Social Security Disability Program Embraces HiTechnology

Social Security Disability Process Embraces Technology
It is estimated that 3.3 million claims for disability benefits will be filed by year’s end. The disability programs have evolved since their inception. It is now it is an imperative in order to deal with the growing number of claim expected as the “babyboomers” reach the so called illness and injury prone years. SSA continues to push the envelope in the practice of embracing technology. The latest announcement, heralding the collaboration between SSA and Microsoft, involves using their software “Health Vault” as a tool to collect medical information to expedite disability claims. http://www.ssa.gov/pressoffice/pr/ms-healthvault-pr.htm
It is not only the prospect of adjudicating the number of cases anticipated that concerns the program’s designers. The back log of claims has resulted in severe delays requiring some individual to wait of up to 3 years for a disability determination. Another technological solution was recently described by the Commissioner of SSA. “This year, through Compassionate Allowances and our Quick Disability Determination process, over 100,000 Americans with severe disabilities will be approved for Social Security disability benefits in a matter of days rather than the months and years it can sometimes take,” said Commissioner Astrue.
This advance uses the “Electronic Disability Collect System” (EDCS) to electronically identify eligible claims. This is a computer program that uses a “Predictive Model”, perhaps interfacing with HealthVault, and selects the eligible person within what Commissioner Astrue considered “as having a high degree of probability”.
For this process to work the individual applying for disability benefits would have to use Health Vault as their depository of their personal health information or PHI as it is referred to in the HIPAA act. “Social Security and Microsoft are developing a technical prototype connecting the two organizations that will be available later this year. The agency also will collaborate with Microsoft to study current personal health record standards, gaps in those standards, and options for filling those gaps” according to Commissioner Astrue. In the effort to process millions of claims a year in a timely fashion, SSA and Microsoft will investigate methods to gather and maintain the private health information on every American.
Currently, SSA grants approximately 38% of the applications filed. The remainder of the claimants either abandon their claim or become involved in an appeals process that takes years in some instances. It is admirable that SSA is looking for methods to provide benefits to those who fit a “predictive model” in a matter of days rather than years as Commissioner Astrue pointed out. The question remains ;what do we do to expedite those claims of individuals denied because the medical information does not fit that predictive model. The claims that are included in the current backlog of cases are all on appeal. This means none of them met the scrutiny of a disability examiner and state agency physician reviewing their applications and medical documentation. How will the implementation of these hi-tech initiatives impact the statistics?
It will be interesting to learn the percentage of cases granted utilizing the new initiatives. Unless it is significantly higher than 38%, SSA can still anticipate a significant number of cases in the appeals stage. These cases will require the attention of an Administrative Law Judge and the time required for a hearing.
There are initiatives to alleviate the backlog of cases pending hearing. SSA hired over 100 more Administrative Law Judges. Claimants are offered hearing via video conference which takes less time for the hearing office staff. This would allow the judges to hear more cases per month.
The Administration has given authority to staff attorneys in the hearing offices to review cases and recommend approvals for on-the-record favorable decisions.
The system requires upgrades to keep pace with growing demand for assistance. Technology can alleviate some of the problems. No matter what changes are made by the Administration, a successful case requires that the claimant provides accurate medical information. A case that can be approved based on a predictive model using a clearinghouse of personal medical information from a computer program probably would fall within the 38% currently approved at application.
The remainder of cases will be processed using technology like electronic claim files, video hearings and other time saving procedures. No matter what technology is applied, behind every claim is a person. By nature of the program involved, all of these people are in distress physically and mentally. SSA can impersonalize the process but the person feels the impact.