Tennessee has the highest number of denied medical disability claims in the United States. In 2017, 72% of applicants were denied – the national average is 66%. The state contracts medical doctors to review all Medicare disability claims. These doctors are paid per review which means the faster they can work, the more money they make.
The federal standard of reviewing disability claims is 1.5 cases per hour. Of the 50 contracted medical doctors in Tennessee, over 25 of them exceed that amount. One of them reviewed a case every 12 minutes.
Some of these cases are short and a few pages. Others comprise of several hundred pages, lab reports, MRI results, X-rays, work records, and other important information. It is the medical doctor’s duty to review the case, in full, and report their findings back to the state. Opinions from experts and previous employees say there is a shortage of medical doctors to review the cases; therefore, it’s impossible to do so without making wrongful rejections.
Speedy Reviews Pay Off
According to an in depth investigation by USA Today, at least seven different medical doctors made over $1 million between 2013 and 2018 from reviewing disability claims. Others made over $400,000 per year. One doctor, who wished not to be named, said it’s unethical and could lead to a tragedy.
Sadly, this was the case for one man, Alan Chrisman, who was diagnosed with Stage 4 Colorectal cancer. The illness had spread to his lungs and intestines and doctors explained that he would likely not get better. Mr. Chrisman applied for disability and was confident that he would get it. Afterall, he had been contributing to the Federal program for the last 30 years working as a stonemason. Dr. Thomas Thrush was the physician to review his claim, and he concluded that Mr. Chrisman was not ill enough. Dr. Thrush reviews a case every 12 minutes, on average, and has made over $2.2 million since 2013. As it appears Thrush was trying to get through as many cases as possible, he failed to review a critical document, that being a discharge paper which clearly stated that Mr. Chrismans’ cancer was inoperable and had metastasized – a prognosis that is, without question, qualifiable for disability. Mr. Chrisman and his wife has since hired a lawyer to help them with their case.
The state of Tennessee is going through great lengths to hide this alarming situation, so much so, that they fired whistleblower Dr. John Mather, former chief medical officer for disability programs at the federal Social Security Administration and medical disability claim reviewer. Tennessee is also manipulating the amount of time spent on the denied cases. Even if the medical doctor takes just a few minutes to review the case, they fold in the required time spent rather than the true time spent.
Amongst the medical doctors who have been given a contract by the state to review medical disability claims, two are convicted felons, two more have had their medical license placed on probation, one is no longer able to treat patients, one has a history of medical misconduct, and another lost his license two times in 20 years.
Since Mr. Chrisman hired a lawyer, his disability claim was reversed, but he cannot turn back the time which had him waiting to receive the medical care he deserved. Unfortunately, Mr. Chrisman is one of the lucky people whose claim was re-reviewed and the mistakes were caught. Less than 2 percent of applicants will get their disability claim rejections reviewed by the Social Security Administration. Even though denials can be appealed, the claimant has to wait a long time while going through this process. In 2017, a minimum of 9,570 people lost their life while waiting for their appeal to be listened to.
Do you need help with your disability claim? If so, please call The Higgins Firm right now for a complimentary consultation.