When a person applies for disability benefits under the SSA programs, they must state what medical problems they have that are disabling and who has been treating them for these. They are also required to give their work history and discuss how the medical problems have affected their functioning.

The initial application is made to the State Disability Determination Services (DDS) in the state where the claimant resides. The DDS investigates the claim by obtaining copies of medical records and by verifying work history and FICA payments. If the claimant does not have a doctor or if there is not an adequate evaluation in the records, then DDS must arrange for a medical exam at DDS expense. Usually, the DDS has a group of physicians in various specialties who know the requirements of the program and who regularly do consultative exams for the program.

Once the medical evidence (records) is received, it is given to a physician to evaluate. This physician is an employee or contractor of the DDS who only sees the records. If the physician knows the claimant or has cared for him or her in the past, then this physician does not process the case.