Social Security Administration’s Use of Consultant Doctor’s
July 12th, 2019 by Attorney John Colvin
GOVERNMENT ACCOUNTABILITY OFFICE
TO INVESTIGATE THE SOCIAL SECURITY ADMINISTRATION’S
USE OF CONSULTANT DOCTORS
As we previously reported earlier this year in a blog post, a Tennessean newspaper investigative report found that some doctors in Tennessee were denying a high rate of applicants while reaping large sums in fees. The article also illustrated that the doctors being used by the Disability Determination Section in Tennessee were being provided a financial incentive that rewards speed, based upon payment on a per case basis to review disability claims. Furthermore, due to Social Security’s case backlog and pressure to protect taxpayer funds, some doctors wrongfully deny low income people who are unable to work.
Unfortunately, the rejections also lead to loss of health insurance and other necessities for many deserving disability applicants. United States Congressman John Larson of Connecticut recently issued a statement stating that a federal investigation is being launched so that more information is uncovered and disclosed to Congress about this little-known practice of state disability determination sections using outside doctors to help make disability determinations.
Congressman Larson chairs the Ways and Means Social Security subcommittee and has requested that the Government Accountability Office examine the system of using contracted doctors known as medical consultants. The GAO has approved Congressman Larson’s request and will launch an investigation sparked by the disturbing facts reported by the Tennessean that some doctors were earning more than $400,000 a year reviewing claims, and racing through up to five applications per hour, even though some applications can contain thousands of pages of medical records.
Many advocacy groups have applauded the launch of the GAO investigation as a positive step in safeguarding against serious problems and abuses that can occur with relying on paid medical consultants that have a financial interest in the number of reviews that they can perform on behalf the state disability determination sections. We too applaud the efforts of Congress in leveling the playing field for deserving applicants who are truly disabled and in need of benefits that rightfully belong to them and that they have paid into Social Security over their working career.