How physician office closings impact the disability claim process

Another impact of COVID-19 on the disability claim process

A recent Merritt Hawkins Survey of America’s Physicians detailed the changes that have occurred due to the pandemic:

How does all of this effect the disability claim process?

The attending physician is a key party to the life of a disability claim. These changes will have an impact on the information that we receive, how we receive it, and possibly when we receive it.

Many insurance carriers have already experienced some impacts to their process due to delayed responses to requests for information or lack of information due to limited patient visits. Telemedicine is great for many conditions and situations, but it could prove problematic for disability claims if proper treatments, tests, and prescribed therapies are unavailable.

What are the impacts to the SSDI process?

On the SSDI front, we have seen a backlog of Consultative Exams (CEs) that could be related to these changes, as well. The shortage of available physicians has translated to a shortage in CE providers. Many former providers are no longer offering CEs and, the ones that are, are seeing fewer claimants. The backlog of CEs has resulted in a national decline in decisions and, ultimately, SSDI awards and offsets. 

How can we best manage these realities into the future?

Going forward, it will be critical to establish a level of function as soon as possible after claim submission as a baseline for future conversations about expectations and prognosis. With the baseline established, the attending physician can more comfortably talk with the claimant about improved health and return to work options. This baseline can assist them with telemedicine calls or in person visits, once they resume.

If needed, PDA clinical resources can help with calls and conversations with attending physicians. Our nurses and physicians are well versed in establishing the current level of function and discussing future expectations for continued improvement.

We expect a fair amount of turmoil to continue with the healthcare delivery system as we make our way through the “new normal” and we are bracing for the coming fall surge which will only exacerbate some of these challenges.