What Social Security's shift to in-house reviews means for you

Social Security has moved the medical review process for disability claims entirely in-house, meaning the agency now handles all medical assessments itself rather than contracting with state agencies or private companies. This change affects how your medical evidence is evaluated, who reviews your case, and how long the process takes. The shift began in phases starting in 2022 and has now expanded across all states.

Previously, Social Security contracted with Disability information Services (DDS) — state agencies that employed doctors and psychologists to review medical records and decide whether applicants met the agency's medical criteria. Now Social Security employs its own medical and psychological consultants to do this work directly. The decision-making standard remains the same, but the people making the decisions and the systems they use have changed.

Key Takeaways

  • Social Security now employs its own doctors and psychologists to review medical evidence instead of using state-contracted agencies, a transition that completed across all states by 2024.
  • The medical criteria for approval have not changed — Social Security still uses the same Listing of Impairments to determine if your condition is severe enough to may have access to.
  • Processing times vary by state and current workload, so you cannot assume your case will move faster or slower just because reviews are now in-house.
  • You submit medical evidence the same way you always have — through your process, your representative, or your doctor — and the in-house reviewers see the same records the old system did.
  • If your claim is denied, you still have the right to appeal through the same process: reconsideration, hearing before an administrative law judge, and further appeals if needed.

How the in-house review process works

When you file for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) based on disability, your medical records go to a Social Security medical or psychological consultant who works directly for the agency. That consultant reviews your medical evidence against the Listing of Impairments — the official list of conditions that Social Security considers disabling. The consultant writes a report recommending approval or denial, which a disability examiner then uses to make the final decision.

The medical consultant does not examine you. They review only the medical records you submit, records your doctor sends, and records from hospitals or specialists you have seen. If Social Security believes it needs more medical information to make a decision, it may request that you see a doctor for a consultative examination — this part of the process has not changed. The consultant's job is to translate your medical records into a medical opinion about whether your condition meets Social Security's criteria.

Social Security has been hiring medical and psychological consultants across the country to handle this work. The agency has regional offices where these consultants work, and cases are assigned based on workload and specialty. A consultant reviewing a claim for severe arthritis is different from one reviewing a psychiatric condition, though both follow the same medical standards.

What has stayed the same in the approval process

The medical criteria for disability have not changed. Social Security still uses the Listing of Impairments — a detailed manual that describes what medical evidence is needed to prove a condition is disabling. Whether your case is reviewed by a state DDS doctor or a Social Security consultant, the standard is identical. Your medical records are still evaluated the same way, and the evidence needed to win approval is the same.

You still submit your process the same way: online through Social Security's website, in person at a local office, or by phone. You still provide medical records the same way: by authorizing Social Security to request them from your doctors, by submitting them yourself, or by having your representative send them. The in-house consultants see the exact same medical evidence the old system did.

Your appeal rights have not changed either. If your claim is denied, you can request reconsideration, then a hearing before an administrative law judge, then further appeals to the Appeals Council and federal court. The same evidence that would have won under the old system can still win under the new one.

Processing times under the new system

Social Security has not published a single national processing time for disability claims under the in-house system. The time it takes depends on how busy the regional office handling your case is, whether Social Security needs to request additional medical records, and whether a consultative examination is necessary. Some states have reported faster processing; others have reported delays as the agency hired and trained new consultants.

Initial claims typically took 3 to 6 months under the old system, though this varied widely by state. Early reports from the transition period suggest processing times remain in a similar range, but you should not assume your case will move faster just because reviews are now in-house. The bottleneck is often not the medical review itself but the time it takes to gather medical records from multiple providers.

If you want to know how long your specific case is taking, you can check your status online through my Social Security (the agency's online portal) or call your local Social Security office. They cannot tell you exactly when a decision will come, but they can tell you what stage your case is in.

Why Social Security made this change

Social Security moved to in-house reviews to reduce its dependence on state agencies and to standardize the review process across all states. Under the old system, different states had different staffing levels, different backlogs, and different approval rates for the same conditions — a person with the same medical evidence could be approved in one state and denied in another. Social Security argued that bringing reviews in-house would create more consistency.

The agency also cited cost and efficiency. Contracting with state DDS agencies meant Social Security paid for services it did not directly control. By hiring its own consultants, Social Security could manage the process more directly and adjust staffing based on its own workload forecasts.

The transition has been gradual. Social Security began piloting in-house reviews in some states in 2022, expanded to additional states in 2023, and completed the transition nationwide by 2024. During the transition, some states operated a hybrid system where both state DDS and Social Security consultants reviewed cases.

What to do if your claim is pending or has been denied

If you have a claim pending, your case is being reviewed under the new in-house system unless it was already decided before the transition in your state. You do not need to do anything differently. Submit medical records the same way, respond to any requests for information from Social Security, and keep your contact information current so the agency can reach you.

If your claim was denied and you want to appeal, the process is the same as it always was. You have 60 days from the date on your denial notice to request reconsideration. If reconsideration is also denied, you can request a hearing before an administrative law judge within 60 days of that denial. Many people hire a representative — either a lawyer or a non-lawyer advocate — to help with appeals, and representatives can charge a fee only if you win.

If you believe your case was mishandled or that medical evidence was overlooked, an appeal is your chance to present that evidence again. The administrative law judge will review your entire case from scratch, not just the parts Social Security's consultant reviewed.

How to find information about your specific case

You can check the status of your disability claim through my Social Security at ssa.gov. Create an account if you do not have one, sign in, and look for your claim status. The portal shows whether your case is pending, approved, or denied, and sometimes shows what stage it is in (medical review, decision pending, etc.).

You can also call Social Security's main number at 1-800-772-1213 to speak with a representative about your case. Have your Social Security number ready. If you are deaf or hard of hearing, you can use the TTY number 1-800-325-0778. Representatives can tell you what documents Social Security has received, whether more information is needed, and what happens next in your case.

If you have a representative — a lawyer or advocate — they can contact Social Security on your behalf and often get faster responses than you would calling directly.

Frequently Asked Questions

Will the in-house system approve or deny more claims than the old system?

Social Security has not reported a change in approval rates since moving to in-house reviews. The medical criteria are identical, so the same medical evidence that would have won approval under the old system should still win approval. However, approval rates vary by condition and by individual circumstances, not by which system reviews the case.

Can I request that a specific type of doctor review my case?

No. Social Security assigns cases to available consultants based on the type of condition and current workload. You cannot request a particular consultant or specialty, though Social Security will assign a consultant with relevant informed to your condition — a psychiatrist for mental health claims, for example.

Does the in-house system mean I will be examined by a Social Security doctor?

Not necessarily. The in-house consultant reviews your existing medical records. Social Security may order a consultative examination if it needs more medical information, but this happens under both the old and new systems. You would see a doctor Social Security refers you to, not a Social Security employee.

What if I disagree with the medical consultant's decision?

You can appeal. Request reconsideration within 60 days of your denial notice. If that is denied, you can request a hearing before an administrative law judge, who will review your entire case and can order additional medical evidence if needed. The judge's decision can overturn the consultant's recommendation.

Are there any states where the old system is still being used?

No. Social Security completed the transition to in-house reviews nationwide by 2024. All disability claims are now reviewed by Social Security's own medical and psychological consultants, not by state DDS agencies.