Social Security asked the National Academies of Science, Engineering, and Medicine to examine health care utilization, including in-patient hospitalizations, emergency department visits and hospital readmissions, to determine whether these medical visits equaled severity of conditions as it relates to the Social Security disability process.
Big surprise, this group was unable to correlate health care utilization to severity of impairments as it relates to Social Security’s disability standard of gainful employment.
This report is summarized in a press release, but this is far from earth-shattering news. As a disability law office that assists claimants with the Social Security disability process, we see all types of clients. Some of them have 20 or more doctors they see for their impairments, which results in thousands and thousands of pages of medical records, but we also have clients who have just a handful of doctors, resulting in hundreds of pages of medical records. More medical records does not equate to a more severe impairment or a successful disability case, it is what is in the records that matters most.
People get caught-up in facts like how often someone goes to their doctor or is hospitalized for a condition, but that is not how Social Security determines if someone has impairments severe enough for them to work at a fulltime level and maintain gainful employment. Considering Social Security sponsored this study, but knew going into it, that health care utilization does not equal severity, one wonders why this study was conducted at all?
Social Security works with Disability Determination Services (DDS), a state agency, for lower-level disability determinations for Social Security disability cases. The examiners at DDS are required to analyze medical evidence on a disability claim to determine if the severity of impairments meets disability listings. Instead of conducting a study with an outside agency, Social Security should have just worked with DDS on this matter.
