If you check in the archives of this site  for the other postings for processing time, you will be able to see the other rankings for past times. Indianapolis has improved so that it no longer hovers in last or next to last place, and it has not for many months now. Be sure you check out the Archives for postings on many different issues connected to a Social Security Disability claim or you are not getting the full benefit from this site!

Regenstrief Institute to help improve disability determination through health information technology

INDIANAPOLIS –- The Regenstrief Institute has been awarded a Recovery Act contract to help the U.S. Social Security Administration and Indiana healthcare providers shorten and improve the process of making disability case determinations through automation. Work is scheduled to begin March 31.

The process of acquiring medical information for an SSA disability claim involves numerous requests to multiple healthcare providers treating the individual seeking disability benefits. This process can take weeks or even months following an application for benefits. Physician offices, hospitals and others health care provider must gather the individual’s recent medical information and submit it via fax or U.S. mail.

The Regenstrief Institute, an international leader in heath information technology, created and operates the Indiana Network for Patient Care (INPC), a secure statewide health information exchange that providers use to help improve the quality, safety and efficiency of care that their patients receive. Improving the disability determination process complements other functions of the INPC, including surveillance for influenza outbreaks and access to a patient’s diverse medical records when providing emergency care.

“We will leverage the capability of the INPC to quickly and efficiently collect the information requested electronically by SSA, with the specific authorization of the person applying for disability benefits, and securely transfer it to the government so the disability decision process can be completed more rapidly. This will make that process more efficient – both because it will be faster and also because the medical data compiled will be more complete. It also will take the time and expense of going to many different providers, assembling the necessary records and filling out forms off the shoulders of patients and decrease the need for providers to search for and send records manually,” said Brian Dixon, MPA, project manager for Regenstrief’s SSA contract.

To effectively make decisions regarding applications for disability, the SSA needs the same kind of medical information that physicians utilize when making diagnoses, treatment, and referral decisions. Healthcare providers in Indiana rely on the INPC to securely and privately share clinical data which is utilized daily to support healthcare services throughout Indiana.

“Facilitating the processing of patients’ disability claims is another example of how healthcare providers throughout Indiana have worked together with the Regenstrief Institute and Indiana Health Information Exchange to ensure that their patients’ healthcare information is used to enhance their care,” said J. Marc Overhage, M.D., Ph.D., director of medical informatics at the Regenstrief Institute, Regenstrief Professor of Medicine at the Indiana University School of Medicine, and president and C.E.O. of the Indiana Health Information Exchange.

Disability benefits determination is a large-scale process. The SSA expects to receive more than 3.3 million disability benefits applications in fiscal year 2010, a 27 percent increase over the 2008 fiscal year. Annually, more than 15 million requests for medical records are sent to healthcare providers.

When you apply for disability, your claim is sent to a state agency that SSA hires to made the medical determination of  whether you are disabled. In many states this is called the Disability Determination Service,  DDS, while in Indiana the current name is the Disability Determination Bureau, DDB. It is these State workers that decide your claim.

The National Association of Disability Examiners, NADE, describes itself as:

a professional association whose purpose is to promote the art and science of disability evaluation. The majority of our members work in the state Disability Determination Service (DDS) agencies where 15,000+ employees adjudicate claims for Social Security and/or Supplemental Security Income (SSI) disability benefits. As such, our members constitute the “front lines” of disability evaluation.

A recent issue of The NADE Advocate, Volume 26, Number 1,  provides insight into why SSA may make the wrong decision in your case.

The growing complexity of the Social Security and SSI Disability Programs, coupled with the need to produce a huge volume of work, justifies even more the need for adequate resources in order to provide the service that the American public has come to expect and deserve from SSA. It takes an average of two years for a newly hired disability examiner to become fully trained and proficient to the point they can function independently and contribute to the process of making timely and accurate disability decisions. Thus, decisions not to replace productive personnel when they leave can take two or more years to correct even after new hires are made. NADE has long maintained that it is critical for SSA to be provided with the resources needed to hire and train new staff that can perform these duties. Low salaries, hiring restrictions and the stress of the job have contributed to high attrition (12.3%) in the DDSs. (Emphasis added)

Constantly having to replace 12.3% of the workforce and it taking two years before they can function independently, plus the stress of the job to get the work out fast, combined with low pay, may be a reason that DDB makes the wrong decision so many times.

