What Astrue Didn't Talk About

I have given summaries of what Commissioner Astrue said at last week's Senate Finance Committee hearing. It is worth listing some things he did not talk about, or at least did not talk much about.

• Any plan for quickly working off Social Security's enormous backlog in holding administrative hearings. Even though Astrue has apparently been told if he does not come up with a plan that Congress may enact statutory time limits on holding hearing and issuing decisions, the best that Astrue can come up with is a plan that maybe, possibly, hopefully would reduce the backlogs to a near acceptable level in five years, but no guarantee on that.
  
• The "brute force" approach to eliminating Social Security's backlogs that the Commissioner had talked about at his confirmation hearing. Astrue used this phrase once. He did talk about increasing Social Security's workforce. However, in general, Astrue concentrated upon management approaches to reducing backlogs, an approach which has failed miserably in recent years.
• Any modeling of what could be done at Social Security given various budget funding levels. Astrue seemed to be promising exactly this at his confirmation hearing, but stayed away from this subject last week.
• The Social Security Administration's own recommended budget for fiscal year (FY) 2008 of $10.44 billion.
  
• The Congressional budget for Social Security which will probably be about $10.1 billion for FY 2008. Astue wanted only to talk about President Bush's much lower proposed FY 2008 budget for Social Security, even though it is a dead letter. Astrue continued the, at best, unprovable line first advanced by his predecessor that there would be no backlog problem if Congress had just adopted President Bush's budgets for Social Security over the years. I think most knowledgeable people just roll their eyes at that one. Why is Astrue so concerned with deflecting responsibility away from President Bush? Astue is supposed to be independent, unconcerned with making Bush look good or bad.
  
• Social Security's budget for years beyond FY 2008. Should he not already be lobbying for the FY 2009 budget and beyond?
• Any plans for dealing with Social Security's staffing shortages at its Field Offices, Teleservice Centers and Payment Centers.

OIG Report On SDW

Social Security's Office of Inspector General (OIG) has issued a report on Phase 6 of Social Security's Special Disability Workload (SDW).

So what is the SDW? SDW concerns 466,000 SSI recipients who appeared to be insured for Title II benefits, but who were not getting those benefits, basically as a result of the agency's failure to take all appropriate claims. As a result, more appropriated funds were spent on SSI benefits and those people, most of them disabled, did not receive all the benefits they were due. Many were underpaid by huge sums of money.

The SSI recipients entitled to SDW review were identified through computer searches of Social Security's databases. Social Security started working through those 466,000 cases in 1999 and is still not finished. This report has only to do with some of those scheduled for SDW review who could be properly excluded from review by a more advanced database search, but the report gives a good background on SDW. The public has paid little attention to SDW, but it has been and remains a very big deal for the Social Security Administration and for the affected claimants.

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To Recap The Astrue Plan

Here is my recap of what Michael Astrue, Commissioner of Social Security, announced as his plan for dealing with Social Security's enormous hearing backlog, with my comments in brackets after the items of his plan:

• Wants to get the caseload per ALJ down to 360 cases with a processing time of 250-275 days. [That's the best you can do as a goal! Historically, the processing time has seldom been as high as your goal.]
• Most aggressive timeline for eliminating backlog is five years. [Gee, with an unlimited budget, I promise I could do it in less than two years.]
• Hire enough Administrative Law Judges (ALJs) to get to 1,250 ALJs in fiscal year (FY) 2008, which ends on September 30, 2008. [Why not more? What is the plan for more ALJs beyond FY 2008?]
• Appoint Senior ALJs and bring in some ALJs who have been working in other agencies. [Trivial, especially considering that the plan, apparently, is to only let the Senior ALJs work at the Office of Disability Adjudication and Review (ODAR) central offices in Falls Church, VA. Those who would be interested in working -- but somewhere else -- are apparently to be told that they are not needed. Why?]
  
• Hire more ALJ support staff. [Definitely needed]
  
• More overtime at hearing offices. [Definitely needed, but overtime is expensive.]
  
