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Author Topic: What is Quality Review?  (Read 29404 times)

SSDAdmin

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What is Quality Review?
« on: September 26, 2009, 07:21:02 AM »
Please share your experience if your case went to Quality Review.

What step in the process did your application go to Quality Review?

How long did it take?

What was the result? Did you find out the initial decision before it went to review?

Who does the review and how do they select the cases?
« Last Edit: August 14, 2012, 04:42:52 PM by Hyacinth »
I speak from experience not expertise.

SSDAdmin

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Re: What is Quality Review?
« Reply #1 on: January 03, 2010, 08:49:28 PM »
In a nutshell Quality Review is a check on random cases after a decision is made to make sure that a decision is correct and no mistakes were made. 

The DBQ or the Disability Quality Branch has the option of overturning the decisions made on the cases that are presented to them. 

This happens once a decision is made so ultimately the step in the process this happens is whenever a decision is made the case can go for review.

I was told it takes between 30 and 60 days for the review to take place but of course this information is subjective.

There is no way to find out what the initial decision was before it went to review.

I think this step is horrible.  It's bad enough to wait for a decision but to then have to wait for that decision to be reviewed must be almost too much to bear.
I speak from experience not expertise.

wanderer

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Re: What is Quality Review?
« Reply #2 on: January 20, 2010, 12:08:32 PM »
IF they have done their job properly then there shouldn't be an issue. I was approved, basically told that be the man that told my initial claim. Then it went to QR. I guess I was lucky in this case. I didn't like it, and worried, and I don't think they pull denials, just the approved cases.

Mark

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Re: What is Quality Review?
« Reply #3 on: January 20, 2010, 04:11:55 PM »
IF they have done their job properly then there shouldn't be an issue. I was approved, basically told that be the man that told my initial claim. Then it went to QR. I guess I was lucky in this case. I didn't like it, and worried, and I don't think they pull denials, just the approved cases.

I think they say that they pull "random" cases however the majority are approvals. 
They also say that the majority of those cases are Medical Vocational Allowances.
What that means is a case that was approved but does not meet Social Security's Official Listings of Impairments.
In most cases you would have to have a Disability that fits into their list of impairments.
But, if your examiner still feels that you have an ailment that would preclude you from "substantial gainful activity" basically working and earning above their standard.  Then they can still find you disabled.
Apparently that throws up a red flag and can send you to quality review. 
That said.  I don't see how they can say that the pulling of cases is random at all. 

knowsalittle

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Re: What is Quality Review?
« Reply #4 on: January 20, 2010, 04:46:28 PM »
O.K. 

What evidence do you have that cases are not pulled on a random basis???

Mark

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Re: What is Quality Review?
« Reply #5 on: January 23, 2010, 10:29:33 PM »
O.K. 

What evidence do you have that cases are not pulled on a random basis???

I probably should have said in the opininion of my Attorney. 
I also have read the same information many times on alot of different blogs and forums.
But, in the future I will be sure to state in, in my opinion or that of my Attorney.

junior

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Re: What is Quality Review?
« Reply #6 on: June 24, 2010, 04:32:38 PM »
IT IS THE LAW THAT CONGRESS PASTED SSA MUST REVIEW 50 PERCENT OF APPROVALS AT THE INIATIAL AND RECONSIDERATION LEVELS,WITH AND INFUSIS ON CASES WITH HIGH PROBILITY OF BEING INCORRECT.GOT THIS INFORMATION FROM SSA WEBSITE.
« Last Edit: June 24, 2010, 04:36:43 PM by junior »

Doc76013

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Re: What is Quality Review?
« Reply #7 on: June 24, 2010, 05:47:00 PM »
Juinor,
     That is totally correct, this happened over cases that had no reason to be approved being rubber stamped and sent either approved or denied. It is SSA's way of auditing the DDS. Thanks for the info.

Peace

Doc

xroadsgrad

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Re: What is Quality Review?
« Reply #8 on: June 24, 2010, 07:15:45 PM »
In a nutshell Quality Review is a check on random cases after a decision is made to make sure that a decision is correct and no mistakes were made. 

The DBQ or the Disability Quality Branch has the option of overturning the decisions made on the cases that are presented to them. 

This happens once a decision is made so ultimately the step in the process this happens is whenever a decision is made the case can go for review.

