Computerized Medical Records to Streamline Social Security Disability Claims

Software developers at the Wright State Research Institute have developed a system that may dramatically streamline Social Security disability claims.

The U.S. Social Security Administration (SSA) evaluates an individual’s claim for disability benefits; the system will soon use electronic medical records to reduce the decision time from 100 days or more to as little as 48 hours. Researchers at Wright State have dubbed their health information exchange “HealthLink.” They developed it under a $750,000 contract with the SSA. The agency awarded a total of $17.4 million in contracts to 15 health care companies for electronic medical records as part of the American Recovery and Reinvestment Act.

“The use of Health IT will dramatically improve the speed, accuracy and efficiency of this process, reducing the cost of making a disability decision for both the medical community and the American taxpayer,” said SSA commissioner Michael J. Astrue.

HealthLink launched as a pilot program in December, 2011, with 500 doctors. During the trial, which lasted nine months, HealthLink averaged one Social Security eligibility determination per doctor per month without incident.

The SSA’s Health IT program is an effort to bring greater speed and power to the agency’s disability eligibility determination process by harnessing the potential of electronic medical records. The records are sent through the Nationwide Health Information Network.

Each year, the SSA receives over 3 million disability claims. To determine eligibility, it requests over 15 million medical records from about one half million health care providers. Currently, the vast majority of those records are transmitted by mail or fax. Electronic records provide huge savings not just in time, but also in the labor and supplies associated with the tasks of printing, copying and mailing records.

Just as with paper medical records, the release of electronic medical records requires patient authorization. HealthLink developers said that they have implemented comprehensive security protocols regarding worker access, physical security, and data transmission. The computer hardware that runs HealthLink is located in HIPAA-certified facilities on campus at Wright State.

HealthLink developers say that the system generates revenue and is commercially viable. They have seen interest in creating an independent commercial entity based on the system. HealthLink is available to doctors who use the Internet-based medical records system known as athenaClinicals, and Wright State is seeking additional users of the system to expand HealthLink’s network. The research institute also plans to support competing records system EpicCare.

The creators of Health Link say they hope to be a leader in the nascent industry of electronic medical records.

Posted on Thursday, November 15th, 2012. Filed under News & Press, Social Security Disability.

Lawsuits Filed over Highway Crashes in Florida

Thirteen lawsuits were recently filed against the state of Florida’s Department of Highway Safety and Motor Vehicles from family members of people who were killed on Interstate 75 or from individuals who injured in those accidents. Eleven people died on Interstate 75 near Gainesville on January 29, 2012.

It is highly unusual for such a large number people to die in auto accidents in such a short period of time. The numerous crashes occurred in the early morning when a mixture of smoke from wildfires and fog gathered in the area and decreased driver visibility in an area of roadway that also was unlit. A highway patrol officer suggested the road be kept closed due to the unusual conditions, but allegedly, someone higher up in his chain of command decided to keep the roadways open. Six separate fatal crashes in the area, involving six tractor trailers, a motor home, a van and a number of cars. Eighteen people were hospitalized in addition to those that died.

The Florida Highway Patrol later stated that the crashes were unavoidable, while a report from April developed by the Florida Department of Law Enforcement reports that errors made in decision-making by the Florida Highway Patrol contributed to the deadly accidents. The Department of Law Enforcement said there were not enough signs available to provide motorists with much-needed information about the lack of visibility and danger. The Florida Highway Patrol countered that it is the responsibility of the Department of Transportation to provide proper signage. The highway patrol also stated that some motorists did not reduce their speed, even though they were driving into low-visibility conditions, which contributed to the number of accidents. Separate analysis of different reports conducted by the local newspaper did identify alcohol use in two accidents, but there were no injuries or deaths associated with them.

Of course, it isn’t surprising that no state agency wants to accept the blame. The accidents in January caused a tremendous loss of life, which, at this juncture, appear to have been avoidable. The lives lost caused incalculable anguish on the part of family members who lost loved ones. While lawsuits have been filed, it could be many years for the survivors and their relatives to be handed judgment and resolve the suits.

Posted on Monday, October 15th, 2012. Filed under Auto Accidents, News & Press.