• Hire 492 personnel at hearing offices in this fiscal year. [Not bad, considering Social Security's budget, but not enough to replace normal attrition.]
• Reduce the number of aged cases, basically working first on the oldest cases, to get that number down. [This helps equalize the hardships, but does nothing to reduce the overall backlog.]
• Compassionate allowances. [Apparently nothing more than a new name for Quick Disability Determinations, which was little more than a new name for procedures already in place for quickly approving the most obvious allowances.]
• Going to paperless files as quickly as possible. [Has anyone noticed productivity gains from paperless files? It may be useful in the long run, but it is not doing anything about the backlogs, other than to make them worse in the short run.]
• Directly place documents into the e-file that currently have to be printed and then scanned, such as earnings records and appeal forms. [It is an indictment of the eDIB system that this cannot already be done.]
• Provide shared access to electronic folders. Now, when the Appeals Council remands an e-file, it has to be printed out. [It is a terrible indictment of eDIB that this is not already possible.What is the point of eDIB if everyone cannot share the same file?]
• Allow attorneys to access their clients' files online. [That would be great. Will Michael Astrue still be Commissioner of Social Security when this become possible?]
  
• Will streamline "pulling" exhibits for remaining paper files. [Tell me more -- much more.]
• Authorizing ALJs to hold hearings on unworked files. [They were already authorized to do this. Why not require ALJs to hold hearings on unworked files? Astrue does not mind upsetting the ALJs by saying he wants legislation to give him more control of ALJs. At least demanding that ALJs hold hearings on unworked files is for a good cause.]
• Discourage claimant attorneys from submitting duplicate medical records. [Giving attorneys earlier access to their clients' files would help -- but only so much. We are talking about basic human nature here.]
  
• Wants e-pulling of exhibits. [It will never work. This will just waste money. Some things take manpower. This is one of them.]
  
• Will study senior attorney decisions. [He must study this because he needs the approval of the Office of Management and Budget (OMB) for new regulations. My guess is that OMB will not approve, because if they were going to approve, they would have done so before the hearing. Of course, Astrue could have gone ahead with senior attorney decisions without OMB approval, simply by labeling those decisions as reconsideration decisions, but that might have annoyed OMB. What is the problem with OMB approving senior attorney decisions? It will lead to more claimants being approved more quickly. If you think about why OMB would not like that, you begin to understand why Astrue's plan is not more aggressive.]
• Wants each ALJ to issue 500-600 decisions per year. May increase this to 500-700. [Why not just make the number 1,000 a year and solve the problem that way? I am being sarcastic. Quality has long since been sacrificed to get to the current production level. No further productivity gains should ever be asked of ALJs, in my view, since I believe that we are already well past any realistic limits on what will ever be possible without sacrificing quality, no matter what technology is deployed. Assuming that further productivity gains can be ordered from above is folly.]
• Update technology at hearing offices. [Fine, but every dollar spent on technology is one less dollar spent on more warm bodies to get the work done. On the whole, I would rather see Social Security err on the side of less technology and more personnel. Technology is a one time purchase. New employees keep costing money and are hard to get rid of. OMB prefers to avoid new hires.]
  
• Use computer generated profiles to determine which cases can be reversed on the record, that is, approved by an ALJ without a hearing, and which cases can be allowed with further development and which cases can be remanded to reconsideration for allowance. [Basically, this is re-recon. It worked in the past and should work now. Get it going quickly!]
• Use medical expert (MEs) witnesses who work with ODAR offices to screen cases for possible on the record reversal. [Interesting, but there is one huge problem. Social Security has few of these MEs available anymore since they have not raised the rate they pay MEs in many, many years.]
• Open National Hearing Center at ODAR central office in Falls Church, VA. [Foolish idea that does nothing about the backlogs. Because Social Security does not trust ALJs, it wants to have them close by agency brass so they can be carefully supervised. That has been the plan for Medicare ALJs. Bad idea.]
  
• Centralize printing of ODAR notices. [Sounds like over-centralization to me.]
• eScheduling of hearings through the use of electronic calendars. [Could be useful, but I am not sure that there is enough potential productivity gain to justify implementation at a time when staff is already stressed out by workloads and an overload of change.]
• Make the Findings Integrated Template (FIT) method of drafting ALJ decisions mandatory.
  
• Allow electronic signing of ALJ decisions.
  
• Develop a quality assurance program for the hearing process. [Where have I heard this idea before? This keeps getting mentioned but never happens because there is no way of defining quality much less measuring it. Even if you could define it and measure it, trying to do so would almost certainly violate the Administrative Procedure Act.]
• Enhance Hearing Office Management Information System. [So you can get accurate, timely and depressing reports on just how far behind you are.]
  
• Wants legislation giving Social Security more authority over ALJs. [Why, why, why does Astrue want to waste time and effort on this. It should not happen and it will not happen. The ALJs have far more credibility than Social Security management does. Congress will never give Astrue this kind of power. Get over it!]
  
