Here are some interesting excepts from the Testimony Before the Subcommittee on Income Security and Family Support of the House Committee on Ways and Means and the Social Security Administration.
The hearing was held on March 24, 2009. For full transcript, visit this link.
All emphasis has been added. The “soup to nuts” (a perhaps unfortunate moniker), review confirms our post before the hearing, that the real problems begin at the state agency DDSs, where 54 different agencies make the first determinations. While the Field Offices or federal agencies that handle the technical aspects of claims, are overwhelmed by logistics, once adequately staffed the inference appears to be problems will be alleviated. Conversely, the DDS is not suffering from lack of staffing as much as lack of expertise. Training is only hinted at by Asture in a new and promising Star Chamber review, but is the other theme that could significantly affect the entire process. Of course, the wait that ensues from the DDS denial to the ALJ hearing reflects on the hearings process. However, since ALJ’s allow about 50 percent of the cases heard, one has to wonder if the DDS was making accurate decisions more often, fewer appeals would exist and the backlogs would be significantly diminished. This is an old battle, but reflects SSA’s decision inconsistency and its effects. Real folks are waiting up to 811 (and beyond) days to get a disability decision.
-------------------------------------------------
Patrick O’Carroll, Inspector General, Social Security Administration found that the average claim adjudicated in 2006, when decided initially by a DDS, was concluded in 131 days, but that if a claim was adjudicated upon a request for reconsideration, that time more than doubled, to 279 days. If a claim was appealed to an ALJ, the 279-day wait almost tripled, to 811 days, or 2.2 years. While issues surrounding the DDSs and the processing of both initial claims and requests for reconsideration are material to the overall backlog, …O’Carroll’s soup-to-nuts review establishes that the real delays begin when an appeal is filed. It was at this stage that the processing time jumped from 279 to 811 days. He recommended, “SSA publish this measure to show disability waiting time from the claimant’s perspective, to better inform Congress and the public.”
From the GAO:
SSA’s total backlog of disability claims doubled from 1997, reaching 576,000 in 2006, which has resulted in claimants waiting longer for final decisions. The backlog was particularly acute at the hearings level. SSA also experienced declines in field office service delivery, with average customer wait times in field offices increasing by 40 percent from 2002 to 2006, and over 3 million customers waiting more than 1 hour to be served in 2008. Two key factors likely contributed to the backlog and service delivery challenges: (1) staffing reductions or turnover of field office staff and key personnel involved in the disability claims process, and (2) increased workloads. In particular, initial applications for disability benefits grew by more than 20 percent over the past 10 years.
Although DDS staff increased about 4 percent from 1997 to 2006, DDSs have experienced high rates of staff turnover and attrition. Attrition rates for DDS disability examiners, who are state employees, were almost double that of SSA federal staff. Many DDS senior managers we spoke with said that turnover of experienced disability examiners has affected productivity. For example, from September 1998 to January 2006, over 20 percent of disability examiners hired during that period left or were terminated within their first year. DDS officials said the loss of experienced staff affects DDS’ ability to process disability claims workloads because it generally takes newly hired examiners about 2 years to become proficient in their role.
In addition to disability claims backlogs and increased processing times, other aspects of SSA’s service delivery at field offices have declined in recent years. From fiscal year 2002 to 2006, the average time customers waited in a field office to speak with an SSA representative increased by 40 percent from 15 to 21 minutes. In fiscal year 2008, more than 3 million customers waited for over 1 hour to be served. Further, SSA’s 2007 Field Office Caller Survey found that 51 percent of customers calling selected field offices had at least one earlier call that had gone unanswered.
Declines in field office service delivery measures coincided with a period of staff turnover and losses agency wide. From fiscal year 2005 to 2008, SSA experienced a 2.9 percent reduction in total employees and a 4.4 percent reduction in field office employees. At the same time, employees and managers reported high levels of stress. When asked, 153 employees at 21 offices rate the stress they experienced in attempting to complete their work in a timely manner and 65 percent reported feeling stress to a great or very great extent on a daily basis, while 74 percent of office managers described high levels of stress.
SSA projects an increase in disability claims and other workloads over the coming years while at the same time anticipates the retirement of many experienced workers. Specifically, SSA projects: overall 13 percent increase in retirement and disability claims from fiscal years 2007 to 2017. A growth of 22 percent in the number of retirement and disability beneficiaries from 2007 to 2015. That nearly 40 percent of its current workforce will be eligible to retire in 5 years and 44 percent will retire by 2016.
From Commissioner Astrue’s Statements
Improve consistency and accuracy on complex policy issues; we have instituted a process for resolving disagreements between DDS disability examiners and Federal quality reviewers. In cases where the two components disagree on substantive issues, staff experts review the case and reach consensus. We anticipate we will resolve our most complex cases through this Request for Program Consultation (RPC) process. In addition, the RPC enables us to quickly pinpoint training needs and clarify or modify policies where necessary.
We plan to develop and implement a common case processing system for the DDSs.Currently, each of the 54 DDSs has its own unique processing system. A common system will help us take advantage of rapidly changing health care industry technology and provide the foundation for a seamless electronic disability case processing system.Our DDS partners agree that we need a common system, and we are working closely with them to develop requirements. This essential improvement will modernize and streamline our disability process, and we can only make important improvements on a timely basis, such as eCat, if we have a common system.
Thursday, March 26, 2009
Monday, March 23, 2009
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.
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.
Monday, January 26, 2009
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.
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.
Monday, January 12, 2009
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.
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
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.
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.
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.
Subscribe to:
Posts (Atom)