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."
Monday, September 24, 2007
Thursday, September 6, 2007
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.
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.
Tuesday, September 4, 2007
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.
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.
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.
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.
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
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
Subscribe to:
Posts (Atom)