Social Security has posted the allowance rates on disability claims at the initial and reconsideration levels for the 2022 federal fiscal year, which ended on September 30, 2022. Last year when these numbers were revealed, I asked why there was so much variation from state to state. I still have the same question. Sure, there are some demographic differences but why are 69.5% of disability claims approved at the initial level in Alaska but only 29.8% in D.C.? Demographics can't account for a difference that great. Closer to home for me, why did North Carolina have a 35.9% allowance rate at the initial level but in the neighboring states of Virginia and South Carolina the allowance rates were 41.3% and 42.8% respectively?
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I've always attributed particularly low award rates at the hearing level to certain states (ie alaska) being actually difficult to reside in. So in theory, there should be more adverse evidence generated by such conditions (claimant drives 4+ hrs to a doctor appointment, claimant gets along great with a carpool group to go shopping, limited social safety net in general limits treatment, etc.) Obviously those facts can be dealt with, but the variance in initial vs recon is another matter entirely. Yeah that's odd. I do know my state judges DDS on an "accuracy rate," and they get a budget enhancement based on that, which is a disincentive to award at recon. Curious if other states also do that?
ReplyDeleteIt would be interesting to study possible factors. Availability and quality of health insurance amongst applicants. Race. Rural/urban. I did a quick comparison and some states that refused to accept Medicaid expansion had lower than average initial and recon grant rates (Florida, NC, MS, GA and NC), but some that refused it were above average in both (KS, WI, TN, AL, SC).
ReplyDeleteI can only speak for the state I am in. I get a lot of repeat filers. I would say 75-80% of the claims I take for disability have previously filed at least once but usually 2-3 times. They just continue to file and then at some point meet the age requirements that allow them.
ReplyDeleteBy far the #1 condition for kids is ADHD. For the adults it’s primarily back pain and diabetes and depression.
Not saying those can’t be severe, just saying they don’t seem to get approved at a high rate.
Alaska is a hardcore state to live in. There are a lot of accidents (moose and cars are a very very bad thing), YEARS of firewood gathering (back injuries), it's very dark for a good part of the year (depression...etc..etc..) There are so many reasons Alaska has a high approval rate, I can't name them all. One nasty slip on the ice can be a life changer for some (no, they don't de-ice parking lots, only entryways). Also, for being a former deep dark red state (though turning purple again), they have a lot of compassion for the disabled. It's a hard state to live in anyways, let alone to become disabled in. I noticed Wyoming (small populated state too) had a slightly higher than average approval rate.
ReplyDeleteI do think there are a variety of factors including age when people file and the mix of SSI/DIB claims. Certainly, availability of medical care cuts both ways. Sometimes the medical care actually helps people get better and they don't file or the lack of medical care leaves them sicker but also means lack of evidence to support a claim. Also, different offices have cultures for good or bad just like some hearing offices used to use Medical Advisors in every case and some never did. Offices that are low pay pass on those traditions to new hires at State Agencies and the reverse is also true.
ReplyDeleteI would also be interested in knowing the percentages of partially favorable versus fully favorable at either initial or recon. It seems that a large portion of approved cases at the State Agency have later onset dates. I don't think I have ever seen a closed period allowance at the State Agency even when a person had back surgery a year after the onset date and may actually have gotten better.
DC might be better to compare to a large city vs a state. Also it may be more people on welfare that have to file just to keep their benefits.
ReplyDeleteThe high Alaska rates somewhat makes sense. The SSA and OHO really don't want to do hearings up there either in person or in video at least before the pandemic. I have done many hearings in Alaska especially Anchorage and Ketchikan. Usually the Seattle OHO ALJs handled it. But it seems like winning the OHO hearings was not that easy. It was like they avoid hearings at all costs but scrutinize those that made it to hearing.
ReplyDeleteNow do ALJs
ReplyDeletePeople have bias.
ReplyDeleteAlaska really has nothing it can be compared to... but, Iowa and Nebraska are very similar... One large metro area and a 2nd smaller metro... lots of similar occupations, demographics, etc. But, Iowa is 43.1% and Nebraska is 49.1%. What also is similar to Iowa and Nebraska? Kansas, which is 54.9% An 11.8% difference between Iowa and Kansas can't really be explained away.
ReplyDeleteI'd like to see an analysis for IAR rates. Some states will pay a cash welfare benefit while a disability/SSI claim is pending, and some rehab facilities require claimants to apply for that cash benefits. This creates an incentive to repeatedly file for benefits at a young age, or with disabling conditions that don't meet a listing, etc.
ReplyDelete@2:30 - Most of those states will pay cash to those waiting for SSA only IF the states know they have a high likelihood of being approved, as if they're not approved, the claimants' have to pay the money back to the state. That is how I understand it. Blood/turnip thing....
ReplyDeleteThis is not a new phenomenon. There have (almost?) always been big variations in rates between States.
ReplyDeleteStudies have only ever been able to explain part of this variation.
Some people have attributed this unexplained variation to a differing “adjudicative climate” within different States.
Works for me.