Reports of Burns Prompt Coffee Maker Recall

Sunbeam Products, Inc. has announced a recall of over half a million Mr. Coffee brand coffee makers. The recall is in response to reports of a defect that has already caused injury to a number of users.

“Product safety recalls are serious business,” said Zephyrhills personal injury attorney Robert Alston. “The media do a good job of getting the information out there, but consumers need to do the legwork of checking to see whether their specific product has been recalled.”

The U.S. Consumer Product Safety Commission, Health Canada, and Sunbeam Products are cooperating on the voluntary recall. The announcement applies to certain Mr. Coffee Single Cup Brewing Systems sold in the United States and Canada. The product is just under one foot tall, has a removable drip tray, and comes in black with red, white, or silver trim. They were sold for up to $80 at retailers including Wal-Mart, Target, and Bed Bath & Beyond, as well as online merchants.

Reports indicate that steam can build up in the brewing chamber to the point where it forces the chamber open during brewing, ejecting hot water, steam, and coffee grounds. 164 users have reported the brewing chamber opening, and 61 have reported burns to their face, hands, or upper torso. 59 of those burn reports were in the United States, and two in Canada.

Sunbeam Products has created a website at www.mrcoffeerecall.com where consumers can find out if their unit has been recalled and get further instructions. Eligible customers will be able to return to coffee maker and receive a replacement at no charge to them. In the meantime, those with recalled machines should stop using them immediately.

“Anyone injured by a consumer product should document the injury and speak to an experienced personal injury attorney as soon as possible,” added Mr. Alston.

Posted on Tuesday, October 9th, 2012. Filed under News & Press, Personal Injury.

Child Seriously Injured in Florida Interstate Crash

A 6-year-old boy was seriously injured in an accident on Interstate 10 in Santa Rosa County in western Florida on Friday night. The driver of a Ford F-150 veered off the roadway onto a shoulder to avoid a vehicle directly in front that slowed suddenly. In the process, the truck’s driver from Crestview struck a tree near the road. The 6-year-old boy was in the truck at the time of the accident and was seriously injured. Minor injuries were sustained by five others, including one adult.

Injuries sustained in accidents like this can be deceptive. What first seemed to be a superficial cut or bump may progress into internal pains or symptoms like dizziness or a loss of balance. If such problems emerge later, it is very important that they are documented correctly at the time of the accident because, if they are not, there may not be a sound basis for pursuing a legal case.

In this particular instance, the driver who caused the truck to veer off the road to avoid a rear-end collision was at fault. She was charged with impeding the flow of traffic, failure to display registration and failure to provide proof of insurance. The official documentation of these charges and the police investigation is what allows a case to be made and prosecuted.

Similarly, if someone is injured in such an accident, all of the medical details must be documented properly, so the victims can bring a case to court if there is good reason. Victims of personal injury sometimes don’t know the full extent of their injuries until after the accident. Soft tissue injuries, vascular injuries and even traumatic brain injuries may not appear immediately, and yet their diagnosis and documentation is key information in a personal injury case.

And in an accident like this one where children are involved, the consequences of an injury are greater. Children’s bodies and minds are growing at a continuous rate, and untreated medical injuries could interfere with their physical, mental and social development. Having a competent Florida personal injury attorney can help cover the finances required to care for victims of auto accidents.

Posted on Sunday, September 2nd, 2012. Filed under Auto Accidents, News & Press.

Risky Driving Behavior an Indicator of Mortality On or Off the Road

While it may seem obvious that reckless driving can lead to injury or death in an automobile accident, a new study suggests that a record of risky driving is a good indicator of general mortality as well.

The study, “More Than Just Data: Motor Vehicle Records as Lifestyle Indicators for Life Insurers,” was completed by RGA Reinsurance Company and LexisNexis Risk Solutions. Researchers found that there was a significant correlation between drivers who received citations for serious moving violations and the likelihood that the person would suffer a non-vehicle-related death.

