The Coalition for Citizens with Disabilities (CCD) is a large umbrella group lobbying and advocating in D.C. for persons with disabilities. The CCD is composed of about 100 organizations helping the disabled population. The CCD was largely ignored when Republicans controlled both houses of Congress and the White House. It becomes more important now that Democrats control the House of Representatives.
The CCD has put out a statement on Improving Decision Making at the Disability Determination Services. Here are a few excerpts:
... It is the position of the CCD Social Security Task Force that the state Disability Determination Services (DDS) should only review a claim one time and that the current second level of review they perform, called reconsideration, be eliminated. ...
Although the Task Force does not have a specific recommendation regarding what performance metrics should be for DDS employees, it is the Task Force position that the completeness of the file upon which the decision is based should somehow be included in those metrics. ...
[Social Security should] Consider creating impairment specific explanations and forms that claimants can provide to their physician and other treating sources outlining what information is most helpful to SSA in evaluating the claim and including the types of tests which help establish meeting the listing in question. ...
SSA should review more denials of initial claims. TDRs [Targeted Denial Reviews] allow SSA’s Office of Quality Review (OQR) to examine unfavorable decisions of disability claims issued by state agencies. Fewer than 3 percent of initial level denials receive TDRs; the number performed varies each year based on resources available to the agency. In comparison, Sections 221 (c) and 1633 (e) of the Social Security Act require SSA to review at least half of the favorable decisions issued by state agencies. ...
13 comments:
As a parent of a young adult with a rare disorder, I get asked a lot about filing for SSI or DAC benefits so I agree with the idea of impairment specific forms and background. Too many parents I know are in that "Sally can do anything" mode and downplay their kid's deficits and overlook key areas when applying. Unaware of the legal guidelines, they are living in the "my kid has xxx, so where is the funding" world and don't get that they need to prove things (things that indeed they often have spent a lifetime fighting against, such as they do have issues and limits and problems) and often really specific things (IQ, specific tests and results, ADL strengths and weaknesses etc). Awareness of the listings and what meets them is vital but on their own, what parent or person knows? There are things that they could do (pull records, talk with school staff or the needed specialists) if they knew they had to do those specific things. Instead they apply and due to ignorance do not focus the DDS on the things the DDS needs to make a decision.
So anything that would help out the family or individual and the DDS is a plus in my book.
Makes sense. My home state of MI is rolling back recon later this year. Not sure what the point of this exercise is other than making my clients wait another 3-5 months for their eventual hearings.
The point of rolling back recon is not just the delay but the hope by SS that more people will be dissuaded from filing a Request for Hearing.
Take a look at the Star Chamber known as the Appeals Council.
DDS denied at initial application on an OBVIOUS disability, WITH ALL RECORDS IN THEIR POSSESSION (that's important). Lawyered up, got SSDI on a reconsideration, a reconsideration where they received NO new information. Why was it denied initially? They couldn't give me a reason. Thousands paid to lawyer for NOTHING. Even the lawyer was baffled. She was prepared for a hearing, only for approval in 30-45 days on a recon. Ridiculous, to say the least. This was 16 years ago. It's so sad to hear it hasn't changed. d:-(
Problem with no recon is that if the forms are not sent back to DDS on time, it is an easy 'failure to cooperate' or 'insufficient evidence' quick denial and on to the hearing level for a 2 year wait. At least with recon, there is a chance to get the info and evidence to them.
When you have folks who are not trained as lawyers making legal determinations regarding whether someone is disabled it creates a huge problem. And that's why DDS and OHO have so many problems. Too many folks without legal training and cases get bungled because of it.
10:13, I don’t think lack of legal training is the issue at the DDS level. If anything, adding lawyers to the initial stages would result in lower payment rates, because they’d be more cognizant of the burden of proof and more skeptical of conflicting statements from applicants and/or doctors. Lawyers would also be more strict with onset dates and listings (if they’re applying the rules correctly).
The disability standard is not friendly to applicants, so training people to apply the rules to the letter is just asking for more denials.
10:52, Well, having folks with no legal training does not help because they don't obviously know how to apply the law or interpret laws and apply them. That certainly does not help matters one bit. And, that's a problem throughout DDS and OHO. When folks don't have the capability to handle cases properly all it does it slow down processing of case and that leads to increases in the backlogged cases at DDS and OHO for no good reason.
So if ALJ's make the right decision, why is there such a range of allowance percentages? If the ALJ makes more correct decisions than DDS, why don't all ALJ's make the same decision? Why isn't there more consistency in allowance/denial rates?
And who gets more training on medical conditions, terms, procedures, diseases; ALJ's or DDS analysts? DDS analysts get ongoing training throughout their career. ALJ's do not. Yet they both have to read and evaluate medical evidence.
It's ironic that the fact that SSA is so slow in getting a case to a hearing is the reason that attorneys can make a living representing clients. If SSA were more efficient, this might not be profitable to attorneys.
I am SORRY, but I am confused; why is an 'appeals process' a BAD thing? I was initially denied, and then approved and began to receive benefits. The initial doctor who examined me was determined to deny me; I could tell by his exam, demeanor and questions. The second doctor was fair and listened to me. It was the results of the doctors report that SS went on, because they claimed they had no medical records, which they could have easily asked for.
DDS analysts are not lawyers and therefore they are not equipped to handle legal determinations likes ALJ's/lawyers are. You can provide them with all the training you want, but in the end they are not lawyers and they do not analyze evidence as well as lawyers can. And it shows. And SSA is so slow in getting a case to hearing because of too much laziness by too many folks. Hopefully, the new Commissioner will alleviate that problem by getting rid of folks who don't do their jobs. And there are currently many of them.
2:43, ALIs do get ongoing training throughout their careers. AALJ conferences, quarterly OCEP training videos and other SSA-produced videos on demand. And while ALJ pay rates vary, so do local District Court rates -- that's a feature of judging in general...and most ALJ pay rates, whether 40% or 70%, still exceed DDS pay rates.
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