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Congressman calls for investigation into doctors roles

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How some docs earn massive cash denying incapacity claims
Michael Schwab, Nashville Tennessean

NASHVILLE, Tenn. – The chairman of a Home Methods and Means subcommittee is requesting an investigation into docs employed to evaluate purposes to the federal incapacity program.

U.S. Rep. John Larson, D-Conn., cited latest stories by the USA TODAY Community in a letter despatched Wednesday to the U.S. Authorities Accountability Workplace, the federal authorities’s chief fiscal watchdog company. 

The community’s reporting “raised considerations in regards to the high quality of such critiques and it may lead to incorrect eligibility selections,” a information launch accompanying the letter stated. 

In Tennessee, an investigation revealed some docs have been racing by purposes submitted by individuals in search of to show they’re too sick or injured to work.

Extra: Need to understand how the federal authorities grants incapacity advantages? It’s going to price you.

Tennessean investigation: How some Tennessee docs earn massive cash denying incapacity claims

Rep. John Larson and colleagues reintroduce the Social Safety 2100 Act on Jan. 30, 2019. (Picture: Mark Wilson/Getty Photos)

Paid by the case, docs have been reviewing as much as 5 software information per hour. Consultants stated such speedy evaluate of purposes, which may include 1000’s of pages of medical information, is not believable. Lawmakers in Tennessee have already called for an investigation. 

When the USA TODAY Network requested data from the Social Security Administration to examine the performance of doctors in every state, the agency presented a $2.3 million estimate to provide those public records. 

Larson, who chairs the Social Security subcommittee, is asking the GAO to conduct its own state-by-state examination of doctors’ performances. 

In Tennessee, doctors who review applications are all on contract, paid a flat fee ranging from $30 to $47 per case. Some physicians were billing upwards of $400,000 each year.

Larson is requesting the GAO examine how widespread the practice of paying contract doctors is among states, and report on how much doctors are compensated. He is also asking the GAO to report on what qualifications and performance measures are required of these physicians. Larson has also requested an analysis of the quality of disability decisions. 

The GAO can accept or decline requests from members of Congress. If the office accepts a request, it then assembles a team of experts to conduct an audit. 

The Social Security Administration runs the nation’s disability program, which provides cash payments to Americans who can demonstrate they are too sick or injured to work. The estimated average monthly disability payment is $1,234. The federal government delegates to states the responsibility of reviewing applications to determine who qualifies. 

States hire doctors to review the application files and make recommendations on an individual’s eligibility for disability. 

Denials can be appealed, but the wait time for a judge can stretch to more than a year. 

“Accurate and prompt determinations are necessary to allow eligible people to access their benefits and gain relief from economic hardship,” Larson’s letter said. 

In fiscal year 2017, at least 9,570 people died waiting for their disability appeals to be heard. 

Follow Anita Wadhwani on Twitter: @AnitaWadhwani

Observe Mike Reicher on Twitter: @mreicher.

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