Since 1999, NYS has been one of ten states in SSA’s Disability Redesign Prototype. As discussed on the first page of this newsletter, the prototype has ended. But in addition to testing the elimination of reconsideration, the prototype also tested the “single decision maker” model for disability determinations. Under the model, DDS Disability Examiners with SDM authority could complete all disability determination forms and made initial disability determinations in many cases without medical or psychological consultant (MC or PC) signoff. MC or PC review and signoff was still required for all Title XVI (SSI) childhood disability claims and for all Title II and Title XVI with less than fully favorable determinations involving mental impairments.
But the Bipartisan Budget Act of 2015 (“BBA”), P.L.114-74, required SSA to ensure that a qualified physician or, where mental impairment is indicated by the evidence, a qualified psychiatrist or psychologist complete “the medical portion of the case review and any applicable residual functional capacity assessment.” The provision “shall apply with respect to determinations of disability made on or after” November 2, 2016. Despite that requirement, SSA extended its testing of the “single decision maker” model for initial and reconsidered disability determinations “until no later than December 28, 2018.” The extension was designed to provide SSA the time necessary to reinstate uniform use of medical and psychological consultants.
SSA has announced it finally ended the SDM model on October 1. 2018. So look carefully at the eCATs in your exhibit files to make sure a qualified PC or MC has signed off the initial – and now reconsideration – decisions. The NY Division of Disability Determinations has apparently been busy trying to hire new consultants to keep up with this change. See https://statejobs.ny.gov/public/vacancyDetailsView.cfm?id=63055.