Researchers conducted an analysis of over 7.4 motor vehicle record (MVR) requests and found that the data set is a good predictor of a person’s likelihood of dying in general, not just in an automobile accident. Drivers with major violations, such as excessive speeding or alcohol-related infractions, had a 70 percent higher all-cause mortality rate than drivers who did not have such violations. The study found that having six or more violations on an MVR increased a person’s mortality rate by 80 percent.

The trends apply to different genders and age groups as well. While women generally have lower rates of violations, the connection between major violations and all-cause mortality is greater for women than for men. For women with major driving violations, the mortality rate is 100 percent greater than women with clean driving records; for men, the number is 61 percent.

The number of driving violations of any kind is itself a strong predictor of mortality, according to the researchers. The greater number of violations on a driver’s MVR, the higher the mortality rate. Drivers with two to five violations had a mortality rate 24 percent higher, while individuals with six or greater had a 79 percent higher rate.

The worst risk is represented by drivers with a high number of major driving violations. One major violation increases the all-cause mortality rate by 51 percent, while four or greater brings the rate to more than twice that of drivers who did not have major violations.

Explaining the results, Elliott C. Wallace of LexisNexis was quoted in the New York Times as saying that people with a great number of major driving violations are “probably engaging in other high-risk lifestyle activities that lead to death at a higher rate than the average person. If you live a very risky lifestyle, you are going to die sooner.”

Posted on Wednesday, July 4th, 2012. Filed under News & Press.

Social Security Disability Adds 13 Conditions to Compassionate Allowances Program

The Social Security Administration recently added 13 new conditions to the Compassionate Allowances program that fast-tracks disability decisions within the agency.

The new conditions were introduced in December as part of an ongoing effort to innovate and streamline the agency’s work, according to Social Security Commissioner Michael J. Astrue.

The conditions that were added to the list mostly are immune system, mental and neurological disorders, according to a press release from the agency. They include the following:

• Malignant Multiple Sclerosis

• ALS or Parkinsonism Dementia Complex

• Pulmonary Kaposi Sarcoma

• Angelman Syndrome

• Paraneoplastic Pemphigus

• Multicentric Castleman Disease

• Progressive Supranuclear Palsy

• Lewy Body Dementia

• Primary Effusion Lymphoma

• Corticobasal Degeneration

• Lowe Syndrome

• Primary Central Nervous System Lymphoma

• Multiple System Atrophy

The SSA’s Compassionate Allowances program spots conditions that always meet the standard of disability for the purpose of Social Security Disability Insurance. This way, once an individual is diagnosed with the specific condition, their case can be moved more quickly through the system.

“We need to keep innovating and making our work more efficient,” Astrue said in a press release. “With our Compassionate Allowances program, we quickly approved disability benefits for more than 60,000 people with severe disabilities in the past fiscal year. We have made significant improvements, but we can always do more.”

The Compassionate Allowances program began in 2008 with only 50 conditions. The original list included cancers, rare genetic disorders, adult brain disorders and early-onset Alzheimer’s disease. With the addition of 13 in December, the program now lists 113 conditions that can be moved through the agency with less stress for the individual, according to the release.

New technologies made available to the agency allow for faster identification of individuals with Compassionate Allowances so that quick decisions can be made.

The agency is committed to the relatively young program as an efficient upgrade of protocol. In the fall, the Social Security Administration launched a grant program available to graduate students to help the agency improve its list. The agency already awarded a grant worth $1.5 million over the course of five years to a group called Policy Research Inc.

The Disability Determination Process Small Grant Program is designed to improve the disability process. The program is actively looking for graduate students to apply for grant stipends for relevant research that is innovative in the field of disabilities.

The agency also recently upgraded the disability application online for individuals with conditions on the Compassionate Allowances list.

Posted on Friday, March 16th, 2012. Filed under News & Press, Serious Injury.

More Frequent Wage Reporting Would Help Cut Down on SSI Overpayments

The Social Security Administration is calling on private insurers that pay workers’ compensation as well as state and local agencies to report payments to the agency to help cut down on fraud and overpayments.

In a recent speech to the U.S. House Ways and Means Subcommittee on Social Security, Carolyn Colvin, deputy administrator for the SSA, explained that funding shortages are forcing tough decisions to be made. The administration is trying to streamline income reporting to cut back on how long it takes to catch overpayments for Social Security Disability Insurance and the Supplemental Security Income programs.

