Quality Assurance Review Board???

[que1920]

What is the name of your state (only U.S. law)? Louisiana

I recently applied for social security in April 2010. I have been undergoing medical treatment for a bulging disc and hip pain since July 2009. They sent me to their doctor for a CE exam on 8/31/10. I have called several times to see if their is a decision of yet. I was told by one representative a decision was made on 9/3/10, but then it was randomly picked to be reviewed by the Quality Review Board. Does this mean I have been approved? Or, Should I begin seeking a lawyer. I'm in Louisiana.

 

[Swgfan]

At this point all you can do is wait and see because an ultimate decision has not been made yet.
If your curious what a "quality review" means, I copy and pasted this information for you and this should answer some of your questions. By the way, I'm from Louisiana myself, around the Alexandria area in the middle of the state.


Function
•The purpose of the Quality Review process is to make sure that the adjudicators and medical examiners that have processed the claim came to a legal decision in the case. It is a system of checks and balances within the Disability Determination Bureau to make certain the regulations governing disability allotments are being followed properly.

Process
•When a decision is made on a claim by the examiner and medical staff working on the case, it is either chosen for review or it continues on in its processing as an allowance or a denial. If it is chosen for review, a specially trained reviewer looks at every aspect of the claim for any discrepancies and comes to a final decision.

Considerations
•This reviewer may ultimately overturn the examiner's original decision, or the reviewer may ask for a more detailed investigation of an aspect of the claim. Often, the original decision is only under question because some aspect of the claim hasn't been thoroughly clarified. This may be either specific medical information such as blood tests, x-rays or CT scans or it may be third party accounts of daily functioning.

Time Frame
•When a claim is chosen for Quality Review, the claim will always be delayed somewhat in its processing. This delay may be only a few days, or it may last several weeks. Depending on the nature of the investigation required by the reviewers, and the difficulty in obtaining the needed information, claims can sometimes be delayed for months.

 

[que1920]

My Thanks

Thank you for taking out the time to respond to my question.


The entire process is quite confusing. I've been told that they only review claims when the examiner is trying allow benefits...