... If a claimant disagrees with SSA’s initial disability determination, he/she can appeal that determination. In most cases, the first level of review is a reconsideration by the disability determination services. In 1999, SSA eliminated the reconsideration level in 10 States. In these 10 States, the first level of appeal was a hearing by an administrative law judge (ALJ). In 2019, SSA began reinstating the reconsideration level in the 10 States. ...
Of the 616,917 claimants denied at the reconsideration level in CY 2015, we estimate 86,400 (14 percent) did not take action after the reconsideration denial while 530,500 claimants (86 percent) appealed to an ALJ and/or filed new claims. Of the 530,500 claimants, we estimate 290,000 (55 percent) subsequently received allowance decisions.In FY 2018, it took on average 79 days longer for a claimant to receive an allowance decision by an ALJ in States with the reconsideration level of appeal. ...
Reinstating the reconsideration level allows for a uniform disability process that standardizes services for all claimants nationwide. With reinstatement of the reconsideration level, the Agency estimated $3.9 billion in program savings over a 10-year period (FYs 2019 to 2028). ...
And why is it that reconsideration saves hundreds of millions of dollars a year? Because it increases delay and frustration for disabled people. Fewer of them get an ALJ hearing because they drop out after the added hurdle of reconsideration. For OIG, however, causing sick people to suffer delay and frustration is of no consequence, as long as it saves money. The attitude isn't far from being "The only good disability claimant is a denied disability claimant."
I'm anti-reconsideration. It is wasteful and pointless. Put more resources and time to making a better decision at the initial level.
ReplyDeleteI'm sure the 50,000+ people that receive benefits at recon on an annual basis instead of waiting an extra 16-22 months for a hearing would agree with the thought that recon is useless. I'd love to see a survey of people denied at the initial level if presented with the option of having a 10-13% chance of getting a favorable decision a few months after the initial denial versus waiting another 18 months to get a hearing. It would be especially interesting to see if they were also aware skipping reconsideration would save them less than 3 months (79 days) over taking the chance with recon.
ReplyDeleteBut I guess for reps, causing these 50k+ sick people to suffer delay and frustration is of no consequence. This attitude isn't far from the only good claimant being a delayed claimant.
This system cracks me up sometimes. The emphasis is always on making it harder to get help whether it is stated or unstated. This is a rationing system and a hazing for the disabled.
ReplyDelete@2:31-
ReplyDelete"This attitude isn't far from the only good claimant being a delayed claimant."
Isn't that the idea that the entire SSA disability system is built on? But, of course, its the reps that are the bad guys.
I am a Michigan attorney. I was very disappointed when the reconsideration level was reinstated in Michigan late last year. Overall, it is a significant waste of time and resources.
ReplyDeleteFor the overwhelming number or majority of claimants who do not receive a favorable decision on reconsideration, the severe consequence of mandatory reconsideration is that an average added delay of 75 - 120 days is inserted into the slow turning gears of a system already noted for long delays in processing claims -- delays that should be regarded as an intolerable and unacceptable way of treating claimants.
By late autumn last year, Michigan had done a good job, relatively speaking, in reducing the delay from date of denial to ALJ hearing to an average of 180 days, plus or minus. It was only a few years ago we were waiting 24 - 30 MONTHS for a hearing after the denial at the DDS level.
Of course, the virus pandemic has disrupted and stalled the in-person hearing system. And, now add 75 - 120 days of delay because of the reintroduction of the reconsideration level.
@2:31 I consider an 87% denial rate to be bad odds. Personally, I'd rather get started on that hearing wait list sooner rather than later. Also, maybe more of those 13% of people paid at recon would get paid at the initial level if everyone's work wasn't practically doubled artificially (because of recon) and could put more resources into the initial review.
ReplyDelete@2:31. Thanks for the snark. But getting rid of the reconsideration level would help claimants. Getting rid of it decreases the waiting time for MOST claimants (which, by the way, decreases the amount they are owed and the corresponding attorney's fees). You are right that 13% get approved at recon - but at the cost of many, many more people being denied and having an extra 3 months added to their misery. There are no easy answers. But your sarcasm is pointless and your post has no solutions.
ReplyDeleteYes, the snark is really unnecessary. I tell my clients the odds at each level, and they invariably think that they will be among the 9% approved at Recon in my state. If we were to take the resources wasted at recon and added them to adjudication, the wait time for the hearing could be further reduced for all claimants.
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