What Is an Adjudicator?

DefinitionsRules and Regulations
Written By Jacky Writes

Understanding the Decision-Makers in the SSDI Process

In the Social Security system, “adjudicator” is not a single job title—it is a functional term for anyone authorized to make a formal decision on your claim.

Before diving into the technical details, it helps to understand the word's everyday meaning. Dictionaries define the verb adjudicate as making a formal judgment on a disputed matter. While this sounds like the work of a judge, not all adjudicators sit in courtrooms. In plain English, an adjudicator is simply a "decision-maker"—a person trusted to look at the facts, apply the rules, and reach an official conclusion.

The Social Security Administration (SSA) adopts this broad definition in its internal policy manual (POMS GN 01010.001). The manual defines adjudication as the specific act of applying the law to the facts to issue a determination. Consequently, an adjudicator is any employee empowered by the Commissioner to approve or deny benefits.

Here is the exact definition from the SSA policy manual:

"An adjudicator is an employee with delegated authority from the Commissioner of Social Security to approve or disapprove applications for Social Security benefits. Adjudicators are title II and title XVI Claims Representatives (CR), title II Claims Authorizers (CA), and other personnel with specifically delegated authority." (POMS GN 01010.001, emphasis added)

This definition covers a wide range of officials. It includes the Claims Representatives in local field offices who review your work history and income, as well as the Disability Determination Services (DDS) examiners, Hearing Officers, and Administrative Law Judges who evaluate your medical condition. Understanding who these different decision-makers are can make the complex SSDI process feel much clearer.

How SSA Uses the Term “Adjudicator”

For Social Security, 'adjudicator' describes what a person does, not just their specific job title. These employees usually work in field offices (FOs) and processing centers (PCs) and sign the official adjudicative screens (decision-making computer screens) and forms that put a decision into effect.

At the same time, the federal regulations use more specific titles—such as:

  • DDS disability examiner

  • Disability hearing officer (DHO)

  • Administrative Law Judge (ALJ)

  • Appeals Council judges/administrative appeals judges

All of these are adjudicators in the broader sense: they evaluate evidence and make formal determinations or decisions under SSA’s rules. The exact label depends on which stage of the SSDI process you’re in and which part of SSA is handling your case.

Below is a simplified guide to the main adjudicators you may encounter.

Types of Adjudicators in the SSDI Process

1. Field Office & Processing Center Adjudicators (Technical / Non-Medical Issues)

Before your case ever reaches DDS or a judge, SSA field offices and processing centers handle “technical” eligibility and entitlement issues.

Who they are

  • Claims Representatives (CRs) in field offices

  • Claims Authorizers and related staff in processing centers

What they do

  • Take and develop your SSDI application

  • Verify non-medical eligibility factors (insured status, work credits, dates, etc.)

  • Apply SSA entitlement rules and sign the decision computer screens and forms that authorize the initial determination on those issues

According to POMS GN 01010.001, these Field Office Claims Representatives and Processing Center Claim Authorizers are adjudicators because they have delegated authority from the Commissioner to approve or disapprove applications and to sign the official decision screens and forms.

Important:
These Claims Representatives and Claims Authorizers generally do not decide whether you are medically disabled under SSA’s definition—that medical determination is made by DDS, DHOs, ALJs, or the Appeals Council. You can read more about medical decision adjudicators below.

2. DDS Disability Examiners (Initial & Reconsideration Levels)

DDS Disability Examiners are the case specialists responsible for evaluating your claim at the Initial and Reconsideration levels. They are the primary individuals tasked with answering the medical question: “Is this person disabled under Social Security rules?” They have different responsibilities than the Claims Representative.

These DDS examiners work for Disability Determination Services (DDS). DDS offices are state-level agencies that make disability determinations on behalf of the Social Security Administration. Even though examiners are state employees, they are required by law (20 C.F.R. § 404.1503) to follow federal regulations when deciding your case.

These SSDI claims examiners act as project managers for claims. Their specific duties include:

  • Collecting medical records and relevant evidence.

  • Applying the SSA’s five-step sequential evaluation process.

  • Scheduling Consultative Examinations (CEs) if the file lacks sufficient medical evidence.

  • Drafting the official written determination and rationale.

The Adjudicative Team: It is important to note that the DDS Examiner generally does not make the final medical decision alone. According to POMS DI 24501.001 and 20 C.F.R. § 404.1615, they work as part of an adjudicative team alongside a Medical or Psychological Consultant (a licensed doctor employed by the agency), with exceptions for some extreme cases.

  • The Examiner manages the case, assesses vocational factors (age, education, work history), and applies the legal rules.

  • The Consultant reviews the medical evidence to validate the severity of the condition.

In most cases, both must sign the determination to create a legally binding decision.

