It Keeps Getting Worse

     From a recently released report:

From Social Security's Freedom of Information website

Disability Examiner Losses

 

From a report by Social Security's Office of Inspector General

NADE Newsletter

     The National Association of Disability Examiners (NADE), whose members work at state agencies making disability determinations at the initial and reconsideration levels for Social Security, has released its most current newsletter, concerning its National Training Conference in Oklahoma City in August. Presentations by John Owen, Associate Commissioner of the Office of Disability Determinations, Hope Grunberg, Associate Commissioner of the Office of Disability Policy (ODP), Ben Gurga, Deputy Associate Commissioner of ODP, Kasey Torres, Director of the Division of Disability Quality and Kevin Huse, Deputy Assistant Inspector General For Cooperative Disability Investigations are summarized.

Some Pics

     The Commissioner of Social Security, Martin O'Malley, visited Raleigh yesterday for an event at the Governor's Mansion to celebrate the 70th anniversary of North Carolina's Disability Determination Service (DDS). My partner and I received an invitation to the event. Here are a few pictures. 

    First, me with Commissioner O'Malley:

    Second, a picture of my partner, Crystal Rouse, with the Commissioner:

    Next, a picture of Rose Mary Buehler, the Regional Commissioner for the Atlanta Region, myself, Joseph Lytle, the Deputy Commissioner for Hearings Operations and Crystal.

    Finally, a picture of the NC DDS employees in attendance.

    The venue was not large enough to accommodate the entire workforce at NC DDS.

State Disability Determination Services Processing Times

 

SSA Stops CDRs For The Remainder Of The Fiscal Year

     From Emergency Message EM-24021:

With the enactment of our full-year appropriation for this fiscal year, we are lowering our Full Medical CDR t[Continuing Disability Review] arget from 575,000 to 375,000.

This reduction will allow DDSs [Disability Determination Services] to focus on processing Initial Disability Claims and Reconsideration cases. The field offices will not send additional Full Medical CDRs to the DDS for the remainder of FY 2024. ...

Do not assign unassigned CDRs pending in your receipt or staging queue. DDS should take no action on the unassigned Full Medical CDRs. ...

Age 18 Redeterminations:

If you have sufficient evidence in file at the publication date of this emergency message, make the Age 18 Redetermination.
If the evidence in file at the publication date of this emergency message is insufficient to make the Age 18 Redetermination:
a. Do not initiate additional development, such as requesting medical evidence of record (MER) or school records;
b. Do not schedule for consultative examinations (CE); and,
c. Do not assign to medical or psychological consultant(s) for review. ...

Interview With The Commissioner

    From things said by Social Security Commissioner Martin O'Malley during an interview conducted by reporter Lisa Rein of the Washington Post:

... I wasn’t asked to come here because everything was going great, right? We’re in a customer service crisis; that cannot be denied. ...

There is a theme running through this stuff [I've done]: It’s small.

[W]e executed on a bunch of little short-term, quick wins. Our new general counsel has probably said yes in 60 days more than any [Office of General Counsel] leader has said in 10 years. ...

I have been unpleasantly surprised by how dire the staffing situation is. ...

[W]e’ll be rolling out an action plan for the remainder of the year that will better organize over 150 actions under 21 initiatives, all of which are intended to take a bite out of these processing times [at Disability Determination Services]. ...

Clearly we need a more modern assessment of the widely available occupations out there [used in disability determination]. And we are taking a fresh look at this project [to create a new occupational data system], and at what we forecasted we might have to spend. ... Many members of Congress expressed their concern about the amount of money that we have put into this and the amount of time that it has taken. There’s still a systems component, and that also has a price tag. I would say it’s a big policy issue. There will be some winners, some losers. ...

Deep Red In More Than One Way

 

From a Social Security fact sheet

You Get What You Pay For

     Social Security has decided to post a Freedom of Information Act response they've given showing the rates at which the Alabama Disability Determination Section (DDS) paid for medical examinations and some other things they ordered. This is from 2020 so it's a bit out of date but take a look. I'm only posting the first page here. The whole thing which runs to 20 pages is linked above. The last page may surprise you a bit.

    Don't these rates seem a little low -- or maybe a lot low?

Click on image to view full size

Perfect Timing?

    Wouldn't now be the time to end the reconsideration step in Social Security disability determination? Over the years the objection to doing that has been that that it would throw too many cases to the hearing level but at the moment the backlogs are enormous at the initial and reconsideration steps and quite low at OHO. Doing it now would kill two birds with one stone. You'd dramatically reduce the backlogs at DDS and you'd give OHO something to do at a time when they're rapidly running out of work. It would create the "drinking from a fire hose" problem at OHO but I'd rather see that than have OHO lacking work while DDS struggles. 

    By the way, I have a vested interest in seeing this come to pass since I have a vested interest in seeing Social Security disability claims resolved expeditiously. Is that a bad thing?

