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Business Guide
Lesson
Seven In this lesson, we are going to discuss several operational considerations that may not have been covered elsewhere in our training materials. Our primary focus in this lesson will be document security.
When you and a potential client sign SSA Form 1696 Request for Representation form, you become that client’s authorized representative before the Social Security Administration. Of course, the 1696 must be sent to the Claimant’s local District Office or to the Examiner handling the case in order to make this relationship official. Although this document allows you to act on the claimant's behalf, it does not authorize you to disclose any part of the claimant's file to any unauthorized person. As a disability representative, you must never disclose any part of a client's file to anyone other than the claimant or an officer within the Social Security Administration.
The following suggestions are designed to protect you and your service from legal action related to the sharing of client information. It is not unusual for a claimant to request that you send a copy of a document within his/her records to a physician, attorney or a family member. Avoid this pitfall if at all possible! Inform the claimant that Social Security regulations prohibit you from sending copies of a claimant’s record to any unauthorized individual. The claimant may then state that he is giving you permission to send the record. His word isn’t enough. If the claimant wants you to send any part of his record to anyone other than a Social Security official, indicate to the claimant that you need his request in writing. Make sure that the request contains a verifiable claimant signature. Another way to avoid problems with confidentiality is to send the requested materials to the claimant. Even if the claimant request that a record be sent to him, make sure you have the request in writing with the claimant’s signature. In this circumstance, the claimant may then forward his personal information to anyone his likes. We further suggest that you:
If anybody else, including the claimant's family members, requests evidence in your possession, avoid sending the materials without written permission from the claimant or a designated third party. Usually the claimant or his/her third party will be assisting you in acquiring records. However, the reverse as describe above does happen. You should also restrict sending out Social Security or Company generated materials. This restriction should include such important documents as your formal argument and correspondence letters generated during the case. The less information you share, the less likely confidentiality will become an issue.
Most disability advocates practice locally. We define the term local as a practice that only accepts cases from clients who reside within the same state as the representative. Limiting your practice to within your state is an especially smart move for beginner and most intermediate disability advocates. Allowing yourself to accumulate local experience in the field before attempting out-of-state cases allows you to develop professional maturity. Practicing locally also enables you to: 1. Learn how your State's Social Security and DDS offices work. 2. Formulate relationships with within your local Social Security offices. 3. Eliminates the need for you to travel outside of your state. 4. Your customer base and service market is closer. Although we do not recommend face-to-face meetings as a rule, occasionally it might be preferable. The closer you are to your customers, the easier it is to attend hearings. 5. Local marketing is always less expensive than national marketing. 6. A single state is much easier to demographically understand and target. 7. Disability advocacy is a community-based service. Therefore, being a member of the community provides a subtle marketing advantage. 8. Easier to become known locally without large distribution advertising. 9. Word-of-mouth marketing also works much better within a community. Although you may approach the national disability market anyway you like, we suggest that you concentrate on your own community first. Establishing your service within a small demographically feasible community in the early stages of your business, allows for easier expansion later on.
When you do decide to expand your service to another state, use a Partner located in that state. Using a partner who lives in the state you are expanding into allows for all the advantage of a locally practicing advocate without the out-state headaches. For example, If you are representing a case in another state and an ALJ request a hearing, you must attend the hearing. Social Security will usually not reimburse the advocate for an out-of-state hearing which means that you must foot the bill. Logically, this situation can be avoided by allowing your out-of-state partner to handle the hearing.
As a Disability Advocate you'll quickly discover that working as a representative requires that you maintain well-documented files on each client. All of the materials kept in a client's case folder are important both to your business and to the claimant. Most of the forms, records and other documents used in your practice are both personal and confidential. Here are a few suggestions for working with client records:
Keeping a copy of all signed forms and correspondence is the best way to avoid future problems while simultaneously running an efficient business. Any materials received from Social Security, including questionnaires and medical evidence must remain strictly confidential. These materials should be kept in a private file and/or a secure computer for at least three years after representation. After three years, you have the option of destroying these records if you wish. Destruction of records should be done in such a manner as to assure that no unauthorized individual will ever get the opportunity to review these materials.
Legal action against an ethical disability advocate is extremely rare. However, this rarity does not mean that it can't happen! One way of protecting yourself long term, is to keep some of the more important pieces of case evidence after three years. The most important records to retain long term are:
The above materials will provide you with enough information about a particular case, to enable you to mount a preliminary defense if needed. Even through legal action against advocates is rare, it is always a good idea to think ahead and be prepared.
There is nothing wrong with using the old file cabinet approach to record keeping. This approach has worked in the past and it will work now. However, things are slowly but surely changing in this industry. Large database companies are starting to invest heavily in digital record keeping on a entirely new scale. The idea of digital record keeping, also known as the paperless office, is in fact fairly old, but has been gaining momentum in the last few years. A paperless office would be revolutionary for the Social Security disability program. It could increase this agencies efficiency level by fifty percent. A digital office is very much a part of Social Security's strategic long-term planning. Knowing that these changes are coming makes it a good idea to begin preparing yourself now. Disability Associates is doing its part to move disability advocacy forward into the digital future with the creation of our new Advocate Client Manager Pro software. With our Advocate Client Manager Pro (ACM Pro), you can create and keep a digital record of claimant records in a single location. The ACM also allows you to perform all of the standard functions of a disability advocate while documenting each action within the system. We've also added new security features and a host of other unique capabilities to the ACM Pro. The ACM Pro is the first step to creating your own digital office environment.
Although paperless record exchange and storage are here yet, Social Security and the advocacy industry are not far behind. Within your service, it’s a good idea to keep using paper files when appropriate. However, if you have our ACM Pro software, try to get comfortable with digitizing client records whenever possible. Digital records provide a more efficient format for information exchange and much easier storage.
You may approach document control any way you like. However, here are a few suggestions for controlling digitized records:
If you are not sure about how to use the ACM Pro to it’s fullest potential, invest in the ACM Pro Manual. This illustrated guide will help you to better understand this powerful record keeping database program.
The Continuing Disability Review (CDR) is another good reason to keep client records for a period of at least three years. A Continuing Disability Review is a process where Social Security reviews the medical status of a person who is already on disability benefits. The CDR review date is sometimes referred to as the diary or reevaluation date. Social Security disability claims are usually give a diary date of three or seven years. The diary date is determined by the age of the claimant at the time he/she became disabled. Younger individuals are given the shorter three year diary date because a younger person is more like to show medical improvement over time. When a case is called by Social Security for a Continuing Disability Review (CDR), the claimant will be notified by mail. If you represented the case, the client will probably call you in a panic, worried about losing his benefits. When this occurs, there are several actions you can take to help the claimant through this process. Here are just a few:
Basically, here is what happens in a CDR review. Social Security will review the client's current medical status and determine if there has been medical improvement. If the client has improved to the point of being able to perform work, Social Security will cut off his benefits. The claimant will be paid two additional months of benefits before the termination of benefits is complete. You can assist the claimant in appealing this termination if the claimant wishes you to do so. By keeping the client's records, you're in a perfect position to assist the client in the CDR process. See the Social Security Guide for more information about the Continuing Disability Review process.
Lesson eight will discuss several of our unique approaches to expediting the Social Security disability claims process. ******************** Copyright © 20011 Disability Associates, Inc. All Rights Reserved. |
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