Sunday, October 18, 2009

Do Social Security Disability Judges Read your Medical Records?

This might seem like an odd title for a blog post but someone in a forum or on another site--I can't recall which--recently wrote that ALJs (administrative law judges, the individuals who conduct disability hearings for social security) not read medical records, nor do social security administration MDs, who, the poster went on to say, also do not perform lab tests. Is this even remotely true?

Well, the "social security administration MDs", as this person phrased it, are actually medical consultants who are assigned to case processing units that are full of disability examiners. The examiners themselves spend the better part of their days reading medical records. And, no, these SSA medical consultants do not perform lab tests. But, then, why would they? Their purpose is not to deliver treatment, nor is it to render a diagnosis. Their purpose, in part, however, is to do something similar to what a disability examiner does, which is read the claimant's medical records and then determine the claimant's relative ability to engage in work activity, either at one of their former jobs or at some type of other work.

Why is there a disability examiner and an MD employed by the social security administration performing similar functions? Because the examiner is the individual who actually takes care of the leg work for the development of a disability claim. The examiner requests the records, does followups when the records fail to arrive, conducts interviews with disability claimants (usually regarding their work activity, medical treatment sources, or their activities of daily living), and considers vocational issues that may influence the case, in addition to medical issues that may influence the residual functional capacity rating a claimant is given.

The social security disability doctor does none of the legwork required to get the actual elements of a case lined up.

However, the medical consultant (or psychological consultant, if the claimant's alleged impairments are of a mental nature) does review the examiner's writeup of the case and performs his or her own rating of the claimant's functional abilities and limitations. And the doctor does this because...he or she is a doctor while the examiner is not.

Disability examiners are not medical professionals. They are trained to evaluate medical record documentation and to consider such documents in the context of the SSA disability process. But, in most instances, the opinion of a disability examiner only becomes valid if the examiner's unit medical consultant signs off on the case, thereby giving it a stamp of approval from a licensed physician.

Now, having said that, there are some disability examiners who are empowered to make their own decisions without input from a social security administration MD. And these examiners are known as SDMs, or single decision makers.

Frankly, I think the whole idea of SDMs is completely bogus and ridiculous, and unfair to claimants. After all, if a disability examiner actually possessed the skillset necessary to substitute his or her judgment in the place of input from a licensed physician...then the examiner should be out there working as a doc and earning a commensurate salary.

But that's obviously not the case and single decision maker examiners are simply a way for the social security administration to push cases without the input of a doctor----probably to save money and to maintain more control oover decisional outcomes (i.e. hold down the number of approvals on social security disability claims and SSI disability claims).

Return to the Social Security Disability SSI Benefits Blog

Other Posts

Disability Benefits for Mental Illness (bipolar disorder, schizophrenia, depression)
Filing for Disability - SSD application tips
Filing for Disability - Tips for Filing a Disability Appeal
Why Does it Take Two Years to Get to a Disability Hearing?
Will you get Approved for Disability if you have an Open and Shut Case?
Denied disability claim - appealing the denial
Waiting for Social Security disability to be approved can be crushing



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