Articles from prior issues of The Advocate

May/June 2001

Nade In New Hampshire - Prototype In New Hampshire
by Terry Batchelder
Prototype Unit Supervisor/NADE Member

The New Hampshire DDS has now completed 18 months in PROTOTYPE. Accuracy is high, as is our allowance rate. Many adjudicators are enjoying the challenge of the single decision maker responsibility and everyone’s individual knowledge base — medical, vocational, and technical — continues to increase. Caseloads continue to increase with the average now being about 150 cases, with a high of 250. These caseloads would have been high even under the old system, but here in our DDS, claims are distributed daily, not held back/staged. Claimant Conferences are going along without problem.

The requested upgrading which the NH DDS adjudicators initiated and which was backed by the NH DDS Administrator, is in the final stages of consideration by the NH Department of Personnel. Hopefully, we will hear the outcome within the next few months. We have recently hired and are in the process of training two new adjudicators in the Prototype process — Ginny Rhinehart and Peggy Vieira. They have both done decisions as single decision makers and are beginning to do Claimant Conferences. Both Ginny and Peggy are being guided by our two Immersion prototype adjudicators, Martha Rheaume and Lisa Beck, but all adjudicators and Medical/Psychological Consultants are helping in the training/mentoring process. Of course, non-complex denials and easy allowances are hand-picked to allow our two new adjudicators to learn the process and gain confidence.

Just before Thanksgiving, NH DDS had a Prototype Onsite Visit from SSA Central and Regional Office personnel. They met with all our adjudicators, supervisors, medical consultant and QA staff. The Central and Regional Office people did some training and case discussion but the most valuable part of their visit was the question and answer session. The high point of the presentation appeared to be that we need to consider and weigh ALL MEDICAL SOURCE OPINION not just “acceptable medical source opinion”.

Consideration of vocational issues in Prototype claims continues to take a great deal of time and in many cases, takes more time to investigate and sort out than the medical and SDM processes. Bottom line is a denial is a denial is a denial… no matter how much time is put into investigating what the claimant did for work in the past in many, many of these claims. Verifying work in the DOT and then considering transferable skills and/or citing three appropriate jobs which the claimant is still capable of doing is a waste of good adjudicator time when the final outcome will be a denial!!! There must be an easier, less costly and more time efficient way to get through this part of the decision making process.

All in all, Prototype in New Hampshire is the only way that initial claims are processed. Our hard working and dedicated staff continue to upgrade their knowledge and skills and make the process work. CONGRATULATIONS TO ALL INVOLVED.