathing down your neck to get your average processing time down and your total pending below the office average. You have cases in your caseload that are aging (processing time has exceeded 120 days) sometimes through no fault of your own. You spent the first 100 days playing phone tag with the claimant while trying to collect all of the medical reports from the sources listed on the application only to find out there's not enough information in the file to make a decision. At this point, an examiner is forced to schedule an examination for the claimant. However, the appointments are backed to the point where the first available date for your claimant is 30-45 days out. It could get very discouraging to see cases you know how to process and close age because the system doesn't have the resources to get an appointment scheduled sooner than a month.
At my worst point as a disability examiner, I believe I was working around 145-150 cases at one time. This was during my the tail end of my first year leading into my second year. While I thought I still didn't have a firm grasp as to what I was actually doing when processing claims, I was granted single decision maker privileges and moved to another unit. I spent a about a year and a half in my new unit. Almost two years in, I was still learning the system and trying to find ways to improve my efficiency. During the middle of my third year, I was assigned to a new unit, the QDD unit (Quick Disability Determinations). It was in this unit where the gravity of what I was actually doing as an disability examiner hit me.
The QDD unit was formed to process claims for individuals who were diagnosed with terminal illnesses, rare diseases, and advanced stages of cancer. The goal for processing QDD cases was to get them in and out in less than 30 days. For the most part, I was able to meet this goal. However, this was the hardest year and a half I spent working at the disability office. I was getting to see through medical reports and conversations with my claimants the worst medical conditions an individual could possibly suffer from. Some of my claimants died before I could make a decision on their claim. While I never met most of my claimants, I would mourn their losses as if I had known them. Was there something I could do to process these claims faster? Probably, but I had to stop beating myself up and come to the realization that I was only one person and I would get cases out as fast as possible. If I had let my cases continue to weigh me down, I could not effectively do my job and be of service. That would have affected my claimants more than my meeting my processing times. While it was very demanding and sometimes depressing to work in this unit, my knowledge and application of the rules and regulations of the entire disability program increased dramatically. My average processing time went from around 80 days per claim to less than 60 days. During my most productive week as a disability examiner, I closed over 35 claims. I consistently had the lowest processing time and the lowest pending caseload in the entire office. I was able to identify in minutes rather than hours or days what needed to be done on a claim and the quickest and most cost efficient way to get it done.
I spent the rest of my career as a disability examiner floating around the units helping examiners decrease their overall caseloads and helping the office reduce its aged case log. Despite my efforts, I didn't make the impact I would have liked to. Examiner caseloads were and still are out of control. Some examiners are still having difficulty determining what's actually a disability and what isn't. Pretty much every level of the disability process has a backlog, which is only compounding this problem. Wait times are getting longer and longer. The unfortunate truth about all of this is the work force is at every level is overwhelmed and overworked. The end result is claimants have to wait forever to get a decision. The unfortunate by product is some of these individuals will lose their homes, independence, and in worst cases their lives waiting for the system to get its act together.
To the disability examiners are who still fighting the good fight and are doing the job because of its importance and not just for the paycheck, I want to thank you. Without the work you do, countless Americans would lose more than they already have.
