By Bethany Anderson
“You never get approved on your application, unless you hire a lawyer to fight it out for you,” said a 17-year Johnson County Army Veteran, (who has asked to remain anonymous) with physical and mental injuries to show for it, as he talked about the denial of his Social Security Disability application.
Sadly, Tennessee is reportedly posting the highest denial rates for disability applicants in the nation. A recent report based on USA Today Network/Tennessee investigation included such data as the ejection of 72 percent of all claims in 2017, as well as the national average for denials at 66 percent.
According to the report, experts along with former and current state employees have much difficulty in reviewing cases quickly, without making mistakes, which may reportedly lead to wrongful rejections of disability benefits.
The above-mentioned investigation examined more than five years of data for physicians and psychologists who review disability applications showing that between January 2013 and July 2018, some doctors raced through cases with more than half of all contract physicians outpaced the federal standard of 1.5 cases per hour, and that one out of every five doctors doubled that pace.
The investigation revealed that seven high-volume doctors billed for more than $1 million each between fiscal 2013 and 2018. These physicians’ annual payments range from $103,000 to $451,000. By contrast, the acting chief of the Social Security Administration, a Cabinet-level position, earned $240,000. For some physicians, this was not their sole source of income.
According to the investigation, staff doctors whose compensation is not tied to the number of cases they review take more time. These doctors reviewed cases at a rate that is in line with federal recommendations. They typically earned less than $150,000 annually, according to the state’s salary database. However, the state only employed a small number of staff doctors. Beginning this year, the state is reportedly terminating all doctors on salary and relying solely on contract physicians.
As reported recently by The Tennessean physician, Dr. Thomas Thrush, is one of dozens of doctors contracted to review applications for Tennesseans seeking disability. Anita Wadhwani and Mike Reicher, reported that the doctors are paid a flat rate for each application file they review. How much they earn depends on how fast they work. Thrush, like many of the doctors who contract with the state, works very fast.
In fiscal year 2018, he reviewed — on average — one case every 12 minutes. Thrush’s productivity has paid off. He earned $420,000 for reviewing the applications of 9,088 Tennesseans applying for disability during the year ending June 30. He has made more than $2.2 million since 2013. On average, 80 percent of the cases he reviewed were denied, the report said. The Tennessean also reported that five current and former contractors and state employees believe disability applicants are wrongfully denied to process as many applications as possible. Most spoke to The Tennessean on the condition of anonymity, for fear of reprisal.
“It’s like a cash register,” said one contract physician. “From our perspective it’s unethical. From a consumer’s point of view, it can be a tragedy.”
“Who knows how many applicants for disability benefits have had their applications denied without justification,” said Dr. John Mather, a former chief medical officer for disability programs at the federal Social Security Administration.
A Johnson County mother of an autistic child who also suffers many physical health issues, said, “I applied on behalf of my daughter so that she can begin to get the help she will need. But after a long waiting period, she was denied with little to no explanation as to why.”
“My daughter has serious health concerns that need daily care and will soon require major surgeries as well as a lifetime of therapy,” she said adding, “How could they possibly deny her after so much medical proof of her conditions and her needs. I don’t understand. What are we supposed to do?”
The Johnson County Veteran quoted earlier said, “Well, this would explain a lot. No wonder they deny everyone so quickly when they don’t have enough doctors reviewing cases and those who are doing it are rushed or corrupt.”