Consultative examinations are set up by the State agency in the event that the claimant alleges a specific disability but offers no or insufficient medical evidence to support it. The rate decreased by 1.5 percentage points from fiscal year 1974 to fiscal year 1975. This was the result of better medical evidence of record (MER) documentation by examiners through increased telephone communication with attending physicians. It is estimated that each CE case requires 130 minutes additional processing time due to examiner and clerical time needed to schedule and arrange appointment, as well as to followup and evaluate evidence received.

•  

  FY 1975 = -3.07 work-years

  FY 1974 CE rate = 21.5%

  FY 1975 CE rate = 20.0%

               -1.5% difference

  165,535 cases ×.015 = 2,483 cases

  =2,483 cases ×130 minutes = -322,793 minutes

  -322,793 minutes ÷60 = -5,380 hours

  5,380 hours ÷1,750 = -3.07 work-years

General physical examinations replace CE's in most cases and involve claimants compromising the lower economic strata of the population who lack adequate medical records needed for case development. Therefore, general physical examinations will be required. The GPE rate is estimated at 16 percent during fiscal year 1975 and each GPE case requires 90 minutes additional processing time.

•  

  FY 1975 = +22.70 work-years

  165,535 cases ×.16 = 26,486 cases

  26,486 cases ×90 minutes = 2,383,740 minutes

  2,383,740 minutes ÷60 = 39,729 hours

  39,729 hours ÷1,750 = +22.70 work-years

Medical evidence of record (MER) refers to medical evidence already on file in a physician's office, clinic or hospital, such evidence being needed by the State agency to adjudicate the medical aspects of the claim. The involvement of the purchase of MER increases case processing time by 15 minutes. The MER rate increased by 5 percent from fiscal year 1974 to fiscal year 1975, according to estimates.

•  

  FY 1975 = +1.18 work-years

  165,535 cases ×.05 = 8,277 cases

  8,277 cases ×15 minutes = 124,155 minutes

  124,155 minutes ÷60 = 2,069 hours

  2,069 hours ÷1,750 = +1.18 work-years

In the interest of getting the denial letter to the claimant more quickly, the State agency was instructed to type denial letters on initial claims and to release the notice. The denial rate in fiscal year 1975 is estimated at 50 percent, an increase of 1 percent over fiscal year 1974. An additional 12.5 minutes per case processing time results.

•  

  FY 1975 = +.19 work-years

  165,535 ×.01 = 1,655 cases

  1,655 cases ×12.5 minutes = 20,688 minutes

  20,688 minutes ÷60 = 345 hours

  345 hours ÷1,750 = +.19 work-years

The State agency began making personal and telephone contacts with claimants denied at the reconsideration level to clarify the reason for the denial. It is estimated that these contacts increase the processing time per case by 94 minutes. The estimated fiscal year 1975 affirmation rate is 52 percent and an estimated 26,402 cases will be affected.

•  

  FY 1975 = +12.29 work-years

  26,402 cases ×.52 affirmation rate = 13,729 cases

  13,729 cases ×94 minutes = 1,290,530 minutes

  1,290,530 minutes ÷60 = 21,509 hours

  21,509 hours ÷1,750 = +12.29 work-years

The purpose of the quality assurance program in this exercise is to review DA &A cases for technical and substantive accuracy and consistency, as well as to review medical evidence for completeness and definition. An estimated 2,100 cases will be sampled during fiscal year 1975 and each case sampled requires 105 minutes additional processing time including clerical, supervisor, multiple handlings and review time.

•  

  FY 1975 = +2.10 work-years

  2,100 cases ×105 minutes = 220,500 minutes

  220,500 minutes ÷60 = 3,675 hours

  3,675 hours ÷1,750 = +2.10 work-years

The Advanced Record System (ARS) is a teletype system linking the DDS work locations to central office. It provides central office with State agency operating statistics and is used by the State agency for case inquiry information. The system was installed in fiscal year 1974 (June 1974). It is estimated that the system will require 2.50 work-years to operate, but that 1.75 work-years will be saved in manual preparation of 877's and similar reports requiring manual development.

