The National Association of Disability Examiners (NADE), an organization of the personnel who make initial and reconsideration determinations on Social Security disability claims, has issued its Summer 2011 newsletter. Here are a few excerpt from NADE's summary of Commissioner Astrue's remarks at a NADE regional training conference in April:
The DDS accuracy rate has increased from 94% to 98% over the last decade. ...
SSA continues to try to make the work process easier, such as eliminating step 4 ...
Commissioner Astrue acknowledged the mounting concerns regarding the disability process and, in particular, fraud involving treating physicians, abuse of the childhood disability program, and issues involving Medical Improvement process for CDRs. [Continuing Disability Reviews] Due to the differences in rules at the DDS [Disability Determination Services, where NADE members work] level and those at the hearing level, it is often impossible to remove some beneficiaries from the rolls when they are reviewed for medical improvement. These are all issues to hopefully be addressed in the future of this program.
By the way, as a survivor of the 60s, I love their ad for their training conference coming up in Los Angeles. I think I had something like this on the wall of my dorm room 40 or so years ago.
Does anyone know what the differences in the rules are regarding CDRs at DDS and hearing level? And why do these differences make it "often impossible to remove some beneficiaries from the rolls when they are reviewed for medical improvement"?
ReplyDelete"it is often impossible to remove some beneficiaries from the rolls when they are reviewed for medical improvement".
ReplyDeleteAre these statements revealing SSA's hidden goal? Perhaps it's so hard because these beneficiaries maybe actually disabled
"Perhaps it's so hard because these beneficiaries maybe actually disabled"
ReplyDeleteI just fell off my chair laughing!
Read the POMS...as disabled claimants on the rolls age over time, policy recognizes that their medical conditions generally will not improve to the point that the claimant will be able to adjust to a working environment again; generally speaking, of course. Some CDRs do get ceased, but the medical records must show medical improvement.
ReplyDeleteYou have to love statistics when it comes to SSA. DDS boasts of 98 % accuracy yet 80 % of their cases are reversed at the appeals level.
ReplyDeleteWhen SSA seeks funding from Congress it boasts of the $10.00 saved for every dollar spent. Yet most cessations are reversed on appeal as acknowledged by the NADE concern.
I think it means that the decisions made by the ALJ's are not ones that are allowed to be made by the DDS analysts. ALJ's have broader authority. Otherwise there wouldn't be to appearance of the hard judges and the easy judges (forgetting the ALJ's who collude with attorneys in WV for the moment). So does DDS deny too many or do ALJ's approve too many? Glass half full or half open?
ReplyDeleteAlso comes down to lawyers making a case for another lawyer at the ALJ level. At the DDS level, the staff do not have trained legal minds or experience.
Anon 9:30, Thank You! Very Helpful! Anon 12:08
ReplyDeleteYou have to show medical improvement to cease someone on a cdr, unless it is an age 18 SSI case. And as folks age, they enter new grid criteria, making it harder to prove that they both have improvement and do not meet the criteria for the listing applicable to their age. Plus, CDR's are so far behind, it might have been 5,6,7 years since someone was due for a CDR, which compounds what I just stated.
ReplyDeleteWhen an ALJ reverses a DDS denial, it does not mean that the DDS was inaccurate in their decison. Much time passes from a DDS denial to an ALJ allowance and any number of things change such as a new disease like liver cancer at the hearing level but was never even a diagnosis at the DDS level, or the ALJ was able to obtain medical records that the DDS couldn't for whatever reason, or the claimant turns a year or 2 older which places her in an adverse vocational category. Also, ALJs do have judicial powers that a measly DDS examiner does not. The ALJ can almost do whatever they want to.
ReplyDelete