SOCIAL SECURITY ANNOUNCES NEW INTERNET TECHNOLOGY TO SPEED UP DISABILITY CLAIMS PROCESSING: OPPOSITION ALREADY FORMING

Since 2000 the SSA has failed miserably to keep up with the increasing numbers of disability claims being filed. By its own account the waiting time for a disability claim to be processed by the SSA is measured, not in months, but in years. The number of cases waiting to be heard now exceeds 750,000.

CBS Evening News recently presented a primetime investigation of the failures of the SSA to timely process claims: "Disabled and Waiting".

In response, the SSA has announced and implemented new technology and plans in attempt to speed up the disability claims process.

ONLINE FILING and APPEALS

One of the first and most promising innovations is that claimants can now avoid the long lines at the SSA offices and file their disability claim and appeals online. The SSA has digitized most of its claims forms on its website: www/ssa/gov. A claimant who wishes to file a new application for disability benefits can now apply directly online. The SSA website will take the claimant through a series of questions and forms to fill in online and then submit the application to the proper SSA office for that claimant. If the claim is then denied by the SSA, the claimant can now file her appeal online as well by going to the SSA appeals website.

BARCODE IDENTIFICATION

Once a claim is filed the SSA will now assign and provide to that claimant a computer barcode. That barcode contains details of the claimant and her claim with the SSA. Claimant who have new or additional medical reports or other paper documents to submit to the SSA will place a copy of that barcode on top of any new documents and can fax or mail that to the SSA. The SSA will then be able to use the barcode to make sure that the documents are routed to the proper SSA office and claims file.

MEDICAL RECORDS EXPRESS FILING

The SSA also makes it easier for medical providers to send claimants' medical files directly to the SSA. Instead of printing out reams of paper reports for claimants and charging the claimants for copy costs, medical offices can file a claimant's medical records directly on line with the SSA, saving time and money for the claimant. All SSA claimants should notify and encourage their medical providers to use the SSA Electronic Records Express website to file needed medical records in a claim directly with the SSA online.

DIGITAL FILE

The SSA now digitizing the majority of claims files. Thus instead of storing, copying, and mailing huge paper files, the claims file will be in digital format. And per SSA Policy CJB 07-06 (08/20/07) the SSA must provide a copy of the electronic case file to the claimant or her representative on CD-ROM upon request. A SSA Form 3288 can be used to make this request.

NATIONAL HEARING CENTER

On December 17, 2007 the SSA implemented the National Hearing Center. This Virginia office will have an initial panel of seven SSA judges who will start conducting hearings of long delayed disability claims located around the country by video teleconference. By concentrating the judges in one area and conducting hearings by video from locations across the country the plan is that multiple hearings can be held and processed more quickly and efficiently than the current face-to-face hearings that takes months and years to currently schedule in local SSA offices.

"FIT" PROGRAM

Finally the SSA has mandated use of the Findings Integrated Template Program, also known as "FIT". FIT is an online tool that allows representatives and SSA Judges to quickly format and produce a claim's decision. Representatives can use FIT to format a proposed decision on a claim for submittal to a SSA Judge prior to a hearing. If the SSA Judge agrees with the proposal he need only approve the FIT decision and there is no need for a hearing; once again saving time and money.


Opposition Forming to New Technology

So with these new technologies being implemented by the SSA to help deserving claimants and families obtain their needed disability benefits, what could be the hold up and obstruction? Not surprisingly, the opposition to these new processes to speed up the SSA comes from within the SSA itself; its own staff and judges.

The SSA Judges' union, the Association of Administrative Law Judges is strongly opposing the National Hearing Center. SSA Judges are appointed for life with salaries of more than $100,000 on average with additional full federal medical, disability and retirement benefits. SSA Judges currently are essentially unregulated as to when and how often they must hold hearings and when they must produce decisions in claims. The ALJ Union argues that the National Hearing Center will result in eventual closing of the local SSA hearing offices and subsequently the loss of jobs for many localized SSA Judges.

In regard to the new FIT program, designed to speed up the decision making process by SSA Judge's by using pre-formatted online decisions, not surprisingly, not all SSA Judge's are using the FIT program and continue to hold hearings when more than likely no hearing was necessary. In addition the SSA FIT program has already failed to keep up with current software and is now incompatible with the most current Word and Office programs.

In regard to the use of digital files and CD-ROMS, many SSA local offices continue (either out of lack of training or knowledge or even perhaps out of fear of loss of job security) to keep claims files in unnecessary, expensive and cumbersome paperfiles. Many claimant's routinely complain that when they properly request to be provided copies of their claims files the local SSA office staff simply refuse to comply and provide file copies. These acts of defiance by local SSA offices lead to further delay and frustration as claimants are left wondering for months or even years as to what the status is of their claim and what the SSA local office is doing to process their claim.