The important point for you is that you should not be discouraged when your claim is turned down at the initial or reconsideration stages. With approximately 65% turned down on initial application and approximately  93%  turned down at Reconsideration,  you should take the steps necessary to increase your odds of winning. You will need an experienced attorney in Social Security claims to help you increase your odds in what NADE calls a “growing complexity of the Social Security and SSI Disability Programs.”

Unlike many attorneys, I will begin to help you with your case before your file your claim.  Read When Should I Hire An Attorney For My Disability Case? for my reasons why. What are you doing to increase your odds of winning?

The bad news is that the wait is still over two years long from the Request for Hearing. It is important that you keep seeing your doctor during your long wait so that your medical condition will be documented.

I recently posted that Indianapolis had dropped from 144th place out of 147 to 147th out of 147 (now the worst in the nation) with an average processing time of 896 days from the time of the filing of the Request for Hearing. Yesterday I posted on the Congressional Subcommittee that will be holding hearings to examine SSA’s management of its hearing offices and to explore measures that can be taken to improve productivity.

The hope is that by transferring cases from an Indianapolis judge to a judge in another office that  the cases will be heard sooner than if they stayed here with our Indianapolis Judges. Time will tell if this is how things really work out. There have been times in the past where cases where transferred out to other judges and by the time the case was heard and decided, no time was really saved.

Also, out of town judges are not familiar with our local physicians and hospitals and the way they do things. This can sometimes make a difference in how the out of town judge views the medical care that a claimant receives or the medical evidence. For example, if Doctor X is recognized in the local community as being THE expert on heart conditions to which all other doctors defer and the judge does not know this, the judge might not give as much importance to Doctor X’s opinion as he/she otherwise would if the Judge lived here and knew about Doctor X. In some cases, this could be very important.

The notice is not clear if the judge will actually travel here to Indianapolis or if the Judge will do the hearing by Video. Unless SSA has made improvements to the video equipment that it used in the past, I can not recommend video hearings. I had one client that was desperate for a hearing and the medical evidence was very, very strong. She could not wait any longer and we did a video hearing. The quality of the picture was so poor that if I had to pick out of a line up the judge that conducted the hearing, I would have to guess as I could not clearly see her features. I have been told that the more technically inclined judges can figure out how to control the camera at their end and adjust the focus and can zoom in to see the cliamant—I just have no way of knowing if that judge I have never seen before has the technical expertise to adjust the equipment so that the judge can really see my client. The picture is not “high definition TV” quality. I was not impressed. Some attorneys love it.

Indianapolis still needs more judges and support staff. Hopefully SSA can find the money to hire both for our Indianapolis hearing office. All of our Indianapolis hearing office employees are working as hard as they can. Hopefully this transferring of cases will benefit the claimants by causing their hearings to be heard sooner than if the case was left with our judges.

According to the background material in the announcement, the average processing time from the time that the Request for Hearing is filed is now 532 days. As I recently noted, the Indianapolis Office of Disability Adjudication and Review has an average processing time of 896 days and Indianapolis is ranked 147^th out of 147 hearing offices.

The background material confirms what I previously posted: years of too little money to hire support staff have caused us to end up where we are today. If you do not have enough workers to do the work, it will just pile up and take longer and longer to get it done.

In announcing the hearing, Chairman McNulty said, “Earlier hearings have demonstrated that prolonged underfunding has resulted in the loss of staff needed to process disability cases at the Social Security Administration.  This has led to an unprecedented backlog of unprocessed claims and untold suffering.  The agency must have the resources it needs to eliminate this unconscionable backlog.  At the same time, we must ensure that SSA uses these resources as effectively as possible.  This hearing will examine SSA’s management of its hearing offices, and explore measures that can be taken to improve productivity without compromising the right of claimants to a fair and impartial decision on their case.”

The announcement notes that concerns have been expressed that the agency’s plans for hiring support staff are not sufficient to address the large hearings backlog, that planned automation improvements will not meet expectations, and that an overemphasis on speed could degrade quality or compromise program integrity.