Friday, August 24, 2007

One Million and Counting

Opinion today by the Rochester Democrat & Chronicle

RJE - Good factual article. While the article mentions fraud as a factor, it pales in comparison to under staffing. SSA employees are aging, burning out and retiring. Processing claims requires a skill set that takes years to learn. Even if Congress were to wake up and increase staffing, the results will be slow as staff come into competency. System changes, like the ones Mr. Astrue has been pushing, must be coupled with staff increases. And, accountability for employees at all levels should accompany increases. Morale is low in many offices, from the local SSA Field Offices, to the Disability Determination Services in each state and in the Appeals offices where too few Administrative Law Judges are under pressure for more and faster hearings with little accountability. System changes must include more than staffing, fraud finding and tweaking. All aspects of SSA should be re evaluated and simplified. One step that SSA took several years ago was implementing Process Unification. That kind of bold, systemic change is what the agency needs in our opinion ...

One million people by 2010. That's the estimated backlog of pending cases for Social Security Disability Insurance benefits.To handle that increase, due largely in part to the aging of baby boomers, the approval and appeals process must be altered.The Social Security Administration is making an effort to screen and prioritize cases that are or will be 1,000 days old by the end of September.That's a start. But those are just bare minimums. Implementing those things won't be enough to address the growing backlog, currently at 745,000 cases.

Michael Astrue, SSA commissioner, blames understaffing and an increase in claims. While not much can be done to decrease the number of claims as boomers age, an increase in staffing should be a top priority. Congress, which has provided an annual average of $150 million less to SSA than President Bush has requested since 2001, needs to ease the strain on the system.Practicing fiscal responsibility as well as preventing fraudulent claims from slipping through are priorities. Yet ensuring that the country's disabled population is being adequately and promptly assisted is of greater import.

Some people have been able to get assistance through other avenues such as Veterans Affairs benefits while waiting on SSDI benefits, but not everyone has that option. The long waits — the national average is 17 months — are leading to troubling outcomes such as bankruptcies, foreclosures, drug use and even suicide.

Allowing a streamlined process for those applicants who have already gone through an extensive vetting process from the VA or suffer from a certain type of disability may be one way to decrease caseloads. Change is needed immediately. Congress and SSA officials must act or the future of the country's disabled population will grow even bleaker.

Tuesday, August 21, 2007

Rigors of the Poor House

Tonight, having finally addressed the basics of hyperlink, DACR's nascent Blog cites an excellent tenet in SSA adjudication, often ignored or overlooked. This comes from one of our favorite websites involving SSA Disability Representation, David Traver's Connect .

The site features an important but often overlooked tenet, one advocates as well as adjudicators would do well keeping in mind...

The Social Security Act has a moral purpose and should be liberally interpreted in favor of claimants. Conklin v. Celebrezze, 319 F.2d 569 (7th Cir. 1963). ". . . [T]he regulations should be liberally applied in favor of beneficiaries." Dugan v. Sullivan, 957 F.2d 1384, 1389 (7th Cir. 1992) quoting Wyatt v. Barnhart, 349 F.3d 983, 986 (7th Cir. 2003). "That [the Social Security Act] should be liberally construed in favor of those seeking its benefits can not be doubted." Carroll v. Social Sec. Bd., 128 F.2d 876 (7th Cir. 1942) citing Helvering v. Davis, 301 U.S. 619, 640-645, 57 S.Ct. 904 (1937), et seq. Where the question is a close one, the doubt should be liberally construed in favor of the social security claimant. All doubts of interpretation are to be resolved in favor of coverage. “The hope behind this statute is to save men and women from the rigors of the poor house as well as from the haunting fear that such a lot awaits them when journey's end is near.” Helvering, at 641.

Monday, August 20, 2007

Social Security Staff cutbacks + Case Backlogs = Change in Service

For those who work daily in the world of SSA, it comes as no surprise that employees as well as advocates have similar goals and frustrations. To wit:

Cleveland Plain Dealer Reporter Karen Farkas, in a copyrighted story dated Saturday, August 18, 2007, interviewed a local manager of a Social Security Field Office. The article is entitled Q&A on the future of Social Security - Staff cutbacks, case backlogs affect service. The entire Q and A may be found at the following link:

http://www.cleveland.com/printer/printer.ssf?/base/news/1187425856238390.xml&coll=2&thispage=2

The article notes that even with a $2 trillion trust fund for its budget, the Social Security Administration is in serious jeopardy, facing increasing backlogs as it processes more claims with fewer employees. In a set of questions and answers, the reporter interviews an SSA Field Office employee, now a manager who notes he has spent his career at the agency. He began as a claims representative in 1975. What follows are some of his comments.

