SSDI evals

[Woodsjd]

Hi all! I am a PhD psychologist licensed in VA for 5 years moving to CA for my spouse's 1 year medical fellowship. We are moving with an infant and I'm not looking for a full time job because of the baby and the fact that we will only live there for a year. A colleague suggested I do Social Security Disability evals to make extra money on my own schedule.

A few questions:
1) Is this legit and financially worth the time?
2) Who do you contact to get started?
3) Is this something you can do from home?

---

Members don't see this ad.

 

[PsyDr]

1) No. Go look up what the SSA defines as disability. It's basically confined to people just this side of comatose . Like if you can throw a newspaper or utter the phrase, "you want fries with that", you're not disabled. It's low paying work, that incentivizes high volume, low quality work. No testing, but who needs to follow professional guidelines? You're also inviting in people with the social ills of poverty into your office. Remember the acronym YAVIS? It's the opposite of that.

2) Who knows?

3) No.

 

[Therapist4Chnge]

It's not worth the low $ paid to you. Your two best bets are contracted assessment work or utilization review for insurance companies.

 

[psych.meout]

It's not worth the low $ paid to you. Your two best bets are contracted assessment work or utilization review for insurance companies.

How does one get into contract assessment work or utilization reviews?
Do they pay well?

 

[deleted343839]

How does one get into contract assessment work or utilization reviews?
Do they pay well?

Paging @erg923

All it took for me to get invitations to do SSI disability evals was a license, an email address, and a pulse. Someone basically cold called me with an invitation to do these, which should tell you something. I actually talked to the person and it was like a sales pitch. They saved the dreadfully low compensation for the end.

So, my advice is to do something else. Try telehealth?

 

[AbnormalPsych]

Remember the acronym YAVIS?

I haven't heard this acronym since grad school.... boy, I miss those layup YAVIS patients.

 

[WisNeuro]

How does one get into contract assessment work or utilization reviews?
Do they pay well?

Utilization reviews are run by the insurance company, or they contract it out to a third party. Pays 140-280 an hour

 

[BuckeyeLove]

I just started doing consulting with SSA (I think what some may have been referring to above, not the insurance stuff) doing claims reviews, and I've found that to be way better than doing the evals. I've told this to many people who think about doing these: the only times ive ever been scared for my safety is in doing SSA evals, and I've sat in front of more psychopaths than you can count. You often don't know much about who is coming in, and they will view you as one impediment in order to either a. get that $ or b. keep getting that $. The consulting with SSA is way less risky, and a nice supplement to the other high risk work I do in my practice.

If youre doing the consultative exams in the community, the only way to make it financially viable is to do what I saw some mentors of mine doing (which was in many's eyes unethical, including mine), where they had psych assistants do most of the interviewing, then they would swoop in for 5 minutes at the end. Oh they would also schedule 20 exams in like a 5 hour period. So let's say they had a 66% show rate. a buck60ish x 13ish appointments and they essentially had their hourly rate doing other work (i.e., 400ish). That's the ONLY way that I know of that the "hustlers" I know do these.

 

[keepsclimbing]

One of my practicum sites trialed doing SSDI evals while I was there. They elected not to continue doing them because the compensation rate was low and the no-show rate was high. They were contacted by the state about doing them and they were conducted at our clinic.

I'm not positive about the laws, but could you treat clients in VA via telemental health while you are in CA? That would be something that you could do from home, on your own schedule.

 

[Seven_Costanza]

One of my practicum sites trialed doing SSDI evals while I was there. They elected not to continue doing them because the compensation rate was low and the no-show rate was high. They were contacted by the state about doing them and they were conducted at our clinic.

I'm not positive about the laws, but could you treat clients in VA via telemental health while you are in CA? That would be something that you could do from home, on your own schedule.

This isn’t possible. The provider would need to be on site to use the proper equipment and software. There’s a lot of coordination involved with telemental health at the VA.

 

[Sanman]

This isn’t possible. The provider would need to be on site to use the proper equipment and software. There’s a lot of coordination involved with telemental health at the VA.

I think they meant VA as in Virginia, not Veterans Affairs.

 

[Seven_Costanza]

I think they meant VA as in Virginia, not Veterans Affairs.

Ohhhh...oops! Please ignore me then.

 

[keepsclimbing]

I think they meant VA as in Virginia, not Veterans Affairs.

Yes, sorry for not being clear. My (limited) understanding is that telemental health providers generally need to be licensed in the state where the client is located - and it sounded like OP is licensed in Virginia. I was wondering if OP could provide telemental health services to clients in Virginia while OP is in California. (The only person I know who does this is a social worker in Massachusetts and I don't know anything about her infrastructure or logistics - just that she has been able to make it work.)

