Thursday, September 25, 2008

Social Security Commissioner Releases New Agency Strategic Plan

Today, the Social Security Administration officially released a glossy five-year plan, identifying challenges and offering agency goals. Timing is interesting as the recent hearings on Capitol Hill requested long term planning. The goals are ambitious and the devil in the details. We will look closer in the days to come. However, getting a disability decision in 20 days at the initial level appears the greatest challenge. The Hearings backlog is mentioned with the usual techno and staffing solutions which also merits more discussion. The Appeals council backlog will be monitored and the details seem sparse. Regardless, for a preview, follow the link below, to the agency's site where the plan resides in full.

New Agency Strategic Plan

Monday, September 15, 2008

September 16, 2008 - Another SSA Congressional Hearing

Tomorrow there will be another hearing on the unconscionable back log of SSA disability claims. Claimants will be described as “mired in a Nixon-era process” The same refrains will fill the air; Congress hasn't adequately funded Social Security for years; 80 million baby boomers have overwhelmed the system, and there are not enough employees. Not enough support staff, not enough judges, not enough disability examiners and too few SSA field office workers. We will be reminded the backlog is not because people are cheating the system and not because they don't qualify for benefits. Rather, we will be reminded that what is needed is more money from Congress and the White House, who together are polling between 9% and 20% approval with American tax payers. They are an easy target and they will be reminded that taxpayers can no longer “put off a major reform of the disability claims process any longer.” Commissioner Astrue will be criticized for more of the same incentives and streamlining that the SSA routinely proffers, even though he has been the first Commissioner in 15 years to get funding adequately increased, more ALJs hired and finally held at least somewhat accountable. There will be a hue and cry for Americans who need disability benefits. Certainly we will be told that Social Security needs to be fixed, and fixed quickly.

But what we are unlikely to hear is the word quality. Zen and the art of disability claim adjudication. We will not hear about the wide variance of allowance rates and program inconsistencies across the nation. We will not likely hear that the initial claims filed by those alleging disability are more often than not denied, leading to appeals which are less likely but still far too often dismissed by judges when they should be allowed. We will not likely hear about an Appeals Council that reviews these ALJ denials, only to reverse very few and doing so without offering claimants specific reasons. Listen for the word training. But don’t expect a discussion regarding the concept of adequate training for SSA employees who need to get it right the first time the claimant walks in the field office, the first disability decision an examiner makes and the first hearing a judge presides over.

We can not buy or blame our way out of this unconscionable back log by pointing to lawmakers and demographics and demanding a quick fix. We need to provide adequate funding, but more importantly hold the agency accountable for making the right decision at the right time. Quality decisions, adequately trained staff, accountable judges and appeals level decision makers who render consistent and open decisions are basic tenets that should not be smoldering in the background. Adequate funding must be accompanied by quality performance – simply making the right decisions more than the wrong ones is a concept the agency needs to own and the critics need to grasp.

Tuesday, September 9, 2008

“Unconscionable backlog & untold suffering” - Congress takes a look at SSA's hearing offices.

In a press release today, entitled Clearing the Disability Backlog, the Subcommittee on Social Security's Chairman McNulty announced a Hearing on the Performance of Social Security Administration Appeals Hearing Offices. We provide some of the salient points of the release below, including the focus of the hearing which will be on the performance of SSA’s hearing offices, factors that affect productivity, initiatives SSA is taking to increase efficiency and productivity, and other approaches to improving productivity without compromising the quality and impartiality of decision-making or the due process rights of claimants.The hearing will take place on Tuesday, September 16, 2008, in room B-318 Rayburn House Office Building, beginning at 10:00 a.m.

