The workflow for Social Security disability benefits determination has historically been a slow one, with hospitals and patients often waiting months for records to be requested, collected and manually transferred through faxed or mailed documents before a decision can even be made.
These determinations decide whether a person qualifies for disability benefits, which are the income support and often health insurance for people unable to work due to serious medical conditions.
Now, the process is starting to shift to real-time electronic data exchange.
In February, the Social Security Administration joined the Trusted Exchange Framework and Common Agreement (TEFCA), a national interoperability framework that sets standardized rules and infrastructure for securely sharing electronic health information across different systems. Since then, hospitals have begun making real progress toward faster, more seamless disability determinations, according to Dr. David Kaelber, chief health informatics officer at MetroHealth System in Ohio.
Dr. Kaelber, who is also a practicing internist and pediatrician at the health system, noted that MetroHealth has a history of health information exchange with the SSA. The organization began participating in SSA data sharing efforts in 2014 through early health information exchanges like eHealth Exchange and The Sequoia Project.
But the SSA joining TEFCA marks a big shift, Dr. Kaelber said. Instead of relying on custom, fragmented health information exchange connections that had to be built and maintained individually, hospitals and the SSA are using a standardized national framework that can scale data retrieval across many systems.
“We’ve moved to the 2026 version of health information exchange,” Dr. Kaelber declared. “It’s a more robust health information exchange. It’s following all the current rules and regulations around patient safety and confidentiality, and what TEFCA is really trying to do is grease the wheels on appropriate health information exchange.”
He explained that MetroHealth handles about 600 disability applications per month. In the legacy process, SSA determinations could take months, largely because of slow record retrieval processes and staff needing to manually retype information across systems — both of which would introduce delays and potential errors.
Because most healthcare data is already within EHRs, this manual transfer process is outdated, Dr. Kaelber pointed out. In contrast, TEFCA-based exchange can shorten record transfer times from weeks or months to seconds, he said.
Overall, Dr. Kaelber believes the new process benefits multiple parties. It’s good for patients, as it results in faster access to disability benefits and less financial uncertainty. For the SSA, this change drives improved efficiency, and for providers, it means less administrative overhead and better patient satisfaction.
Faster disability determinations can also reduce downstream harm, including medical debt for vulnerable patients, Dr. Kaelber added.
Epic is playing a key role in operationalizing this shift, with its EHR system serving as one of the main pathways connecting hospitals to the SSA via TEFCA exchange.
Once patients authorize access, medical records can be shared automatically between providers and the agency, noted Nihit Bajaj, a technical coordinator at Epic.
Bajaj said many of the hospitals currently connected to the SSA are Epic customers, but the longer-term goal is to bring in providers that use other EHR systems as TEFCA adoption expands.
Dr. Kaelber seconded this message.
“There’s just so much on your plate at a healthcare system that doing the SSA connection just continues to fall down on the list. And I think something like the SSA joining TEFCA and Epic supporting TEFCA hopefully will significantly accelerate the connections being made so that many, many more patients throughout the U.S. can benefit,” he remarked.
Photo: Yuichiro Chino, Getty Images
