Social Security Disability Eligibility Cuts Treating-Physician Rule, Keeps Appeal Waiting Times Long

The Social Security Disability program benefits millions of Americans, no matter how old or young they are. However, a new rule imposed by Social Security recently may make it harder for any patient of any age to be approved for social security disability eligibility. This is because the administration has recently introduced a new rule where doctors’ reports would no longer be used to determine an individual's eligibility to receive benefits.

Rule changes such as this present additional challenges to hospitals and healthcare institutions trying to determine if their patients qualify for disability benefits. 

Social Security Disability Eligibility Removes Treating-Physician Rule

Social Security Administration Announces an Update to Its "Treating-Physician Rule"

The Social Security Administration has just said that it will now eliminate the use of what is known as the "treating-physician rule" as a basis of disability eligibility. The said rule refers to Social Security's previous practice of giving a doctor's report significant weight in supporting a person's disability entitlement. Previously, Social Security adjudicators are required to consider evidence of disability as presented by the medical professional treating the claimant.

Under the new regulations, however, the said rule would no longer be used to determine an individual's social security disability eligibility. This would make it much more challenging for a patient to prove that they are entitled to receive disability payments when they are trying to make a new claim. On the other hand, the Social Security Administration will also no longer give additional weight to any disability determinations of any other government agencies, including the Department of Veteran Affairs. 

Waiting Time to Make an Appeal After an Initial Denial Continues to Take Too Long

Despite recent changes in rules, what stands to remain the same, nonetheless, is the time that it would take for an initial denial of benefits to be appealed. According to current standard practice, it would take around two years for a claimant to be able to have a hearing on their appeal. This poses a problem, however, as a claimant's health condition may have already degraded significantly during the waiting period and may now be unable to attend their hearing.

As much as 1.4 million are said to be waiting for a disability hearing presently. So far, the average waiting time for a hearing vary depending on the area. For instance, the typical wait time is 18 months in Evansville and 16 months in Fort Wayne. On the other hand, the wait time for a hearing in Indianapolis can be as long as 19 months.

Number of Americans Receiving Social Security Disability Payments Continues to Go Down

There are reportedly around 8.8 million people throughout the United States who are receiving social security disability payments. This is said to be the lowest in nearly five years.

In fact, a report done in January found that number of payees had fallen slightly to 8.79 million from 8.89 million back in January 2016. With the new rules in place, these payments can be expected to continue decreasing year after year.

On the other hand, there had also been a decrease in the number of applications for benefits each year. In 2016, there were only 2.32 million benefits applicants compared to 2.93 million 2010.

As rules get removed and waiting times continues to lengthen, a medical institution may end up dealing with more and more patients who are suddenly unable to afford their treatment and care. To help navigate the complexities of the Social Security Disability program, it helps to consult with an experienced eligibility management firm who can help your healthcare facility maximize disability collection and reduce unpaid medical bills.

Disability claims approval getting tougher,
New Social Security Administration rules go into effect,
Eligibility for Social Security Disability Benefits,

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Categories: Social Security Disability Eligibility