When the Social Security Administration waits for beneficiaries to report changes in their income, it can take too long and invites problems, Colvin said.

“By requiring plan administrators to provide payment information to us promptly, this proposal would improve the integrity of the [workers’ compensation] and [public disability benefit] reporting process, improve the accuracy of SSDI benefits and SSI payments, and lessen our reliance on the beneficiary to report this information,” she said.

The agency considers the goal of curbing improper payments to be key in the Social Security Administration’s strategic plan to “Preserve the Public’s Trust in Our Programs,” she told the subcommittee.

Funding issues are forcing the administration to do fewer continuing disability reviews and significantly fewer SSI redeterminations. The agency does SSI redeterminations on the nonmedical factors that make a beneficiary eligible for SSI. Since the agency has cut back on the number of reviews and redeterminations, it has needed to rely more on the strategic use of the processes and staff, she told the lawmakers.

By asking private insurers and state and local agencies to report income to the SSA, the reporting can trigger some reviews and increase the agency’s efficiency. In the past two years, the agency’s work to continue disability reviews has paid off. In about a third of the work, CDRs found that a disability had ceased and suspended benefits.

SSI redeterminations are up since 2007 after falling the five years before that. The numbers are up because funding increased for program integrity, she said. The increased funding has enabled the agency to improve SSI overpayment accuracy rates by almost four percent in three years.

Colvin asked members of the subcommittee to push for provisions in the President’s budget that would require employers to report wages quarterly. The more frequent the reporting, the easier it is for the agency to accurately distribute benefits, she said.

Posted on Friday, February 24th, 2012. Filed under Social Security Disability.

SSI and SSDI Could be Revamped

The Social Security Administration is working on new initiatives that could cut down on wasteful overpayments, disincentives to work and costly labor time to investigate payments.

The Work Incentives Simplification Pilot is a legislative proposal being considered by Congress that could replace well-intentioned but complicated laws meant to incentivize disability beneficiaries to return to work. The work incentives proved too burdensome for an agency already fighting funding cuts.

Carolyn Colvin, deputy administrator for the Social Security Administration spoke to the U.S. House Ways and Means’ Subcommittee on Social Security in late January.

She explained that the new legislation could kill regulations like trial work periods and the extended period of eligibility that are overcomplicating the work of the administration.

The law now says people on Supplemental Security Income, or SSI, are on a sliding scale as they return to work. So, for every $2 an SSI beneficiary earns, $1 is removed from their SSI benefit, she said. Improper SSI payments happen when beneficiaries fail to notify the administration of new work, new assets or a raise or reduction in salary.

Each beneficiary is a different case with a different employer and a different income. Each case has to be individually handled, which often means contact with the employer. Most cases are complicated and require small bits of work and starting and stopping until enough information is gathered to make a decision, she said.

This type of work takes considerable expertise and training and the administration simply does not have the resources to do it well, she said.

There also are plenty of crossover beneficiaries who qualify for SSI and Social Security Disability Insurance C as many as 30 percent of SSI recipients also get SSDI between 18- and 64-years-old. Because the two programs are guided by two sets of rules, the labor for the Social Security Administration is overly burdensome, she said.

Officials hope the new WISP plan will address a disincentive to work by eliminating a beneficiary’s fear that if they get a job, they will lose their benefits.

The work incentive policies are difficult for beneficiaries to understand and for the administration to oversee, Colvin told the subcommittee.

The goal of WISP is to test some simplified work rules that would still be subject to tight evaluation. Officials hope the WISP will encourage people to work while reducing administrative costs, she said.

WISP also would count beneficiaries’ earnings when they are paid instead of when they are earned so that SSDI and SSI rules would be better aligned.

A qualified attorney can represent clients in Social Security cases to help make sure they fully explain their case.

Posted on Tuesday, February 14th, 2012. Filed under Social Security Disability.

