"Let's Get Loud" Series - DDS's Laziness

by Susan Golden

Claimant 4 – Consultative Exams ordered by the State agency

Ms. G  applied for SSD benefits on June 26, 2024.  Ms. G was an elementary school teacher for 33 years.  She suffers from severe migraines, vertigo, severe back problems and anorexia, to name a few of her impairments.  On August 5, 2024, we submitted supporting medical reports from Ms. G’s treating doctors, which included an EMG and a pharmacy printout.

On August 22, 2024, my assistant, Samantha Diamond, received a phone call from Mr. Begelman, the analyst at the State agency assigned to Ms. G’s case.  He was calling to advise us that he was scheduling Ms. G. for a Consultative Exam (“CE”) with the IMA, the company that SS contracts with to perform CE’s.  According to the regulations, CE’s are supposed to be scheduled only after making best efforts to obtain the necessary information from the treating sources, which are the preferred source.  When Ms. Diamond asked Mr. Begelmann= if he had reviewed Ms. G’s file and seen what we submitted, he admitted that he hadn’t even looked at the file yet.  So without even knowing what was or was not needed, and without doing the bare minimum required by the regulations, Mr. Begelman scheduled Ms. G for a CE with IMA.

Notably, most of the time the “specialists” at IMA are from the wrong medical board, if they are certified at all, let alone trained in the specialty that is relevant to the claimant’s impairments.  Additionally, IMA doctors claim they do not have any records or information from the State agency about claimants, which begs the question, how do they know what exam to perform?  IMA also has signs all over their offices which state that Social Security claimants are not allowed to record their exams, yet in small print on the same sign it states that Workers’ Comp claimants are allowed.  That disparate treatment is ridiculous, and if our claimant tries to record an exam, the IMA employees cry that their HIPAA rights are being violated.  HIPAA only applies to a person’s medical information - it provides no rights, and has no relevance, to IMA staff.  Since IMA admits to allowing Workers Comp claimants to record exams in the very same offices where the SS claimants are being examined, by the very same staff, and the very same doctors, then IMA must be confessing to countless HIPPA violations.

Consultative Exams

The State agency continues to send claimant’s letters stating that they “need” to, and “must,” be examined by Social Security doctors.  They don’t.  I have regularly posted about why the DDS letters are misleading and inaccurate.

Once again, I represent a claimant, this one an attorney from Hewlett with cardiovascular and mental impairments, to whom the State agency sent repeated letters insisting that he attend a consultative examination (“CE”).  Because of COVID, he wanted his doctor to perform the CE, which is what the regulations actually require.

The claimant was awarded Social Security Disability (“SSD”) benefits without the need for a hearing.  Obviously, it was not necessary that he attend a CE in order to be eligible to receive SSD benefits.

The analysts at the State agency like to harass and threaten people.  If you don't have a disability attorney representing you who is experienced with dealing with these analysts, you will have a very difficult time doing so on your own, not to mention the stress and heartache it will cause you.  We have over 35 years of experience representing disabled workers.  You can call our office for a free phone consultation.  Our offices are conveniently located in both Nassau and Suffolk counties on Long Island.

Consultative Exams ("CEs") and the State agency ("DDS")

I get more questions about CEs than any other topic.  DDS schedules CEs before they even request records from the claimant's treating doctors, who according to Social Security's own rules are the "preferred source" for medical information.

I represent a 48 year old Medical Assistant from Bay Shore whose impairments cause suffering from debilitating pain.  The DDS representative handling the case told my office that this was a very strong case, with an overabundance of medical evidence.  Nonetheless, the representative still denied Social Security Disability ("SSD") benefits solely because the claimant did not attend a CE.

My client was approved today at her hearing.  The ALJ acknowledged all of the supporting objecting evidence I obtained from the claimant's treating doctors, which included MRI's, scans and other objective test results.  The ALJ found the claimant's testimony to be credible, consistent with the treatment provided, and the treating doctors' opinions to be persuasive.  The fact that the claimant did not attend a CE was not even mentioned.

DDS continues to practice the boondoggle policy of scheduling needless CEs for claimants.  The CE gives DDS the excuse to ignore the large amounts of medical information in the file, and deny the claim based on the vague CE opinions, which the federal courts uniformly deride.  CEs delay benefits as they force claimants to defend themselves against the typically fraudulent exams those doctors perform.

My client is extremely happy that she retained an experienced disability attorney who was able to obtain a favorable outcome for her, rather than trying to take on Social Security by herself. Please call my office for a free phone consultation if you are thinking about applying for SSD benefits.  My office is conveniently located in Melville, Long Island.

