Disability Determination: The Administrative Process and the Role of Medical Personnel

Disability Determination: The Administrative Process and the Role of Medical Personnel

Disability Determination: The Administrative Process and the Role of Medical Personnel

Disability Determination: The Administrative Process and the Role of Medical Personnel

Synopsis

Who determines whether persons are disabled and eligible to receive the billions of dollars that are awarded in benefits under federal disability programs today in the United States? What kinds of standards are applied in making awards to millions of applicants? And how are disability determinations made and claims adjudicated? Bloch provides a careful study of disability determinations in five major federal programs. He calls for reform and a greater use of medical personnel in these determinations.

Excerpt

There is no standard form of administration for federal disability programs. Each set of programs outlined in chapter 1 is administered by a different agency: the Social Security disability programs, including Disability Insurance Benefits, Childhood Disability Benefits, Spouse's Disability Benefits, and Supplemental Security Income, are administered by the Social Security Administration; the Railroad Retirement program by the Railroad Retirement Board; the Civil Service Disability Retirement program by the Office of Personnel Management; the Veterans programs, including compensation and pension benefits, by the Veterans Benefits Administration of the Department of Veterans Affairs; and the Black Lung program by the Office of Workers' Compensation Programs of the Department of Labor. the decisions of each agency are subject in turn to review by different administrative appellate bodies: the Social Security Administration has an Office of Hearings and Appeals; the Railroad Retirement Board has a Bureau of Hearings and Appeals; the Department of Veterans Affairs has a Board of Veterans Appeals; the Department of Labor has an Office of Administrative Law Judges and a Benefits Review Board. Appeals from the Office of Personnel Management are heard by the independent Merit Systems Protection Board.

These various agencies and appellate bodies operate not only at different locations and with different personnel but also under different--often quite different--rules and procedures. There are, of course, many similarities at the agency level due to the fact that each agency's procedures are designed to process disability claims. For . . .

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