•  

  FY 1975 = +.63 work-years

  2.50 work-years -1.75 work-years = .75 work-years

  .75 ×1/12 FY 1974 = .06

  .75 - .06 = .69 carried over into FY 1975

  .69 - .06 = +.63 work-years change

Beginning in fiscal year 1975 the State agency began sending out a team of four paraprofessionals to physician's offices, clinics, and institutions in order to gather medical reports. This was done to speed up case processing.

•  

  FY 1975 = +4 work-years

Beginning fiscal year 1974, the State agency began condensing the narrative used in describing the basis for its decision on the Form SSA-831 (Disability Determination Form). A total of 10.02 work-years was saved in fiscal year 1974. No changes are foreseen for fiscal year 1975, fiscal year 1976, and fiscal year 1977.

•  

  FY 1975 = 0 work-years

  10.02 FY 1975 .10.02 FY 1974 = 0 work-years

Beginning fiscal year 1975, the State agency did away with the checklist form used by clerks to ensure that each case folder contained the necessary medical forms. Elimination of this procedure save 15 minutes processing time.

•  

  FY 1975 = -23.64 work-years

  165,535 ×15 minutes = 2,483,025 minutes

  -2,483,025 minutes ÷60 = -41,384 hours

  -41,384 hours ÷1,750 = -23.64 work-years

Beginning fiscal year 1975, the State agency eliminated form no. 217 (routing form) prepared by its mailroom clerks. The elimination of this procedure saved 6 minutes processing time per case affected. Sixty percent of the dispositions will be affected, according to estimates in fiscal year 1975.

•  

  FY 1975 = 5.67 work-years

  165,535 ×.60 = 99,321 cases

  99,321 cases ×6 minutes = 595,926 minutes

  -595,926 minutes ÷60 = 9,932 hours

  -9,932 hours ÷1,750 = -5.67 work-years

It takes 200 hours to train 1 clerk and a period of 15 months to train 1 examiner before he or she is 100 percent productive compared to the journeyman level. Examiner trainees are not productive during their first 200 hours (classroom training). They are 50 percent productive during the first 6 months after classroom training and 75 percent productive during the second 6 months after classroom training.

Due to the amount and complexity of budget and medical documentation type work the State agency added 12 more methods and procedures analysts to its existing staff of 2.

•  

  FY 1975 = +11.64 work-years

  14 cumulative work-years FY 1975 minus 2.36 (2 work-years

  FY 1974 ×1.18 increase in dispositions from FY 1974 to

  FY 1975) = 11.64 work-years.

The increase and complexity of staff type work in the budget and medical liaison areas necessitated the State agency to increase its staff supervisory ratio from 1 to 10 to 1 to 5. Before fiscal year 1975, both staff and nonstaff supervisory ratios were 1 to 10. Moreover, staff personnel accounted for 20 percent of the work force.

•  

  FY 1975 = 8.60 work-years

  432 (FY 1974 total work-years) ÷10 = 43.20 total supervisors

51.80 - 43.20 = +8.60 work-years

The State agency began planning its decentralization in fiscal year 1974 at which time 1.75 work-years was expended. A total of 3.25 work-years is estimated to be expended in fiscal year 1975.

•  

  FY 1975 = +1.50 work-years

  3.25 FY 1975 - 1.75 FY 1974 = 1.50 work-years

In order to reduce the number of pending cases, the State agency decided to take some expedient measures which saved 29.5 minutes processing time per case. This was begun in fiscal year 1975 and affected 55,000 cases.

•  

  FY 1975 = -15.47 work-years

  55,000 cases x 29.5 minutes = 1,622,500 minutes ÷60 = 27,041 work-years ÷1,750 = -15.45 work-years

The State agency experienced with an IBM paper sorting machine during fiscal year 1975 for future implementation possibilities. A total of 1,500 cases were used in this experiment which required 50 minutes each additional processing time.

•  

  FY 1975 = +.71 work-years

  1,500 cases ×50 minutes = 75,000 minutes

  75,000 minutes ÷60 = 1,250 hours

  1,250 hours ÷1,750 = +.71 work-years