 

 

Fraudulent CE's

Social Security constantly sends claimants to Consultative Exams ("CEs"), even when the claimant has supporting medical documents from their own treating doctors.  Social Security's own rules specify that the treating provider is the preferred source, and a CE only needs to be scheduled if a claimant does not submit medical documents from their own doctors.  Nevertheless, Social Security almost always ignores their own regulations, and schedules unnecessary CE's for the claimants to attend.  Unfortunately, most of the time, this is not in the claimant's best interest.  The companies that Social Security hires to perform the CEs, and the doctors who perform them, routinely commit fraud.  If you do attend a CE, it is vital that you note everything that the doctor does and does not do, and the length of the exam.  You should bring someone with you to the CE who can be a witness at a hearing if you do get denied based on the CE.

 

Social Security Fraud

by Susan Golden 

It seems as if we are always hearing stories about people who are defrauding the Social Security Disability (“SSD”) system. We read about it in the newspapers, and we watch it on the news. Even 60 Minutes and 20/20 have devoted entire segments to those stories. While there may be a small minority of people who improperly receive SSD benefits, most people who apply are honest and hard working individuals, who would much rather continue to work if they could. However, what the media is not reporting is how the Social Security Administration (“SSA”) is defrauding us. 

The SSA disability process is getting more corrupt by the day. The SSA does whatever it wants, without any repercussions, without any real checks and balances. When someone files an application for SSD benefits, his or her local office processes it. The local offices constantly lose important paperwork, which holds up the applications, or even deny applications based upon the local office’s own errors and incompetence. When they do eventually process the SSD application, the local office sends it out to the New York State Office of Temporary and Disability Assistance, to review the medical evidence. Much of the time, the local office does not forward all the paperwork, including medical records that the claimant has submitted, creating more problems for the claimant. The biggest joke of all is the “reviewing” of the claim by the “analyst” at the NYS office. They don’t follow their own rules and regulations, important medical evidence is misplaced, or worse yet, purged from the record, in order to provide them with a specious basis for denial. The State agency also fabricates communications with treating doctors. 

Perhaps the greatest injustice of all is the State agency’s practice of scheduling claimants to attend Consultative Exams (“CE’s”), which are frequently performed by unqualified doctors, who usually misrepresent their findings. As a result of the fictitious CE findings, claimants are typically denied SSD benefits. Importantly, the SSA’s own rules state that a treating doctor should perform any CE, although the State agency rarely, if ever, complies with those rules. 

To avoid being denied SSD benefits for supposedly “failing to cooperate,” which is the SSA’s practice if the claimant does not attend the CE, we have advised our clients to video tape their CE’s. There is no Social Security rule or regulation that prohibits recording of a CE, which has become necessary since the doctors blatantly lie about what occurs during the exam. Notably, the New York State agency overseeing workers compensations (“WC”) benefits has a rule explicitly stating that a claimant can video tape an independent medical exam (“IME”), which is equivalent to the SSA CE, precisely to guard against fictitious exam findings. It defies logic for a claimant with both an SSD and WC claim to be allowed to tape an IME but not a CE. 

One of our clients went to his CE today, and recorded the visit. However, the person at the CE receptionist desk from Industrial Medicine Associates (“IMA”) told our client that they would not allow him to record the CE, and asked him to leave their office. It was the IMA doctor contracted by the SSA, not the claimant, who refused to proceed with the CE. The claimant recorded the IMA receptionist saying they would claim that the claimant failed to show up for his CE, which is an unmitigated lie. In fact, it seems that IMA’s claiming that a claimant failed to appear for his CE is an act of fraud that must be investigated by the SSA Office of the Inspector General (“OIG”). 

The sad fact is there apparently is not a damn thing that can be done about these fraudulent practices. Over the years, we have shown how CE reports are replete with medical findings that could not possibly have been made, and have requested that the matter be referred to the OIG, but to no avail. Therefore, claimants will most likely continue to be wrongly denied SSD benefits for purportedly not attending the CE, or attending one that culminates in a report containing fraudulent findings. 

The SSA should help the disabled, especially the homeless, which increasingly includes many veterans. Instead, the SSA only hurts and demeans the people who need help the most; those who can no longer work and have no money to survive. It is a travesty and disgrace. When will the media do a story about this?