In announcing the hearing, Chairman McNulty said, “Earlier hearings have demonstrated that prolonged underfunding has resulted in the loss of staff needed to process disability cases at the Social Security Administration. This has led to an unprecedented backlog of unprocessed claims and untold suffering. The agency must have the resources it needs to eliminate this unconscionable backlog., [ emphasis added.] At the same time, we must ensure that SSA uses these resources as effectively as possible. This hearing will examine SSA’s management of its hearing offices, and explore measures that can be taken to improve productivity without compromising the right of claimants to a fair and impartial decision on their case.Over the past several years, SSA’s disability claims backlogs have grown to unprecedented levels, with more than 1.3 million Americans currently awaiting a decision regarding their claim. Backlogs are particularly severe for the more than 765,000 Americans who have had their cases denied at an earlier stage of the process and have requested a hearing before an Administrative Law Judge (ALJ). These individuals now wait an average of 532 days for a decision on their appeal. This hearing will focus on the performance of SSA’s hearing offices and SSA’s overall management of these offices.

SSA’s hearing process is an important one for claimants..[a]pproximately two-thirds of those who appeal to the ALJ level are awarded benefits. However, the process is very labor intensive for SSA, typically requiring clerical staff to prepare the case file, obtain evidence and schedule the hearing with all necessary experts and other participants; ALJs to review the case, conduct the hearing, and make a decision; and attorneys or paralegals to draft the decision and accompanying legal rationale for it, based on the judge’s instructions.

According to a recent report from SSA’s Inspector General (IG), the productivity of SSA’s hearing process has improved in recent years. In 2005, SSA produced 421 dispositions per ALJ. By 2007, productivity had increased by 13 percent, to 474 dispositions per ALJ. However, hearing office performance varies significantly between offices. The IG found that productivity was often hindered by a lack of hearing office support staff, a conclusion the IG had also reached in a March 2005 report. Interviews with ALJs and hearing office staff also identified other factors that could affect productivity, including the use of a number of techniques to promote speedier processing (such as spending less time reviewing the case and conducting the hearing). Finally, the IG found that a small number of ALJs – approximately 1 percent – processed fewer than 200 cases per year even though they were employed as full-time adjudicators. At the same time, the IG reported that some judges – about 2 percent – issued more than 1,000 decisions in a year. This could raise concerns about the quality of these decisions.

Saturday, August 9, 2008

Social Security Disability Backlogs, Safety Nets and the Commissioner Speaks

Commissioner of Social Security, Michael J. Astrue, recently spoke to The Atlanta Journal-Constitution staff writer Ann Hardie about the backlog of 761,000 disability claims pending nationwide and in particular the Atlanta region. The complete article was published on 08/03/08. The interview reveals Mr. Astrue’s continued focus and how the ordeal affects his blood pressure.

Q: When you became commissioner, you must have known there was a backlog?

A: Oh sure. When you get a call about a job like this and you size it up, you say, "What is the challenge?" The top priority was trying to fix the backlog issue.

Q: I've been struck by just how devastating the backlog has been to people's lives.

A: It is what makes it so important to try to fix. We are trying to make it better for as many people as fast as we can.

Q: People know about Social Security, but I'm not sure how many think about the disability program.

A: In terms of the public perception, they associate us primarily with retirement. And that is unfortunate, because we are an important part of the safety net generally, and the disability programs are a key part of that.

Q: Folks say the difference between today and 10 years ago is that it is not unusual for someone to die waiting for a hearing.

A: I think that is actually not true. We are actually trying to look at those numbers. There are a significant number of people who die. I don't deny that it happens. But when you are talking about a sick group of people, and most of the people are sick, you are going to have that happen statistically a certain percentage of the time.

Q: How stressful is your job?

A: If you are doing this job right, you can't help internalizing some of this stuff. I am taking more hypertension medication than I was a year ago.

Q: A lot of folks say the backlog problem was caused by a lack of resources.

A: It is extremely complicated. Congress has come in under the president's budget 15 straight years until this year. Maybe it is partly our fault. I think we had a reputation on the Hill for being a "can do" agency. It was easy for Congress to keep throwing things at us. I think a lot of people miss the sheer size of this system. Right now, we have about 2.6 million people every year applying for disability benefits, and just under 600,000 show up at the hearing and appeals process. These are enormously complicated files and getting more so every year.

