Controls Over Medical Examinations Necessary for the Social Security Administration To Better Determine Disability

In 1978 the federal disability insurance program and the Supplemental Security Insurance program paid about $72 million for independent medical examinations of persons claiming disability. The need for and the quality of the medical information purchased is not well documented. Program officials do not know how often state agencies have paid for independent medical examinations which were too comprehensive or were inadequate for determining disability without further information. The way disability decisions are reached differs considerably among the 54 state agencies under contract with the Department of Health, Education, and Welfare (HEW). Social Security Administration (SSA) budget officials have attempted to control the increase in the number of examinations by limiting budget increases until program officials could justify them. Two of the most important factors in determining what the consultative examination purchase rate should be and the number of examinations being purchased unnecessarily are program documentation standards and state agency case development practices.