New IMA Fraud & Worse

Industrial Medicine Associates (“IMA”) has a contract to perform consultative examinations (“CE”s) for Social Security Disability (“SSD”) claimants. The IMA CE’s engages in numerous questionable activities, including its fraudulent releases, violating the law by failing to notify attorneys of CEs, fraudulently claiming that CE are needed when they are not, and making fraudulent findings. Searching my blog will reveal countless additional examples of IMA misconduct. 

As stated in my blog entry from October 5, 2012, because of IMA’s dishonesty, I advise my clients to videotape CEs by IMA: 

“There is no rule, regulation, statute, guideline, or case law that precludes an SSD claimant from recording his or her CE. There have been countless times where IMA doctors have been banned from performing CE’s, or their opinions have been rejected, after substantial evidence or cross examinations showed they falsified CE findings. If IMA doctors perform CEs in accordance with the regulations, then they should have nothing to hide, and should have no problem with the videotaping. Videotaping an IMA CE is consistent with the SSA recording experts and witnesses at hearings. IMA has a protracted history of acting improperly. Read some of my prior entries on this topic: 11/22/10, 6/6/12, 5/17/12, 10/5/11, 6/29/12, 6/16/12,3/8/10, 8/31/12, 8/11/08, 4/21/10, 6/4/12, 9/8/10, 8/16/12. IMA has a contract with New York State to perform CEs, for which it gets paid a ton of taxpayer money. Medical Experts at hearings are videotaped, and IMA has no excuse or legal authority to justify its refusal to have its doctors videotaped while performing a CE ordered and paid for by New York State. Perhaps if IMA refuses to perform a large number of CEs when claimants try to videotape them, the State will terminate or refuse to renew its contract with IMA” 

I previously pointed out that the Workers’ Compensation law specifies that a claimant has the “right to video tape or otherwise record” an examination. IMA does workers comp exams just as they do CEs. IMA told one of my clients yesterday that they could not record the CE, and pointed to a new sign that says, “To maintain client confidentiality, video and/or audio recording is absolutely prohibited anywhere in this facility.” In small print below, the sign adds, “This policy does not apply to Workers Compensations exams.” 

The new sign admits that IMA is failing to maintain client confidentiality when it performs workers compensation exams. The governing agency should investigate IMA’s admission. Furthermore, IMA failed to explain how an SSD claimant’s recording their own exam can breach the claimant’s confidentiality. Moreover, IMA has refused to provide any explanation for its disparate treatment of disability claimants. 

Most importantly, it seems to me that since IMA’s contract for providing CEs does not state that they can prohibit videotaping, their conduct constitutes a breach of contract. Even if IMA were to renegotiate its contract to allow it to refuse videorecording, it does not trump a claimant’s right to record their own exam. That is why IMA claims that its “policy” is prohibit videorecording, because there is no law that enables it to do so. 

In April 2009, the New York State Inspector General and the Inspector General of the Office of the State Comptroller reviewed the contract that the Office of Temporary and Disability Assistance (“OTDA”) gave for performing CEs. The report addressed the allegations of Diagnostic Health Services that OTDA blatantly favored IMA in providing services. The IMA contract costs taxpayers about $20 million dollars for CEs in Bronx, Queens, Nassau and Suffolk. When will the State investigate IMA’s conduct?

SSA Self Policing

“Letting a fox guard the henhouse” illustrates the foolishness of placing a person in charge of something when they have a conflict of interest. When you assign somebody a duty that places that person into a position where he can exploit the situation for his own benefit, then you are letting the proverbial fox guard the henhouse. That is the situation created by allowing the Social Security Administration (“SSA”) to decide the propriety of Freedom of Information Act (“FOIA”) requests. 

We represent a claimant for Social Security Disability ("SSD") benefits. Despite the fact we had submitted supporting evidence from his treating doctors, the SSA scheduled a Consultative Exam ("CE") for him. The client went to the CE, even though he was in a lot of pain, but when he arrived IMA said the CE doctor was out that day. No one from the SSA, State agency, or IMA ever tried to reach the claimant to tell him the CE doctor would not in that day. 

To prove that the DDS/IMA were committing fraud, we filed a FOIA request. Our request included: 1. The number of other patients the CE doctor was scheduled to see that same day, May 8, 2015, at the IMA offices in Hempstead, NY. 2. A copy of all the other patients' medical reports (with the names and Social Security numbers redacted) from May 8, 2015, who were examined by the same doctor that was scheduled to examine our client on that date. 3. The time records for all exams performed by the Hempstead IMA doctors on May 8, 2015. 

