Update on Disability Determination Issues
Alan D. Entin
Contributing Editor for Disability Determinations
Chair, Division 42 Disability Determinations Committee
Amy Rabinove, J.D.
Director of Federal Regulatory Affairs, APA Practice Directorate
Recently on the Internet, Rick Small wrote about the need for "some lobbying or other work" from the Disability Determinations committee regarding a pilot program that Social Security is beginning which would allow disability claims to be adjudicated without input from a "medical consultant," either a psychologist or a physician. Since the inception of the proposal regarding the expanded role of the disability adjudicator into a "disability claims manager," the Division and the Practice Directorate have been active in opposing the proposal.
The following response to Dr. Small was posted on the Internet from Amy Rabinove, J.D., Director of Federal Regulatory Affairs at the P.D., and myself.
"As some of you may know, the Social Security Administration is currently pilot testing a proposal that would expand the role of SSA disability decisionmakers. Currently, initial determinations of disability involve a team approach; a joint decision is rendered by a state agency medical or psychological consultant and a state agency disability adjudicator.
The expanded role that is currently being pilot tested places sole responsibility for the initial determination of disability with a "disability adjudicator", who may consult with medical or psychological consultants at his or her discretion. This represent a significant departure from current practice.
APA has actively opposed this proposal since its inception. We have submitted written testimony to Congress, written numerous comment letters to SSA, and met with SSA officials on several occasions.
We have argued that the disability claims manager should never have the discretion to independently decide a claim for disability benefits, and we have strongly encouraged SSA to retain the current system. Determinations of disability are frequently quite complex, especially in cases alleging mental impairment. Moreover, the SSA disability programs are medically based, reflecting disability criteria that involve medical impairments, and requiring the evaluation and resolution of highly technical and conflicting medical evidence. Despite assurances from SSA that disability adjudicator will be highly trained, we have argued that no level of in-house training can possibly compare to the education and expertise possessed by professionally educated medical and psychological consultants."
We will continue to monitor the pilot testing which is currently underway, and will keep you apprised as more information becomes available.
Editor's note: Richard Small, Ph.D. is past-president of the Pennsylvania Psychological Association and currently a member of the APA Council from Pennsylvania.