Articles from prior issues of The Advocate

May/June 2000

Comments by The National Association Of Disability Examiners
on the
Proposed Standards For Privacy Of Individually Identifiable Health Information

THE NATIONAL ASSOCIATION OF DISABILITY EXAMINERS (NADE) is a professional association with the majority of our members being disability examiners, quality assurance and public relations personnel, hearing officers, physicians, administrators and support staff employed in the state Disability Determinations Services (DDS) agencies. However, our membership also includes physicians, psychologists, attorneys, advocates, representatives from private insurance companies, Social Security claims representatives, and other professionals not in the DDSs who work with, and are interested in the evaluation of disability claims. We believe it is the diversity of our membership, as well as our experience working with the Social Security and SSI Disability Programs which provides us with a unique perspective and understanding of those programs and the public they serve.

NADE would like to take this opportunity to offer comments on the proposed standards for privacy of individually identifiable health information.

The Disability decision-making process begins with individuals in identifying their disabling condition(s), the date they were last able to work because of the condition(s), the type of treatment received, and sources and dates of treatment. Examiners must evaluate all of the aforementioned as well as any other physical or mental conditions and the total impact on the claimant’s ability to perform work-related functions. This process is, unfortunately, a very time consuming process, especially when you remember that disability claimants are unemployed individuals and not yet of retirement age.

The Social Security Administration is currently taking steps to improve and enhance the service provided to our customers. Such steps include enhanced retrieval of medical records via electronic transfer. Some DDSs are using electronic transfer, which has significantly decreased claim processing time, providing faster decisions for our customers. Any measure to eliminate and/or restrict use of a signature on file standard would be detrimental not only to SSA’s customer service goals but also to the public.

The current disability process allows examiners to initiate development on each claim upon receipt in the DDS. Using the current standard release form (SSA-827) and the disability reporting forms, examiners are able to identify sources of medical evidence for the appropriate adjudicative period on individual claims and requests the evidence immediately. Use of the current SSA-827 also allows adjudicators the ability to request necessary medical evidence of record (MER) when treatment has been provided subsequent to the filing of the Disability claim and when not identified on the disability reporting forms. Under the current process, examiners are required to develop the medical history of an individual for the 12-month period preceding the alleged onset of disability. The past medical history must cover a longer period in certain conditions. More often than not, an individual does not identify all sources and/or dates of treatment. Many cannot name specific tests and some are not able to remember any specifics about the past medical history. Regardless, examiners must obtain the past and current medical records. The contents of the medical records often reveal other sources of MER which must then be obtained.

Although the adjudicative process remains lengthy, examiners must retain the ability to access individual medical records as needed to provide individuals with accurate decisions. Any alterations to the law prohibiting and/or limiting full access to the medical records of disability claimants would be detrimental to the Social Security Disability Programs as well as our disabled citizens and their dependents.

NADE asks that the Social Security Disability Programs be exempt from any laws that may interfere with the collection of medical evidence and/or the Social Security Administration’s measures to enhance the collection process.