The workflow for determining Social Security disability benefits has historically been slow, with hospitals and patients often waiting months for records to be requested, collected and manually transferred via faxed or mailed documents before a decision can even be made.
These determinations determine whether a person is eligible for disability benefits, which provide income support and often health insurance for people who are unable to work due to serious health conditions.
Today, the process is starting to move towards electronic exchange of data in real time.
In February, the Social Security Administration joined THE Trust Exchange Framework and Common Agreement (TEFCA)a national interoperability framework that defines standardized rules and infrastructure for the secure sharing of electronic health information between different systems. Since then, hospitals have begun to make real progress toward faster, more transparent disability determinations, according to Dr. David Kaelber, director of health IT at the MetroHealth System in Ohio.
Dr. Kaelber, who is also a practicing internist and pediatrician within the health system, noted that MetroHealth has a history of exchanging health information with the SSA. The organization began participating in SSA’s data sharing efforts in 2014 through early exchanges of health information like eHealth Exchange And The Sequoia project.
But the SSA’s joining TEFCA marks a significant change, Dr. Kaelber said. Instead of relying on personalized, fragmented health information exchange connections that had to be established and maintained individually, hospitals and the SSA use a standardized national framework that can extend data retrieval across numerous systems.
“We have moved to the 2026 version of health information exchange,” Dr. Kaelber said. “It’s a more robust health information exchange. It meets all the rules and regulations in place regarding patient safety and privacy, and what TEFCA is really trying to do is grease the wheels for proper health information exchange.”
He explained that MetroHealth processes about 600 disability claims per month. Under the old process, SSA determinations could take months, largely due to slow record retrieval processes and the need for staff to manually re-type information into systems, leading to delays and potential errors.
Since most health data is already in EHRs, this manual transfer process is obsolete, Dr. Kaelber emphasized. In contrast, the TEFCA-based exchange can reduce record transfer times from weeks or months to seconds, he said.
Overall, Dr. Kaelber believes the new process benefits multiple parties. This is good for patients because it allows faster access to disability benefits and reduces financial uncertainty. For the SSA, this change means greater efficiency, and for providers, it means fewer administrative costs and better patient satisfaction.
Faster disability determinations can also reduce downstream harms, including medical debt for vulnerable patients, Dr. Kaelber added.
Epic is playing a key role in operationalizing this change, with its EHR system serving as one of the primary pathways connecting hospitals to SSA through the TEFCA exchange.
Once patients allow access, medical records can be shared automatically between providers and the agency, noted Nihit Bajaj, technical coordinator at Epic.
Bajaj said many hospitals currently connected to SSA are Epic customers, but the long-term goal is to bring in providers who use other EHR systems as TEFCA adoption grows.
Dr. Kaelber seconded this message.
“There are so many things to do in a health system that the SSA connection continues to fall off the list. And I think something like the SSA joining TEFCA and Epic supporting TEFCA will hopefully greatly accelerate the connections being made so that more and more patients across the United States can benefit,” he noted.
Photo: Yuichiro Chino, Getty Images
