From the Atlanta Journal-Constitution:
Last week, I wrote about Acworth resident Mary Ann Statler and her devastating, ruinous trek through the Social Security disability process. ...
The column prompted response from people intimately familiar and utterly frustrated by the backlog, including some lawyers who make their living at it.
“The toll is a human toll,” said Jonathan Ginsberg, an Atlanta attorney who devotes a lot of his practice to disability claims. “It’s very, very frustrating.”
The choke point in the process occurs when an applicant appeals a denied claim to an administrative law judge. That process is so backed up that applicants wait an average of 23 months to get a hearing in the agency’s downtown Atlanta office.
To add insult to the injury, Ginsberg said once one of his clients gets a hearing scheduled, the outcome can largely depend on who gets the case. Some judges approve a vast percentage of their cases, while others deny an equally large number. ...
The administrative law judges in the agency’s downtown Atlanta office approve an average of 47 percent of the claims they hear, but that figure hides an incredible deviation among the judges. On the high end, one judge approves 74 percent of claims before him, while at the low end another approves just 19 percent. ...
n fiscal 2010, administrative law judges approved 62 percent of disability claims and denied 25 percent. The rest of the cases were dismissed for various reasons, including from people who abandoned their claims after months or years of delay. By fiscal 2016, approvals had dropped to 46 percent while denials increased to 35 percent. ...
[Marilyn] Zahm [president of the Administrative Law Judge union] said there is definite pressure from the agency to get judges to find against workers....
Zahm said she has offered a streamlined way to process paperwork for cases where a worker’s disability claim is found “fully favorable.” These are non-controversial cases where a judge has already decided in favor of the worker, and there are tens of thousands of these cases, she said.
“I even had someone draft the (decision) templates for them,” she said.Maybe I just want it to be so but I'm getting the feeling that tectonic plates are shifting. Even Republicans who really wanted to believe that there is vast fraud in the Social Security disability programs now realize that Eric Conn was a bizarre one-off that had nothing to do with what was happening elsewhere. Their hope that they could pour lots of money into fraud investigations and turn up one juicy story after another hasn't panned out. There was a reason that I and others who work on behalf of the disabled were never concerned about more money going to program integrity. We knew that there was nothing of consequence to be found. We were only concerned about the diversion of money from the day to day work of making decisions on disability claims. Now, reporters and others are focusing more and more on the tragic reality of horrible delays and harsh decisions at Social Security. Stories such as the ones we've seen lately in newspapers have a cascade effect. A reporter somewhere else in the country reads the Atlanta Journal-Constitution piece and gets an idea for a story that he or she can write with new quotes from local people. Republicans on the House Social Security Subcommittee are now struggling to come up with a cover story to explain why their inadequate appropriations are the reason why Social Security has such terrible backlogs. I don't think their excuses are going to give them cover for long.
But, so far, there has been no response. ...
12 comments:
Marilyn Zahm is a joke. The claim that the Agency is "pressuring ALJs" to deny claims because they won't approve a streamlined favorable decision is hogwash. If the Appeals Council would not nit-pick every decision and send some back for unfathomable reasons, we would not have this issue. Eant to speed up the process and reduce the backlog? Eliminate the AC or make their "judges" go through the same process of selection as ALJs. Or let line judges serve on the AC in virtual details from their home office.
Applicant: I am disabled, give me money.
Attorney: You must believe my client. Give me my fee.
SSA: You present your case so well, I need nothing more. Take this money for the rest of your life.
It's refreshing to have someone like Zahm to go on the record to admit something that we all know to be true: there certainly has been pressure from "above" for ALJs to deny more claims. There is no other way to explain the double-digit decline in the percentage of approved cases since the Conn story broke. This is especially true in the new ALJs that have joined the ranks. I hope Charles is right and the pendulum starts to swing slowly back to the middle.
@7:30 and 9:26
Zahm argued to the 7th circuit increasing ALJ caseload encourages favorable determinations because unfavorable caseloads are easier to write. I suppose this is two sides of the same coin but I still do not get it. Favorable decisions are usually short.