VA ORDERED TO RESPOND TO MEDICAL REQUESTS

Military veterans who apply for social security disability benefits need to provide SSA forms of their medical treatment to the SSA to prove their disability claim. In the past, these vets have been frustrated as the VA doctors and medical staff generally refused to respond to such requests for completion of these medical forms in SSA claims.
However that has now changed.
VHA Directive 2007-024 requires the VA medical to honor all requests by patients for completion of non-VHA medical forms.
All veterans who are applying for SSA disability and finding that their VAMC facility is refusing to complete SSA forms should provide this directive to their VAMC director.

THE GOVERNMENT ORDERS YOU TO BE MEDICALLY EXAMINED BY THE PERSON BEHIND THE MASK. SHOULD YOU TRUST THEM?

The scene is repeated dozens if not hundreds of times per day across the country. You yourself may have experienced it or know someone who has.
You have applied for benefits from the United States government.
These can be social security disability benefits, or perhaps federal worker's compensation benefits as you were injured on your federal job.
You submit your medical reports from your trusted family doctor to the government.
All appears well.
But the government is not so sure. The government wants more medical information.
But not from your own treating doctor.
No, they want it from one of their own doctors. A "for hire" doctor the government pays to examine you and give his opinion of your medical status.
The government sends you a formal notice that you must appear for an examination by their doctor. This government doctor, based on his one time examination of you, will very likely hold the final decision as to whether or not you will receive or be denied your needed benefits or even, further medical care.
The failure to appear for that exam can be used by the government to delay or even deny your needed benefits.
You do not know who this doctor is, you have never met him.
His office very commonly appears to be a temporary office with no medical equipment and no medical staff present. The examination itself commonly takes only a few minutes regardless of the extent of your injury, disease or past medical history. Under some circumstances the government will forbid you any right to have anyone else present in the room with their doctor for his exam. More often than not the government doctor will refuse to give you a copy of his examination report despite your request.

Despite all these misgivings and uneasiness, thousands and thousands of Americans routinely trust and accept these government "for hire" doctors as medically competent and legitimate.

The fact is that under current federal benefits programs laws, Americans have very little choice of whether or not they must attend and be examined by these government doctors. The failure to show for the exam will very likely result in the end of their benefits. But should you blindly trust the government and give them full faith that they are placing your health and well-being in the hands of a fully competent medical provider?

Absolutely not.

For example, in the past two months alone, I have come across more than once not only questionable doctors on the government payroll, but doctor's whose entire ability to practice medicine appears at issue.
In a recent claim the federal government ordered a claimant to be examined by their doctor to see if the claimant should be continue to receive federal medical benefits for his severe medical condition; a condition already fully accepted by the government. The government doctor was paid by the United States taxpayer for his examination and for his report. The government doctor, not surprisingly, found that after his one time exam, the claimant's government benefits should be ended. While the doctor remains on the government payroll, the claimant's government benefits are terminated. Upon my review of this government doctor, my suspicions as to his medical competence and ethics were confirmed. In fact this government doctor has multiple federal indictments against him for:

Mail Fraud
Making False Claims Against the United States
Making False Statements Relating to Health Care Matters
and Health Care Fraud.

Neither the doctor nor the United States disclosed this known information to the claimant prior to or even after his examination. Apparently, despite multiple indictments for fraud against the United States, the doctor currently remains fully licensed in Texas and on the government payroll.

In another claim just reviewed, the government ordered another civilian to be examined by one of the government's doctors. Once again the government used their "for hire" doctor to terminate the claimant's much needed medical care and benefits. Once again, no disclosure was made to the claimant by the government or the doctor, that the doctor was actually on five years probation with restricted medical and surgical practice limitations in Florida and Colorado. As far as can be seen this doctor also remains on the government payroll and practicing medicine.

Americans who are applying for federal benefits, such as social security disability, federal workers' compensation or federal medical disability retirement are required to submit to examinations by the government's choice of physician; as often and wherever the government deems necessary. However the caveat is that the regulations generally require that the government physician be medically qualified and competent. Whether or not these government "for hire" physicians actually are medically qualified or medical competent appears to be of less and less concern of the government and will likely not be disclosed to the claimant.

It is up to you the claimant to investigate and find out if the doctor that the government is ordering you to see, is indeed medically competent and qualified. The vast majority of the government doctor's are qualified and competent. But should you blindly trust and put full faith in that assumption? That could be very foolish and could result in direct harm to you and your federla benefits claim.