Wednesday, October 19, 2005



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.





Return to the Social Security Disability SSI Benefits Blog















Other Posts:
How to apply for disability
Are you automatically denied for Social Security Disability or SSI when you first apply with an initial application ?
Who makes the Social Security Disability decision ?
Filing for disability
Social security disability benefits
Social Security Disability SSI virginia

3 Comments:

Blogger Moogle said...

Disability Blogger,

Thanks for your comments on my blog, Moogle's Thoughts. I do have some experience, both positive and negative, with trying alternative remedies for migraines. I would be happy to share the info with you.

Please email me directly so we can get a discussion going. I won't post the address here, but you can find it on my blogger profile.

Thanks,
Tracy

3:55 PM  
Blogger Erica said...

Diablitity Blogger,
I was really suprised by your blog web site. Refreshingly so! Great info and very helpful. I was looking specifically for information about the Trial Work Period for those who are attempting to get off of disability. Yeah!
I have a weird situation though- I have been working and was misinfomed about the amount of $ I could earn without affecting my social security in any way. I was told the wrong amount by Michigan Rehab Services and as a result have lost 6 months of the 9 alloted me. I need to file an appeal and have not been able to find information about this type of situation or any like it. It is my hope that I can get the time credited back to me. Any suggestions? You seem to be one of the only possible places to get a straight answer! Thanks in advance.

11:07 AM  
Blogger Disability Blogger said...

Hi Erica,

First of all, this would just be a piece of advice for anyone relying on social security disability or ssi related information that does not come from SSA or from a fairly knowledgeable attorney or non attorney disability representative: don't rely on it. I used to be a social services case worker (medicaid among others) and later I was a disability claims examiner. It didn't take long for me to realize as an examiner that the information being routinely doled out about disability programs by the likes of social services, vocational rehab, mental health, and a number of other institutions was so far off the mark it just wasn't funny. So, as a warning for everyone, unless the information comes from an official source or a knowledgeable source you feel you can trust, don't believe it---or believe it but at your own risk.

It sounds like you have an overpayment situation. Typically, this is what you do in an overpayment scenario: call the social security office and ask for a "request for waiver of overpayment form". They usually refer to it by the form number, but, personally, I like names not numbers. Fill out the waiver and explain the following: why you think the waiver is not your fault, and why you can't pay it back. If the waiver is denied, you are allowed to follow the appeal process and even get the issue heard by an administrative law judge. If, eventually, you are denied on the waiver, you will probably be allowed the option of having a small percentage of your benefits deducted each month, assuming you are still receiving benefits, which I wasn't sure from your post if that was your case. Typically, I try to stay away from trial work period issues and leave those to CR people at social security (I am a former disability examiner and my background had to do with medical determinations versus work issues). Good luck on your situation.

6:04 AM  

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