From the Spring 2020 newsletter of the National Association of Disability Examiners (NADE), the voluntary organization of personnel who make disability determinations for Social Security at the initial and reconsideration levels, concerning a meeting with Grace Kim, Social Security's Deputy Commissioner of Operations and John Owen, the Associate Commissioner of the Office of Disability Determinations:
... The NADE board brought up an agenda item that was noticed in various regions. There have been problems seen where the DDS [Disability Determination Service] is contacted by an office claiming to be an appointed representative who filed the SSA-1696 [appointing an attorney or other person to represent a Social Security disability claimant] with the field office but it is not in the electronic file. Grace mentioned that this is a customer service issue and someone has been appointed to look into the issue. ...
This is a big problem for people like me. We keep submitting the 1696 form repeatedly and field offices do nothing with it. This leaves us incapable of representing the claimant before the agency. This problem has been around for years and it's been getting worse.
I don't understand the process but, apparently, it's ridiculously difficult for field office personnel to enter the appointment of a representative in their computer system. I think most of those who represent claimants would prefer some system where we could enter the information directly. I don't see how imposing this work load on field office personnel adds any layer of protection for claimants or the system. If there's some issue with us abusing the system, it's not hard to find us or to take action against us.
I don't understand the process but, apparently, it's ridiculously difficult for field office personnel to enter the appointment of a representative in their computer system. I think most of those who represent claimants would prefer some system where we could enter the information directly. I don't see how imposing this work load on field office personnel adds any layer of protection for claimants or the system. If there's some issue with us abusing the system, it's not hard to find us or to take action against us.
There is also material in the newsletter about how NADE members are coping with the changes brought about by Covid-19. I'm not going to reproduce any excerpts here but reading it might be a good idea for those who have had little contact with DDS personnel. There are a lot of unjustified negative attitudes about disability examiners. The system may be uncaring but the people aren't.
With the old SSA1696/SSA1695 requirements, the attorneys would all too often list several attorneys on the SSA1696 then just submit a SSA1695 for the main attorney. The fee must be split between all the attorneys listed on the SSA1696. So I ended up having to call the attorneys offices to get the SSA1695 for the unregistered attorneys and then do the tedious job of entering all of the attorneys info to RASR.
ReplyDeleteI think the new SSA1696 is designed to force the attorneys to submit the registration info (old SSA1695) for every attorney, when they first submit the form. This is a good idea.
It would also be wise to have the attorneys enter their registration inforrmation directly into RASR.
For the time being the attorneys can upload section 5 of the revised SSA1696 (which includes all the info from the SSA1695) into the electronic folder using their Electronic Records Express (EPE) access. This should are done for unregistered attorneys because PC personnel no longer have access to fax machines due to COVID-19.
“The Board suggested the OIG consider looking at the issue of representatives who seek denial at the re- consideration step so they can push cases to an ALJ hearing.“
ReplyDeleteWhat in the heck does this refer to? How could a representative even try to do this? What evidence is there of this? I find it very hard to believe, based on many years of experience as a representative. I would love to hear more about this. If if is true, something definitely should be done about it.
@7:36 you mean reps can upload docs electronically without the rqid and other routing info? DDS tells us not even to send stuff to ere because nobody logs it prior to the hearing level.
ReplyDeleteOh 9:23 AM, where to begin?
ReplyDeleteDoesn't take a genius to understand that the longer a case drags out, the bigger the rep's cut$$$ of the backpay$$$.
To name an example- 55 YO truck driver alleges mental issues only at initial. They provide only the psych treating source and ADLs. Maybe at reconsideration, a primary care doctor will be listed (or more often- the examiner must tease it out of the rep/claimant). In those records, what do we see?! Ah recent back surgery, knee replacement, RA. Who's this Dr. Baker? And whats this reference to seeing ortho, pain management, and cardiology? But then the claimant fails to respond to anything or attend a physical CE. Weird. After that silly reconsideration step, it's smooth sailing for the attorneys the next 2 years years until hearing, where, miraculously, the rep produces all the records a couple days before the hearing date and the claimant is easily med-voc allowed- just like they would have been at initial, had they not been obscuring the physical issues.
Other tricks- failures, "address jumping", not attending CEs, hiding treating sources, providing similar treating sources but wrong location, etc. Examiners have a hard enough time assessing all the alleged conditions of their 150+ case loads, so most don't have the time to dig around for unalleged conditions.
SO MANY reps do this. Complete and utter disservice to claimants.. I don't know how they can sleep at night.
@6:59
ReplyDeleteNo it doesn't. An early award, especially in light of the retroactive provisions of Title II nearly always pay more at the initial phase and recon, then any increase a result of hearing level delay would cause. I would gladly take 2 recon awards with approximately 18 months in benefits than 1 hearing level 30 months in benefits award, particularly given the vast majority of labor costs is at the hearing level, not the initial/recon level.
It's not "smooth sailing" at the hearing phase because developing medical evidence is literally 90% of our time and effort and development of the record is 90%+ of the time/effort spent at the hearing level. As to willfully obscuring the physical issues, we do not do that, and the majority of gridrule awards is a result of age changes, not medical changes.
As to examiners having 150+ case loads, yeah their greed certainly is the claimants problem, not the administration's issue. That makes sense. Any doctor with a duty of care would be commiting malpractice in that circumstance, yet the examiners get away with it.
There are many reasons why some examiners have a case load of 75 and others over 150 but examiner greed is not one of them
ReplyDeleteLetting the reps. upload the forms themselves is a great idea -- this problem has been around for so many years that it's pretty clear SSA won't or can't correct it (but how hard could it be to upload the form? -- setting aside any issues with the form itself, the forms seem to disappear into thin air over and over again.).
ReplyDeleteWhat’s the point of adding months to your client’s wait for a hopefully favorable decision by giving DDS information at the reconsideration level? When nearly 90% are going to get another denial. Now, if a client wants a shot at recon or they are a good candidate for a possible win at recon, then go for it. Otherwise, it’s try to get on line for the hearing as soon as possible. Reconsideration should have been abolished, not extended to the other regions. And between the time a decision is rendered and an appeal is filed, there is often no new information to provide.
ReplyDelete