Tennessee Makes SSD Backlog Shrink by Shortchanging Applicants
February 11th, 2019 by Attorney John Colvin
Tennessee Social Security Disability Insurance (SSD) applicants have their lives on the line when they apply for benefits. They can’t work, may be diagnosed with a fatal condition and are facing severe financial problems. Many of them have had the SSD rug pulled out from under them by doctors hired by the state to review their files.
For some SSD applicants, part of the process involves having a physician review the application and supporting evidence. That decision can result in an approval, a requirement that the applicant be personally examined by another physician or a decision that the application is denied. That denial could take months or years to reverse, causing some of the state’s most vulnerable people to suffer severe hardships.
The Tennessean reports that these doctors, hired by the state on a contract basis, are paid based on the number of cases they handle. This encourages brief, incomplete reviews of files that may be hundreds of pages long, because the more reviews they do, the more money they make.
While the federal government states that these roughly fifty physicians should average reviewing three cases in two hours, some of Tennessee’s doctors are flying through four to five an hour. The newspaper reports that some of these doctors are making hundreds of thousands of dollars a year. One doctor averaging five decisions an hour earned $420,000 for looking at 9,088 applications during fiscal year 2017-2018. He has made more than $2.2 million from the program since 2013.
He denies about 80% of the cases he reviews, while the nationwide average for denials is 66%. Tennessee, contracted out by the federal Social Security Administration (SSA) to screen SSD applications, has one of the highest denial rates in the country at 72%.
The SSA reviews less than 2% of all rejections nationwide, according to an analysis by the National Organization of Social Security Claimants’ Representatives. Those whose applications are denied have the option of retaining an attorney to help them through the appeals or reconsideration process.
Some of these outside physicians also have histories of misconduct. One is a convicted felon; two others were put on probation; and another had his medical license revoked twice and can’t treat patients (many of these contracted physicians do this work on a part-time basis).
Dr. Kanika Chaudhuri, is one of the doctors paid to review SSD applications filed by Tennesseans. She evaluated 3,872 cases last fiscal year, earning $192,000. She recommended denial of 78% of her cases. Outside experts and former and current state employees claim it’s impossible to review cases quickly without making mistakes and incorrectly rejecting disability benefit applications.
She was interviewed by the newspaper and claimed that there’s no “direct” pressure by the state to clear a lot of cases; however, “[t]hey recommend that we must keep up. They always recommend you do your best. There are so many applications and so few doctors. We are overwhelmed with cases.” The SSA sets goals on controlling caseloads; and if they aren’t met; the state can suffer financial penalties.
Up until 2017 the SSA’s rules stated that the opinion of the physician treating the applicant was given more weight than that of a physician hired to review the file. Since then the rule has been flipped, and now it’s the reviewer’s opinion that’s more important. All too often, those opinions are based on rushed reviews of application files by doctors who know the pressure is on to clear cases.
If you have sought SSDI benefits and have been denied, or if you need guidance with the application process, we may be able to help. We understand how a denial of benefits can affect families, and we care about people receiving the compensation to which they’re entitled. Get your free consultation today – call us or complete our contact form.
The information on this website is for general information purposes only. Nothing on this site should be taken as legal advise for any individual case or situation. This information is not intended to create, and receipt or viewing does not constitute, an attorney-client relationship. No representation is made that the quality of the legal services to be performed is greater than the quality of legal services performed by other lawyers.