Letter to Gail Ennis, Social Security Administration Inspector General - Reed, Larson Ask SSA Inspector General to Analyze Customer Service During COVID-19 Pandemic

Letter

Dear Inspector General Ennis:

We write to request the Office of the Inspector General (OIG) to assess the Social Security
Administration's (SSA) current process for obtaining medical evidence of record (MER) for
disability claims.

Medical evidence is used to determine if an individual's condition is severe enough to be eligible
for Social Security Disability Insurance and/or Supplemental Security Income benefits. SSA
often obtains medical evidence directly from claimants and SSA is also responsible for making
every reasonable effort to help the claimant obtain medical reports from his or her medical
sources. SSA requests millions of medical records each year from healthcare facilities and
health professionals across the country to obtain evidence of an individual's medical condition.
While an important part of the disability process, the most recent report on this topic from the
OIG is from 2001 and does not reflect changes to the process over the past nearly 20 years.

With that in mind, we are interested in understanding the following:

1. What share of MER is obtained directly by SSA from providers compared to from
claimants themselves? How has this changed over time?

2. With respect to MER that is obtained directly by SSA:

a. What is SSA's current process for obtaining medical evidence in the form of
either electronic medical records (also known as Health IT) or traditional paper
records?

b. What is the cost for SSA to obtain MER? How does cost vary by form, type, or
state?

c. What is the processing time to receive MER and how does it vary? What
challenges does SSA face regarding receiving MER quickly?

d. What challenges does SSA encounter regarding the acceptance of Form 827
authorizing the collection of MER? Do these vary by state or provider?

3. What were the results from SSA's June 2018 Request for Information (RFI) for Social
Security Administration's National Medical Evidence Collection, SSA-RFI-18-622?
Specifically, what information did SSA receive as a result of the RFI and what actions
did the Agency take (or does the Agency continue to take) based on the responses to the
RFI?

Thank you for your attention to this matter and we look forward to seeing your response.

Sincerely,

Source