In response to our FOIA request, Mary Ann Zimmerman, Acting Privacy Officer, claimed that she did not have our client’s Social Security number, even though it was right at the top of the FOIA request. Yes, Zimmerman claimed that she could not see the Social Security number, which was the very subject of the FOIA request. Then, to make matters even worse, Zimmerman claimed that she did not have proof that we are the claimant's Appointed Representative, even though the SSA had already acknowledged receiving the proof. 

Zimmerman then claimed that she needed the written consent of the claimant whose records were requested. However, we never asked for any personally identifiable information. In fact, we specifically asked for "a copy of all the other patients' medical reports (with the names and Social Security numbers redacted) who were examined on May 8, 2015. In other words, Zimmerman’s response was nonsensical at best as there cannot be a need for the written consent of people when no personally identifiable information was requested. Since we explicitly stated that no personally identifiable information was requested, it is not possible for the FOIA request to constitute an invasion of anyone's personal privacy or violation of the Privacy Act. 

Not surprisingly, the SSA’s Glenn Sklar upheld the decision to deny the FOIA request by citing boilerplate language about the FOIA. Sklar’s only individualized claim was that releasing generic information about the number of exams and their duration performed by IMA doctors would somehow lead to the disclosure of personally identifiable information. Sklar knows that rationalization is a lie because it is impossible to identify a claimant who went for an IMA exam by providing the number of IMA exams and their duration. That is the type of opprobrious misconduct that occurs when you allow the SSA to police itself.

Court Said IME Doctor Lied

New York State Supreme Court Judge Duane Hart concluded that an “independent medical expert” (“IME”) named Michael Katz, who insurance companies regularly employed to undercut workers' compensation claims, lied about how extensive his exams were. 

Dr. Katz claimed that he performed various tests during his 20 minute examination. However, the claimant’s videotape of the exam showed that it lasted less than two minutes, and that the tests were not done. Judge Hart declared that Dr. Katz had lied, and stated that the matter should be referred to the District Attorney to prosecute for perjury. The judge also imposed $10,000 sanctions upon the attorneys representing the insurance company that hired Dr. Katz. 

Long Term Disability insurers are well known for their using IMEs to create evidence to contradict the supporting treating medical experts. However, it seems to me that Judge Hart’s conclusions can also be applied to the consultative examinations (“CEs”) that are done in connection with Social Security Disability (“SSD”) hearings. 

I have advised administrative law judges (“ALJs”) for years that the CEs are fraudulent because the reports contain exam finding that never took place. I have even advised some of my clients to videotape the exams, a practice that I will now universally endorse. 

It seems to me that if a fraudulent exam by an IME in the context of a State workers compensation case is perjury, then a fraudulent CE in the context of a federal SSD case would be a false or fictitious statement in violation of 18 U.S.C. § 1001. Since a doctor who seeks payment from the Social Security Administration under Medicare for tests that were not done can be prosecuted under 18 U.S.C. § 1001, then why can’t a doctor who seeks payment from the Social Security Administration under the SSD program for tests that were not done be prosecuted under 18 U.S.C. § 1001?

Consultative Examinations

If you apply for Social Security Disability (“SSD”) benefits in the New York metropolitan area, you will probably be sent to a doctor from Industrial Medicine Associates for a consultative examination (“CE”). Although the regulations actually provide very limited circumstances when a CE is appropriate, Social Security requires them in the vast majority of cases. CE’s are a single exam, and as the courts have ruled, provide opinions that are vague.

A CE’s opinion is usually unreliable compared to a treating doctor’s opinion. A CE frequently takes insufficient time to perform an adequate exam. Many claimants have testified that their CE lasted less than five minutes, and one examiner was even removed from CE eligibility after admitting he lacked the time to perform valid exams.

I represent a former dry wall apprentice, janitor-custodian, and tow truck operator whose on-the-record request for a fully favorable decision (“OTR”) was approved today by an Attorney Advisor. In granting the OTR, the Attorney Advisor explained that he gave less weight to the CE’s opinion because it was based on only one exam, and was vague.

The five Queens Administrative Law Judges (the “Queens Five”) who are the subject of the class action alleging that they are biased against claimants, constantly deny claims by elevating the opinions of CEs over treating physicians. If an Attorney Advisor understands that it is improper to give greater weight to a CE than a treating physician, then shouldn’t the Queens Five be able to understand that too, especially since their decisions have been rejected by federal court judges for that very reason?

