From the Web site of the Texas Department of Assistive and Rehabilitative Services:
The Department of Assistive and Rehabilitative Services, or DARS, administers programs that ensure Texas is a state where people with disabilities, and children who have developmental delays, enjoy the same opportunities as other Texans to live independent and productive lives.
The department has four divisions:
- Rehabilitation Services
- Blind Services
- Early Childhood Intervention Services
- Disability Determination Services
The Disability Determination Services department is the one involved in deciding whether Social Security disability applicants qualify for benefits. The department has a very good question and answer section on their Web site, and I am going to reproduce it here in order to help Social Security disability applicants:
The DARS Division for Disability Determination Services (DDS), funded entirely through the Social Security Administration (SSA), makes disability determinations for Texans with severe disabilities who apply for Social Security Disability Insurance and/or Supplemental Security Income. Texans with disabilities apply for benefits at their local Social Security Office and their applications are forwarded to DDS for a disability determination; however, SSA is responsible for making final decisions as to whether or not a person is eligible to receive benefits.
To apply for disability benefits, call the Social Security Administration at 1-800-772-1213 or visit their website at www.ssa.gov to learn more about the application process for disability benefits. If you have already filed a disability claim with Social Security, you may contact Disability Determination Services about processing your claim at 512-437-8000 or 1-800-252-7009 with information or questions concerning your claim.
Frequently Asked Questions about DDS
Following are some answers to frequently asked questions about DDS and the disability determination process.
- “I had a heart attack two months ago and am now disabled. My doctor tells me not to work. What can I do?”
- “My spouse died last year. I can’t work because of arthritis. Can anyone help me?”
Often you may hear questions like these about disability. This page explains what you should know about the disability program administered by the Social Security Administration. It also describes the agency in Texas responsible for making disability decisions – Disability Determination Services, a division of the Department of Assistive and Rehabilitative Services.
The Social Security Administration administers two disability programs which help people who are unable to work because of severe physical or mental impairments. They are designed to replace part of the income you and your family lose if you become disabled. Many times a person qualifies to apply for both of these programs.
The first program is Social Security Disability Insurance (SSDI). It is related to work. A person earns coverage for themselves and family members by paying Social Security tax. The program covers workers who are disabled, disabled widows/widowers and disabled adult children of workers.
The second disability program is Supplemental Security Income (SSI). It is related to means – what you have or own. If you do not own much or have much income, you may be able to qualify for this part. Income and resources possessed are considered. This program covers adults and children who are eligible.
Federal law and the Social Security Administration provide the instructions used to determine whether a person is disabled. Therefore, a person filing for disability in Rhode Island is evaluated using the same guidelines as a person filing in Texas.
“What is a disability?”
From the Social Security Administration website:
The definition of disability under Social Security is different than other programs. Social Security pays only for total disability. No benefits are payable for partial disability or for short-term disability.
Disability under Social Security is based on your inability to work. We consider you disabled under Social Security rules if you cannot do work that you did before and we decide that you cannot adjust to other work because of your medical condition(s). Your disability must also last or be expected to last for at least one year or to result in death.
This is a strict definition of disability. Social Security program rules assume that working families have access to other resources to provide support during periods of short-term disabilities, including workers’ compensation, insurance, savings and investments.
For more specific information about the disability program, please consult the Social Security Administration website (www.ssa.gov).
“How do I apply for Social Security disability benefits?”
Texans with disabilities contact the Social Security Teleservice Center (1-800-772-1213) or the local Social Security field office. The field office phone number can be found in the blue pages under “Government Offices – United States – Social Security Administration.” You can also apply online at www.ssa.gov. You will be asked to complete forms about your condition. Persons at the Social Security office will be able to help you with these. The forms will ask you to:
- describe your condition;
- tell how it prevents you from working;
- list doctors who have treated you – name, address, telephone number, dates of treatment;
- explain past work activity;
- authorize release of medical information to Social Security and its agent, Disability Determination Services.
Then Social Security office personnel mail these completed forms to the DARS Division of Disability Determination Services in Austin.
“How is my application processed?”
When your application is received, it is assigned to a trained Disability Examiner. The examiner reviews the forms and writes your medical sources to obtain medical evidence. Your doctors are asked:
- What is wrong with you?
- When did the condition begin?
- How does the condition limit your activities?
- What have medical examinations and tests shown?
- What treatment has been provided?
Your doctor is not asked to decide whether you are disabled. The decision is made by a state agency team which includes a disability examiner and a medical consultant.
Usually the examiner receives enough evidence from your sources to make a decision. If more evidence is needed, a special examination is arranged and paid for by the Disability Determination Services with funds from the Social Security Administration. In many cases, you will be asked if you want your doctor to do the examination.
After all the needed evidence is obtained, the examiner and medical consultant consider all the facts in the case:
- how severe the condition is,
- when it began,
- how long it has lasted,
- how it affects your ability to work,
- your age, education, and work experience.
