"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.