From Emergency Message EM-25009 issued last Friday:
This emergency message (EM) provides the Disability Determination Services (DDS) and federal disability adjudicating components with disability case processing guidance for Disability Examiner Decisional Authority (DEDA). DEDA will temporarily allow qualifying disability examiners to make fully favorable disability determinations in adult cases based on physical impairments alone without medical review by medical consultants (MC), but with the flexibility to consult with an MC at the disability examiner’s discretion.
These temporary instructions apply to initial level claims, including initial-level claims pending at the DDS and federal disability case processing sites (DPB, DPU, etc.).
The Social Security Administration (SSA) faces unprecedented initial disability claims backlogs surpassing the 1.12 million case mark, resulting in high average processing times and claimant wait times. A contributing factor to the increase in average processing time is the general requirement that qualified physicians, psychiatrists, and psychologists (referred to in our policy as medical consultants (MC) and psychological consultants (PC)) complete the medical review of all initial level disability determinations combined with an insufficient number of MCs and PCs. See Section 221(h).….
If this issue comes up in your confirmation hearing, Frank Bisignano, what say you?
9 comments:
Would this unprecedented initial disability claims backlog have an affect on SSA 455 disability update form processing?
I am a former SDM (single decision maker) adjudicator. This system worked well when we had it before. Medical consultants take forever to review cases and in my experience, typically didn't do a very comprehensive job because they are paid a flat fee per case reviewed and there is no incentive for them to actually review everything as thoroughly as they should. I expect this will be a positive change for deserving claimants. They are using seasoned adjudicators for this work and they are at least as qualified as ALJs to make these decisions.
We used to be able to do this but only with certain impairments. A newborn weighing 700 grams for example. They took that away when there was a marginally increased approval rate. There was no increased error rate
Frank Bisignano will NOT implement this EM but ending telework is on top of his agenda.
I suppose it's harmless given it's only as to favorable determinations...but isn't this directly in violation of 42 USC § 421(h)?
I used to be able to do this with all physical impairments when I was a SDM 20 years ago.
Interesting that EM directs agency/DDS to use telework as an incentive to lure MCs to work for SSA/DDS. lol
Guess MCs won't have to RTO.
Regarding the comment about telework, even if the new commissioner wants to end telework, the SSA disability program is administered by the states. Wouldn't telework/no telework be at the discretion of each state's governor?
Yes
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