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Physcians paid to decline clients from SSI
Apr 7, 2014

There seems to be an unspoken agreement between the "medical community " and the government/ private insurance to prevent HIV/AIDS clients from receiving disability benefits. Some don't realize that physcians are paid by the government and private insurers to respond to medical inquiries. This reminds me of the days when physcians were paid not to reccommend treatment or costly referrals, only they are recommending no disabilty benefits for their own gain. How much are physcians paid to disclose confidential medical information that may be used against their own clients??

Response from Mr. Chambers

I have no idea what physicians are paid, and, personally, I don't believe they are paid to deny people.

Social Security (SSA) does not ask a treating physician if his/her patient is disabled or not. In fact, if a doctor says the patient is disabled Social Security ignores that opinion because doctors don't understand Social Security's definition of disability.

SSA does request the medical records from treating doctors, and they do pay doctors to copy their records, but, to my knowledge that is the only payment a treating physician can get from SSA.

On the other hand, SSA does contract with private physicians to examine applicants for disability called a Consultative Examination (CE), when the claimant's records don't give enough information to approve the claim. I attend these with my clients, and, speaking only of examining doctors in southern California, they are not very high quality and they tend to spend very little time with applicants. I've seen some psychological exams lasted less than 10 minutes.

I have seen the invoices and in this area SSA tends to pay about $100 - $130 per exam. Perhaps that is why the exams take so little time. I have also seen the reports they send to SSA. Using boiler plate formats, the reports tend to be 8 - 12 pages, and frequently comment on results that were never examined. I've seen some that gave a different person's history from that of the claimant.

Do these doctors that do the CE exams feel that they are encouraged to turn down claimants? I can see how they might get that impression since SSA pays them, but did SSA tell them to do it? Even if they did, it will never be proven. Personally, I don't think so. I do think the exams are so superficial it's tough for disability to be spotted unless it is very visible. HIV often isn't visible.



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