Recording A CE

Regardless of what the medical records reveal, the State agency tells a Social Security Disability (“SSD”) claimant to go for consultative examinations ("CE”). CEs almost invariably contain fraudulent findings. For example, the CE report will say that the claimant had no trouble getting on and off the exam table, when the claimant only sat in a chair. This has been happening for many years.

To guard against fraudulent findings, I advise my clients to video record the CE, which are performed by ­IMA. Because there is no law, rule, or regulation that prohibits a SSD claimant from recording the CE, IMA claims that it is against their policy. However, in IMA offices, they have signs stating that claimants can record their exams, so their “policy” is specious at best. 

I represent a 52 year old former teacher for the deaf whose SSD application was approved by an ALJ today. The State agency had denied the claim on the grounds that the claimant refused to attend the CE. The claimant testified that when the IMA doctor saw the claimant’s spouse recording the exam, the doctor threw a fit, left the exam room, and refused to return. The claimant further testified that she never refused to answer any question or submit to an exam by IMA. If the reports of IMA doctors actually reflected what transpired during their exams, then there would be no reason for IMA’s “policy.”

Sadistic IMA Conduct

The Free Dictionary defines harassment as the systematic actions of a group, including threats and demands, whose purpose may be merely to gain sadistic pleasure from making someone fearful or anxious. That definition applies to the manner in which IMA Disability Services (“IMA”) treats Social Security Disability (“SSD”) claimants. 

For many years, my clients have advised me that the consultative examinations (“CEs”)  performed by IMA contain findings that could not have been made. Consequently, because of IMA’s dishonest conduct, I have advised claimants to videotape their CE. There is no rule prohibiting an SSD claimant from videotaping their CE, and there is a rule permitting workers compensation (“WC”) claimants to videotape examinations. 

I represent an SSD claimant who appeared at IMA for a CE. IMA told him that WC claimants can videotape exams, but not SSD claimants. When my client showed IMA that the letter scheduling the CE did not prohibit videotaping the CE, IMA said that their policy is to prohibit the taping, and therefore, IMA refused to perform the CE. 

IMA refused to explain why the same person could tape the exam if he were seeking disability benefits from WC, but not SSD. There is absolutely no rational[NO e] or legitimate reason to treat the same person differently just because the source of IMA’s funding is different. Therefore, logic dictates that the purpose of IMA’s systematic inconsistent and arbitrary actions is to gain sadistic pleasure from making SSD claimants fearful or anxious.

IMA Disability Services

Virtually every applicant for Social Security Disability (“SSD”) benefits on Long Island, and also in many areas around New York City, gets a letter stating that he or she “must” be examined by a “specialist” from IMA Disability Services (“IMA”). The letter always encloses a release so that the claimant can receive a copy of the IMA report. These letters are misleading in several respects.

First and foremost, the use of the word “must” is misleading because most claimants do not need to be seen by a doctor from IMA. The rules require the SSA to specify exactly what information is supposedly needed, and why the SSA claims the information is needed, which is rarely done. Moreover, the rules provide that the SSA cannot insist that a claimant attend a consultative examination (“CE”), such as the IMA exam, without first seeking the particular information from the treating physicians, or asking them to clarify any alleged inconsistency. Once again, that is virtually never done.

The word “must” is also misleading because many times, even after insisting that a claimant must attend an IMA exam, and after threatening to deny a claim if the applicant refuses to attend, SSD benefits are approved anyway. I represent a DHL delivery person whose SSD application was approved today two months after he was told that he must attend an exam by IMA.

The releases provided with the IMA demands are a joke. To date, despite countless submissions of the releases, IMA has never released one of its reports. IMA will say that it lacks the authority to release its report, which IMA will claim must be requested from the State agency. However, since the State agency does not release the IMA report before making its decision, an applicant is precluded from submitting a rebuttal.

There are countless other reasons under the rules that make CEs inappropriate. Not surprisingly, since IMA makes enormous amounts of money from performing thousands of CEs, the overwhelming vast majority of the IMA reports contradict the claimant’s disability allegations. Therefore, the demands for IMA exams should be vigorously objected to in writing.

IMA Exams In New York

In New York, the Division of Disability Determinations of the New York State Office of Temporary and Disability Assistance (“OTDA”) decides if the medical evidence supports an application for Social Security Disability (“SSD”) benefits. If the OTDA believes that the claimant’s medical information is unavailable or insufficient, then the OTDA can pay for a consultative examination (“CE”). The Social Security rules and regulations clearly state that a claimant’s treating doctor is the preferred source for a CE, which Administrative Law Judges reluctantly admit.