Frustrated as those who wait for hours in an office or get a recording when they call for help with retirement benefits, survivor or disability benefits or Supplemental Security Income, the manger stated; "We are really concerned for the public,...we want them to get good service, the right amount of money and not wait so long. People are dying before disability decisions are made.It has been difficult to get Congress to approve increases because SSA's appropriations are included with other agencies and officials look at the overall budget. The agency asked for $10.4 billion for 2008, and President Bush proposed $9.6 billion ($304 million over the previous fiscal year). No decision has been made.”

When asked by the Plans Dealer Reporter why the backlog in disability claims, the employee responded;

“About 90,000 more people have filed each of the last five years. Budget cuts have led to the lowest field office staffing level since the early 1970s.” And, regarding the future? The manager stated there was a significant concern about the increasing number of baby boomers. Not only those who file cases, but SSA employees. Most of the staff was hired in the 1970s, and "we are facing a retirement wave. It takes three to four years to get proficient on the job."

Even so, this manager and other employees who responded to a recent survey, still have high job satisfaction, because they want to help people. “It's not right in America to have to wait. They should have prompt service and prompt decisions.”

Emphasis added and quotes have been combined for brevity. DACR blog thanks The Plain Dealer for use of this article.

Saturday, August 18, 2007

SSA Proposes changes for Reviewing Officials and roles in Demonstration Projects

Proposed Suspension of New Claims to the Federal Reviewing Official
Review Level, Changes to the Role of the Medical and Vocational Expert
System, and Future Demonstration Projects

The Social Security Administration recently released a notice of proposed rulemaking, proposing to modify the disability administrative adjudication processes to suspend new claims to the Federal reviewing official (FedRO) level, now operating in the Boston region.

Claims already received will continue to be processed by the FedRO and a related component of the disability determination process, the Medical and Vocational Expert System (MVES), commonly known as the Office of Medical and Vocational Expertise (OMVE). The agency also proposes to remove the MVES/OMVE from the disability adjudication process for new claims. “We are making these proposals to ensure that we continually improve our disability adjudication process. Lastly, we are requesting comments on using the MVES/OMVE to develop and manage a national registry of experts."

http://a257.g.akamaitech.net/7/257/2422/01jan20071800/edocket.access.gpo.gov/2007/pdf/E7-16071.pdf

Wednesday, August 8, 2007

The NFL looks to SSA Disability

The following is excerpted from an updated article on ESPN Page 2., dated August 8, 2007

http://sports.espn.go.com/espn/page2/story?page=easterbrook/070807

The story, entitled, Tuesday Morning Quarterback Returns!, by Gregg Easterbook, involves a long discussion of NFL retirement and disability issues. However, of note is a link to the SSA disability process by one Mike Ditka, (former coach of da bears), to wit:

Ditka said there are 300 former players who unfairly have been denied disability checks. When asked for his source, Ditka "acknowledged he might not have been correct on his estimate and quickly changed the subject," the Chicago Tribune reported. Ditka further declared the NFLPA disability claims process onerous because "If you make people fill out enough forms, if you discourage them enough, make them jump through enough hoops, they're going to say, 'I don't need this.' " Certification of an NFL disability qualifies one for up to $224,000 a year for life -- it's an awful burden to fill out some forms in return for $224,000 a year? Disability claimants should be required to prove their conditions are bone-fide, otherwise those who aren't really disabled would file for the money. Former players protest that the NFLPA uses a law firm to review disability claims, which in turn means they need legal advice. Yet the Social Security Administration uses law firms to review disability claims, and advises claimants to hire a lawyer. In response to older players' requests, the NFLPA just announced that disability eligibility will be based on Social Security Administration rules. That should standardize the process, though not necessarily increase awards. As of June, four percent of the NFL's 8,000 former players were receiving disability payments.

Sunday, August 5, 2007

New State by State review of Hearings Backlogs


Note, while Kansas has its problems, the backlogs are nationwide. This is a new state by state review of the pending Administrative Law Judge Hearings. SSA is in the process of hiring new Administrative Law Judges and the Commissioner has been proactive in this process. Still, we are quite a ways from reducing the problem.


SSA’s budget has not kept pace with the need to replace skilled baby boomers who are retiring. And I am talking about SSA employees who work for the agency as well as the public who end up applying. The bottom line is the agency is understaffed and underfunded. One solution would be more comprehensive “up front” reviews by SSA. That is, a thorough review of the merits of new hearings cases when they arrive in the Hearings Offices, Officially titled Office(s) of Disability Adjudication and Review or ODAR.