3. Medical & Psychological Consultants (MCs / PCs)

These are licensed physicians, psychologists, and certain other qualified specialists who are part of the DDS adjudicative team.

What they do

20 C.F.R. § 404.1616 and POMS DI 24501.001 describe MCs and PCs as members of the team that makes disability determinations, with responsibility for the medical portion of the case.

In most cases, MCs and PCs do not make the overall disability decision by themselves. They complete the medical portion of the file—often including residual functional capacity (RFC) assessment forms—and their opinion becomes part of the evidence the DDS disability examiner uses, along with the rest of the medical records, work history, and other information in the file, to decide whether someone is disabled under SSA’s rules

4. Disability Hearing Officers (CDR Medical Cessation Hearings)

If SSA decides your disability may have improved after you have already been approved for benefits, it can start a Continuing Disability Review (CDR). When SSA (through DDS) proposes to stop your disability benefits for medical reasons, you generally have the right to ask for reconsideration of that cessation, which in medical CDR cases includes a disability hearing with a Disability Hearing Officer (DHO).

Who they are

Disability Hearing Officers (DHOs) are experienced disability adjudicators with special training in CDR cases.

They must be independent of the original cessation decision, meaning they were not involved in the earlier determination that your disability ended. (See POMS DI 33001.001 and DI 29001.005.)

What they adjudicate

DHOs primarily handle medical cessation cases in CDRs—that is, situations where SSA says you are no longer disabled under its medical rules.

They may also decide certain related issues, such as some adverse reopenings of prior favorable CDR decisions, as outlined in POMS DI 33001.001 and DI 29001.005.

Under 20 C.F.R. §§ 404.914–404.917, your disability hearing is conducted by a DHO, who:

Reviews your file and any new evidence you submit

Holds an informal, non-courtroom hearing where you can explain your situation and present additional information

Weighs the updated medical evidence and any testimony

Issues a written reconsidered determination on whether your disability continues or has ended

If you disagree with the DHO’s reconsidered determination, you can appeal and ask for a hearing before an Administrative Law Judge (ALJ).

5. Administrative Law Judges (ALJs)

If you appeal beyond DDS (or beyond a DHO decision in a CDR case), the next step is a hearing before an Administrative Law Judge.

What they do

  • Conduct a de novo (fresh) hearing

  • Take testimony from you and any witnesses (e.g., vocational or medical experts)

  • Review all medical and vocational evidence

  • Issue a new, independent decision

ALJ responsibilities and hearing procedures are governed by 20 C.F.R. §§ 404.929–404.953. ALJs are among the most visible adjudicators in the SSDI system and have broad authority to re-decide your case at the hearing level.

6. Appeals Council Judges (Administrative Appeals Judges)

If you disagree with an ALJ decision, you can request review by the Appeals Council, which is part of SSA’s Office of Analytics, Review, and Oversight (OARO).

What they may decide

  • Deny review and let the ALJ decision stand

  • Grant review and issue their own decision

  • Remand (send) the case back to the ALJ for further proceedings

Under 20 C.F.R. §§ 404.967–404.981, the Appeals Council’s decision (or its refusal to review) is generally the final level of administrative adjudication before you can file a civil action in federal court. (An experienced SSDI attorney can help you with appeals and civil actions.)

Appeals Council judges are adjudicators who focus on:

7. Adjudication Officers in Test Procedures (Less Common)

SSA regulations also describe a role called an adjudication officer, used in certain test procedures once someone has requested an ALJ hearing in a disability claim.

Under 20 C.F.R. § 404.943, an adjudication officer:

  • Acts as your primary point of contact after you request a hearing and before the hearing is held

  • Identifies issues in dispute and develops evidence

  • Conducts informal conferences

  • Has authority to issue a fully favorable decision before the case goes to an ALJ, when the evidence supports it

This role is not part of every claim; it appears in specific “test” procedures authorized in the regulations, but it is another example of an adjudicator in SSA’s disability system.

Why Understanding the Adjudicators Matters

Submitting a claim often feels like sending a message into a deep void. However, on the other side of that silence is a specific legal procedure known as adjudication—a structured workflow driven by a team of distinct human experts. Understanding the specific roles of those evaluating your claim—from Claims Representatives to DDS Examiners to Administrative Law Judges—can transform how you approach your case.

Knowing who is reading your file allows you to organize your medical records and work history with greater clarity and purpose. While no outcome is guaranteed, this insight strips away the mystery, making the process more transparent and empowering you to be an active participant in your claim.

FAQs

Q. Who makes the first disability decision on an SSDI application?

A. Your SSDI case is a federal case, but the first medical disability decision is usually made by your state’s Disability Determination Services (DDS) office. Under 20 C.F.R. § 404.1503 and subpart Q, state agencies make disability determinations for SSA using federal rules.

