Social Security Disability - reform and suggestions regarding
There's an excellent site online - www.disabilitydoc.com - and I couldn't help but comment on one of Dr. Holden's (a former dds medical consultant) writings.
Here's the doc's post regarding reform suggestions: http://www.disabilitydoc.com/commissioners-new-plan-letter/
Dr. Holden's got a few interesting points. One, disability examiners don't get enough medical training. As a former examiner myself, I don't mind saying that. And I seriously question the entire of concept of SDM's (single decision maker examiners can slap decisions on cases without the input of their unit medical consultants----how crazy is that? Examiners are NOT doctors)
Also, I never really understood just why it is that an ALJ is necessarily needed to preside over disability hearings. Judges are not medical professionals and disability hearings are not legal court proceedings in the strictest sense, which is exactly why non attorneys are allowed to represent claimants at such hearings.
I really have no major problem with any of Dr. Holden's assertions. However, I guess it's true that we are all, to some extent, limited by our experiences and this holds true for MD's as well.
While Holden's suggestion for more indepth medical training for dds examiners is a good one, his suggestions for overall reform miss the REAL PROBLEM (IMO - just my opinion) with dds. What's that problem?
Here it is: DQB, or the disability quality branch. As all examiners, reps, judges, and CRs know, a percentage of completed dds files are sent off to this unit to see if all the i's are dotted and all the t's are crossed. And, interestingly enough, more cases that were MARKED FOR APPROVAL come back reversed than vice-versa.
When a case is returned from dds, it's like a black mark for the examiner because it directly implies that he or she flubbed up. It's a black mark for the unit supervisor because the return came back to his or her unit. And it's a black mark for the dds administrators because the more DQB returns you get, the worse it makes your agency look.
So, human nature being what it is, what is the outcome at all dds locations in the good old usa?
It means that supervisors tend to exert an iron grip over the examiners in their units. It also means that supervisors will always lean more toward denials rather than approvals And...if a case is one of those cases that is right on the line, you can be sure that the examiner won't stick his or her butt on the line because the likelihood is that the unit supervisor will "have to talk to the examiner about his or her decision-making ability".
I am not saying that we need to dispense with quality review. But, I think it's pretty plain that external quality review has had an insidious effect on dds claims processing-----with disability claimants coming out the clear loser.
Now, this may not have occurred to Dr. Holden because he was not an examiner. And it may not have occurred to most reps because they, too, were never examiners (though some went on to become reps later). And it certainly would not occur to an SSA CR because, for all intents and purposes, they know very little about
social security disability. They just take the applications and send them on to DDS.
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