Social Security Disability:

Action Needed to Improve Use of Medical Experts at Hearings

HRD-91-68: Published: May 20, 1991. Publicly Released: May 20, 1991.

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Pursuant to a congressional request, GAO reviewed the Social Security Administration's Office of Hearings and Appeals' (OHA) use and selection of medical experts (ME) to provide testimony or evidence for disability hearings and cases.

GAO found that: (1) OHA policy required the selection of such experts on a rotational basis by medical specialty, when possible; (2) when purchasing expert testimony, OHA did not ensure compliance with either its rotation policy or federal procurement policy; (3) medical experts were consulted in approximately 12 percent of all OHA hearings; (4) OHA lacked adequate controls at the hearing office level to ensure the fair selection of experts; (5) some administrative law judges requested medical experts by name; (6) repeated use of individual experts led to questions regarding the fairness of the hearings; and (7) in Chicago, recruitment efforts were insufficient to ensure the availability of more than one expert in high-demand medical specialties.

Status Legend:

More Info
  • Review Pending-GAO has not yet assessed implementation status.
  • Open-Actions to satisfy the intent of the recommendation have not been taken or are being planned, or actions that partially satisfy the intent of the recommendation have been taken.
  • Closed-implemented-Actions that satisfy the intent of the recommendation have been taken.
  • Closed-not implemented-While the intent of the recommendation has not been satisfied, time or circumstances have rendered the recommendation invalid.
    • Review Pending
    • Open
    • Closed - implemented
    • Closed - not implemented

    Recommendations for Executive Action

    Recommendation: To improve the use of medical experts, the Commissioner of Social Security should instruct OHA management to: (1) issue necessary procedures to ensure compliance with OHA rotation policy and federal procurement policy; and (2) use staff who are separate from administrative law judge (ALJ) influence for selecting and scheduling medical experts and to document justification for medical expert selections out of rotation order.

    Agency Affected: Social Security Administration

    Status: Closed - Implemented

    Comments: Each regional office: (1) issued a memo on rotational policy and the need to separate ME scheduling from specific ALJ; and (2) established a system for monitoring adherence to the rotational policy. Action was completed March 31, 1992.

    Recommendation: To improve the use of medical experts, the Commissioner of Social Security should instruct OHA management to require regional offices to monitor and analyze medical expert use and identify medical expert recruitment needs.

    Agency Affected: Social Security Administration

    Status: Closed - Implemented

    Comments: Operational manuals were revised to include specific instructions for monitoring and analyzing ME use and recruitment needs. An automated expenditure accounting system will identify use and fees paid to each ME. A system is being used until the automated system is ready. Action was completed March 31, 1992.

    Recommendation: To improve the use of medical experts, the Commissioner of Social Security should instruct OHA management to review recruitment guidelines to identify additional means to reach potential medical experts.

    Agency Affected: Social Security Administration

    Status: Closed - Implemented

    Comments: SSA reviewed existing guidelines and incorporated more detailed and comprehensive recruitment instructions into the operations manual. Action was completed September 30, 1991.

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