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?

 

As Long As It Saves Money, It Has To Be A Good Thing

     From a recent report by Social Security's Office of Inspector General (OIG):

... 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."

How Much Disability Adjudication Costs At Each Level

     From Improving the Social Security Disability Determination Process by Jack Smalligan and Chantel Boyerns for the Urban Institute:

Click on image to view full size

     This report recommends improving the reconsideration step although it is vague on what an improved reconsideration step would look like. 

     Over the decades that I've been involved with the Social Security disability process the reconsideration stage has been remarkably stable. Apart from experiments with eliminating it, recon just hasn't changed over the years. My conclusion is that even though everyone knows recon doesn't make the system fairer, it still meets the perceived needs of Social Security policymakers by introducing an extra hurdle that reduces the number of people asking for hearings. If you're looking for any other reason for its existence or any way to improve it, you're looking in vain.

Appropriations Bill Moves Forward With Many Directives For Social Security

     The House Appropriations Committee has reported out the bill that includes the appropriation for the Social Security Administration's operations. As expected, it includes a $300 million increase for Social Security. This is barely enough to keep up with inflation. The Senate bill is likely to be worse for Social Security.

     As usual, the Committee report on the bill includes a number of directives for the agency, which start at page 228 of the report. This year's bill includes a high number of these directives. Here's a list:

• Prepare report within 60 days on Administrative Law Judge selection;
• Include more information in Beneficiary Verification letters;
• Prepare report on negotiations with employee unions;
• Encourage proper consideration of headache disorders in determination of disability;
• Prepare update for Committee on agency's information technology modernization;
• Brief Committee on mailing paper statements;
• Prepare report on utilization of Social Security programs by persons suffering from muscular dystrophy;
• Prepare report on occupational information system project;
• Prepare proper research designs for all pilot projects and prepare a report on all such pilots;
• Prepare report within 180 days on improving Disability Determination Services process, including addressing the role of the reconsideration stage;
• Stop the proposal to charge fees for replacement Social Security cards;
• Stop pursuing the plan to consider social media postings in determining disability;
• Strongly urges agency to not proceed with plan for mandatory video hearings;
• Provide report within 90 days on strengthening vocational expert program;
• Strongly urges agency to not go forward with proposed regulations that would eliminate inability to communicate in English as factor in determining disability.

     One thing that didn't make this long list is a directive to strongly consider increasing the cap on fees that attorneys and others can charge for representing Social Security claimants.

CCD Issues Position Paper On DDS Reform

     The Coalition for Citizens with Disabilities (CCD) is a large umbrella group lobbying and advocating in D.C. for persons with disabilities. The CCD is composed of about 100 organizations helping the disabled population. The CCD was largely ignored when Republicans controlled both houses of Congress and the White House. It becomes more important now that Democrats control the House of Representatives. 

     The CCD has put out a statement on Improving Decision Making at the Disability Determination Services. Here are a few excerpts:

... It is the position of the CCD Social Security Task Force that the state Disability Determination Services (DDS) should only review a claim one time and that the current second level of review they perform, called reconsideration, be eliminated. ...

Although the Task Force does not have a specific recommendation regarding what performance metrics should be for DDS employees, it is the Task Force position that the completeness of the file upon which the decision is based should somehow be included in those metrics. ...

[Social Security should] Consider creating impairment specific explanations and forms that claimants can provide to their physician and other treating sources outlining what information is most helpful to SSA in evaluating the claim and including the types of tests which help establish meeting the listing in question. ...

SSA should review more denials of initial claims. TDRs [Targeted Denial Reviews] allow SSA’s Office of Quality Review (OQR) to examine unfavorable decisions of disability claims issued by state agencies. Fewer than 3 percent of initial level denials receive TDRs; the number performed varies each year based on resources available to the agency. In comparison, Sections 221 (c) and 1633 (e) of the Social Security Act require SSA to review at least half of the favorable decisions issued by state agencies. ...

When Members Of The Ways And Means Committee Speak, Social Security Needs To Pay Attention

    There's an op ed in the Philadelphia Inquirer from an attorney with Community Legal Services, which has a distinguished history of Social Security advocacy, and two members of the House Ways and Means Committee, denouncing the long appeal backlogs at Social Security and the reimposition of the reconsideration step in Pennsylvania.

Senators Object To Reinstating Recon

     Ten Senators have written the Acting Commissioner of Social Security to urge that she not reinstate the reconsideration step in the disability appeals process. If they’re successful, I hope they’ll also urge that recon be ended in those states where it remains in effect. I think it’s time for the process to be the same in  all states using.