Even though I submit medical tests, functionality opinions, and clinical records, when I file SSD applications, the OTDA almost without exception sends notices for my clients to go for a CE by IMA Disability Services. IMA Disability Services, which has also gone by the name Industrial Medicine Associates, is part of The IMA Group (collectively, ”IMA”).

Why are claimants always told to go to IMA when the rules and regulations clearly state that the treating physicians are the preferred sources for CEs? Why are claimants told they have to go to IMA CEs in virtually every case? I represent a 59 year old bricklayer whose SSD benefits were paid today two months after I filed his application, even though the OTDA sent two letters stating that it was “necessary” for him to be examined by an unnamed doctor from IMA. Obviously, the CE was not necessary.

The OTDA is supposed to issue three year contracts for performing CEs through a competitive bidding process. David Pulver, the President of IMA, gave a private cocktail party and fundraiser for Alan Hevesi while he was Comptroller. The Comptroller and Attorney General are supposed to review the CE contract process, and the fundraiser occurred when IMA’s contract was pending review at Hevesi’s office. Alan Hevesi plead guilty to unrelated corruption charges, and was sentenced to 1-4 years on April 15, 2011.

As of 2009, IMA held the contracts for performing CEs in 12 of the 13 regions in the State, and now apparently holds all 13, even though a State investigation revealed that IMA engaged in a practice of improperly altering and submitting documents to OTDA in connection with its bids for CE contracts, as well as other improprieties. How much does the OTDA pay IMA annually? Certainly, IMA has a great incentive to retain its monopoly.

The money that goes to IMA comes from our taxes. It would seem that anyone interested in preventing the wasting of tax revenues would want to ask a lot of questions about IMA CEs. Since the State found that there was no undue influence behind the OTDA issuing contracts to IMA, why, as noted above, are claimants reflexively sent for IMA CEs when they are in fact not necessary? Even if a CE is necessary, why does the OTDA insist that IMA perform the exam when many claimants’ doctors would conduct the CE without cost to the taxpayer? How much do we actually pay IMA in total each year for CEs? How much would we save if the OTDA only sent claimants for a CE when they were actually necessary, and then to treating doctors?

IMA & DDS

The questionable relationship between IMA and the State agency  continues, without any meaningful oversight.  It seems nobody is concerned about the thousands of unnecessary exams.

We were retained by a 55 year old pharmacy tech from West Babylon with progressive orthopedic impairments following a motor vehicle accident, after her Social Security Disability (“SSD”) application was denied.  As usual, the claimant was sent a letter stating that it was “necessary for” her to be examined by an unnamed doctor from IMA Disability Services.

In light of the persistent COVID-19 pandemic, we advised the State agency that it was more important now than ever to comply with the regulation concerning a consultative examination (“CE”).  After all, according to Social Security’s website, they continue to conduct many hearings by telephone due to COVID-19.  We advised the State agency to make a decision because the claimant was not willing to postpone a CE with IMA.  Additionally, we advised the State agency that whatever information it believed was needed from IMA, could be requested from the claimant’s medical sources, who are the preferred source pursuant to the regulations.

The claimant did not attend a CE with IMA.  We received a Notice of Award today for the claimant, who provided all her medical records and reports from her doctors.  The State agency’s motivation for disregarding the CE regulations remains unclear.  However, it is clear that the State agency’s letters asserting the IMA CEs are “necessary” is untrue.  The claimant’s application should never have been denied in the first place.

 

State Agency-IMA Bad Faith Tactics

Regular readers of my blogs know that I have described how the State agency routinely deceives Social Security Disability claimants into going for examinations by doctors from IMA Disability Services. It seems the State agency is employing new tactics in order to assure that claimants go to these exams.

The first tactic is conveniently failing to notify me when my client has been asked to attend a consultative examination ("CE") by IMA. I first learn about the CE only after I see the claimant's efolder on appeal after the State agency has denied the application. The second tactic is calling the claimant on the telephone to tell them to go to the IMA CE, but mailing the notice to me two days before the 9am CE, which the State agency knows will not be delivered until after the CE. When I ask the claimants why they did not tell me they were going to the CE they said they thought I knew. In fact, one client told me today that they thought it was my office that was telling them to go the CE.

The State agency's unethical tactics are designed to circumvent my interposing objections to the CE or advising the claimant not to attend. What makes the State agency's tactics all the more unethical is that they have been specifically advised in writing that they are not to contact the claimant directly without my prior written authorization in violation of their own rules - POMS GN 03910.050.