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Social Security disability determinations. Knowledge and attitudes of consultative physicians
T S Carey1, S W Fletcher, R Fletcher
1Division of General Medicine and Clinical Epidemiology, University of North Carolina, Chapel Hill 27514.
Medical Care
|April 1, 1987
Summary
Physicians performing consultative examinations for Social Security disability applicants often feel unprepared and lack knowledge of disability programs. Many find determining impairment from a single exam nearly impossible.
Area of Science:
- Medical sociology
- Public health policy
- Disability studies
Background:
- Social Security Administration (SSA) annually contracts physicians for consultative examinations (CEs) for disability applicants.
- Significant annual expenditure of $135 million by SSA on these CEs.
- Limited understanding exists regarding the physician demographics and perspectives on impairment determination for disability evaluations.
Purpose of the Study:
- To investigate the characteristics and views of physicians conducting CEs for disability applicants.
- To compare these physicians with a control group of physicians in similar specialties.
- To understand physician preparedness and knowledge regarding SSA disability programs.
Main Methods:
- Survey of 153 physicians performing CEs in North Carolina (consultative group) and 165 physicians in similar specialties (comparison group).
- Response rates: 75% for consultative group, 66% for comparison group.
- Data collected on physician demographics, examination volume, and opinions on disability claims and programs.
Main Results:
- Consultative physicians generally performed fewer than 6 CEs per month.
- Both groups exhibited skepticism towards disability claims; a majority believed most applicants could be employed.
- A significant portion of consultative physicians (53%) reported learning little about disability programs, and 58% found impairment determination difficult from a single exam.
Conclusions:
- Physicians performing CEs often feel ill-equipped and lack specialized knowledge of disability programs.
- Despite challenges, consultative physicians were less likely to perceive the SSA as difficult to work with compared to the control group.
- Disability determination agencies rely on physicians for evaluations despite physicians reporting inadequate preparation and knowledge.