There was a hearing Monday on a motion to prevent the Social Security Administration from forcing almost 1,500 former clients of Eric Conn to prove all over again that they're disabled. There's no decision yet from the Court but the attorney representing the class has posted about the hearing on Facebook. He says that he gave the judge his best estimate that only about a third of the claimants would be able to obtain legal representation. Training for volunteer attorneys is tentatively scheduled for August 29.
One big question is what evidence does SSA have to justify the exclusion of all of the evidence from the named doctors. Based on the Senate materials and hearing, I have not seen anything that justifies the blanket exclusion of all of the substantive medical reports from the doctors. If the government response is that the doctors used boilerplate language, then SSA might as well shut down the entire CE process. For that matter, some boilerplate language is inherent in mass justice systems such as SSA's.
ReplyDeleteI think it's being more than a bit disingenuous (or just incorrect) to say the problem was use of boilerplate language.
ReplyDeleteI feel like Coburn's report made it pretty clear the problems were things like one psych dr. "evaluating" dozens of people in a single day/reviewing 30 files in a single day, the AMSs not actually seeing the Cls, and the AMSs all submitted one of a very small number (wasn't it like 90+% of the MSSs submitted by each of Conn's AMSs was one of 10 or so forms unique to each source?) of template MSSs.
I've seen some CE sources get nailed for reporting to do 15 CEs in a day or some such, but SSA quickly acted to bar them from further CEs and I would bet all their assessments were thrown out, too. But a fear of using "boilerplate" or the CE system itself being in jeopardy I think is an illogical extension of SSA's actions here.
From SSR 00-2P:
ReplyDelete5.A "similar fault" finding concerning a material fact may constitute evidence to be considered in determining whether there is reason to believe that "similar fault" was involved with respect to other evidence provided by the same source, and may justify disregarding other evidence from that source. Also, the evidence relied on to make a "similar fault" finding in one claim may be considered in deciding whether there is "similar fault" in another claim or in deciding whether to give less weight to evidence in another claim.
I don't think you can call it disingenuous or incorrect at all. If each RFC (boilerplate or not) was accompanied by a medical report/opinion (which they were) and that medical report lined up with existing medical records, then those were not false or fraudulent. (Interesting that Coburn left THOSE out of his Senate Report.)
ReplyDeleteFurthermore, these doctors not only evaluated the claimant personally but reviewed the medical records in their file as well - it is not unheard of for a doctor to examine a patient and then use those exam notes in conjunction with the claimant's own medical records to write an opinion - which is what was done in these cases with the reports being dated the day of the examination. (Realistically, they were written following the exam and medical record review and forwarded to office staff when complete).
While most want to speculate that these doctors just cranked out report after report on a given day, received their payment and went home to dinner, that simply is not the case and if considered logically isn't really possible.
And yes, I know you will ask, I do know all of this first hand. No, I will not reveal my identity. You can take it or leave it.