Safety is Critical Now That the Home is Full of Toys

The Consumer Product Safety Commission announced late last year that toys were safer for the holiday season then they had been in years, but just because the holidays are over and all the presents are unwrapped does not mean parents can let up paying attention to their children’s playthings.

Injuries and recalls of dangerous toys are down for a number of reasons. New safeguards have limited the use of lead, third-party testing has highlighted problematic toys and the Department of Homeland Security is helping to track shipments leading to more toy seizures. The agency also set tight limits on the use of some phthalates and cadmium.

Toy recalls were down sharply in FY 2011. Only 34 toys were recalled last year – down from 46 in 2010, 50 in 2009 and 172 in 2008, according to a CPSC release.

Toys with small parts, balls and balloons continue to be the most problematic, according to CPSC chairwoman Inez Tenenbaum. Toys that are inappropriate for certain age groups can be deadly. There are about 15 toy-related fatalities every year and half of those are attributed to choking on balls and balloons.

“Strong toy standards support the production of safer toys in the marketplace,” Tenenbaum said. “Parents and toy shoppers also always need to be vigilant by choosing age-appropriate toys and keeping small parts, balls, and balloons out of the hands of young children.”

Deflated balloons should always be discarded immediately. Toys with small parts can be a dangerous choking hazard and should be kept away from children under 3.

Children under 6 years old should be kept away from magnets, which if swallowed can be potentially harmful and possibly fatal, according to the CPSC.

More than 180,000 children under 15-years-old went to the emergency room in 2010 because of toy-related injuries. More than any other toy, non-motorized scooters sent more kids to the ER with lacerations and broken bones, according to the CPSC press release.

Riding toys including scooters, skateboards and in-line skates should be used only with appropriate safety gear like helmets and knee pads. Safety gear should be fitted properly by an adult.

Even though the main gift-giving month is over, the CPSC advises diligence from parents as toys are exchanged or bought with gift cards received during the holidays. Now that parents have a house full of toys, it is important for parents of children of different ages to keep toys separated from younger siblings that can be hurt by them.

Posted on Wednesday, January 18th, 2012. Filed under Personal Injury.

Social Security Administration Commissions Independent Study of Judges Deciding Appeals

Federal administrative law judges who hear Social Security Disability appeals have widely ranging records that may indicate unfairness in the appeals process.

The Social Security Administration is commissioning a review of the entire disability system to make sure it is not awarding benefits to those who do not deserve it and to make sure the agency is not denying benefits to those who do deserve them.

The SSA will review the work of about 1,500 disability appeals judges across the country whose rates vary significantly from the norm. Some judges award benefits less than 20 percent of the time while others award benefits almost 100 percent of the time, according to a story in the Wall Street Journal.

The Administration has already decided to stop notifying applicants who their judge will be in their appeal to discourage shopping an appeal to a more lenient judge.

The Administrative Conference of the United States will take on the review. The independent government study organization hopes to make recommendations for updating the appeals process in 2012.

The Social Security Disability Insurance program provides financial assistance to Americans who cannot work. The Wall Street Journal reported that the program paid $130 billion in 2011 to 10.6 million people.

If a case comes before a federal Social Security judge, it has already been denied twice at the state level. There is a tremendous backlog of cases at the federal level.

In September of 2011, there were more than 771,000 people waiting for their appeal to be heard. The SSA has been working to address the backlog issues and it has cut down on the number of people who die while they wait for their appeal to be judged, according to the WSJ.

The hearings usually last about an hour. Some critics have said judges pushing cases through much more quickly than that are cutting corners and not doing thorough reviews. The conference plans to factor how much time judges look at cases into its review.

The SSA’s commissioner told Congress in the summer of 2011 that judges awarding disability benefits more than 85 percent of the time cost the agency another $1 billion a year. The Wall Street Journal reports that there are more than 100 judges whose award percentages are that high.

Overall, the federal court system is finding errors or overturning about half of the decisions made by Social Security judges. The independent study will review how the federal courts are looking at the cases to make sure it is interpreting the SSA’s rules consistently, according to the WSJ. A qualified Social Security Disability attorney can help clients file appeals with the agency.

Posted on Monday, January 9th, 2012. Filed under News & Press, Social Security Disability.