Social Safety Administration: Actions Wanted by SSA to Guarantee Incapacity Medical Consultants Are Correctly Screened and Skilled

Social Safety incapacity advantages are usually meant to assist individuals who can not work because of a incapacity. The entire state companies that evaluation incapacity claims seek the advice of with physicians to guage claimants’ medical eligibility.

Issues have been raised about:

  1. SSA’s oversight of states’ consultants, and
  2. Whether or not paying contract consultants per declare impacts the standard of their work.

SSA can not ensure that the state companies’ consultants are certified and skilled to appropriately inform selections on incapacity claims.

SSA coverage requires state companies to display screen their consultants by checking them towards a database of people barred from collaborating in federal applications. Additionally, SSA coverage units necessities for state companies to offer preliminary and follow-up coaching. Nevertheless, state companies advised us they don’t all the time accomplish that.

Of the 52 companies:

  • 14 mentioned they didn’t constantly carry out required checks on consultants both when hiring or yearly, and
  • 9 mentioned they didn’t give consultants some component of required preliminary or refresher coaching.

We additionally seemed into whether or not paying consultants per declare quite than an hourly or wage price—which 19 companies do—impacts the standard of their work. Our evaluation of SSA knowledge didn’t discover conclusive proof of a hyperlink between how a state pays consultants and the standard of incapacity selections in every state.

Employment of Incapacity Consultants by State

We surveyed incapacity companies that evaluation claims within the 50 states, District of Columbia, and Puerto Rico. We additionally analyzed SSA high quality assurance knowledge by state, reviewed SSA insurance policies and related federal legal guidelines and laws, and interviewed SSA officers and officers from companies in a number of states.

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