Patients Are Denied Eligibility for Social Security After New Rule Imposed To Counter Fraud, Backlog

As Republicans and Democrats continue to debate the future of the social security program disability program, one thing is become strikingly clear. Many Americans are suffering as a result of long backlogs, which might consequently mean more delays for any disability case to be heard and possibly approved.

According to former Social Security Administration acting deputy commissioner Jason Fichtner, the backlog had actually started around the time of the recession. He said that at that time, a great number of people who applied for benefits were disabled. However, it did not mean that they were unable to work. Because of this trend, such a backlog has begun snowballing.

Eligibility for Social Security Under Attack Due To Fraud and Backlogs

Social Security Backlog Has Caused Long Wait Times for Hearings

Today, more than a million Americans are currently waiting for their hearings. Depending on the state, waiting for a hearing may take an average of almost 600 days. On the other hand, getting a hearing is anything but reassuring for most Americans. Per Lisa Ekman from the National Organization of Social Security Claimants' Representatives, only around 45 percent of people who apply for disability benefits receive approvals.

Social Security Is Wary Of Fraud

The approval process is strained as Social Security is also trying to fight a significant volume of disability fraud. Earlier this year, one fugitive attorney had pleaded guilty to orchestrating a scheme in order to defraud the federal government of as much as $600 million. Eric Conn had said that he planned to defraud the Social Security Administration by using bribes that he paid to a judge and doctor to process and approve disability claims from his clients. Conn had processed 1,700 client applications for Social Security between 2006 and 2016.

New Rule May Mean More Denials For Certain Conditions

Earlier this year, Social Security has been trying to address these fraud using several measures. One of this by introducing a new rule that eliminates any special consideration granted to a person's longtime doctor when determining eligibility for social security disability.

Because of this new rule, however, it could mean that patients with illnesses must see an outside doctor cannot readily assess them and therefore may be denied benefits. This goes for conditions such as multiple sclerosis, schizophrenia and lupus. At the same time, these denials would also lead to a further increase in the backlog that the system is already entangled in.

Due to this, various healthcare facilities and institutions may face increasing challenge in verifying eligibility of a patient when it comes disability. Don't let this take a toll on your own resources. Instead, seek the assistance of an eligibility management expert in order to help get necessary and timely patient information. This way, you and your staff can go back to focusing on what you do best: delivering world-class healthcare to patients.

Disability Fraud,
New Rule May Worsen Backlog For Social Security Disability Claimants,
Long Waits And Long Odds For Those Who Need Social Security Disability,

Pete Ash

Pete is the Vice President of Sales & Client Services at DECO Recovery Management. He covers the Mid Atlantic region and specializes in Medicaid related topics. It is DECO’s Mission to maximize reimbursement to our clients by leveraging innovative technology, processes and compassionate advocates to provide exemplary service.

Categories: Social Security Disability Eligibility