@9:16
It is not for the rest of your life. Recipients are reviewed generally within 2 years and benefits and are terminated if they recovered. If they recovered prior to the review, SSA seeks back the money they sent you. SSA has full ability to recoup whatever benefits were improperly paid. They can garnish your wages, take future benefits, take your tax refund assuming you go back to work, etc.
lol, any alleged pressure is just in the ALJs head. It doesn't exist and even if it did it wouldn't matter because ALJs are untouchable. Nothing bad can happen to you for performance only conduct as evidenced by the ALJs approving 75+%
I like how they strategically insert the word "worker" for sympathy from the reader. I see plenty of Title XVI apps from people that have no worked. lol worker, calm down Elizabeth Warren
10:21. You are back in the Reagan years. Except for faiure to cooperate disability ceases the date of the cessation letter and terminates two months after that. ...not when improvement occurs. Also it is rare that there is a medical review within two years
First, I'm glad they could use Charles' favorite stock photo of HQ.
Second, Marilyn says a lot of things, but to state there is pressure to deny cases is absurd. There is pressure not to dispose of 600 cases on the record without a hearing, which was a natural consequence of the Huntington scandal as well as numerous other judges disposing of 1000+ per year without holding hearings on more than half of them. The pressure is to make sure the decision is justified, not to avoid paying it entirely. If that made a judge's job more difficult, then that judge wasn't doing the job correctly to begin with. Those are probably the same judges that think denials are easier to adjudicate and write than favorable decisions.
Third, I know a rep runs this blog, but I suppose we'll just ignore this statement that could very well explain the drop in favorables at the hearing level. “Up until that point, the agency pushed judges to pay cases” and clear the backlog, she said. “They turned a blind eye because so many cases were being adjudicated and going out the door,” she said. “That’s all they cared about.”
This point is always ignored and never mentioned on this blog as the reason for the vast number of approvals prior to 2011 or so. When you have judges cranking out 1000+ at an 80+% approval rate (higher if you remove dismissals from the equation), you're going to have an inflated favorable rate across the board. Daugherty wasn't the only one negligent in their duties, though he's hopefully the only one criminal in performing them.
@5:02
I have seen it happen this year. Every case I've seen either was continuation, or an overpayment, never a termination and no overpayment.
Can you cite a POMS or HALLEX where it says SSA will not seek an overpayment?
@540 PM One can request a waiver and be found to be w/o fault if appealing a CDR cessation in good faith. I think just about all are in good faith so if the person does not have the income or resources to repay the overpayment, it's an easy waiver. SI 02260.007 GN 02250.036
re: 5:40pm
When benefits are medically ceased (which doesn't happen that often as 80%+ of medical reviews result in continuation of disabiltiy), the cessation month is generally the month the cessation notice is sent. After Reagan's mass retroactive purges of the disability rolls in the early 80's, most of the retroactive cessations were done away with. However, there are a still a few situations where the agency pursues retroactive cessation. The POMS that covers that is DI 28005.205.B.
https://secure.ssa.gov/apps10/poms.nsf/lnx/0428005205#c
The overpayments on cessation cases (absent the relatively rare fraud/similar fault cases) mostly come about as a consequence of the cessation appeals process which affords claimants the right to elect statutory benefit continuation while appealing. SSA does pursue those overpayments, but so long as the claimant can show he/she pursued the appeal in a "good faith belief" he or she was disabled, collection of medical cessation overpayments can be waived if the person can also show an inability to repay.
Overpayments would occur when the claimant asks for benefit continuation after benefits were ceased. Or if there was SGA work activity after the TWP. One fellow thought he was supposed to get a 9 month TWP every year. So after 5 or 6 years there was a big overpayment. Neither of these scenarios meant they were ceased retroactively due to medical improvement having occurred in the past. That did occur during Reagan's misguided attempt to jumpstart and thus take credit for the Pickle bill. Improvement did not have to be shown of course and they had us cease people retroactively even one month after an ALK decision if we had new medical records showing a Listing not met for example
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