Social Security has posted numbers through the end of 2022 showing how many people filed disability claims, how many of those claims reached a Disability Determination Service (DDS) for adjudication and how many were approved. Note that the number of claims filed and the number reaching DDS went up slightly but the number of awards went down. How come? Serious problems at DDS units around the country.
It doesn’t matter how many get approved or denied. I’m working the front desk all day or answering the phones all day or taking claims all day due to the staffing shortage.
ReplyDeleteI’m not processing allowances regularly nor am I amble to load appeals regularly. So the people who are trying to file or need SSN cards are clearly more important.
How come? Since the number of apps is up, that leaves two possible reasons. It is intentional, or it is incompetence. Neither is acceptable, and the situation really deserves a Congressional investigation. Claimants are suffering through delays in approvals and wrongful denials. Both are costly for those who are already out of work. Delayed approvals end up costing thousands in attorney fees for a hearing.
ReplyDeleteDelayed approvals and wrongful denials both lead to poor claimant outcomes due to lack of funds for housing, medical care, and also by causing negative mental effects.
If it is intentional, they are denying cases in the hopes the claimants will go away and not appeal. This is a quick and dirty way to get the work off of their desks, and there are a number of claimants who will give up and not appeal.
I suspect it is incompetence, which includes lack of manpower and poorly trained examiners due to attrition. Turnover is very high at the DDS units. There are many cases where DDS clearly does not read the file. At the initial and recon levels, DDS ignores diagnoses from specialists (even listing-level conditions) and improperly discounts supporting diagnoses and opinions from their own CEs.
It’s due to lack of staff. Why would I do it intentionally? I’m one person trying to do the work of 5. Why don’t you come help?
Delete@ 11:07 The DDS didn't even wait long enough to even receive my medical records, in my case. I got approved on a reconsideration. It was an obvious case of disability. My lawyer just shook her head and recommended a reconsideration without high hopes, but sure enough, 30 days later I had an award letter. , and a bill from the lawyer.
ReplyDelete11:07 I will throw in a third alternative to conspiracy or incompetency, it could simply be they are not disabled. Just because you apply doesnt mean you are disabled.
ReplyDelete@1:51 correct.
ReplyDeleteInterestingly enough the agency is making a goal to get more people to file for SSI when we can't even handle the amount of applications and claims we have pending or coming in as it is. Why? Why don't we care about the people who have already filed whose cases are sitting around for months and months.
ReplyDeleteIn the last year there has been a marked shift in how New York DDS reviews app/recon cases. In particular they are using bogus vocational findings to deny claims that are easily won at hearing the level. DDS medical experts are also deliberately ignoring consultative exam opinions that assign greater limitations (they always check off that "no opinion in the record provided greater restrictions.) This makes their opinion essentially legally deficient at the hearing level, which makes hearing wins even easier (and Fed court wins much easier if the ALJ relies on these opinions).
ReplyDeleteBut the medical decisions of DDS medical experts have also been astoundingly bad. For example, I just had an attorney advisor approval at the hearing stage for a case that I retained a few months ago. I appealed the case and did not submit any new records. Attorney advisor approved the case mostly based on mental health limitations of this 60+ year old client. Amazingly, the DDS medical expert determined that this client has no severe psych impairment--despite all the psych records being submitted and the consultative examiner assigning multiple marked limitations
I have to finish working on our firm's 2022 approval statistics--but in 2020 over 40% of our firms case approvals were from DDS at the app/recon stage. If I had to estimate, that figure is closer to 20% in 2022.
Never chalk up to incompetence that which could be systemic maleficence. Incompetence gives you mistakes in all directions. When the "errors" are always in one direction (as in, against the claimant), that is a systemic denial function.
ReplyDeleteThanks. There’s nothing quite like getting treated like trash by the public, your employer and now some random know it all on the blog.
DeleteKeep it coming Tim. Thank you for all you do.
Random know it all? More like a victim of this systemic denial culture. It took 6 YEARS to get what I was promised. Promised by this government, by the Congress, etc. I was told my complaints "weren't credible" by an ALJ who less than 6 months earlier, was deciding whether signs were too close to the road. Those complaints had 10, 15, and 20 YEARS of documentation. So, spare me your outrage, whether feigned, or not.
DeleteAgain, thank you for all you do to make this a better place.
