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Approved for SSDI/SSI, but Selected for Review?

Seattle, WA |

I was told verbally by DDS and local SSA office that my disability application was approved. However, I was picked for an OPQ review.

How often are approvals overturned in this review? Could my young age and high education level potentially be used against me?

Also how long does this review typically hold up the process? One person @ SSA said 7-10 days, another said there is no way of knowing.

Thank you very much for your time and consideration!!

The SSA office said I was randomly selected for a review by the Office of Quality Performance. This was after I was found medically eligible for SSDI/SSI. Thanks

Attorney Answers 5


SSA says they do most reieiws in 30-60 days and that over 90 percent are upheld. Age and education are certainly relevant vocational factors that are considered.

The information you obtain from this website is not legal advice.

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I am unfamiliar with the term OPQ review. However, from the sound of your situation, it sounds like the case has been selected for a quality review. (At least that is how the DDS's in my are refer to them).

Quality reviews are extremely common at the DDS level. I have been told by examiners in the states where I practice (Tennessee and Mississippi) that there is a near 100% rate of review for favorable determinations. (I assume the same is the case for Washington state, though I do not practice there.) Sometimes, they result in a reversal of a favorable determination. Sometimes, the award goes through.

As far as an overall reversal rate from quality reviews, I have never seen any hard numbers on that. I can tell you from my experience with my clients, probably one in five will be reversed. There is really no way of telling you how likely it is that you will have your case ultimately denied in this situation. Yes, factors like age and educational level play a role in these determinations, but that are certainly not the only thing that DDS is using to make their determination.

If you are ultimately denied, I think it is important that you do not get discouraged and give up. There are real institutional pressures on the state DDS's to deny. The claims that they allow are clear and obvious cases of disability. The fact that they are close to awarding you, tells me that you likely have a case that an ALJ would pay at hearing. If you are denied, you need to consult an attorney in your area. Though there are good national firms, as a rule I think you will be better off with a local attorney in a case like this. I would consult with NOSSCR to see which of there members are practicing in Seattle.

Best of luck.

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Two of my clients have been through this. The length of your wait can vary widely; one client waited three months and then the approval was "approved" and went forward. The other client waited a year and had the approval overturned. Yes, I think that your youth was quite likely a reason that your application was pulled for review (this is known as a quality control review) but it won't necessarily affect the outcome. If you don't already have an attorney representing you, I recommend that you get a good local social security attorney to represent you.

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So long as you have not been working and your health has not improved, you shouldn't worry. The length of process like anything depends on many factors - backlog, who is reviewing the file, etc.

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This is a quality review. It's pretty common. It varies so much case by case that it's hard to give you solid answers on time or your chance of reversal. If it reversed, I recommend you seek an attorney to assist you in the appeal process.

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