TN 10 (02-02)
DI 39501.020 Federal/State Relationship
1. State entities
DDS - State Disability Determination Services
Parent Agency - the agency immediately above the DDS in the State hierarchy, which participates in management, decisions affecting the DDS
State Agency – that agency of a State which has been designated by the State to carry out the disability or blindness determination function. State agency may also denote the parent agency or whatever agency is above the parent agency in the State hierarchy depending on the circumstances.
State - any of the 50 States of the United States, the Commonwealth of Puerto Rico, the District of Columbia, or Guam. It includes the State Agency.
2. Federal entities
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
DDS's make determinations based on the law and regulations and on written guidelines issued by SSA.
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.”
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.
States have the option of administering the program in compliance with SSA's standards or ending their participation in the disability program.
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
The Commissioner is responsible for SSA's disability programs and operates under broad delegation from the President.
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.
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.
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:
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
Setting targeted levels of performance
Establishing a threshold level which clearly defines the lowest level of acceptable DDS performance
Creating a system of intermediate goals
Setting forth actions SSA will take to assure unacceptable performance does not continue.
4. Basic responsibilities of SSA
Work with the States to provide and maintain an effective system for processing claims
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.
Review regulations and other written guidelines periodically to insure effective and uniform administration of the disability program
Provide training materials--and in some instances--conduct or specify training as required by the regulations
Provide the State Agency with funds for necessary costs in making disability determinations based on submitted estimates and available funding.
Monitor and evaluate DDS performance
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
Make timely and accurate disability determinations
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
Provide management needed to carry out the disability determination function
Provide organizational structure, facilities, qualified personnel, medical consultant services and a quality assurance function
Furnish timely reports and records
Submit reports of expenditures as required
Cooperate with audits
Ensure that all applicants for and recipients of disability benefits are treated equally and courteously
Maintain property and equipment used for disability program purposes
Safeguard records created in making disability determinations
Take part in research and demonstration projects
Maintain liaison with the medical profession and organizations that may facilitate performing disability determination function
Assist SSA in other ways SSA determines may promote the objectives of effective and uniform administration
Establish cooperative working relationships with other agencies concerned with serving the disabled.