Q: I know you have heard this —- that the system is set up to discourage people.

A: I understand how it feels that way. I don't believe that Congress ever had that intent at all.

Q: You said the bar to meet disability is real high.

A: Essentially, you are supposed to be unable to work at all, or to any substantial degree, for a period of 12 months or more. That is tougher than most private-sector policies. That is tougher than the [Veterans Affairs] standard. That is something that Congress decides, and it is a tough balance because this all comes out of trust fund money.

Q: There have been reports that even with all your efforts the backlog continues to grow?

A: We are nine months into this fiscal year, and we are at an increase of about 18,000 cases for the year. I am not happy about that. But the rate keeps going down. If you look historically, it went up at about 75,000 cases a year for many years in this decade.

When I started here, we had about 65,000 cases that had waited 1,000 days or more. Some of those cases had been waiting 1,400 days. We set a goal to get rid of them by the end of the year, and we hit that goal. This fiscal year we set the goal at 900 days. We slightly are ahead of schedule.

Q: Let's talk about Atlanta. Why are we so bad? Why are we so slow?

A: The system as a whole was under-resourced. But the money we had was not distributed equally around the country. I don't know why the Atlanta and Chicago regions received less support given the level of filings. These regions have been the biggest beneficiaries of the reallocation of resources, and there is more coming.

Wednesday, July 23, 2008

Hearings in 75 days and Decisions in 15 ?

The interesting part of this July 16, 2008 article, complete version found at the St Petersburg Times website, involves Rep. Kathy Castor's proposed legislation this week to break the backlog.

Vacant judgeship adds to wait for aid
By Waveney Ann Moore, Times Staff Writer

The tens of thousands of people stuck in the national backlog for Social Security disability benefits might disagree, but the agency's top official argues progress is being made in ending the crisis.

The progress is hard to see in the Tampa Bay area, however, where the caseload is among the highest in the nation and an office sits empty awaiting the hiring of a much-needed judge.

The most recent figures indicate that 761,042 people are waiting across the country for hearings to address their claims. In the Tampa hearing office, the number is 14,524, the highest in the state.

The situation prompted Rep. Kathy Castor, a Tampa democrat, to propose legislation this week to break the backlog. Castor's bill would require that a hearing be held between 60 and 75 days from the date it is requested, and that a final verdict be given no more than 15 days after the hearing.

Social Security officials in Baltimore could not answer questions Tuesday, but in April, Commissioner Michael J. Astrue told Congress the agency has made "slow and frustrating progress in fixing our service delivery problems."

One step taken was the hiring of additional administrative law judges and support staff members to handle the hearings. In the Tampa office, though, that has yet to pay dividends.

Funds were appropriated in December to allow the office to increase its number of judges from 16 to 17, but the new judge's office remains empty.

"They started the hiring process in late April or early May. I don't know why it (has taken) so long," Castor said. "A judge was hired … the office is ready. For some reason, the person that was hired refused the posting. So now they're not going to start the next round of hiring until the beginning of October.

During his testimony, Astrue told Congress that the agency has begun using a fast-track system to decide allowances in an average of six to eight days. But thus far, only a small number of new claims were being processed this way, he said.

Video conferencing is being introduced to help break apart the worst logjams, he said, and the agency is going to begin a pilot program called "compassionate allowances."

Linda Fullerton, co-founder of a national grass roots organization called the Social Security Disability Coalition, is not impressed.

Fullerton, who lives in Rochester, N.Y., said she waited for a year and a half to get her benefits. When the wait devastated her finances, she got angry enough to start a cyberspace group that now numbers 3,000 members, she said.

Sunday, July 6, 2008

Backlogs Front Page News In Indianapolis

From front page of the Indianapolis Star – Sunday July 6, 2008. The following article by S. Rudavksy considers the disability backlog big news. The Star ran this article, excepted below, about the state and nation's continued delays in obtaining a disability hearing.