 

This Is What's Going On At Ground Level

    Here's a note made recently by an employee at my firm about a pending disability claim that may give you some idea of the state of service at Social Security :

TC [telephone call to] ____ DO [District Office] and she said there is an initial claim that has been sitting there since 7/14/2023. She is sending it to the CR [claims representative] Mr. ____ but he is off.

    In case you don't understand the context, the DO only takes the claims. They don't make medical determinations. Those are made at Disability Determination Services (DDS). Under normal circumstances -- which don't currently exist -- new claims are forwarded from the DO to DDS in a week or two. Even if there is some technical problem, the claim isn't supposed to be sitting at a DO for six months! 

    For this to happen there has to be no effective tickler system at the DO. I'm sure there's supposed to be one but it's broken down entirely under the enormous pressure of overwhelming workloads.

    I'm not even mad at the personnel involved because I have an idea of just how overwhelmed they are.  If a case happens to fall by the wayside now, we're just about at what I've described before as the "Not now. Not later. Not ever" stage of service. Problems aren't being straightened out.

    And please don't blame my firm. We've been trying for three months to find out what happened to the case. It's almost impossible to get anyone on the phone. There's no smart trick that solves cases like this. There's far too many of them. We're not supposed to be Social Security's tickler system anyway.

Initial Processing Backlogs

     Social Security has released numbers showing the backlogs at the initial level on disability claims. This is from more than six months ago but I don't think there's been significant improvement since. The situation may be worse. The processing time is expressed in days. You can click on the images to view them full size.

OIG Report On Pandemic Effect On DDS Processing Of Disability Claims

     From a report by Social Security's Office of Inspector General (OIG) on the effects of the pandemic on processing of Social Security disability claims:

While SSA received fewer initial claims during the pandemic, it took the DDSs [Disability Determination Services] longer to process them than the year before. Before the pandemic, DDS’ average processing time for an initial claim was 95.5 days. This increased to 139.4 days and 135.5 days, respectively, during the first and second years of the pandemic. Numerous factors contributed to this:

• CEs - The number of CEs [Consultative Examinations] performed during the pandemic decreased, as SSA suspended in-person CEs for a period of time. Once DDSs resumed in-person CEs, they still had issues scheduling CEs because for example, (1) not all CE providers returned to conducting CEs and (2) claimants refused to attend in-person CEs because of fear of exposure to COVID-19.
• DDS Staffing and Training – About 4,000 DDS employees resigned or retired during the pandemic, but DDSs hired 4,305 employees during this same time. However, it takes a newly hired disability examiner an average of 2 years to become proficient at processing most initial claim workloads.
• Telework and Communication with Claimants – During the pandemic, most DDS employees teleworked, so the DDSs needed to adjust to how they processed certain workloads. SSA provided the DDSs with basic cellular telephones to communicate with claimants, but claimants were wary of answering the calls as the telephones’ caller identification did not show the incoming call was from a state agency.
• Policies and Procedures – During the pandemic, SSA updated policies and procedures on how the DDS should operate. The updates included combined instructions with the field office, which confused some DDS employees about what pertained specifically to DDS processes.

Over 1 Million Waiting

     The Deseret News in Utah reports that over one million people are waiting for Social Security to act on their disability claims. 

    They include state rankings showing the percentage change from 2019 to 2022. Here are the top ten worst states:

1. Florida = 156%.
2. South Carolina = 147%.
3. Texas = 142%.
4. North Dakota = 132%.
5. Wisconsin = 130%.
6. Kansas = 128%.
7. Arizona = 120%.
8. New Hampshire = 114%.
9. Mississippi = 111%.
10. Georgia = 98%

    Now here are the top ten best states. Note the actual improvement in six of them:

1. Connecticut = 7%.
2. Minnesota = 5%.
3. Washington, D.C. = 2%.
4. Missouri = <1%.
5. Nevada = <-1%.
6. South Dakota = -4%.
7. Rhode Island = -11%.
8. Oklahoma = -11%.
9. Washington = -11%.
10. Vermont = -21%.
11. Alaska = -51%.

SSAB On DDS

     The Social Security Advisory Board (SSAB) has issued a 27 page report titled Social Security and State Disability Determination Services Agencies: A Partnership in Need of Attention. It's mostly descriptive. It does say that the DDS's are "struggling" and that " ... the Board believes long-standing frictions between SSA, state governments, and the DDSs call for ongoing review of how SSA and the DDSs work together and how the agency incorporates DDS needs into its overall strategic, performance, workforce, and contingency plans. ..." There's nothing I'd call a recommendation in the report.