I was told it takes between 30 and 60 days for the review to take place but of course this information is subjective.

There is no way to find out what the initial decision was before it went to review.

I think this step is horrible.  It's bad enough to wait for a decision but to then have to wait for that decision to be reviewed must be almost too much to bear.


i was told yesterday that they have 30 days to issue a decision after going to the QAR , then today was told they have 60 days.. so who knows what the real deal is..

Doc76013

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Re: What is Quality Review?
« Reply #9 on: June 25, 2010, 04:58:47 AM »
In a nutshell Quality Review is a check on random cases after a decision is made to make sure that a decision is correct and no mistakes were made. 

The DBQ or the Disability Quality Branch has the option of overturning the decisions made on the cases that are presented to them. 


This happens once a decision is made so ultimately the step in the process this happens is whenever a decision is made the case can go for review.

I was told it takes between 30 and 60 days for the review to take place but of course this information is subjective.

There is no way to find out what the initial decision was before it went to review.

I think this step is horrible.  It's bad enough to wait for a decision but to then have to wait for that decision to be reviewed must be almost too much to bear.


i was told yesterday that they have 30 days to issue a decision after going to the QAR , then today was told they have 60 days.. so who knows what the real deal is..

That is correct they do have the option, however normally if your file was approved at the DDS it is likely to stay that way. I have known cases that were returned at 15 days, 30 days, but have not heard of any yet that went over the 30 days.

tpt3333

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Re: What is Quality Review?
« Reply #10 on: June 25, 2010, 08:07:59 AM »
how do you know if your case went into qr? i was bench approved at aj on april 1st. i have received 2 checks so far but i have not received my backpay. they say its in processing center. would they tell me if it was in QR. its been almost 90 days. im i just worrying too much that they are going to reverse my fully favorable dec.?

Doc76013

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Re: What is Quality Review?
« Reply #11 on: June 25, 2010, 08:17:36 AM »
how do you know if your case went into qr? i was bench approved at aj on april 1st. i have received 2 checks so far but i have not received my backpay. they say its in processing center. would they tell me if it was in QR. its been almost 90 days. im i just worrying too much that they are going to reverse my fully favorable dec.?


If you are receiving your monthly benefits then you have been approved. QR would be before any benefits would be paid, and yes the SSA would tell you however this at the time is not what you are in. The backpay will be forthcoming and congrats on your approval. Sometimes the backpay comes before the monthly other times after each situation is different. Again Congratulations.

Peace

Doc

williamNM

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Re: What is Quality Review?
« Reply #12 on: July 01, 2010, 04:37:12 PM »
Just found out today that my claim was sent to Quality Review.  I received this information when calling to check on my claims status - which was submitted March 21, 2010.  What's kind of unique about my claim is that it was filed under Compassionate Allowances and yes, my illness falls under this category.  The reasoning for compassionate allowances is to expedite disability claims due to the severity of one's health condition.

Thus far my claim has not been handled expeditiously - at all.  According to my case worker my claim was sent to Quality Review on the 25th of June.  I'll post any and all updates as they're received. 

So there you have it - even a claim filed under Compassionate Allowances can be randomly selected and sent to Quality Review - thus extending the determination process. 

Lucky me! 


Doc76013

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Re: What is Quality Review?
« Reply #13 on: July 01, 2010, 05:13:59 PM »
William.
   Did the rep tell you whether or not you had been approved at the DDS level ? If so then you are one of those fortunate people that will have a longer wait until your first CDR. Mine took about 15 days to complete and be sent back to SSA. I was approved and my number came up as to a QR. It usually takes from 15 to 30 days to complete and it is very unusual to have QR overturn a DDS decision.

Hope that helps

Doc

 

xroadsgrad

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Re: What is Quality Review?
« Reply #14 on: July 01, 2010, 07:56:36 PM »
i talked to ssdi again today on the 800-772-1213 line.. she was acting funny as if I should have received papers already from the state level? as if she thought i would have already gotten an approval letter , she paused for a minute or so then came back on, then she started acting nervous and went on to tell me that my papers have been at the QR since june 10,  for 21 days, and then she says it takes 60 days no matter what and I won't hear anything til august 9th.. is that the way it works.. i'm in california , is it different here?

 

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