- DISABILITY CLAIM FAQ
The Social Security Administration (“SSA”) has been using the electronic claims analysis tool (“eCAT”) to document a disability adjudicator’s analysis since 2009. The goal was to foster uniformity so that applicants would be treated the same regardless of where they lived, and to ensure that all SSA policies are considered during the disability adjudication process.
The eCAT produces a Disability Determination Explanation (“DDE”) that documents the detailed analysis and rationale for either allowing or denying a claim. The DDEs of my claimants repeatedly show that the eCAT is failing to ensure the SSA policy of asking treating sources to conduct a consultative examination (“CE”) is being followed.
I represent a 50 year old landscaper with cervical radiculopathy, diabetic neuropathy, and arthritic knees, whose Social Security Disability application was approved today without a hearing by an Administrative Law Judge (“ALJ”) after a State agency examiner named Davidson, who used the eCAT to create the DDE, had denied the application. Davidson denied the SSD application solely because the claimant refused to attend an unnecessary CE that would have violated the Social Security rules and regulations. In the DDE, Davidson misrepresented that she contacted a treating doctor who refused to accept the State approved fee for performing the CE. The truth was that each treating doctor was ready, willing, and able to perform the CE.
To compound matters even further, Davidson also expunged critical evidence from the file that supported the claimant’s application. In the Residual Functional Capacity (“RFC”) section of the DDE, Davidson also misrepresented that no RFC assessments are associated with the claim, yet Davidson even admitted in the Record Source Statement section of the DDE report that one of the claimant’s dual board certified specialists in Pain Medicine and Physical Medicine and Rehabilitation concluded the claimant was limited to sitting 2 hours, and standing/walking less than 1 hour.
The ALJ approved the claimant’s SSD application based on the RFC provided by the claimant’s treating physician. If Davidson had followed the goal of the eCAT, and had complied with the SSA policy of asking treating doctors to perform CEs, then the time and resources of the SSA would have been preserved, and the claimant would have received his approval sooner. The State agency needs to be made accountable for habitually ignoring the purpose of the eCAT.Previous Next
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