More On President's Proposed Budget

     Some highlights from the President's proposed administrative budget for the Social Security Administration:

• Office of Inspector General would get only about a 5% increase in its operating budget. The rest of Social Security would get about 10%.
• "The Budget includes an increase of $60 million for teleservice centers to reduce wait times by over 40 percent and substantially reduce busy rates from 15 percent to 3 percent."
• "Addressing Processing Center Backlogs. The Budget includes an increase of over $75 million for PCs to handle more work."
• "To address the large backlog of initial disability claims and the additional claims we expect to receive in FY 2024, the Budget expands processing capacity by increasing staffing at the DDS offices. As a result, we expect the DDSs to process over 400,000 more initial disability claims and over 200,000 more reconsiderations than in FY 2023."
• Average processing time for initial disability claims would go down from 220 days to 195 days.
• Average processing time for reconsideration disability claims would go down from 224 days to 193 days.
• Average processing time for hearings would go down from 475 days to 320 days.
  

And remember, this is only a proposal. Congress must act on it and Republicans are saying they want dramatic cuts in agency budgets.

Bad Conditions In Wisconsin -- And Most Other Places

     From some television station in Milwaukee:

They can’t work, have little money to fall back on, and are waiting months for the approval of [Social Security disability] claims that could put a roof over their heads. The delays are impacting some of Wisconsin’s most vulnerable. ...

Back in 2019, it took 116 days on average to get an initial disability decision in Wisconsin. Today, it takes 247 days on average. Decisions are made by the Disability Determination Services (DDS) in Madison. ...

Doug Nguyen, regional communications director for SSA, tells Contact 6 they’re working to "reduce the backlog of disability cases that developed during the pandemic." However, he says they need "adequate and sustained funding."

Nguyen says SSA received 55% of the increase President Biden requested for its administrative budget in 2023. He says SSA has experienced historically high attrition at DDS locations and is having difficulty hiring new workers, "similar to the larger labor market."

Wisconsin Department of Health Services (DHS) also blames a transition mid-pandemic to a new federal system for processing disability claims. A DHS spokesperson says Wisconsin’s old system was more efficient. ...

Disability Backlogs Are Cruel

     From the Milwaukee Journal Sentinel (paywall):

A hospital social worker helped Nicholas Johnson fill out dozens of pages of paperwork for Social Security Disability Insurance in September after he woke up from a coma and realized he was paralyzed. ...

Johnson missed two phone calls from the Social Security office while he was in physical therapy. He started the application process over, for a third time, in early January. 

With no income, Johnson can’t pay rent, so he moved in with his grandmother. But her home is too small to accommodate his wheelchair, so family members come over daily to carry him from room to room. ...

Johnson is one of more than 2,000 people in Milwaukee waiting for the Social Security Administration's approval to receive disability benefits, according to the latest data available from the agency. The average wait time is 368 days, leaving many people struggling without adequate housing or money to pay for their basic needs for more than a year. ...

Hope Lloyd is a community living and home supervisor with Independence First who is working with about a dozen people in Milwaukee with spinal cord injuries who haven't been able to get their first disability checks, so they are living in nursing homes or with family. 

"It's not where they belong, but without those expedited payments, they can’t  apply for an apartment because they don't have any income," Lloyd said. "A lot of times, they're the primary breadwinner, so it's just really, really bad." ...

At the state level, the Wisconsin Department of Health Services said a mandated federal update to its computer system in late 2019 further pushed wait times. 

"Wisconsin’s legacy system was superior to the current (federal) system because it included more automatic prompts for examiners that made it easier for them to manage their very high caseloads," said Jennifer Miller, a spokeswoman with DHS. 

Miller said examiners receive specialized training that takes more than two years to become fully proficient.  

"As a result of increased evidence, increased scrutiny, continuously growing case complexity, and a new nationwide case processing system rollout, case production has become more labor-intensive and slower," Miller said. "Adjudicators’ case counts have increased significantly, and the job has become untenable in many states. ...

New Disability Claims Filed Up Slightly But Number Awarded Benefits Continues Decline

     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.

At The Breaking Point

    From Lisa Rein at the Washington Post:

The Disability Determination Division in Austin was at a breaking point.

Inside its vast two-story warehouse, close to 130,000 claims were awaiting review by the state employees who help decide whether Texans will get disability benefits from the Social Security Administration — a backlog that would take at least a year to clear. Nearly 40 percent of the examiners had quit since January, driven out by crushing workloads and low wages that could not compete in the high-tech boomtown. Those who stayed toiled in long rows of cubicles or at home reviewing massive medical files.

Then one week in September came the unthinkable: 75,000 new claims suddenly were routed to an electronic queue already buckling under 2½ years of strain during the coronavirus pandemic. ...

The data obtained by The Washington Post paints a grim picture of the holdups claimants are confronting across the country. In Texas, it took 214 days on average in fiscal 2022 to process an initial application. Wisconsin took 227 days, up from 90 days in fiscal 2019. Florida’s average time has almost tripled to 225 days. Georgia is taking 246 days. And Delaware now holds the record for the longest wait: 261 days. The pileup of cases has driven a normally three-month wait for an initial review to at least seven, the data shows. But in states struggling most to catch up, it’s taking well over a year. ...