The Social Security Advisory Board (SSAB) has done a study on Effectuation of Disability Benefits. It shows that there have been major increases in the time it takes to effectuate disability benefits, particularly SSI benefits. These delays are cruel. The claimant has already been found disabled. He or she is poor enough to qualify for SSI yet must wait many months to receive their benefits. That's wrong.
Below are a couple of charts from the report showing what has happened. Note that the SSAB couldn't obtain good data from Social Security. They had to rely upon data from a large non-attorney representative group. That tells you that this hasn't been enough of a priority at Social Security to even collect good data on it. In addition to giving us an idea of the scope of the problem, the data also gives us an idea of the size of that non-attorney representative group.
13 comments:
The data may be correct but there's no conflict of interest getting the data from non-attorney representatives.
Plus, attorney and non-attorney cases generally took longer to process than other cases. Not to excuse poor service but the numbers look bogus.
There is another subgroup of cases with delays in processing much worse than here.
In cases that are Court Remands where the case is now approved after a new hearing, the typical time to process the actual payment to the claimant, let alone anything to the representative, is at least six months at best to over a year in some cases. The problem is that all such cases for people under 54 are processed in a special unit in the Baltimore PSC. PSC 7. It is so bad, that I have been told by OGC counsel that they are aware of the problem since they hear from representatives who handles the case with them in Court and even if they try to move it along, which is not really their job, they are just told it is a staffing issue.
Given that each of these case is a minimum of three years from application given they went to District Court and are now back and some are more than five years in the process.
And for fees in such cases, there is another six months to a year after the award letter before any fee is approved and paid.
Not saying there’s not serious problems, there are, but this data is bogus. Effectuation time is called FO2 time for SSA personnel and it’s not hundreds of days in any office. A poor office might be 40-50 max. This is tracked closely dnd there’s tons of MI on it. These are likely cases where the FO forgot to pay the attorney and the attorney spent months trying to get the fee but that doesn’t mean the claimant didn’t get paid yet. Again not defending it just saying
I concur with the post at 4:53 pm. I have eight USDC Court remand cases stuck in PC 7, and the oldest has a March 2023 favorable decision date, the others from the summer of 2023. Requests from the Congressional liasons in our districts are no longer helping move the cases forward. In one of the cases, the June 2023 decision came from the AC after Court remand and the PC7 miracuously issued the Title II Notice of Award in August, but mistakenly effectuated the case as a "closed period" case. Since I was still within the appeal period, I ended up filing suit in USDC and then engaged in lengthy discussions with the SAUSA regarding what I was trying to get corrected. That was the only thing that moved the case. The SAUSA was able to get in touch with his "client" and the PC7 issued a corrected Notice of Award in November 2023. Of course, since that corrected notice, my client still hasn't been paid the very large PDA, and the SSI side has not even effectuated a notice so that the offset could be done, despite my client having gone through the PERC interview in June 2023.
When the same people who process SSI allowances are spending all of their time processing RZs and LIs there is no time left to process allowances. It is sad that the workload designed to kick people off benefits receives the resources but actually helping people gets neglected.
5:21, does FO2 time include cases effectuated in PCs? Or those awarded by OHO or the AC (including court remands)? And does it track when the claimant is put into pay or when they also get their back benefits?
5:21 is spot on correct on all points. The only thing I would add: the declining aggregate expertise of FO adjudicators means they likely aren't proficient in processing attorney fees. This is a separate action from effectuating the allowance. The allowance is tracked closely and once the case is paid, the heat is off. Processing the fee is done much later.
10:54 - FO2 time refers primarily to SSI only cases, for which this post was honing in on. FO2 time is from the date of allowance to the date the case is effectuated - when the retro underpayment is computed and monthly benefits initiated. It does not address the disposition of the payment of the retro benefit.
It doesn't speed up processing on the PC7 Court Remand cases when attorneys send in fax asking for the status of the case. It usually slows processing down.
The cases are worked based upon the age of the oldest action control record (ACR), which is the ACR set up for the Court Remand . When fax is received for the status of the case, that sits in the processing backlog until the Court Remand ACR is pulled to be worked. At that time the technician has to look through all the faxes too, which adds time the processing of each case.
What would help is if the attorney would contact their client and get updated direct deposit info, and fax that in. That is useful info and would speed up processing. Old bank data cannot be used.
10:06, is it your experience that people get put into pay at the same time the retro is processed? Anecdotally, it seems that the monthly benefits often start quickly, but the retro can be delayed months (maybe because they're figuring out the attorney's fees? or because after doing what's needed to get a decent FO2 time, FO employees don't want to spend time on the additional inputs needed to release the retro? hard to tell from the outside).
8:46, it's interesting that HALLEX indicates Title II favorable court cases for people over age 54 go to PCs 1-6 https://www.ssa.gov/OP_Home/hallex/I-04/I-4-7-30.html; are they then sent to SAES? Seems like it would be useful for SSA to put some information or a form about submitting updated bank info into the notice with the favorable decision. Or at least put it on SSA's website with best practices for reps. Is the fax number for SAES available online? https://www.ssa.gov/representation/pct_contact_info_under54.htm has a fax number for PC7 (though they list it as being for claimants under 54, no mention of court remands) but I don't know if faxing to that number would get info to SAES, and bank account info is pretty sensitive.
4:34 SAES court cases over age 54 go to PC1-6. But PC7 SAES gets the bulk of the court and court remands because most disability claimants are younger than age 54.
PC7 SAES; ACRs sit in CA PROC for months after the ALJ court remand decision. ACR reaches a certain age and is assigned to a Claims Specialist, who inputs an EF101 award. Then the ACR goes to BA PROC where it sits for months before it gets assigned to a Benefit Authorizer who inputs the payment action.
That would be a good idea to place a sentence in the ALJ decision about providing updated bank info, Otherwise the technician has to call the claimant and then delete bank info if they don't answer the phone and a paper check is issued,. Few want a paper check these days.
@4:34
When the allowance is processed, it initiates monthly benefits, calculates the retro and releases the award notice. This is the point when FO2 time stops. Unless the retro is small, it is a separate action to pay it out. Large retro benefits amounts require a peer review, which is an unavoidable delay.
If the CR is really under the gun, running to put out one fire after another, they may just pay the claim to relieve scrutiny on a pending allowance. The payment of the retro will sit, until those age enough to become an item of scrutiny. Many attorney fees are calculated by automation these days, so that is not the cause for the delay.
The stress of short staffing, inexperienced staff, phones, lobby, pending cases, scrutiny from the RO can cause CRs to adopt a tunnel vision of focusing only on one urgent action at a time, instead of seeing cases in a process to be completed. It may be also a given office may have an entirely separate CR process retro payments and attorney fees, not the person who processed the allowance.
I hope this makes sense.
10:15, very interesting! SSA put out an EM today increasing the amount of retro that requires prepayment review from $5000 to $15,000 so maybe that will speed things up for some cases (probably those awarded at initial and maybe recon, though with the DDS backlogs some of those likely took long enough to exceed $15k in retro). https://secure.ssa.gov/apps10/reference.nsf/links/03152024072331AM
7:58, a minor point in your very informative post but the bulk of DI awards are not to people under 54...https://www.ssa.gov/policy/docs/statcomps/di_asr/2022/sect03c.html says 56.3% were over age 55 in 2022.
SSI is different because there are so many kids and 65+ claims that only about 22% of SSI awards are to people age 55-64 but those wouldn't be at PCs anyway.
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