Section 221(a) and 1633 of the Social Security Act as amended provides that disability
determinations will be made by the State unless it notifies the Commissioner, in writing,
of its wishes to no longer make the determinations.
1. Federal/State structure
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DDS's make determinations based on the law and regulations and on written guidelines
issued by SSA.
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SSA pays 100 percent of necessary costs incurred by the States performing the disability
determination function. See DI
39506.001B. for details on what constitutes “necessary costs.”
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Effective June 1, 1981, DDS's make disability determinations in compliance with regulations
containing performance standards and other administrative requirements and procedures
relating to the disability determination function.
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States have the option of administering the program in compliance with SSA's standards
or ending their participation in the disability program.
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The Commissioner may end a State's participation in the disability programs because
of failure to meet established standards.
2. Roles and responsibilities for administering SSA's disability programs
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The Commissioner is responsible for SSA's disability programs and operates under broad delegation
from the President.
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The Associate Commissioner for Disability plans, develops and evaluates policies and guidelines used by State, Federal, or
private contract providers which implement the disability provisions of the Social
Security Act as amended.
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The Regional Commissioner (RC) serves as the principal SSA officer at the regional level. The RC manages and directs
SSA regional operations in accordance with national standards and policies.
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The Center for Disability within the SSA regional office coordinates disability activities at the regional
level.
3. Implementation of performance standards of regulations
SSA's approach for implementation of the performance standards is directed toward
improving the overall administration of disability programs as follows:
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Establishing administrative requirements that provide the States with management flexibility--while
at the same time enabling the Commissioner to carry out his/her program stewardship
responsibilities--thus setting up the framework for the Federal/State partnership
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Setting targeted levels of performance
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Establishing a threshold level which clearly defines the lowest level of acceptable
DDS performance
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Creating a system of intermediate goals
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Setting forth actions SSA will take to assure unacceptable performance does not continue.
4. Basic responsibilities of SSA
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Work with the States to provide and maintain an effective system for processing claims
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Provide program standards, leadership, liaison, and oversight. SSA will not become
involved in the State's ongoing management of the program except when necessary because
of inadequate State performance.
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Review regulations and other written guidelines periodically to insure effective and
uniform administration of the disability program
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Provide training materials--and in some instances--conduct or specify training as
required by the regulations
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Provide the State Agency with funds for necessary costs in making disability determinations
based on submitted estimates and available funding.
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Monitor and evaluate DDS performance
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Maintain liaison with the medical profession nationally and with national organizations
and agencies whose interests or activities may affect the disability program.
5. Basic responsibilities of the State
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Make timely and accurate disability determinations
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Comply with regulations, rulings and other written guidelines, including standards
established by SSA, and other provisions of Federal law and regulations that apply
to the State in performing the disability determination function
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Provide management needed to carry out the disability determination function
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Provide organizational structure, facilities, qualified personnel, medical consultant
services and a quality assurance function
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Furnish timely reports and records
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Submit reports of expenditures as required
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Ensure that all applicants for and recipients of disability benefits are treated equally
and courteously
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Maintain property and equipment used for disability program purposes
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Safeguard records created in making disability determinations
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Take part in research and demonstration projects
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Maintain liaison with the medical profession and organizations that may facilitate
performing disability determination function
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Assist SSA in other ways SSA determines may promote the objectives of effective and
uniform administration
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Establish cooperative working relationships with other agencies concerned with serving
the disabled.