Requirement To Submit Medical Records Electronically To Go Into Effect Next Month
The Social Security Administration has posted a notice in the Federal Register that the requirement to submit medical records electronically officially goes into effect on November 4.
At initial and recon, we often have to ask for a barcode 3, 4, 5 or more times. In some cases we resort to just faxing the evidence to the field office, which now would be prohibited. We are required to submit all evidence, and submit it electronically, but oftentimes can't get the document required to do so. Another example of SSA making rules under the false premise that they do things correctly 100% of the time. Also, did they ever consider including the barcode in ARS? Of course not.
Excellent news! You all have access to the electronic record. Stop faxing evidence and stop submitting duplicates. Do your job and look through the record. Welcome to the 21st century.
Perhaps it would be helpful if you learned the rules first. It might help avoid submitting duplicative evidence and forcing your clients to pay for records already in the file.
"When you submit evidence received from another source, you must submit that evidence in its entirety, unless you previously submitted the same evidence to us..." 20 CFR 404.935
In the same vein, it would also be helpful if DDS learned how to HITMER records as well. Nothing better than turning a 400-page record into 1300 because it's too difficult to open up the first request and simply request any records created since the previous request.
@711 "1. Contact w/ the SSA and OHO. Once a rep is involved, claimants are generally discouraged from directly contacting the SSA."
Not in my experience from SSA but they are discouraged by the attorneys. I'd much rather ask a client for more information than try to call an attorney office which frequently is not at all helpful. Some are but the really big ones aren't.
1. Your citation is wrong. It's 20 CFR § 404.1512(a)(1).
2. There are lots of circumstances submitting technically "duplicate" evidence is useful. For example, if the PCP's records contain evidence from other treating sources (as is appropriate for a PCP), submitting the PCP's records in their entirety will have duplicate portions within it, but those records confirm the PCP had those records in issuing a medical statement. It also is technically wrong for a MRI or X-Ray contained within a treating source's records to be submitted over-and-over again, but if multiple sources have those in their records (again, which is common), it's important to show those sources had those records available to them.
3. Our state, as well as a lot of states, requires the first copy of records sought in connection with an SSA claim be provided at no charge. So it doesn't cost the claimant any money. Even if that were not the case, you don't know records are duplicate until you request them, so in terms of waste, that's not avoidable. Certainly you can avoid duplicate submissions, in some cases, but that doesn't save the claimant any money.
This may be just a general rule out here in California. I was told it had something to do with the volume of claimants especially in Los Angeles County. LA County alone has 5 OHOs. They simply did not have the staff to handle calls from the claimants and the attorneys.
Still I have had claimants show up at OHOs on their own. I kind of cringe not exactly knowing what they did or said. But there are lot of OHOs near them. This actually helped non-repped claimants especially those who were homeless. They could pop into an OHO with medical records.
So I am glad to know this electronic records rule does not apply to non-repped claimants. Most poorer claimants have a phone but that is about it. Requiring them to submit electronically would be an undue burden.
A rep who submits a duplicate record should have the payout reduced a dollar a page. We hear on this blog how dedicated and diligent you are, so put your money where you mouth is! I can hear the howling now, dont be lazy go through the records!
Not that easy to avoid duplicate records. You often have most but not all duplicate pages when receiving records from same or different sources. The sources often do a lot of cut and paste. A page may seem to be identical to another yet differ by two lines which might not be easy to notice. When DDS requests records from sources who responded previously we usually do request just those records from last visit but often those records reference a study that was done a year or so before so we have to request the earlier records. ERE is mostly a blessing but sometimes a curse. I received about 10 documents from one source each of over 400 pages but most were doctors orders with no evidence saying the person's vitals should be checked every five minutes. None of the vitals were included in this I was able to bookmark and highlight pertinent information for our doctors but if it gets reviewed by OQR or if it comes back for some other reason all those bookmarks will be removed so whoever reviews it next....soon or if it comes back in a few years for a CDR whoever gets it will have to do the same thing all over again.
I have judges who get upset when the page numbers on the records faxed to my office and then faxed to Social Security show missing pages, like I'm hiding something. If the PCP has specialist's records, hospital records, and PT records, SSA is getting them all.
Lots of excuses for shoddy work, just admit it takes time and you cant take the time to do it right, so you come up with excuse and then complain about the system. Removing duplicates from the record might justify some of those outrageous fee petitions where reps try to make it look like they are preparing for the Supreme Court!
At initial and recon, we often have to ask for a barcode 3, 4, 5 or more times. In some cases we resort to just faxing the evidence to the field office, which now would be prohibited. We are required to submit all evidence, and submit it electronically, but oftentimes can't get the document required to do so. Another example of SSA making rules under the false premise that they do things correctly 100% of the time. Also, did they ever consider including the barcode in ARS? Of course not.
ReplyDeleteExcellent news! You all have access to the electronic record. Stop faxing evidence and stop submitting duplicates. Do your job and look through the record. Welcome to the 21st century.