This type of review and others, could result in possibly allowing many claims before they get added to the stack of appeals. SSA states they are going to review the back log problem. The article notes that claimants get legal aid or turn to attorneys. SSA also allows non attorney Claimant Representatives to work with and assist claimants.

By JOHN HANNA Associated Press Writer

Social Security Administration -American Association of People with Disabilities
TOPEKA, Kan.

More than 700,000 disabled Americans are still waiting to learn whether they'll receive federal benefits, and Kansas has the worst backlog of unprocessed claims, a national advocacy group said Tuesday.The American Association of People with Disabilities, based in Washington, released what it described as the first state-by-state look at a backlog of claims before the Social Security Administration. The group compiled its report with Allsup Inc., a Belleville, Ill., company that provides services to claimants.

[the results] - nearly 710,000 cases are still pending at the end of last year - show the Social Security Administration is understaffed and can't deal with a growing number of applications for disability insurance benefits.

The report said nearly 15,000 Kansas cases were pending, with about56,000 Kansans receiving benefits. It said that resulted in a backlog rate of 26.7 percent. Rocky Nichols, executive director of the Disability Rights Center of Kansas, said his and other advocacy groups have heard complaints for years that trying to obtain benefits is frustrating. People who are forced to wait often have medical conditions that grow worse, he said."It can be excruciatingly difficult and a long process," Nichols said."What this report brings clarity to is, potentially, how disproportionately worse it is in Kansas than anywhere else in the nation."Kansas officials believe the delays occur when applicants are turned down for benefits and appeal the decision. The state notes that initial claims are processed in an average of 71 days, nearly two weeks less than the national average.John Garlinger, a spokesman for the Social Security Administration's regional office in Kansas City, Mo., said he would have to review the report more closely to say why Kansas ranked as it did. He said backlogs are a national problem - one the agency is trying to combat."Congress is clearly aware of it. We're clearly aware of it," he said."All the key players are aware that there's a challenge."In Washington, Social Security Commissioner Michael Astrue told a Senate committee in May that disabled Americans were waiting, on average, more than a year and four months to learn whether they would receive benefits. Those benefits average $979 a month for a disabled worker.He said the agency needed more administrative appeals judges and was working to handle cases more efficiently."For some, the long wait for their day in court leads to homelessness and loss of family and friends," he testified.In Kansas, the state has contracted with Kansas Legal Services, a nonprofit group, to help some applicants for disability benefits; others turn to private attorneys.Nichols said in Kansas, the state needs an aggressive program for helping disabled residents navigate the application process. He said the benefit for taxpayers is that people receiving the federal benefits won't be relying on state-funded programs.

Saturday, August 4, 2007

From SSA News Release. This is an excellent move by the new Commissioner. He appears to be choosing the right initiatives at the outset.


Commissioner Astrue Proposes to Extend Social Security’s
Quick Disability Determination Process to all States
Proposed Rule Would Accelerate Benefits to Those Deemed Clearly Disabled
Michael J. Astrue, Commissioner of Social Security, today announced that Social Security will
publish a proposed regulation to extend the quick disability determination (QDD) process to all
State disability determination services. The process is now operating in the Boston region,
comprised of the states of Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island
and Vermont. Under QDD, a predictive model analyzes specific elements of data within the
electronic claims file to identify claims where there is a high potential that the claimant is
disabled and where evidence of the claimant’s allegations can be quickly and easily obtained.
“At my confirmation hearing, I promised to look closely at the disability changes we were testing
in New England and implement nationally those things that were working well,” Commissioner
Astrue said. “We have seen the success of the QDD model in identifying cases that are most
likely to be allowed. To date, 97 percent of the cases identified have been decided within 21
days and the average decision time is 11 days. We plan to build on the success of QDD by
expanding it to all States because it is both efficient and compassionate for us to do so.”
Social Security currently receives more than 2.5 million new disability cases each year. In the
Boston region, QDD cases constituted slightly less than 3 percent of all new cases because the
model does not yet cull a wide enough variety of diseases. Commissioner Astrue has committed
to expanding the number of cases that can be decided through the model as high as possible
while maintaining accuracy.
“The length of time many people wait for a disability decision is unacceptable,” Astrue said. “I
am committed to a process that is as fair and speedy as possible. While there is no single magic
bullet, with better systems, better business processes and better ways of fast-tracking targeted
cases, we can greatly improve the service we provide this vulnerable population.”
The proposed regulation provides for a 30 day comment period. It is on display at the Federal
Register today and, starting tomorrow, can be read online at www.regulations.gov. For more
information about Social Security’s disability programs, go to www.socialsecurity.gov.
Welcome.

This site is for folks interested in disability advocacy and related issues. The main topic will be the issues facing the Social Security Administration. Links will be utilized and editorial content won't be infrequent.