David Camp, NOSSCR Senior Policy Advisor

Every one of you has had a hearing turn on the testimony of a medical expert you had never seen before, working from a file you had spent months building, rendering an opinion that carried more weight with the ALJ than your own treating source. It is worth understanding where that person came from, who pays them, and how much leverage you actually have when you think their opinion does not hold up.

The Contract

SSA just awarded Mednick Associates a new task order to supply medical experts for ALJ hearings across the Western Regions and the National Hearing Center. The key facts:

– Value: $163,375

– Awarded: August 21, 2026

– Term: six months, September 1, 2026 – February 28, 2027

– Coverage: the Western hearing regions plus the National Hearing Center

That $163,375 figure is just a six-month increment, not the full picture. The prior full-year task order for the same western footprint (September 2025–August 2026) was worth $5,288,700: that is the number that shows the real scale of one vendor’s operation across six regions and the National Hearing Center, and it is a lot of geography and a lot of hearings running through a single vendor.

Quick comparison:

– Western primary (current, 6 mo.): $163,375

– Western primary (prior, 12 mo.): $5,288,700

– Eastern back-up (current, 12 mo., Regions 1–4): $9,975

– Eastern back-up (prior, 12 mo., Regions 1–4 and 6): $89,250

Mednick’s reach does not stop at the west. Mednick also holds the standing back-up ME task order for eastern Regions 1–4, a much smaller award at $9,975 for September 2025–August 2026. This back-up role activates whenever the primary eastern vendor cannot cover a case, letting Mednick doctors step in. So if you practice in the east, do not assume Mednick is someone else’s problem: their doctors can still turn up on your docket as a fill-in.

If you practice anywhere in that combined footprint, primary or back-up, there is a real chance the same handful of MEs keep showing up on your calendar, month after month, case after case. And because the roster and the geography can shift with each recompete, this is worth your attention no matter where you practice, not only in the regions named in this particular task order.

This is not new. SSA has contracted out medical and vocational expert services for years rather than employing these witnesses directly, and NOSSCR has tracked the mechanics of that system for some time, including publishing an item on updated payment rates for vocational and medical experts in our December 2023 Forum. But a task order of this size, layered on top of a multi-year relationship covering this much of the country, is a good occasion to walk through how the procurement actually works and what that means for your cross-examination.

There is also a reason to watch this particular vendor relationship right now. SSA posted a Request for Information on medical expert services in early June 2026, with responses due later that month. Both incumbent national ME vendors are currently working short bridge orders instead of full-year contracts. TMAX Government Solutions, which holds the eastern primary role covering the eastern hearing regions, is also reportedly working under a task order structured in shorter increments rather than as a single full-year award. Mednick’s new western order, as noted above, covers just six months instead of the usual year. Read together, that pattern looks like a recompete underway, which means the national roster of ME vendors, and potentially the doctors on it, could look different within the year. Who shows up as the expert witness in your hearing room, and under whose incentive structure, may be about to change, and that possibility applies to the whole country, not just the regions named in the current task orders.

How the Vendor Pipeline Works

SSA does not hire MEs as employees. It contracts with staffing companies, who in turn maintain rosters of physicians willing to review files and testify (usually by phone or video) for a set fee per case. The agency issues task orders to these vendors covering specific hearing offices or regions, the vendor recruits and vets the doctors, and SSA’s Office of Hearings Operations schedules them into individual cases as needed.

The practical effect is that your ME did not go through the same credentialing process as, say, a consultative examiner selected through the state disability determination service. The vendor is doing the vetting, under contract terms that are not fully public, and the financial incentive on the vendor’s side is volume. The more experts it can place into hearings, the more the contract pays out. That does not mean the doctors are unqualified or biased. It does mean you should never assume the vetting was rigorous just because the check comes from the government.

What You Can Actually Challenge

There are three angles worth building into your practice when a contracted ME testifies against your client, and none of them require you to prove bad faith.

Credentials and scope of practice. Ask, on the record, what board certifications the ME holds and when they last treated a patient with your client’s specific impairment. A cardiologist testifying about fibromyalgia, or an internist opining on complex mental health limitations, is fair game for a foundational challenge regardless of how many SSA hearings they have worked.

Frequency and specialization within the vendor’s roster. If you have appeared against the same ME multiple times, or if you know from colleagues that this doctor works almost exclusively through one vendor across an unusually wide territory, that is relevant to how independently their opinions are formed versus how routinized their testimony has become. A doctor who testifies in hundreds of hearings a year develops patterns, and those patterns are legitimate cross-examination territory.

Consistency with the objective record. This is the fundamental of ME cross-examination and it does not change because the witness came from a contractor rather than a treating relationship: pin the ME to specific exhibits, ask them to reconcile their opinion with specific findings, and do not let a broad credibility assertion substitute for a citation to the record.

NOSSCR has built training around exactly this skill set. Our conference CLE programming has included sessions specifically on cross-examining medical experts, and if you have not taken one of those sessions, I encourage you to look for the next one on the schedule.

The Leverage Point Multi-Region Contracts Create

Here is what is different about a contract spanning multiple regions, plus a back-up role in several more: it concentrates a large share of a category of witness under one vendor’s incentive structure, which means patterns are easier to spot and more consequential when you find them. This is not a phenomenon confined to the regions named in the current task order. If members across the country start comparing notes on which experts a single vendor sends into hearings, and how those experts testify, that pattern evidence is more useful than any single cross-examination transcript. I encourage you to post on the NOSSCR Martin Listserv about who you are seeing from Mednick Associates, wherever you encounter them, and how those hearings have gone. That kind of shared observation is exactly what lets us, and Congress, eventually ask whether a concentrated contract is serving claimants well.

This is also where oversight outside the hearing room matters. Congress has looked at contracted medical review quality before. In 2019, Ways and Means Social Security Subcommittee Chairman John Larson requested a GAO study into the quality of medical reviews performed by SSA-contracted physicians, following investigative reporting on rushed, per-case-paid review practices. I submitted written testimony to that same Subcommittee in October 2023 addressing a related structural problem, SSA’s reliance on outdated vocational data systems for hearing witnesses, and urging the agency to move its expert testimony framework into the modern era. The throughline across both issues is the same: when SSA outsources expert testimony to contractors compensated by volume, oversight of who is actually testifying and how well is not optional. It is part of due process.

What I Am Watching

We want to see the terms of these vendor contracts get more transparent, particularly the qualification standards vendors apply before putting a doctor on a hearing roster. We also want to see whether a single contractor covering six regions, with a back-up role in four more, produces the kind of testimony consistency, or inconsistency, that would justify Congressional attention the way the 2019 GAO request did. With a Request for Information already posted and both incumbent vendors on short bridge orders, we expect a recompete of the national ME contracts to play out over the coming months, and we intend to watch whether it changes who is actually showing up in your hearings, in any region.

In the meantime, treat every contracted ME the way you would any other witness whose income depends on the party that hired them: politely, professionally, and with your exhibits open. Where you see patterns worth sharing, share them with your colleagues and with us. I will report back if this contract, the recompete, or anything else in this space generates something worth putting in front of the Subcommittee again.

---