I ended the piece by speculating that at least some of the decline may be due to declining service at Social Security discouraging claimants from applying. I admitted that I had no evidence to support this theory. However, I had forgotten about a study that does support this theory. About two years ago I had posted about a study done by a couple of researchers about what happens to the number of disability claims filed when Social Security closes a field office. They found that the number of claims declined because people with lower education levels and lower earnings were discouraged from applying. The effect they found, 11%, was significant and the effect persisted.
Social Security hasn't closed that many offices. What's happened is that service has declined at the offices which are still open. It's harder to get through to Social Security over the telephone. Your wait time if you visit in person is longer. People get discouraged and give up.
This issue merits more study but I think the discouragement theory looks like a major factor in the decline in the number of disability claims.
I've been seeing quite a bit of just completely appalling stuff from DDS doctors. On reconsideration, I sometimes see the doctor merely copying, word for word, the first doctors comments and conclusions. I'm sure they're not reviewing the records. I think the percentage of favorables at the hearing level run around 43%. That means DDS is getting about 4 out of 10 denials wrong. Seems like they would be trying to improve that but SSA and everyone else seems to be fine with that. I think that is an indication they want to use that wait time for a hearing to discourage claimants.
ReplyDeleteI would say that if they are discourage so easily by a wait at an office or an office closure they were a 50/50 case at best. Those that want the check and Medicare because they are truly disabled are going to do whatever is needed. It just means that we are seeing self denials by your theory.
ReplyDeleteIN this good economy the people on the margins are now getting jobs. some of them part time but they are working and not applying for disability benefits. I cant tall you how many calls we have received saying that they are now working and wish to withdraw their application.
ReplyDeleteto 10:10 am
ReplyDeleteIf you've ever been truly sick (even a bad case of the flu), you know that sick people aren't always able to handle long waits and the frustration of dealing with bureaucracy. yes, long waits are a deterrence to doing anything with SSA.
Sure, the improving economy has motivated those with marginal or worse cases to return to work. But, often what we see are people in tremendous pain or significant psychological difficulties forcing themselve to try to work and they may make it for a while but eventually find themselves applying again. Day after day I listen to clients tell how they would rather be working. I'd say more than 90% of our clients would be working if they could. Sure there are a few slackers just looking for the check but that is a small minority off what we see. Maybe its different elsewhere.
ReplyDeleteWhat concerns me is how much taxpayer money is wasted at DDS. Doctors being paid nice salaries to cut and paste from one document to another. DDS is a waste of money and time. We would be better off to do away with that and just go straight to a hearing. But, DDS isn't about giving claimants a fair review of their case. It is about weeding cases out and disouraging people, even deserving people, from pursing benefits.
@11:05 then how do you explain the number of claims approved by DDS? If they were just there to deny wouldn't the numbers be even higher?
ReplyDelete@11:03 they cant get a check without filing. Your saying an hour or two wait is too much for a lifetime of checks and medical care? I am not buying that, not even a little, I wouldn't believe that in a half of a percentage of all filers. Even those would be able to file on line with a friend, family member or agency. Totally not buying I am to sick to file, that is laughable!
ReplyDeleteThey do tend to approve people with cancer and things like that. I think in our state its about 22%. In my opinion, that's pretty low. Based on the number of approvals at the hearing level, they are getting 4 out of 10 wrong. Regardless of the numbers, do you think doctors not reviewing the files and merely copying the comments of the previous doctor is acceptable? That's reallly nothing compared to the utter garbage we are seeing on a regular basis from these docs. If they were treating patients it would be malpractice. But, since they are just denying benefits to people who are homeless, can't buy food and basic necessities, its okay.
ReplyDelete@11:37
ReplyDeleteIt sounds like you are assuming that people applying for disability benefits have normal abilities and tolerances when many of them don't. I have met a good number people with genuinely severe anxiety disorders and agoraphobia who couldn't tolerate a crowded waiting room for a few minutes, much less 1-2 hrs. Now most SSA office waiting rooms are crowded. There are many physical and mental conditions that can interfere with the process of filing and documenting disability claims. If there are many technicalities, delays and hoops to jump through then the process becomes accessible to fewer people with deserving claims.
