Did the Baltimore SSA Office Force Doctors to Deny Disability Claims?

Submitted by Shane on

A recent article appearing in the Wall Street Journal detailed the efforts of the Baltimore Social Security Administration (SSA) Office to rapidly reduce the backlog of applications for Social Security Disability Insurance (SSDI) benefits in the region. It stated the Baltimore SSA Office’s “crackdown” on physicians who review SSDI claims resulted in several doctors resigning and in the denial of many claims that should have been approved under the SSDI’s guidelines.

Many SSDI/SSI recipients, and others in the disability community, found this story alarming, but it is important to keep in mind that the issues influencing the SSA’s actions, as well as the reaction of the physicians in its service, are quite complex.

What Exactly Happened in Baltimore?

The Baltimore SSA called a meeting of more than 140 of the physicians who review claims for the agency. The meeting’s agenda emphasized the need to process claims more rapidly in order to significantly reduce the backlog of applications in the region.

Specifically, the Baltimore SSA announced:

  • Physicians would be required to process claims more quickly,
  • The payment they receive for reviewing claims would be reduced from $90.00 per hour to a flat rate of $80.00 per application,
  • And, their area of medical specialty would no longer play a significant role in the cases assigned to them for review.

In other words, physicians reviewing SSDI applications would be expected to work more quickly and get paid less for doing so. Additionally, one could argue that the doctors were being asked to sacrifice quality for the sake of quantity, as the more rapid and less medically-focused review of claims could lead to denials for claimants deserved of benefits and approvals for those not truly qualified under Social Security Disability guidelines. This is, in fact, one of the major concerns expressed by physicians in the region.

Why Were These Procedural and Process Changes Implemented?

The average nationwide wait time for an SSDI applicant is about 17 months, though some claims take more than two years to finalize, and the appeals process can result in even longer wait times for those who are initially denied disability benefits. There are more than 700,000 claims pending at any given time, with some sources referencing the total number of backlogged applications exceeding the 770,000 mark in November of 2011.

The overwhelming number of claims pending as well as the influx of new applications – which are due, in large part to members of the baby boom generation rapidly approaching their most disability prone years – are significant factors in the somewhat desperate measures employed by the Baltimore SSA Office.

The goals of the Baltimore SSA Office were to reduce wait times, increase efficiency and decrease administrative expenses – admirable goals in theory. However, the practice through which they were achieved could have lasting and negative consequences, especially for the disabled individuals that the program is intended to protect and assist.

What the Future May Hold

As the federal deficit crisis builds, and the impending depletion of the SSDI Trust looms, we can expect to see generally well-meaning efforts on the part of SSA administrators to reduce costs and speed up application processing times. In other words, offices nationwide may soon face similar issues to those seen at the Baltimore SSA Office, as funding cuts and Social Security reform become major political issues.

SSA administrators across the nation are working with the limited resources at their disposal, and as such, all measures put in place to address efficiency and cost concerns are only temporary fixes that do not get to the root of the underlying problems. Most any solution they do employ may have potentially negative consequences for the system as a whole and the individuals who depend on it. Many believe the only true solution lies in large-scale reform of the Social Security system and in addressing the federal budget deficit – a solution which can only come from Washington.

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