Articles from prior issues of The Advocate

July/August 2001

Forty-Six Years of State Service in Social Security and in Vocational Rehabilitation
by Robert C. Rainie, MD, Medical Consultant, New Hampshire DDS

Dr. Rainie is the most experienced MC in the United States. He joined NADE in the mid-sixties when NADE and the NRA were one organization. He still proudly displays the NADE/NRA certificate on his wall in his office. Dr. Rainie has worked for the DDS for thirty-five (35) years, has been in state service for forty-six (46) years, and today he is still working with the New Hampshire DDS. He is 81 years young!

It hardly seems possible that it was in June of 1955 that Wallace Black, the Commissioner, came into my barely opened office to ask if I would be the medical consultant for the New Hampshire Division of Vocational Rehabilitation. Although this was an unknown specialty to me, I was easily assured that it was purely reviewing cases and advising any necessary medical therapy to get the client back into the workforce. It only would take a few hours a week for a very few dollars. Little did I realize that accepting this proposition would be the most important decision in my life after deciding to become a doctor and then asking my very favorite nurse to become my wife. Case reviews and evaluations became more and more involved and numerous, so that when I sold my practice in 1986, I was requested to become a full-time state employee. This again was a very profitable decision, but I then realized that I was supposed to be retired and I was working harder than ever, so in June, 1987, I returned to my original part-time chief medical consultant on a contract basis, having much more control over my working hours. In 1966, the Social Security Administration introduced the Social Security Disability Program, which has become more involved, more expensive and much more time-consuming than had ever been expected. Over the past 35 years, we have been very fortunate to have had a series of excellent consultants, consisting of five medical, three psychological and one pediatric member. We are such a close knit group that questionable situations are easily dealt with, and vacancies are quite easily replaced by physicians who are considering retiring whom we encourage to make applications for these positions.

We have an ever-growing staff of new examiners who are well-trained by supervisors and superiors while they are in the process of evaluating disability applications. More experienced opinions are readily available, making us one big happy family, all working in the interest of the applicant. Our decisions are considered nationally to represent the result of extensive cooperative deliberation resulting in our decisional accuracy.

Over the years, many changes have occurred which give me concern regarding the future of the Social Security Disability program. In my evaluation and decisions of the Continuing Disability Review cases, I am amazed at the ever increasing size of the folders, in many cases 8 inches or more thick, more than half of which is administrative material. Forwarding only the medical records would greatly reduce the time of review in the State DDS with the decisions much more timely. So much time is wasted separating medical from technical evidence. MINE cases need to be more accurately identified with medical evidence being easily identified to certify a continuing ongoing severe impairment. Initial denials by competent medical or psychological specialists, which are referred to an ALJ, should always have a medical specialist present to support the initial denial decision. Far too many allowances by the ALJ have been found to stay in payment status for ages. It also seems to me that a great deal of time and money are spent in dictating lengthy, far too detailed narrative summaries which are too involved and unimportant for the reader to spend the time making the decision.

I have found this to be a very interesting and challenging part-time job, which gives me the satisfaction of doing something worthwhile, knowing that in any borderline disability case, the decision is always awarded to the claimant. I appreciate this opportunity to express some of my thoughts gathered over these past 35 years in making these disability decisions for these unfortunate residents of the State of New Hampshire, which I love.