A Call From the Senate - Momentum on Both Sides Now ?

Senator Dorgan Wants Investigation of SSA Appeal Delays

As the drums bang, Senator Dorgan has asked the Inspector Generals' office to investigate the SSA Disability Appeal backlogs. The agency, keenly aware of the continuing scrutiny announces new initiatives and a perfect storm continues. The difference is SSA's continued review of novel solutions to deal with the heavy weather. In August 2007, SSA's new Commissioner Astrue restored the attorney advisor program permitting attorney advisers, under managerial oversight, to help reduce the backlogs. The following was released on Senator Dorgan's website last week.

DORGAN WANTS INVESTIGATION OF SOCIAL SECURITY DISABILITY BENEFIT
DENIALS, DELAY IN DECIDING APPEALS
2,800 North Dakotans now caught up in "broken system"

(WASHINGTON, D.C.) --- U.S. Senator Byron Dorgan (D-ND) wants to know
why 2,800 North Dakotans and hundreds of thousands of other Americans
who have submitted disability claims under the Social Security
Administration are being systematically denied, only to have them
approved on appeal - after waiting nearly a year and a half.

"This system is broken," Dorgan said Thursday. "How else can one
explain that the appeal process results in nearly two thirds of the claims that
were previously denied finally being approved? Moreover, the huge
backlog of claims means that many with disabilities are forced to live
in poverty while waiting for a fair resolution of their disability claim."

Dorgan has asked the Inspector General's office to investigate what has
caused these problems and to determine how it affects people.
"This is unfair to a lot of working Americans who have paid premiums in
the form of their social security payroll tax for a program that
includes disability payments if they become disabled," Dorgan said.
"However, it seems that someone has decided they are going to
systematically deny those claims and force those people to wait lengthy
periods of time before an appeal will be heard. We now learn that nearly
two thirds of the claims that have been denied were subsequently
approved on appeal. This suggests to me that a whole lot of folks who
are suffering with disabilities are being mistreated by this system and
I want it fixed. Nationwide, there are more than three quarters of a
million waiting in long backlogs to have their appeals decided.
I don't know whether it is sheer incompetence or a deliberate
decision to delay and deny benefits that people desperately need that
have previously paid through the social security system, but I
intend to find out."

In a letter to the President, Dorgan is also asking for action to
correct the situation. "The bottom line is that elderly Americans
and other poor individuals with disabilities that prevent them earning
a living and paying their bills deserve better," Dorgan wrote. "Social
Security disability benefits keep millions of disabled Americans out of
poverty. But these people who are unable to work and need immediate
assistance to avoid financial collapse do not appear to be a priority
for your Administration."

Social Security Quick Disability Determination Extends Nationwide

SSA Moves Forward With Initiative

We applaud any decrease in waiting times and any cost effective move the new Commissioner undertakes. This press release confirms what many knew was coming. It appears SSA Commissioner Astrue is looking at the initiatives that work and implementing them.

From SSA Press Release
September 5, 2007

Michael J. Astrue, Commissioner of Social Security, announced
that Social Security has issued a final regulation to extend the quick
disability determination (QDD) process to all state disability
determination services. 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
person’s allegations can be quickly and easily obtained.

“The quick disability determination has been very successful and
efficient so far in New England and I am happy to say it will help
people filing for disability benefits anywhere in the United States.
This is a very important step we are taking at Social Security to
improve our disability programs,” Astrue says. Astrue lauded a reduction in pending disability cases that reach 1,000 days while waiting for an appeal hearing. The commissioner reported there are currently fewer than 600 pending cases, down from more than 63,000 cases in October 2006.

In a news release Social Security reported it currently receives more
than 2.5 million new Social Security disability cases and more than 2.3
million Supplemental Security Income cases each year. The release stated
that in New England, where QDD began on a test basis, cases constituted
slightly less than 3 percent of all new cases. Of those, 97% of the
cases identified have been decided within 21 days and the average
decision time is 11 days. Since the model does not yet incorporate as
many diseases as it can, Astrue has committed to expanding the number of
cases that can be identified while maintaining the same level of
accuracy, the release noted. “The length of time many people wait for a
disability decision is unacceptable,” Astrue said. “I am committed to a
process that is asfair 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 final regulation, according to Social Security, is effective as of
September 5, 2007, and will be gradually implemented over the next
several months.

The Disabled Process

We’ve asserted that the entire process must be re-examined. The Charlotte Observer reached a similar conclusion in this article, published on Sunday September 2, 2007. The article discusses the decrease in staff and lack of accountability. We believe that only when the former is resolved will the latter be possible. Accountability is a real issue but, in the current climate, Administrative Law Judges can not be held accountable for the lack of resources they work with. SSA must have adequate resources. The priority here is Congress and the inability to pass a realistic budget. Combine that with a process reexamination and the disability process has a chance for recovery.

This process is disabled

No reason for sick, hurt to suffer waiting for benefits
If you are sick or hurt, and can't work, don't expect prompt help obtaining Social Security benefits -- or even a prompt answer about whether you qualify -- if you live in the Charlotte area. Instead, expect to wait and wait and wait.

How bad is it? An Observer investigation found that waits at the local office where federal disability claims are heard rank among the longest nationwide, 125 out of 141 offices. Some citizens have to wait as long as three years.

That's a disgraceful record for a public program that serves as a critical safety net for workers who become injured or mentally ill. Their needs rate a higher priority.

The federal disability benefits process itself is unacceptably cumbersome, and ought to be streamlined. And for a large portion of North Carolina, it's especially flawed.

Why? One thing reporter Fred Kelly found is that administrative law judges who decide appeals of claims in the Charlotte office don't issue nearly enough rulings to keep pace with incoming cases.

Local judges would not comment on their case loads, saying they are prohibited. But a spokesman for the Association of Administrative Law Judges said a significant amount of the Charlotte judges' time had been diverted to other duties, such as hearing Medicare cases and serving as mentor to new judges. In addition, the local office has only 3.7 support staff members per judge, compared to 4.2 per judge nationally.

If those things are true, change is needed. The Charlotte office serves the most populous region in North Carolina. Why would it be short staffed? The Social Security Administration should beef up resources to match population and need -- and follow up to see that speed and efficiency improve significantly as a result.

One obvious problem: There's apparently no oversight of judges' work. Disability judges face no annual performance reviews and can be removed only for misconduct or corruption.

Here's what it means when there are unacceptably long waits for benefits: Many North Carolinians who are sick, injured or mentally ill lose their homes, fall into bankruptcy or go without medicine awaiting disability payments. Some die before their cases are heard.

That shouldn't happen. Social Security should investigate, find out why and fix it. If it doesn't, the region's representatives in Congress should ask for an inquiry.