They decide whether you are disabled, as defined by the Social Security Administration. Your case may then be randomly selected for a quality review by Social Security staff in Dallas or Baltimore. After completion of the review process, the case is sent to your Social Security office. You will receive a letter about the decision from Social Security.
“How long does it take to make a decision?”
It usually takes several months to make a decision. The time frame varies a great deal, depending on how quickly your medical sources respond to requests for records and the need for special examinations.
“If I want information about my case, who do I call?”
If you think your case is pending in Disability Determination Services, contact the Disability Examiner at 1-800-252-7009 (toll free). If your case is no longer here, contact the Social Security Administration at
1-800-772-12 (toll free).
If you have an attorney or representative handling your case, that individual should contact Disability Determination Services Quality and Inquiries Services at 1-800-252-7009. This department also handles contacts from members of Congress, state legislators, public officials, and the media.
“What benefits do I receive if I’m found to be disabled?”
Social Security pays monthly checks to qualified people with disabilities. If you applied under the work-related program (SSDI), monthly checks begin after a five-month waiting period for disabled workers and disabled widows/widowers. (There is no waiting period for disabled adult children.) You will receive Medicare benefits after receiving checks for two years.
If you applied under the means-related program (SSI), there is no waiting period before you start receiving monthly checks. You will usually receive Medicaid as soon as the application is approved.
“What can I do if I disagree with the decision?”
The Social Security Administration has a specific appeals process. That means if you disagree with the decision, you can ask us to look at your case again. If our decision was wrong, we will change it. When we look at your case again, we look at all parts of it including those which were favorable to you.
Contact the Social Security Administration when you receive the letter about your decision. Ask that your case be reconsidered. You must appeal the decision within 60 days from the day you receive the letter. You will be asked to fill out some more forms, telling us about any changes in your condition and any new medical treatment.
The reconsideration case is then returned to Disability Determination Services where it is handled by a different examiner and medical consultant. Once again medical evidence is obtained. All evidence from the original decision and any new evidence is considered. An independent decision is made.
Some of the reasons to request reconsideration are:
- The condition is more severe than determined.
- The condition has lasted longer than expected.
- The condition has worsened since the decision.
- The condition became disabling earlier than determined.
- Another condition developed which complicates the first condition.
“If I’m found to be disabled, how long do I receive benefits?”
Once benefits begin, they will continue as long as you are still disabled and not working.
The Social Security Administration reviews all allowed cases on a schedule to see whether disability continues. The time of the review depends on these aspects of the condition:
- Is it expected to improve? Review in 6-30 months.
- Is it possible that it will improve? Review in 3 years.
- Is the condition permanent? Review in 5-7 years.
When it is time for the review, your case is sent to the local Social Security office. You will be asked to come in for an interview. The office personnel will help you complete forms asking about:
- your original condition,
- any changes in the original condition,
- new conditions since you were allowed,
- recent medical treatment,
- ability to work because of the condition,
- work activity since you were allowed benefits.
Your case is then sent to Disability Determination Services. An examiner will obtain medical evidence to see whether your condition has improved. The examiner and a medical consultant will decide whether you are still disabled, as defined by the Social Security Administration. If your condition has not improved or if the improvement still does not enable you to work, your benefits will continue. If improvement has occurred and you are able to work, benefits will stop.
“Will I be told when my checks will stop?”
Yes. If you are found to be no longer disabled, Social Security will send you a letter. That letter will tell you when you will stop receiving checks. You will receive a check for the month we find that you are no longer disabled. You will also receive checks for two additional months. For example, if you are no longer disabled in January, you will receive checks for January, February and March.
“If I believe that I am still disabled, can I appeal?”
Yes. There is an appeal process which you can use. By contacting the Social Security Administration (1-800-772-1213), you can ask that you case be reconsidered. After completing necessary forms, the case is sent to Disability Determination Services for a decision. Medical evidence is obtained. If it is proposed that benefits should stop, you will be offered a face-to-face hearing with a Disability Hearings Officer. Once a reconsideration decision is made, there are three more steps you can pursue if you disagree with the decision:
- a hearing before an administrative law judge,
- review by Appeals Council,
- lawsuit filed in federal district court.
“If I feel able to return to work while I am receiving benefits, what should I do?”
If you feel able to return to work, you should contact the Social Security Administration. Also contact the Social Security Administration if you actually return to work while receiving benefits.
“If I feel able to return to work, can I get help in finding a job?”
Yes. First, you can inquire into services through our “ASK US” link. Or, you can look in your telephone directory for the nearest office of the DARS Division for Rehabilitation Services, found in the blue pages under state agencies. A list of all of our offices can be found via our “Offices” link.
If you are unable to locate an office in your community, call the Consumer Assistance and Referral office of the DARS Division for Rehabilitation Services (DRS) at 1-800-628-5115 (toll free).