How a Disability Determination is Made

If you apply for benefits for any of the programs described on our home page your claim will first be reviewed to determine if non-medical eligibility requirements are met. That review is done by the Social Security Administration (SSA) or State of Wisconsin agencies. If you are eligible, your application is sent to the Disability Determination Bureau (DDB) for a medical determination of disability.

At the DDB:

  • We collect medical evidence from your doctors, clinics, and hospitals along with other information about your condition.
  • You may be asked to provide information about your daily activities and work history.
  • You may be asked to have a medical examination, free of charge, if your existing medical records do not provide sufficient information for our evaluation.
  • Disability examiners and medical professionals at the DDB evaluate the evidence to decide if you are disabled based on SSA’s definition of disability.

The Definition of Disability:

For both SSA and State of Wisconsin benefit programs the definition of disability, as defined by the Social Security Act, is used. The definition of disability for adults states that an individual must have a severe disability (or combination of disabilities) that has lasted, or is expected to last, at least 12 months* or result in death, and which prevents working at a "substantial gainful activity" level. The definition of disability for children states that the child must have a physical or mental condition(s) that very seriously limits his or her activities; and the condition(s) must have lasted, or be expected to last, at least 12 months or result in death.

*SSA’s definition of disability does not permit benefit payments for impairments that will not last 12 continuous months.

How You Can Help the DDB Process Your Claim

  • On your application for benefits provide complete names, addresses, and dates of treatment for doctors, clinics, hospitals, and other health professionals who have treated you for your medical conditions.
  • Be sure the DDB has your current address and phone number. Any time your address or phone number changes after you've filed your disability application, DDB needs to know. Call 1-800-423-1938 to report these changes.
  • If you see a new healthcare provider, are hospitalized, or develop new conditions, please let the DDB know. You can report changes to the number provided above.
  • Complete and return any forms the DDB send to you as soon as possible.
  • Attend all medical examinations the DDB schedules for you. The DDB needs the findings from these examinations to determine the full extent of your condition and how it affects you.
Last Revised: June 9, 2017