The Social Security Administration should modify its guidance to require that notices to claimants denying disability claims clearly distinguish medical sources that provided requested medical evidence, sources that responded to the request but did not provide evidence, and sources that did not respond, GAO has said.
According to GAO-09-183R, notices sent to denied claimants may provide inconsistent and sometimes misleading information about the evidence obtained, confusing claimants and potentially generating more work.
A review of initial determinations concluded that in some cases notices provided claimants with a confusing list of reports from medical sources that did not clearly indicate the medical evidence the Disability Determination Services used to reach its determination.
Some notices include all providers that responded to requests for medical records, lumping them all together, even those saying they didn’t have any records.
Federal regulations require that denials be framed clearly and include the evidence used to reach a determination on the claimant’s case, GAO noted.
However, it said SSA tells DDSs to include lists of all medical sources that respond to DDS requests, whether or not they provided medical evidence, and notices typically go so far as to state that denials were based on input received from specific providers, even those who could not produce any records, making it difficult to piece together exactly what led to the denial.
