NCPA - National Center for Policy Analysis

Doctor Revolt Shakes Disability Program

November 22, 2011

Earlier this year, senior managers at the Social Security Administration in Baltimore, frustrated by a growing backlog of applications for federal disability benefits, called meetings with 140 of the agency's doctors.  The message was blunt: The number of people seeking benefits had soared.  Doctors had to work faster to move cases.  Instead of earning $90 an hour, as they had previously, they would receive about $80 per case -- a pay cut for many cases which can take 60 to 90 minutes to review -- unless the doctors worked faster.  Most notably, it no longer mattered if doctors strayed far from their areas of expertise when taking a case, says the Wall Street Journal.

The agency is under political pressure to reduce the backlog.

  • The Social Security Disability Insurance program paid $124 billion in benefits in 2010, up from $55 billion in 2001.
  • The backlog of pending appeals in September was 771,318, up from 705,367 in 2010 and 392,397 in 2001.

In targeting the doctors, the Social Security Administration says it is seeking to overhaul a part of the disability-review process that can be both expensive and slow.  But many doctors and former agency officials say the changes threaten the quality of decisions.  Several doctors said medical opinions were now prone to inaccuracy since many specialists don't have the backgrounds to make decisions outside their areas of expertise.  The new policy could make doctors more likely to award benefits to those who don't qualify and deny benefits to those who are entitled, these doctors said.

  • After the procedures were implemented in Baltimore, an eye doctor was assigned back pain cases, several doctors said.
  • A dermatologist reviewed the files of someone who had a stroke.
  • A gastroenterologist reviewed the case of someone with partial deafness, the doctors said.
  • Two other doctors also said they were pressured to award benefits in cases where they were reluctant.

Source: Damian Paletta, "Doctor Revolt Shakes Disability Program," Wall Street Journal, November 21, 2011.

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