At DDS, a disability examiner gathers your records and reviews your file, and a medical or psychological consultant (a licensed doctor or psychologist) helps with the medical portion of the case, as described in 20 C.F.R. §§ 404.1615–404.1616 and POMS DI 24501.001. SSA oversees this work and can later review or change the decision through appeals, but that first “yes” or “no” on disability generally comes from DDS operating under SSA’s federal standards.

Q. Are Administrative Law Judges (ALJs) considered adjudicators?

A. Yes. ALJs are administrative judges within SSA who conduct hearings and issue new, independent decisions on appealed disability claims. Their authority and procedures are set out in 20 C.F.R. §§ 404.929–404.953, and SSA describes its hearings system—now run through the Office of Hearings Operations (OHO)—as one of the largest administrative adjudication systems in the world. In plain language, ALJs are high-level adjudicators who can re-decide your case from scratch based on the evidence and testimony presented at the hearing.

Q. Do medical or psychological consultants make disability decisions by themselves?

A. Generally, no. Under 20 C.F.R. §§ 404.1615–404.1616, medical and psychological consultants are part of the team that makes disability determinations. They complete the medical portion of the case review and any needed residual functional capacity assessments, but the overall disability determination is usually made jointly with the DDS disability examiner, as summarized in POMS DI 24501.001.

There are narrow exceptions (also in DI 24501.001) where a DDS examiner can sign a determination alone, such as when no medical evidence can be obtained despite reasonable efforts and certain other conditions are met, but those are not the norm.

Q. What happened to ODAR?

A. SSA’s hearing offices used to be part of the Office of Disability Adjudication and Review (ODAR). Effective October 1, 2017, SSA renamed this component the Office of Hearings Operations (OHO) and moved Appeals Council functions into the Office of Analytics, Review, and Oversight (OARO). You may still see “ODAR” on older documents or websites, but “OHO” and “OARO” are now the current names for SSA’s hearing and Appeals Council components.

References

Code of Federal Regulations. (n.d.). Disability and blindness determinations, 20 C.F.R. § 404.1503. Retrieved December 11, 2025, from https://www.ecfr.gov/current/title-20/part-404/subpart-P/section-404.1503

Social Security Administration. (2014, February 20). GN 01010.001 – Adjudicative policy and standards. Program Operations Manual System (POMS) https://secure.ssa.gov/poms.nsf/lnx/0201010001

Code of Federal Regulations. (n.d.). Responsibilities of the adjudication officer, 20 C.F.R. § 404.943. Retrieved December 11, 2025, from https://www.ssa.gov/OP_Home/cfr20/404/404-0943.htm

Code of Federal Regulations. (n.d.). Responsibility of State agency medical and psychological consultants, 20 C.F.R. § 404.1616. Retrieved December 11, 2025, from https://www.ecfr.gov/current/title-20/part-404/subpart-Q/section-404.1616

Code of Federal Regulations. (n.d.). Reconsideration before a disability hearing officer, 20 C.F.R. §§ 404.915–404.917. Retrieved December 11, 2025, from
https://www.ecfr.gov/current/title-20/part-404/subpart-J/section-404.915
https://www.ecfr.gov/current/title-20/part-404/subpart-J/section-404.916
https://www.ecfr.gov/current/title-20/part-404/subpart-J/section-404.917

Code of Federal Regulations. (n.d.). Hearing before an administrative law judge, 20 C.F.R. §§ 404.929–404.953. Retrieved December 11, 2025, from https://www.ecfr.gov/current/title-20/part-404/subpart-J

Code of Federal Regulations. (n.d.). Appeals Council review, 20 C.F.R. §§ 404.967–404.981. Retrieved December 11, 2025, from https://www.ecfr.gov/current/title-20/part-404/subpart-J#404.967

Social Security Administration. (n.d.). DI 24501.001 – The Disability Determination Services (DDS) basic responsibilities. Retrieved December 11, 2025, from https://secure.ssa.gov/poms.nsf/lnx/0424501001

Social Security Administration. (n.d.). DI 33001.001 – General overview of the disability hearing process. Retrieved December 11, 2025, from https://secure.ssa.gov/poms.nsf/lnx/0433001001

Social Security Administration. (n.d.). GN 01010.001 – General description of the claims process. Retrieved December 11, 2025, from https://secure.ssa.gov/poms.nsf/lnx/0201010001.

Social Security Administration. (n.d.). About us – Hearings and appeals. Retrieved December 11, 2025, from https://www.ssa.gov/appeals/about_us.html

Disclaimer

Disclaimer: This article is for informational purposes only and does not constitute medical or legal advice. Consult with a qualified healthcare provider for any medical concerns or questions. Consult with a licensed attorney for legal advice.

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