Disability Quality Branch Review: Will it Affect Your Benefits?

The Disability Quality Branch review is a process engaged by the Social Security Administration to ensure that examiners assessing disability claims follow policies and procedures when making a decision whether to approve or deny a Social Security Disability Insurance claim.

How Does it Work?

The disability quality branch occasionally and randomly pulls cases that have undergone processing or are engaged in any part of the processing stage, whether those cases were approved or denied. According to the Social Security Administration, approximately 1 in every 100 disability claims is pulled at random for review by the disability quality branch.

In some cases, overview and analysis of the disability claim process may be lengthened if the disability quality branch pulls your case. The branch typically spends between a couple of weeks to several months to fully review specific cases, and time spent on them depends on the complexity of the case.

The disability quality branch checks for accuracy, thoroughness, and technicalities in the disability insurance claim process. Technicalities such as inadequate information, lack of signatures, or so forth are common. The Social Security Administration's efforts to provide quality control is encouraging, but the process itself manages only to lengthen the time beneficiaries must wait for claims to be decided.

In many cases, the case reviewed by the disability quality branch is returned to the original case processor or disability office from which the claim originated. These returned cases must again be reviewed and adjusted according to comments provided by the disability quality branch. In addition, offices of the Disability Determination Service and disability insurance claims processors may receive poor marks for returned cases. Examiners with more than minimal "returns" on a yearly basis may find their jobs and positions in danger.

There is continued debate whether review by the disability quality branch functions more in the favor of disability insurance claim beneficiaries or the Social Security Administration's denial of such claims. While it's difficult to predict whether a case will be approved, denied or overturned depends on individual case scenarios as well as reliable and accurate information from medical providers, the beneficiary, and the completeness of records, data and information provided by all parties involved.

Where do Reviews take Place?

The Social Security Administration operates in regions. For example, your local Social Security office initiates the disability application process, and then your case is turned over to the Disability Determination Service. Disability quality branches are located in areas and regions throughout the US. For example, the disability quality branch located in Atlanta, Georgia services the southeastern region.

Yes, review by the board lengthens the time it takes to process a claim. In addition, yes, at times, the disability quality review board has denied disability claims which were previously approved. The best way to protect yourself from a denial of a disability claim, regardless of who reviews your case file, is to make sure it's accurate, complete, and contains all the information initially required by the Social Security Administration when filing for disability. Enlisting the help of a Social Security attorney can also improve your chances of being approved in the initial application stage.