Headline -Getting on disability is a real pain takes average Hoosier more than 2 years to receive a hearing

Dana Smith waited three years for a judge to agree she qualifies for Social Security disability payments. That’s because Indiana has one of the worst records in the country for processing the disability claims of people unable to work because of medical or psychiatric reasons. Once they're approved, recipients get an average of $1,000 a month in financial assistance. For a determination at the Indianapolis offices for Social Security disability or Supplemental Security Income, the average applicant waits 749 days from the time of filing until a hearing before an administrative judge, the step necessary if claims are denied -- and most are.

Most Americans wait 505 days, the Social Security Administration estimates.
Without a job or any source of income while they wait, some applicants lose their homes and cars. Some must live with relatives or friends or in shelters. Some go on welfare. Some die before a final decision. "I was very appalled at how long it took," said Smith, a Southside resident who watched with envy as a friend in Tennessee completed the process in a year. "I kept thinking: any time now, any time now." Government officials blame the national backlog of disability claims on years of agency underfunding and understaffing combined with a growing number of applications from baby boomers. A recent Government Accountability Office report also identified mismanagement as an issue. Nationwide, the Social Security Administration has 10 percent fewer judges to hear case appeals than it did a decade ago, while the number of cases has increased by more than 176 percent, said Carmen Moreno, regional communications director for the Social Security Administration's Chicago region, which includes Indiana. "We're sympathetic over the fact that the waiting times are long, but keeping in mind that we are receiving so much less money than we need, these are the consequences," Moreno said. In Indianapolis, no one filled the chief administrative law judge position for seven or eight months, said Phillip Price, an Indianapolis attorney who has specialized in disability cases for about three decades. Judges have been slow to move on cases, said Price and Steven Jacobs, another attorney who has worked on such cases since 1974. Most cases used to be heard within six months, Price said. "We need more judges, more staff. We need a more efficient staff," Jacobs said. For the first time in a decade, the Social Security Administration this year received more rather than less funding. Congress allocated an additional $148 million to address the backlog, allowing the agency to hire 175 more judges and other staff nationwide.

Buoyed by the infusion of money and staff, the agency processed all cases nationwide older than 1,000 days. Now it's targeting the 135,000 cases across the country that are more than 900 days old, Moreno said. But even with more judges, the wait remains too long, Jacobs said: "It's like saying: 'I'm a lot taller now. I've grown from 3-foot-6 to 3-foot-7.' You're still a shrimp." To help troubled offices like the ones in Indianapolis, a new hearing center in Virginia will allow judges there to assist staff here by conducting hearings by video. The agency also may send traveling judges to the busiest offices, Moreno said.

People should wait no longer than 95 days from application to hearing, said Ethel Zelenske, director of government affairs for the National Organization of Social Security Claimants' Representatives, which also advocates for increased staffing. Social Security Commissioner Michael Astrue has said he would like to see the wait reduced to 250 to 275 days, about half the time applicants face today.

Dana Smith's inability to work stems from a severe car accident at age 14. She now suffers from osteoarthritis in her right hip, bursitis in her right shoulder, migraine headaches and fibromyalgia, which she says causes horrific pain. Smith, 43, said she's tried to work. She's held jobs in offices, in fast-food restaurants, in department and convenience stores, and on a chicken farm. But each time, the pain came back, and Smith had to quit. In December 2003, the man she was seeing (now her husband, James Smith) offered to let her live with him while she applied for disability. She concentrated on her quest for benefits. "Every time I would try to deal with them (Social Security officials), I was told: 'You need to call this number. No, you need to call this number.' You never get a straight answer from anybody," she said. In March 2007, she had a hearing and soon was granted benefits. But she realizes her husband's generosity gave her security many others do not enjoy. "I just hope that something can be done so others don't have to wait this long," she said. "There are other people that are worse off than I am."

