Tuesday, March 28, 2006

Changes to the Social Security Disability system.

From socialsecurity.gov, here's how the disability system will look to change:

1 A quick disability determination process for those who are obviously disabled. Favorable decisions would be made in such cases within 20 days after the claim is received by the state disability determination agency.

2 A new Medical-Vocational Expert System (MVES) to enhance the expertise needed to make accurate and timely decisions. The MVES will be composed of a Medical-Vocational Expert Unit and a national network of medical, psychological and vocational experts who meet qualification standards established by the Commissioner.

3 A new position -- the Federal Reviewing Official -- that will review state agency determinations upon the request of the claimant. This will eliminate the reconsideration step of the current appeals process.

4 Retention of the right to request a de novo hearing and decision from an Administrative Law Judge if the claimant disagrees with the decision of the Federal Reviewing Official.

5 Closing the record after the Administrative Law Judge issues a decision, with provision for certain good cause exceptions to this rule.

6 A new body -- the Decision Review Board -- to review and correct decisional errors and ensure consistent adjudication at all levels of the disability determination process. The current Appeals Council will be phased out gradually.

Quicks comments and thoughts:

Regarding #1, Who the heck is "obviously" disabled? For social security disability adjudication purposes, there's generally no such thing. Under the old system, no matter how severe a claimant's condition was (short of being a terminal TERI case), the disability examiner still had to request the medical records. And under the new system, I would imagine that you'll still have to even if a claimant seems to be "obviously disabled". And here's why: you'll need to establish onset to determine backpay which you can't do that without the records from a claimants sources of treatment. And in most cases you won't get the records fast enough to allow for a 20 day decision.

Regarding #3, is this not "recon" by a different name? Will claimants be less likely to request their "review" than they were a reconsideration? I don't think so. So, what does this mean? Will you have a single Federal reviewing official trying to do the work that was formerly done by many reconsideration level examiners? Or will it mean that the FRO will have his/her own staffing of subordinate reviewing officials? If so, what has really changed? If it walks like a duck and talks like a duck, is it not a duck?

Regarding #5, this step seems particulary hostile to claimants, but most requests for review sent off to the appeals council come back with "request for review" denied anyway. And that's after they've been there for 3 to 24 months.

All of this is being done under the banner of "improving the system" for disabled individuals who need to file for benefits. Perhaps the banner should be changed to "Smoke and Mirrors".

Return to the Social Security Disability SSI Benefits Blog

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Disability lawyer - when to get one
Social Security Disability SSI Massachusetts


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