ReplyDelete@9:19
ReplyDeleteNot sure if you heard, but ERE is now available at initial and recon.
@11:10 but you cannot upload evidence to it at INI and RCN.
ReplyDelete@10:51 make up your mind, do you want us to follow the All Evidence rule or not submit duplicates--be consistent.
ReplyDeleteAnother way to make it harder to represent claimants. Was wondering if this applied to non-repped claimants but it only affects reps.
ReplyDeleteNon-repped claimants actually have some advantages.
1. Contact w/ the SSA and OHO. Once a rep is involved, claimants are generally discouraged from directly contacting the SSA.
2. Claimants will probably get more leeway at the hearing with mistakes or duplicates.
@6:26
ReplyDeletePerhaps it would be helpful if you learned the rules first. It might help avoid submitting duplicative evidence and forcing your clients to pay for records already in the file.
"When you submit evidence received from another source, you must submit that evidence in its entirety, unless you previously submitted the same evidence to us..." 20 CFR 404.935
In the same vein, it would also be helpful if DDS learned how to HITMER records as well. Nothing better than turning a 400-page record into 1300 because it's too difficult to open up the first request and simply request any records created since the previous request.
@711
ReplyDelete"1. Contact w/ the SSA and OHO. Once a rep is involved, claimants are generally discouraged from directly contacting the SSA."
Not in my experience from SSA but they are discouraged by the attorneys. I'd much rather ask a client for more information than try to call an attorney office which frequently is not at all helpful. Some are but the really big ones aren't.
@7:34
ReplyDeleteNot 6:26, but:
1. Your citation is wrong. It's 20 CFR § 404.1512(a)(1).
2. There are lots of circumstances submitting technically "duplicate" evidence is useful. For example, if the PCP's records contain evidence from other treating sources (as is appropriate for a PCP), submitting the PCP's records in their entirety will have duplicate portions within it, but those records confirm the PCP had those records in issuing a medical statement. It also is technically wrong for a MRI or X-Ray contained within a treating source's records to be submitted over-and-over again, but if multiple sources have those in their records (again, which is common), it's important to show those sources had those records available to them.
3. Our state, as well as a lot of states, requires the first copy of records sought in connection with an SSA claim be provided at no charge. So it doesn't cost the claimant any money. Even if that were not the case, you don't know records are duplicate until you request them, so in terms of waste, that's not avoidable. Certainly you can avoid duplicate submissions, in some cases, but that doesn't save the claimant any money.
@ 1:42
ReplyDeleteThis may be just a general rule out here in California. I was told it had something to do with the volume of claimants especially in Los Angeles County. LA County alone has 5 OHOs. They simply did not have the staff to handle calls from the claimants and the attorneys.
Still I have had claimants show up at OHOs on their own. I kind of cringe not exactly knowing what they did or said. But there are lot of OHOs near them. This actually helped non-repped claimants especially those who were homeless. They could pop into an OHO with medical records.
So I am glad to know this electronic records rule does not apply to non-repped claimants. Most poorer claimants have a phone but that is about it. Requiring them to submit electronically would be an undue burden.
A rep who submits a duplicate record should have the payout reduced a dollar a page. We hear on this blog how dedicated and diligent you are, so put your money where you mouth is! I can hear the howling now, dont be lazy go through the records!
ReplyDeleteNot that easy to avoid duplicate records. You often have most but not all duplicate pages when receiving records from same or different sources. The sources often do a lot of cut and paste. A page may seem to be identical to another yet differ by two lines which might not be easy to notice. When DDS requests records from sources who responded previously we usually do request just those records from last visit but often those records reference a study that was done a year or so before so we have to request the earlier records. ERE is mostly a blessing but sometimes a curse. I received about 10 documents from one source each of over 400 pages but most were doctors orders with no evidence saying the person's vitals should be checked every five minutes. None of the vitals were included in this I was able to bookmark and highlight pertinent information for our doctors but if it gets reviewed by OQR or if it comes back for some other reason all those bookmarks will be removed so whoever reviews it next....soon or if it comes back in a few years for a CDR whoever gets it will have to do the same thing all over again.
ReplyDeleteI have judges who get upset when the page numbers on the records faxed to my office and then faxed to Social Security show missing pages, like I'm hiding something. If the PCP has specialist's records, hospital records, and PT records, SSA is getting them all.
ReplyDeleteLots of excuses for shoddy work, just admit it takes time and you cant take the time to do it right, so you come up with excuse and then complain about the system. Removing duplicates from the record might justify some of those outrageous fee petitions where reps try to make it look like they are preparing for the Supreme Court!
ReplyDeleteWhen you remove a duplicate how can you prove it was a duplicate after you remove it?
ReplyDeleteStop requesting altogether. Send SSA a list of providers and tell them to get them.
ReplyDeleteSSA gets records for unreped. Repped claimants must pay for their records. Denial of equal protection. Simple.
former ALJ