Acting on ACUS Recommendations, SSA Implements Major Overhaul of Disability Claim Regulations Governing Medical Evidence

Politics & Government Business

By a News Reporter-Staff News Editor at Politics & Government Business -- Newswire/ -- The Social Security Administration (SSA) has announced the implementation of major changes to the rules governing administrative litigation in its multi-billion dollar a year disability claims program, as recommended by the Administrative Conference of the United States (ACUS). The changes appear in a HYPERLINK "https://www.federalregister.gov/documents/2017/01/18/2017-00455/revisions-to-rules-regarding-the-evaluation-of-medical-evidence" nfinal regulation published in today's Federal Register. The changes are expected to improve the consistency and accuracy of disability decisions, resulting in greater fairness to claimants and the reduction of litigation costs paid by taxpayers. As SSA noted in the regulation's preamble, the revisions were based on a HYPERLINK "https://www.acus.gov/research-projects/improving-consistency-social-security-disability-adjudication" nrecommendation and accompanying report by ACUS.

The new rule implements two important revisions to account for changes in how healthcare is administered. First, it expands the class of healthcare professionals whose opinions can be considered in deciding whether a claimant is disabled to include not only physicians, but also nurse practitioners, physician assistants, and other licensed providers. Second, it eliminates the so-called "treating physician rule" under which the SSA must give "controlling weight" to the opinion of a claimant's treating physician even in the face of conflicting evidence from other-sometimes more qualified-medical professionals familiar with the claimant's condition. The treating physician rule has spawned unnecessary litigation-both in proceedings before SSA and in appeals of SSA decisions to the federal courts-in large part because it is often difficult to determine who qualifies as a "treating physician."

According to Matthew L. Wiener, ACUS's Executive Director, "We are very pleased that, once again, ACUS was able to play so critical a role in improving what the Supreme Court has aptly called the world's largest adjudication system. I am confident that these changes to SSA's evidentiary rules will improve the accuracy of SSA's decisions, make the system more fair for deserving claimants, and reduce the significant costs borne by taxpayers as a result of unnecessary litigation resulting from appeals of SSA decisions to the federal courts. No other government agency could have done what ACUS did here. We thank SSA for its consideration of and reliance upon ACUS's recommendation and report."

This is not the first time that SSA has relied on ACUS recommendations to improve the disability claims systems. In 2015, for instance, the agency relied heavily on the blueprint provided in an ACUS HYPERLINK "https://www.acus.gov/research-projects/ssa-disability-benefits-programs-duty-candor-and-submission-all-evidence" nreport when it amended its rules to require that claimants submit all evidence relating to their claims of disability, not just evidence that supports them.

Keywords for this news article include: Legal Issues, Government Agencies Offices and Entities, The Administrative Conference of the United States.