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Sarah Robichaud

Abstract

Title II and Title XVI of the Social Security Act provide critical support to individuals with disabilities. However, until recently, the way that the Social Security Administration processed medical information to make disability determinations had not changed in any fundamental way since the inception of the Act. The disability determination process is logical for many frequently handled, well-known conditions, yet there are a significant number of cases regarding special conditions that are not as well-known or as frequently considered by the Office of Disability Adjudication and Review, which administers hearings and appeals for the Social Security Administration. The Social Security Administration is currently updating its business model to ensure that people with special conditions receive effective treatment during the disability hearing process. As a step toward reaching this goal, the Social Security Administration recently enacted Compassionate Allowances, a list of conclusively presumptive disabilities. *434 This paper advocates several additional alternatives to further improve the process for cases with special conditions. Using HIV infection as an example of a special condition, this paper recommends (1) using electronic screening tools to efficiently identify cases for adjudication at the earliest opportunity; (2) using specialized medical source statements in combination with Social Security Administration forms to improve the probability of accurately assessing individuals with special conditions; and (3) reviewing cases with special conditions regionally or nationally in order to focus resources to enhance the assessment of such cases. These improvements will help adjudicators in the Office of Disability Adjudication and Review to efficiently handle the backlog of cases dealing with varied and complex conditions and to more effectively serve individuals who have filed for disability.

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