Go look at birthrate data. Births slowed in 1965 and didn't get back to Boomer levels until the latter 80's.
ReplyDeleteGen X is now roughly age 55 and younger and there aren't many of them.
1:50 they can apply by phone and NEVER step foot in an office. Same for online filing. They can get a representative (with no up front out of pocket expense) to assist them with the "hoops" and gather the evidence.
ReplyDeleteWhat do you want? Just send them a check regardless of evidence and entitlement? That's called universal income not disability.
Anyone with even a passing familiarity with how disability adjudication works would not assert that a 40% approval rate at the hearing level ipso facto means that DDS got 4 of every 10 denials wrong. That would only be true if the record stayed static at every level, and new evidence could never be entered after the first determination was issued.
ReplyDeleteMy theory.... more people on the rolls now. Explains the decrease in initial applications, relatively stable/low unemployment rate, and the decreasing labor force participation rate.
ReplyDeleteThe represented are ok provided they have a diligent rep. If they don't have a rep and they can't develop their own claim due to their disability or lack of funds they have problems. If the SSA office is understaffed and overworked they won't be able to help much with those problems. Yeah, that can leave people in a catch-22. I'd say its particularly bad for people fighting overpayments, cessations, and new SSI claims where its hard to find representation.
ReplyDelete@5:52 the number on the rolls is falling primarily because Boomers are turning 65.
ReplyDeleteI agree DDS should be eliminated. Just appeal a denial to an ALJ. The ALJ can grant all the definite disability cases with an OTR like compassionate allowance or terminal cancer. Then, there would be a quicker process.
ReplyDeleteBut the SSA would have to hire more ALJs. The SSA is terrible at that.
The statement that DDS gets 4 out of 10 wrong, is incorrect math. The number of cases decided by DDS is more than the number of cases decided by the ALJ because there is a significant number (don't have the stat) of claimants that do return to work or otherwise choose to not pursue the claim to the hearing. For those who do manage to return to work, it means that DDS got the decision correct. How many is that? 10%? It would take gathering a lot more data to draw the correct percentage of "Cases DDS Got Wrong"
ReplyDeleteWhat is also ironic is that lawyers profit by the lengthy process, which leads to the incorrect perception that lawyers are dragging their feet. If SSA were more efficient and processed claims through the hearing level in less than 12 months (which is a noble goal, I think), the amount of retroactive benefits payable would be reduced which would be a deterrent for lawyers who can't make a living on lower fees. And without lawyers, many claims would be lost at the hearing level as well. So, using this logic, if SSA truly wanted everyone to be denied, they would do what it takes to drive the lawyers out of business, which would be to be more efficient.
It seems to me that SSA now has the mentality that most problems can be solved by automation. It will be interesting to watch as they add more intelligent design systems to find the key words in the medical records and draw a tentative conclusion.
6:30. There is already an issue with the computers tagging someone as a CAL case because their parent said they were two inches tall
ReplyDelete4:31. If the DDS were eliminated who do you think would get the medical evidence in a case?
ReplyDeleteTo add to 4:35's point (and I agree with 6:30's larger point about the math), there are any number of cases where the individual changes age categories while awaiting a hearing that results in a grids case. There are other instances where PRW is no longer PRW by the time the hearing rolls around. There are certainly instances where I've felt DDS has gotten it wrong, but most of the time, it's new evidence, worsening of a condition, or a new age category that results in a favorable decision.
ReplyDeleteAnd 4:31, if you eliminate DDS, whose denial are you appealing? I'm assuming you mean a person applies and goes straight to a hearing or gets an OTR in the hearing office. It's not just judges that would need to be added. Hearing space, attorneys, support staff, etc. would need to be added with space for everyone. I can't imagine the associated cost for that.
Good economy = low filing Bad economy = high filing
ReplyDeleteIt really isnt that hard.
I think lower approval rates (in the name of "quality") combined with longer waits for a hearing are huge discouragements to applications. Plus, a better job market encourages employers to make more accomodations... Throw in the baby boomers at 55+ and you have 4 reasons for fewer applications. If poor service is going to discourage an application, you probably have other options. I can see how it would delay an application, but, if SSDI is your last option... Eventually, you will put in the application. Help me SSA, you're my only hope... A message in a bottle might be a better chance... Faster, too!
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