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GAO Releases Larson-Requested Study on Quality of Medical Reviews in Social Security Disability Eligibility Determinations

November 9, 2021
Press Release

Washington, D.C. - Today, the U.S. Government Accountability Office (GAO) released a study, “Social Security Administration: Actions Needed by SSA to Ensure Disability Medical Consultants Are Properly Screened and Trained”. This study was requested by Chairman of the Ways and Means Social Security Subcommittee John B. Larson (CT-01) into whether doctors who help make Social Security disability benefit decisions are performing high-quality, accurate reviews. The study can be found here.  

“I welcome GAO’s findings and will continue oversight. It is critical that the Social Security Administration (SSA) uses only trained and skilled medical consultants, so that SSA can make the right decision in each case. I concur with GAO’s recommendation that SSA strengthen its capacity to review medical consultants’ performance and its ability to ensure that DDS agencies provide adequate training for medical consultants. I will continue to monitor this issue,” said Larson.  

A series by the Tennessean raised concerns about reviews done by contracted doctors who are paid on a per-case basis by the state Disability Determination Service (DDS) agencies that assist the Social Security Administration (SSA) with claims processing. Larson requested that GAO examine states’ use and oversight of contracted medical consultants and what is known about the impact on the accuracy of the decisions made. 

GAO surveyed 52 state DDS agencies regarding their medical consultant hiring, training, and performance oversight practices. GAO “did not find conclusive evidence of a link between how a state pays consultants and the quality of disability decisions in each state,” as indicated by SSA’s internal quality-review data. However, GAO recommended that SSA strengthen its capacity to review the performance of medical consultants and its ability to ensure that DDS agencies provide adequate training for medical consultants. GAO wrote: “SSA requires state agencies to ensure consultants meet its employment and training standards. While most states we surveyed reported meeting the requirements, several did not. As a result, SSA risks using consultants who are ineligible or not fully trained.” 

Prior releases: 

Chairman Larson Requests GAO Study on Quality of Medical Reviews in Social Security Disability Eligibility Determinations 

GAO Agrees to Conduct Larson-Requested Study on Quality of Medical Reviews in Social Security Disability Eligibility Determinations