2017] SPECIALIST MEDICAL CONSULTANTS 1363
more conspicuous failings have been well documented and adequately
criticized—such as the enormous backlog of cases or the astronomical
Administrative Law Judge (“ALJ”) disability allowance rate4—in 2014, the
number of individuals receiving Social Security Disability Insurance (“SSDI”)
benefits5 and Supplemental Security Income (“SSI”) benefits6 was higher than
ever. Additionally, new SSDI recipients received higher monthly payments
than those individuals already receiving benefits.7
In recognition of what appears to be the nadir of the SSA’s public
standing among taxpayers, Congress, disability claimants, and the general
public, this Note considers a smaller-scale issue arising under the SSA
regulations: the specialty (or lack thereof) of medical consultants (“MCs”),
primarily at the preliminary Disability Determination Services (“DDS”) level.
By principally examining the beginning of the SSA disability process, rather
than the later and more politically charged ALJ hearing process, this Note
illustrates the inherent problems with having non-specialized MCs
performing what can often become medically sophisticated disability
determinations. Specifically, the lack of specialized MCs seriously diminishes
the public’s trust in the accuracy of the disability determination process, while
also creating unacceptable disparities in determination decisions across the
country so that a person’s chance of receiving benefits largely depends on
where they live. This Note demonstrates that requiring DDS MCs to be
specialists in the area of the claimant’s impairment will have positive, far-
2022. Id. As for SSI benefits, it is “project[ed] that SSI program outlays will increase to $60.8 billion in
2039, a real increase of 0.5 percent per year” and that “[b]ecause DI and OASI benefit receipt affect
SSI program eligibility and payment amounts, trust fund reserve depletion has the potential to increase
cost for the SSI program.” SOC. SEC. ADMIN., ANNUAL REPORT OF THE SUPPLEMENTAL SECURITY INCOME
PROGRAM 6, 27 (2015), https://www.ssa.gov/oact/ssir/SSI15/ssi2015.pdf.
4. See, e.g., PERMANENT SUBCOMM. ON INVESTIGATIONS, U.S. SENATE, SOCIAL SECURITY
DISABILITY PROGRAMS: IMPROVING THE QUALITY OF BENEFIT AWARD DECISIONS 14, 14 n.32 (2012),
programs-improving-the-quality-of-benefit-award-decisions (noting that in a 2011 review, the SSA
found that 22% of the hearing decisions had to be remanded for inaccuracy); Richard J. Pierce, Jr.,
What Should We Do About Social Security Disability Appeals?, 34 REG., no. 3, 2011, at 39 (arguing that the
ALJs for the SSA should be eliminated because they consistently grant far too many SSA disability claims
on appeal and cost the SSA upwards of $2 billion per year in unnecessary salaries); David Fahrenthold,
The Biggest Backlog in the Federal Government, WASH. POST (Oct. 18, 2014), http://www.washingtonpost.
com/sf/national/2014/10/18/the-biggest-backlog-in-the-federal-government (detailing how the ALJ
hearing office is 990,399 cases behind).
5. In December 2014, 10,261,268 individuals received SSDI benefits. SOC. SEC. ADMIN., PUB.
NO. 13-11826, ANNUAL STATISTICAL REPORT ON THE SOCIAL SECURITY DISABILITY INSURANCE PROGRAM,
2014, at 11 chart 1 (2015), https://www.ssa.gov/policy/docs/statcomps/di_asr/2014/di_asr14.pdf.
6. In January 2016, 8.3 million individuals received SSI benefits averaging $542 per
month. U.S. SOC. SEC. ADMIN., ANNUAL REPORT OF THE SUPPLEMENTAL SECURITY INCOME
PROGRAM 2 (2016), https://www.ssa.gov/oact/ssir/SSI16/ssi2016.pdf.
7. In 2015, the average monthly payment for a newly disabled worker was $1,270 per
month while an individual already receiving SSDI benefits received an average of $1,166 per
month. SOC. SEC. ADMIN., supra note 2, at 16.