• Co-locating future remote hearing sites with field offices. [Mildly useful, maybe, but it really does nothing about the backlogs. Without a separate entrance for each remote hearing site, there will be many complaints from ALJs, attorneys, and claimants.]
• Wants to get video equipment in all hearing rooms. [In general there are already enough hearing rooms equipped for video to cover the need. More video rooms costs money which could be better spent on more personnel. Quit looking for technological fixes. Astrue was on the right track when he were talking about using "brute force" to deal with the backlogs.]
• Wants to redraft the Listings of Impairments to add more conditions so that more people would be approved as meeting the Listings. [I will believe this when I see it. This project will drag on until Astrue leaves office. In the end there will be virtually nothing to show for the effort. Sounds a lot like Barnhart's Disability Service Improvement plan in that regard.]
• Reorganize the Office of Disability and Income Support Programs. [Does nothing about the backlogs.]
  
• Field office personnel will be detailed to help the hearing offices -- 5,000 hours of work. [There is no excess capacity at the field offices. They have major problems of their own. 5,000 hours is a drop in the bucket anyway.]
• Develop a new case processing and management system for the Appeals Council. [Might be a good idea, but every dollar spent on technology is a dollar less spent on personnel.]
• Have Appeals Council issue final decisions whenever possible. [I thought they already did this.]
  
• Increase propagation of data from other parts of Social Security into ODAR's database system, known as CPMS. [If this were easy to do, it would have happened a long time ago.]
• Improve training for Hearing Office management teams. [More personnel would help these management teams look a lot smarter.]
  
• Encourage more cooperation and communication between Hearing Offices and other parts of Social Security. [Useful, but it does nothing about the backlogs. Those backlogs have nothing to do with failure of cooperation and communication.]
• Work with Office of Quality Performance (OQP) to standarize business processes regarding electronic folders. Apparently, this will involve something like time motion studies gathering data on how much time is taken on each function at a hearing office. [Quit dreaming that you can manage your way out of this hole. The task can be accomplished with "brute force."
  
• Establishing production standards for decisionwriters and produce a lot of reports on decisionwriter productivity. [I thought that productivity standards were already in place. Reports take time that could be used to write decisions.]
  
• Re-align hearing office territories to balance workloads. [I thought this had been happening since forever.]
• Continue inter-regional transfers of cases. [There should have been more of this. There has been way too little regional cooperation, leading to significant backlog imbalances between the regions.]
• Requiring management reports from ODAR offices on a weekly basis instead of a monthly basis, because now much of the work seems to get done at the end of each month.
• Develop a better process for dealing with complaints of ALJ misconduct. [If it were easy, it would have already happened. Does nothing about the backlogs]
  

Enormous Expansion Of Social Security

In what may be the largest expansion of any country's Social Security system in history, the UPI reports that the Indian government plans to expand its Social Security system to cover 390 million non-union workers who had not previously been covered. Those making more than $160 per year will have to contribute 1 cent per day. The Indian goverment will make the contribution for those making less than $160 per year.

An Image From 1989

Social Security Hearing Backlogs Draw Criticism In Seattle

I had earlier posted about the story that Seattle television station KING did on the hearing backlogs at Social Security. Readers might want to take a look at the often emotional responses that story received on the KING website. Has the depth of the anger and outrage over these backlogs has registered with Commissioner Astrue?

Public relations and a Republican Congress that was willing to look the other way allowed former Commissioner Barnhart to get through her years as Commissioner without treating this as a crisis. Michael Astrue is nowhere near as good as Barnhart at public relations, but it is way too late for public relations to work anyway. A Congress controlled by Democrats is not going to let go of this. Sooner or later there is going to be a crash program to get these backlogs down. Michael Astrue could try to get out in front but at the moment, it looks as if he will have to be dragged kicking and screaming into creating a crash program, most likely with statutorily imposed deadlines, or at least the threat of them.

Buffalo News Editorial On Backlogs

The Buffalo News has run articles and editiorials about the terrible delays experienced by Social Security disability claimants in getting hearings on their cases. Here are a couple of excerpts from an editorial the newspaper is running today:

Bow your heads and pray tonight that you never have to claim Social Security disability benefits. Not only would that mean injury, but injury compounded — by the long stretch of years it can take to collect. ...

Much, if not all, of this despair could be alleviated if Congress would stop cutting into Social Security Administration funding, leaving the agency with too few resources to keep up with the flood of applicants. Buffalo is one of the worst, as claimants typically wait nearly two years for an appeals hearing.