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Gaining the Advantage: Understand the Adjudicator Mindset

Since I’m a highly analytical person, I still reflect back on my first hearing as a representative. I’m a lifelong learner, so it’s beneficial to reflect and challenge myself to constantly improve. Asking myself what needs to be changed is a prime way for me to use my previous experience as a Social Security Disability adjudicator to win more disability cases. In a previous post about transitioning from being a Social Security Disability adjudicator to a Social Security representative, I shared what I will do differently in upcoming hearings.

Not everything needs to be adjusted, however—it’s important to continue employing successful strategies, such as using the Disability Determination Explanation (DDE) to support our theory of the case. In fact, when you are at the hearing level, having been denied at the reconsideration level, the DDE is necessary to use in your argument. Moreover, the Disability Determination Explanation is an excellent tool that can emphasize some of the best evidence in your case. Here’s a little known fact I know from previously working as an adjudicator: Most Administrative Law Judges (ALJs) and adjudicators begin the case review by looking at the DDE. Let’s consider how understanding the adjudicator mindset is vital to winning cases and how you can use the DDE to your advantage.

The Adjudicator Mindset

When I worked as an adjudicator, I quickly learned time is a precious commodity within the Office of Hearings Operations (OHO). In order to save time, we started each case review using the Disability Determination Explanation. This was a clever starting point because many Disability Determination Services (DDS) provided a clear review of the facts and medical evidence as of the date of the determination. As an adjudicator, I frequently asked myself, “How far do I have to jump to an allowance from where the DDS left off?” In instances where the Disability Determination Services found no severe impairments, the jump to an allowance, from the perspective of OHO quality review, was huge. If DDS found severe impairments but misapplied the residual functional capacity to past relevant work, the leap was much smaller to an allowance, based on that finding specifically. Remember, many OHO adjudicators will start the review at the DDE before reviewing the evidence.

How to Use the Disability Determination Examination to Your Advantage

Using the Disability Determination Examination can be highly effective. Often, the Disability Determination Services minimizes or entirely dismisses evidence, such as obesity. Using the DDE enables me to emphasize the effects of that missing information on the case. To be fair, a lot of evidence comes in after the DDS determination, but this is precisely why the DDE is so important—it is used to show what new evidence has come in and how it significantly changes the DDS determination. It thus supports an allowance in the case. Indeed, I enjoy showing how Disability Determination Services has missed an impairment, minimized or ignored supporting evidence, completely misapplied the residual functional capacity and past relevant work at Step 4, and listed past relevant work that isn’t actually past relevant work. It is persuasive writing at its best!

So while some changes are beneficial, I certainly plan to continue using the Disability Determination Examination as a Social Security Disability representative. Remember, many adjudicators will begin reviewing the record at the DDE, and when you show the adjudicator why that determination is incorrect, it will be a powerful tool in winning your case!

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