DeleteAs a person with a disability doing my best to work for this agency, I would like to express my gratitude for your kindness Tim.
DeleteHas anyone considered that people who filed during a down turn in the economy due to job loss just may not be disabled? Which is more probable: a secret national coordinated conspiracy to purposefully deny people, OR people who recently
ReplyDeleteLost their jobs or were sick with Covid and lost their jobs but somewhat recovered are not disabled. Let’s use some critical thinking here. Everything is not a conspiracy or a systematic failure. This isn’t the first time waves of new apps haven’t equaled waves of new allowances.
@5:12
ReplyDeleteI see these DDS decisions first hand. They are systematically denying claims that were easy wins a few years ago. At the NYS DDS They are doing this via vocational findings and unsupportable RFC determinations. Our firm represents a large % of corrections officers in New York State, so I have large sample size of the same case type to support my opinion. Age 55+ correction officers were our most common source of DDS approvals pre-2021. The vast majority were wins, and they were highly predictable because the claims often start with years of Workers Comp Medical, including independent medical exams that use SSA's same exertional definitions.
Here is what DDS is doing--they are ignoring favorable Workers Comp IMEs and favorable State agency consultative reports, and assigning ALL of these Correction officers a light RFC. This is even the case where very detailed and credible WC IMEs are limiting the claimant to sedentary work. Second, where a light RFC would have lead to favorable decision a few years back due to lack of tranferability of skills, they are now finding transferability of skills to jobs like security guard. Frankly, I have less of problem with this particular vocational finding, but I have noticed far less supportable vocational findings in other cases. A marked shift compared to a few years back.
The biggest issue is the state agency medical experts. They have become defacto single decision makers. The opinions from the last 12 months simply do not follow the regulations and provide bare bone RFC explanations, often using the same boiler plate justifcations over and over. They are overiding far more supportable WC IME opinions, and their own state agency consultative examiners--again with zero explanation.
It is impossible not to notice this shift because I now tell clients that I have no idea what there chances are at the DDS levels (even when I have access to ALL WC medical). This was not the case a few years back. Fortuatley, all of these cases are getting approved at the hearing level, but I am noticing more an more dysfunction with 1 of 2 OHO offices I deal with most frequently.
Got to love the SSA employees, members of Congress, ALJs, etc that claim that my case is "anecdotal," as if that means it's an outlier... one of a hundred, one of thousand? But, you really don't have to look too hard to find similar cases at Federal Court, in comments left by others, on this blog by their lawyers. What is anecdotal? Maybe the stories of how difficult the work situation is at SSA...are those systemic, or merely anecdotal? Is it really a lack of funds, or poor management of those funds? All I know is I had two ALJs and two decisions. Kamala love Vin Diagrams. Well, these 2 decisions seem to have no overlap. It seems unfeasible that they were talking about the same person, with the same disabilities, based mostly on the same evidence. I don't know if that is systemic, or anecdotal.
ReplyDeleteThen Tim, by your logic, the reports of fraudulent cases where people are getting benefits but can work that are "anecdotal" proves the system is full of fraud.
ReplyDeleteAs I approach my second decade as an ALJ, my answer to why is this happening is things are changing.
ReplyDeleteMedicaid expansion means people who once received little to no treatment until they were really bad off now end up receiving medication or surgery or physical therapy or counseling and are not obviously disabled. The worst place to be in review is to be the person who can work at least 32-36 hours a week and the question becomes how often and how consistently can they hit 38 hours a week on average, just enough to be within employer tolerance for absences.
A lot of people who would have applied for disability in their circumstances four years ago now are in an economy where most suburban and metro area employers are struggling to fill unskilled and semiskilled positions. There is enough desperation among employers to accommodate limitations. More are willing to hire people to work 28-36 hours. If you can make $1600 a month working under 40 hours, chances are disability is a bad financial deal for you as long as you keep pushing.
If US employers would wake up and stick stools in cashier work stations even fewer would apply.
More employers offer at least some tele commuting. Not spending an hour each day in a car or riding a bus makes the workday easier. Being able to work from home partially reclined or with feet elevated means people who can’t sit at a typical work station can keep working.
I am seeing more claimants with no SGA the past 15 years, more with a date last insured in the past. I see more claimants with past denials. I recently awarded benefits to a person with a handful of past denials. Only thing different this time was filing after the 55th birthday.
I’ve always had cases like these but they are a larger part of the docket.