 

[Seven_Costanza]

Yes, sorry for not being clear. My (limited) understanding is that telemental health providers generally need to be licensed in the state where the client is located - and it sounded like OP is licensed in Virginia. I was wondering if OP could provide telemental health services to clients in Virginia while OP is in California. (The only person I know who does this is a social worker in Massachusetts and I don't know anything about her infrastructure or logistics - just that she has been able to make it work.)

Don’t apologize! You very clearly said “treat patients in VA.” I just misread it because of my own bias from being pretty embedded in the VA system.

 

[Sanman]

A couple of FYI things,

1. Telemental health laws vary my state, so you would have to check VA and CA law. I think VA requires a signed informed consent prior to services, so you may have to navigate that. Also I would suggest using a HIPAA compliant video service and not something like Skype

2. Regarding Dept of Veterans Affairs telemental health, you can provide services from home if it is approved by the service. We have some telemental health that is approved that way due to lack of suitable office space.

 

[erg923]

Paging @erg923

Yea, so sent a PM just to clarify a few thing I am aware of in this area.

A general summary for everyone else:

Psychologists do "peer reviews." "Utilization Review" is essentially the same thing, but can be done by nurses or master-level clinicians. In a "peer review" (only MD/Ph.D), you would also be reviewing for the "medical necessity" and clinical appropriateness of the request, but may also be required to the speak with requesting doctor/therapist to gather more information, especially if the request has already been denied once and you are doing a "3rd-level review" (reconsideration/peer-to-peer). Psychologists can review requests for Psychological/Neuropsycholgical Testing, Outpatient level services, and Intensive Outpatient Programs (IOP). Only MDs can review requests for inpatient (MH and SUDs) and Partial Hospitalization Programs (PHPs).

There are 3 or 4 independent companies I am ware of that contract to do these these reviews for insurance companies on a fee-for-service basis. They have a panel of psychologists (and MDs) that review cases as 1099 workers. These contract reviews/reviewers are pretty costly for insurance companies, and often (but not always) provide lower quality reviews and much less "care shaping" information in their reviews....as opposed to when companies hire psychologists to do this full-time internally (where they are actually invested in the work/company/mission vs just "making some side money"). My company and some others (e.g., Optum/UBH) employ psychologists internally for these reviews. My company has 7 full-time psychologist for this. I think Optum/UBH has almost 15? Beacon (formerly Value Options) have some, as does New Directions, AETNA, and various other state health plans throughout the country.

 

[AbnormalPsych]

Yea, so sent a PM just to clarify a few thing I am aware of in this area.

A general summary for everyone else:

Psychologists do "peer reviews." "Utilization Review" is essentially the same thing, but can be done by nurses or master-level clinicians. In a "peer review" (only MD/Ph.D), you would also be reviewing for the "medical necessity" and clinical appropriateness of the request, but may also be required to the speak with requesting doctor/therapist to gather more information, especially if the request has already been denied once and you are doing a "3rd-level review" (reconsideration/peer-to-peer). Psychologists can review requests for Psychological/Neuropsycholgical Testing, Outpatient level services, and Intensive Outpatient Programs (IOP). Only MDs can review requests for inpatient (MH and SUDs) and Partial Hospitalization Programs (PHPs).

There are 3 or 4 independent companies I am ware of that contract to do these these reviews for insurance companies on a fee-for-service basis. They have a panel of psychologists (and MDs) that review cases as 1099 workers. These contract reviews/reviewers are pretty costly for insurance companies, and often (but not always) provide lower quality reviews and much less "care shaping" information in their reviews....as opposed to when companies hire psychologists to do this full-time internally (where they are actually invested in the work/company/mission vs just "making some side money"). My company and some others (e.g., Optum/UBH) employ psychologists internally for these reviews. My company has 7 full-time psychologist for this. I think Optum/UBH has almost 15? Beacon (formerly Value Options) have some, as does New Directions, AETNA, and various other state health plans throughout the country.

How would you recommend one go about looking for peer review positions?

 

[Woodsjd]

Thanks for the quick and helpful responses! Yes, I meant practicing in Virginia, not in the VA system.

This is a helpful clarification about terminology; I am seeking opportunities to do peer review/utilization review on a PT contract basis. Based on the descriptions above, doing SSDI evals does not sound safe, financially worthwhile, or feasible for my situation.

 

[WisNeuro]

How would you recommend one go about looking for peer review positions?

Depends on who does the contracting in your area. Also, easier to get if you are in a specialty area, and if you are boarded. After I get boarded, I started getting approached for a lot more contracted side gigs.