Social Security Staff Fail to Develop Medical Evidence

The Social Security Administration Office of Inspector General recently found that the Disability Determination Services did not always develop all available medical evidence before making a disability determination. The report found that although DDS generally followed policy, sometimes evidence at the initial and reconsideration levels was absent either because the Claimant did not provide the information or the medical source did not respond to requests for the medical data. It was found that DDS staff did not always follow the regulations and policies to make every reasonable effort to obtain evidence and document the attempts in the disability folder.

The Inspector General estimated that about 214,500 cases contained medical evidence at the hearing level that DDS staff could have obtained at the initial decision level but did not. Additionally, the Inspector General estimated that about 235,000 claimants reported medical sources when requesting a hearing, but that SSA staff did not obtain the medical evidence for them.

There were three (3) main reasons why evidence was not obtained: 1) The Claimant did not inform SSA of the evidence. 2) Evidence was requested but not received. 3) No attempt was made to obtain the evidence.

The Inspector General concluded that if all of the existing evidence had been obtained at the DDS level, the claims may not have needed to be appealed for a hearing. It costs nearly four times as much to process a hearing level case as to process an initial level claim. Obtaining the evidence earlier could result in significant administrative savings.

Social Security Disability Attorney and Lawyer, Randy Zeldin, Esq., maintains offices in Boca Raton, Ft. Lauderdale; Boynton Beach and West Palm Beach. Randy Zeldin, Esq. assists individuals in obtaining and presenting relevant medical evidence at the initial application stage. This attorney input can be instrumental in obtaining a favorable result at the initial application stage.