Saturday, June 21, 2008

Social Security Administrative Law Judge Removed For Holding Two Jobs

The following article, by Ann Hardie, can be found in its entirety in the Atlanta Journal-Constitution, published on June 21, 2008. The story involves an apparent exception to the ALJ ranks, but is indicative of a Commissioner who continues to play an active role in oversight of all adjudicative agency components. Excerpts are included below:

For three years, Kelly S. Jennings ruled on disability claims for the Social Security Administration while simultaneously serving as an active-duty lawyer for the Army. This week, a ruling determined the Atlanta administrative law judge can be removed from his civilian job for double-dipping. Social Security has also filed papers to recover more than $309,000 in back pay and interest from Jennings.

By dividing his time between jobs, Jennings could not give Social Security his full attention, which in turn contributed to the nation's mountainous backlog of disability claims, wrote William N. Cates, the administrative law judge who heard the case. Jennings worked in Social Security's Atlanta North office, known as the agency's "backlog capital" of the country. With an average wait of 838 days, the office in May ranked as the slowest in the nation in resolving the appeals of people who say they are too sick or injured to work.

Jennings, who said he made more than $300,000 a year working for both Social Security and the Army, acted "purely for personal gain," Cates wrote. "Judge Jennings' dual employment and the ramifications thereof warrant his removal." In an interview Thursday, Jennings said he was "shocked" by Cates' decision. He said he was among the most productive judges in his office. "It wasn't like I was on the golf course," Jennings said. "I took it upon myself to hold hearings in an effort to reduce the backlog and render decisions to give individuals the benefits they had worked for their entire life. For that, I am being fired."

But last year, the agency filed a claim with the Merit Systems Protection Board, the agency charged with protecting the rights of federal employees, seeking to remove Jennings.

Social Security claimed Jennings improperly held two jobs and failed to fully disclose his active-duty status with the Army. Cates, ruling on behalf of the board, agreed. Jennings plans to exhaust his appeals to keep his job. Social Security officials, citing privacy concerns, will not discuss Jennings' current status. But Jennings said he has been placed on paid administrative leave until a final decision is reached.

"We are pleased by the decision," Social Security Commissioner Michael J. Astrue wrote in an e-mail. "The irresponsible conduct of this employee shouldn't tarnish the reputations of our ALJs, who have helped reduce the disability backlog by increasing their productivity by about 10 percent in the past year."

Jennings, 55, was appointed an administrative law judge and went to work at the Atlanta North office in 1994.For the past 25 years, Jennings also served as a commissioned officer in the U.S. Army Reserve. When he retired last month, Jennings held the rank of colonel with the Judge Advocate General's Corps, the Army's legal arm.

Jennings said he performed active military duty for a few months every year that he served as an administrative law judge and received pay from both the Army and Social Security "with no problem.” His current troubles stem from his continuous military duty from January 2003 to December 2005. Jennings did brief tours during that period in the Middle East. But during most of those years, Jennings said, he worked from 6 a.m. to 3 p.m. at Fort McPherson in Hapeville, providing legal advice for the 3rd U.S. Army based in Kuwait.

He said he spent the rest of the weekdays and weekends working on Social Security cases both in his Atlanta North office and at home. Jennings said he took military leave when necessary to hold hearings. Jennings had signed an agreement with Social Security to work weekdays from 8 a.m. to 4:30 p.m. While Jennings acknowledged that he did not adhere to that schedule, he called it "inconceivable" that his higher-ups were not aware of what he was doing. Military regulations would not have precluded Jennings from holding another government job. But a human resources specialist testified that the Social Security Administration does not allow employees to keep working their civilian jobs if they are activated for military duty. In August 2007, Social Security placed Jennings on paid administrative leave, he said. He is drawing his annual salary of $158,500.

Jennings said his annual Army pay ranged between $140,000 and $155,000 between 2003 and 2005."There was never a time I was double-dipping at all," he said. "I fully earned every dime of my salaries."

Tuesday, June 3, 2008

SSA admits it's time for new tickets........

For those of us who help clients in the disability process, simply the admission by the agency that post entitlement options need reexamination is a step forward.

For a thorough discussion of work incentives, visit Scarborough's blog.

