Acting on ACUS Recommendations, SSA Implements Major Overhaul of Disability Claim Regulations Governing Medical Evidence
SSA adopts ACUS’s recommendations in its final rule
Washington, January 18, 2017 –The Social Security Administration (SSA) has announced the implementation of major changes to the rules governing administrative litigation in its multi-billion dollar a year disability claims program, as recommended by the Administrative Conference of the United States (ACUS). The changes appear in a final regulation published in today’s Federal Register. The changes are expected to improve the consistency and accuracy of disability decisions, resulting in greater fairness to claimants and the reduction of litigation costs paid by taxpayers. As SSA noted in the regulation’s preamble, the revisions were based on a recommendation and accompanying report by ACUS.
The new rule implements two important revisions to account for changes in how healthcare is administered. First, it expands the class of healthcare professionals whose opinions can be considered in deciding whether a claimant is disabled to include not only physicians, but also nurse practitioners, physician assistants, and other licensed providers. Second, it eliminates the so-called “treating physician rule” under which the SSA must give “controlling weight” to the opinion of a claimant’s treating physician even in the face of conflicting evidence from other—sometimes more qualified—medical professionals familiar with the claimant’s condition. The treating physician rule has spawned unnecessary litigation—both in proceedings before SSA and in appeals of SSA decisions to the federal courts—in large part because it is often difficult to determine who qualifies as a “treating physician.”
According to Matthew L. Wiener, ACUS’s Executive Director, “We are very pleased that, once again, ACUS was able to play so critical a role in improving what the Supreme Court has aptly called the world’s largest adjudication system. I am confident that these changes to SSA’s evidentiary rules will improve the accuracy of SSA’s decisions, make the system more fair for deserving claimants, and reduce the significant costs borne by taxpayers as a result of unnecessary litigation resulting from appeals of SSA decisions to the federal courts. No other government agency could have done what ACUS did here. We thank SSA for its consideration of and reliance upon ACUS’s recommendation and report.”
This is not the first time that SSA has relied on ACUS recommendations to improve the disability claims systems. In 2015, for instance, the agency relied heavily on the blueprint provided in an ACUS report when it amended its rules to require that claimants submit all evidence relating to their claims of disability, not just evidence that supports them.
The Administrative Conference of the United States is an independent federal agency dedicated to improving the administrative process through consensus-driven applied research and providing nonpartisan expert advice and recommendations for federal agency procedures. Its membership is composed of senior federal officials, academics, and other experts from the private sector.
The Conference is committed to promoting effective public participation and efficiency in the rulemaking process by leveraging interactive technologies and encouraging open communication with the public as well as making improvements to the regulatory process by reducing unnecessary litigation, and improving the use of science and the effectiveness of applicable laws. Learn more at www.acus.gov.
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