As part of the process for applying for Social Security disability benefits, whether we are talking about Social Security Disability Insurance (SSDI) benefits, or Supplemental Security Income (SSI) benefits, the U.S. Social Security Administration (SSA) will likely have an “independent” review of your doctor’s medical records or possibly conduct his or her own independent medical examination.
The reason we are skeptical about the independent aspect of this medical review is because these doctors are on a panel of doctors in each location that get selected for use in these types of cases and get paid for their medical services. Due to budgetary concerns, the SSA a least seems like it has an interest in denying claims, so it can pay out less in benefits, so if these doctors want to get more work in the future from SSA, it seems like it wouldn’t hurt to side with the SSA and deny benefits, unless it would be ridiculous not to do so. It should be noted that what the SSA thinks is ridiculous is not the same as a normal person in terms of when it is appropriate to find someone not disabled.In addition to the SSA, many of these same doctors will also testify in workers’ compensation hearings at the state level so they may be on both panels and use these cases to either supplement a private practice, or in some cases, as the doctor’s sole source of income. According to a recent news article from the San Francisco Gate, a doctor was removed from a state panel after many complaints were filed about his exams. Some people said he was doing exams in less than 10 minutes, and others said he was not mentioning obvious things like broken bones, the use of a cane during visits, and even an internal bleeding disorder.
While this doctor was no longer allowed to do independent evaluations for the State of California, the SSA had no problem using him to review medical records and examine claimants in SSI and SSDI cases, and he was frequently, if not always, forming the opinion that these claimants were not disabled. SSA was using his testimony over and over again to deny benefits. As a result of this, many claimants filed a class action lawsuit against the SSA. This lawsuit recently settled and, as a result of that settlement, that doctor will no longer be used for SSA evaluations, and the court will be reviewing these claimants plus an additional 6,500 hundred applications that were denied based in part on the opinion of this discredited doctor.
In cases where the claimant does not have legal representation, it is even easier for injustices like this to occur, since nobody is looking out for the claimant’s best interest. For this reason, the best thing you can do to improve your chances of obtaining a fair and appropriate award is consult with an experienced Boston disability lawyer.
If you or a loved one is seeking Social Security Disability Insurance in Boston, call for a free and confidential appointment at (617) 777-7777.
Additional Resources:
Settlement will restore benefits denied by discredited doctor, September 25, 2016, By Bob Egelko, SF Gate
More Blog Entries:
Worker Taxed Thousands for Social Security Disability Benefits He Never Received, June 21, 2016, Boston SSDI Lawyer Blog