This is something we will watch.

‘Ticket to Work’ Program Underutilized

Monday, June 2, 2008
Erin Smith, Staff Writer offers the following:

The Social Security Administration has announced changes to the rules for the “Ticket to Work” program, though the program has not garnered the response they had hoped.

Of the 10 million “tickets” issued nationwide by June 2007, only 171 had been activated, according to Social Security’s Technical Expert Tim Moore.

Moore told the Journal in an interview on Wednesday that he does not have specific numbers for individual states or local areas.

The program is federally funded and was signed into law in 1999. The first phase of Ticket to Work began in 2002 and in 2003,
the final phase of which North Carolina was a participant, was implemented. The program’s intent was to expand providers available
to those with disabilities who are seeking vocational rehabilitation, employment and related services. The program is available in
all 50 states and the U.S. territories.

According to Moore, the program is managed by Maximus, Inc. located in Virginia. When an individual receives their information, they
contact Maximus and the company puts them in contact with the agencies also known as employment networks.

The process of determining who is qualified for Ticket to Work is an automated process, said Moore.

A person must be between the ages of 18 and 64 and receive Social Security disability benefits or SSI. Candidates are selected based
on an automated review, according to Moore.

“It is a voluntary program,” said Moore. “Just because they receive a ticket doesn’t mean they have to activate it. The main advantage
is, if they activate the ticket, while they are active in the process, there is no medical review.”

Commissioner of Social Security Michael J. Astrue said, “Beneficiaries with disabilities will have greater flexibility and expanded
choices in obtaining services they need to attain their employment.”

Social Security is in the process of recruiting more organizations to serve as employment networks and also trying to encourage
greater participation from those who receive tickets, according to Astrue.

The changes include allowing the participation of individuals for a ticket even if they are expected to medically improve;
modifications to the employment network payment systems to create greater financial incentives for providers to participate;
increase the value of the ticket to enable participants to take advantage of “a more effective combination of services from
the state vocational rehabilitation agencies and employment networks;” and better alignment of the Ticket to Work program,
the Work Incentives Planning and Assistance Program, the Protection and Advocacy for Beneficiaries of Social Security Program,
and other Social Security incentives.

Wednesday, January 30, 2008

NPRM – SSA Suspends Proposed Rule Changes

Commissioner Michael J. Astrue asked the Chairman of the Social Security Sub Committee to “suspend” the proposed changes to SSA’s appeal process. Astrue notes in a letter dated January 29, 2008 that after frank and productive discussions with representatives of the disability community, one problem emerged - medical providers denying timely access to medical records.

We agree. This is a longstanding reality. Many providers not only delay, but actually withhold medical records because the claimants are behind in payments to the physician, clinic or hospital where the records are housed. This makes it difficult for appeals to proceed and in many cases, results in a denial of benefits.

Astrue went on to say that it was time for Congress to look into the problem of medical providers who delay or withhold records. Again, we agree.

Finally, Commissioner Astrue also suspended one of the appeal branch initiatives in the Boston Region. These steps continue to raise hopes that a reassessment of the proposed changes will emerge as they meet the reality of the processes facing disability claimants and representatives who advocate for timely and accurate disability adjudication.

Link to Post/ Article

Saturday, January 5, 2008

December 20, 2007 - The House sends Commissioner Astrue a Note on SSA's Proposed Appeal Changes...

"Dramatic changes are unjustified. The backlog is the result of
chronic underfunding of SSA's Administrative budget, not faulty
appeals procedures."

In this 10-page tome, the House of Representatives sends SSA a letter regarding the proposals. The deftly worded, detailed missive displays a firm grasp of the downside to the proposals. Well worth the read, the letter continues in the general skein of what a potentially bad idea this particular move by the agency portends. The letter is signed by John Dingell, John Conyers, Charles Rangel, Pete Stark, Henry Waxman, Howard Berman, John Lewis, Frank Palone, Jr., Jim McDermott, Michael McNulty and Linda Sanchez.