Another Focus on SSA's Challenges

Tomorrow, Tuesday, March 24, 2009, the Committee on Ways and Means, Subcommittee on Income Security and Family Support will hold a joint hearing on Eliminating the Social Security Disability Backlog. The hearing will focus on the Social Security Administration’s (SSA’s) large backlog in disability claims and other service delivery declines, including backlogs in program integrity activities. The entire announcement, which we have excerpted from below; can be found at this link.

In the past, “program integrity” in SSA parlance, has been a vague concept, including quality control, fraud and review of recipients' benefits. This hearing should at least be interesting, as the statistics will be flying. Discussion will include decision delays with, “[m]ore than 1.3 million Americans currently awaiting a decision on their case…...the problem is particularly severe at the hearings level, where the backlog has more than doubled since 2000 – from about 310,000 to more than 765,000 – and the average waiting time is now almost 500 days.”

In the course of waiting 500 days, disabled claimants often exhaust their limited resources. Many lose homes, housing, hope, friends, family and their health worsens. It would be particularly interesting if this hearing additionally focused on the other levels in the disability process such as the local SSA Field offices, which are understaffed, and the initial and early appeal process in the state agencies, which are inconsistent in program application and fraught with error. The state agencies proffer the first determinations of disability. An initial and reconsidered denial is the starting point for the long wait to appear before an administrative law judge.

The agency resources and solutions are both dwindling. The Government Accountability Office (GAO) recently reported that the backlog is now so severe as to warrant a slot in its biennial “high risk” list of federal programs. Clearly, demographics are at play as the population ages and more disability and retirement claims are filed while more skilled agency employees exit. The hearing will discuss provisions involving increased access to professional representation for disability claimants and changing how claimants give consent to release medical records.

Co Chairman Jim McDermott noted that, congress, “[h]as responded to this crisis by providing the Social Security Administration with increased funds in order to begin to actively address this problem, but it is time for the agency to take more action to significantly reduce the waiting period ….also ensuring the integrity of the process.” McDermott allowed that he looked forward to, “[h]earing about the initiatives that the agency is taking to address this problem and what additional steps Congress can take to help.”

The challenge is not so much gaining a focus on the problems. Congress has done this for years and increasingly since 2000. What is needed is a clear view of the agency's and advocates’ proposed solutions. Meanwhile, the wait continues for 1.3 million claimants who simply want their disability cases heard.

Social Security Disablity Notices

What happens when the mail arrives....

The GAO and multiple advocacy groups have criticized SSA's notices. We know there are staffing problems, but a great deal of underpayment as well as overpayment of the agency's funds could be corrected with a willingness to examine and transform communication.

Recently the indepentmail.com news from Anderson, South Carolina, published a fascinating article that tracks what may occur when and applicants and beneficiaries open their SSA notices.

Ways and Means Committee - Subcommittee Assignments

Democratic Members of the Ways and Means Committee met to establish recommendations for subcommittee leadership and assignments for the 111th Congress last week. For Texas, we suggest the assignments look good. Congressman Lloyd Doggett – a long time advocate for SSA applicants and recipients is slated for service on the SSA Subcommittee. Congressman Doggett in addition to the Social Security Subcommittee, was recommended for positions on Health and the Budget Committee. As the only democrat from Texas to be recommended for these positions, we congratulate Mr. Doggett and believe this portends for a high standard of knowledgeable advocacy and oversight in the SSA disability process and matters concerning health and budget issues.

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

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.

“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.

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.