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Sep 7, 2007

Technical Denials Soar -- Why?

The Social Security Administration has issued its 2006 Annual Statistical Report on the Social Security Disability Insurance Programs. Oddly, the report seems to contain almost no information on backlogs, even though statistics on adjudication backlogs may be of more interest to more people than anything included in the report.

Take a look at the outcomes chart. You can click on it to make it larger. It shows a recent dramatic increase in the number of technical denials. There were 104,344 technical denials in 1999 and 615,924 in 2004, according to an accompanying table. That would seem to call for a good explanation, but I cannot think of one other than that Social Security employees were using technical denials as a shortcut to getting their work done. Instead of helping a confused claimant, a Social Security employee would use that confusion as a pretext for denying the claim for failure to cooperate. Does anyone have a better explanation?

The chart also shows that initial awards and Appeals Council awards went down significantly after George W. Bush became President (and Jo Anne Barnhart became Commissioner of Social Security).

6 comments:

  1. The increase was due to the agency reminding employees to officially close out all types of benefits when taking applications. Claims representatives can usually tell when a person does not meet SSDI insured status requirements or when they will not meet the income and resource limits for SSI. However, the agency determined that some benefit entitlement was being missed (as witnessed by the special disability workload where in the records of thousands of SSI recipients were actually due Social Security benefits). Claims representatives are now required to formally close out entitlement to other classes of benefits rather than informally telling the claimant that they did not qualify.

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  2. The comment above is correct--SSA takes t-2 Dib claims on anyone filing for SSI who has any wage postings at all, no matter how little and even if obviously not insured. This is the result of the ongoing SDW(Special disability workload) fiasco in which hundreds of thousands of insured individuals filed for SSI but had no T-2 dib claim taken. That workload is still years from being resolved, and has resulted in painful redirection of agency resources to address.

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  3. Additionally, the rise in technical denials also helps explain the drop in initial and hearings and Appeals council awards rates - total awards increase from 1999 through 2003, but total claims volumes increase a higher rate because SSA is now counting more work to avoid future SDW snafus. Total awards are only lower in 2004 and 2005 because data are grouped in this chart/table by date of application, rather than decision. Many 2004 and 2005 claims are still in process (there's that backlog)

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  4. Interesting to note that the backlog started about the same time as the technical denials increased. It also should be noted that the potential SDW aspects of a case can be taken care of with a closeout letter, but that would be one less claim to support the backlog. Also when the immediate denial is averaged with the six month processing time of the "real case" the resulting three months makes DSI look successful.

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  5. Technical denials are certainly not a "shortcut to getting their work done," as they take longer than a close out letter. Neither does it have anything to do with failure to cooperate.

    It is a fall-out from SDW, we want to ensure claimants' rights are protected and entitlement is properly adjudicated, even when a cursory scan of the record shows no likely entitlement.

    TDs also produce work credit and lower processing time, but this is secondary to the reason above.

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  6. Our anonymous Social Security employees tend to focus on reasons relating to their own workloads, but why not look outside the agency for another reason for the increase in technical denials.

    For some years now agencies and insurors other than SSA have increasingly required their own claimants to file a SS disability claim and bring them the SS denial notice before proceeding with their non-SSA disability or insurance claims.

    These claimants are required to file with SS no matter how obvious it may be that they do not meet the insured status requirements, and in many cases no matter how obvious it may be that their disabilities are temporary or not up to the severity required for SS disability. The SS disability application becomes a convenient screening (and delaying) tool for agencies and insurors not otherwise connected to SSA.

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