Workers injured on the job may qualify for DI [Disability Insurance] benefits in addition to benefits under Federal and State workers' compensation (WC) programs. However, combined DI and WC benefits could result in workers receiving more in disability payments than they earned before they became disabled. To prevent this, Congress enacted the WC offset provision under section 224 of the Act, which requires that SSA adjust DI benefits based on an offset formula set forth in that provision of the Act.
While SSA adjusts DI benefits based on an offset calculation, to protect DI beneficiaries with a continuous WC offset against inflation, SSA is required to re-compute the beneficiary's average current earnings (ACE) [a figure used in computing the workers compensation offset] on a triennial basis. This recalculation is known as a triennial redetermination (REDET). A REDET may result in increased benefits ...
A-04-07-17078 - Alternate Format In 2006, SSA identified 36,177 DI claims that required a REDET. As of June 30, 2007, SSA had completed 21,976 REDETs, from which we selected a random sample of 250 DI claims for review. To determine whether the REDETs were accurate, we
- reviewed all available documentation for independent proof of current WC rates,
- calculated the WC offset based on the current proven WC benefits data,
- compared the total benefits paid to the total benefits owed, and
- obtained SSA's review and comments for each payment error. ...
A-04-07-17078 - Alternate Format SSA did not always accurately process and calculate the 2006 REDETs in our sample. In total, 24 (9.6 percent) of the 250 sampled DI claims we reviewed had payment errors. Of the 24 claims, 19 had payment errors totaling $219,610 related to the WC offset calculation. Based on this error rate, for the 21,976 REDETs in our population, we estimate approximately 1,670 DI claims totaling about $19.3 million had payment errors related to the WC offset calculation. The five remaining claims, totaling $53,320, had DI processing errors unrelated to the WC offset calculation.
Also, 16 of the 24 REDET claims had payment errors that continued after August 31, 2007. Fourteen of these errors were related to the WC offset calculation, and the remaining two were unrelated to this calculation. Based on the number of continuing errors, we estimate that for the 12 months following our audit period, approximately 1,406 claims had payment errors totaling about $4.8 million.
Sep 18, 2008
Errors In Workers Compensation Offsets
A recent report from Social Security's Office of Inspector General (OIG) on workers compensation offset computations will come as no surprise to attorneys who represent Social Security claimants -- or to any Social Security employee who regularly deals with workers compensation issues. The computations are complex and Social Security makes plenty of mistakes. Some excerpts from the OIG report:
A-04-07-17078 - Alternate Format
Sep 17, 2008
Is E-Pulling E-Failing?
I had posted this earlier, but it was hidden in a much longer item. Let me pull it out for emphasis. From the statement of Kathy Meinhardt, Principal Executive Officer for Federal Managers Association Chapter 275, Social Security Office of Disability Adjudication and Review, Federal Managers Association (FMA), Minneapolis, Minnesota to the House Social Security Subcommittee:
Much of ODAR’s promise of increased efficiency is tied to the success of the ePulling initiative. According to the IG report, the pilot is being expanded to five hearing offices and the NHC. Rollout to additional offices is dependent on the performance of the software at the pilot locations. Minneapolis is one of those five hearing offices. We are only eight weeks into the pilot, but at this point, the process has been very time consuming and has slowed the staff down by more than 50 percent. We at FMA believe that many staffing decisions are being considered assuming the success of this initiative. We would caution that its success and ability to deliver significant numbers of folders for ALJ review anytime in the near future is overly optimistic.
Aftermath Of Ike In Houston
From myfoxhouston.com:
Social Security representatives will be prepared to issue immediate payments to residents who cannot reach their mailboxes to get their benefit checks, officials say.
Approximately 20,000 paper checks are due to people receiving Social Security benefits from the affected areas on Wednesday.
Although mail delivery is returning to the majority of the impacted locations, many of the people who evacuated may not be able to return home to get their checks. Social Security representatives are prepared to issue immediate payments from any of their open offices.
However, Social Security officials announced the following offices will be closed on Wednesday, September 17:
• Angleton
• Beaumont
• Conroe
• Galveston
• Houston Downtown
• Houston Northeast
• Houston Northwest
• Houston Southeast
• Houston Southwest
• Houston Teleservice Center
• Pasadena
• Port Arthur
• Office of Disability Adjudication and Review Hearing Office, Houston Downtown
• Office of Disability Adjudication and Review Hearing Office, Bissonnet
• Office of Inspector General, Houston
Sep 16, 2008
Written Statements To Social Security Subcommittee
Some excerpts from some of the written statements for the House Social Security Subcommittee hearing today -- and I am only trying to excerpt what is new, rather than giving you the flavor of the statements. I have added a few of my comments in brackets:
Frank Cristaudo, Chief Administrative Law Judge:
Frank Cristaudo, Chief Administrative Law Judge:
Our present target, which we continually review based on the most current productivity and workload data, is to have a judge corps of 1,250 by the end of next year. [calendar year or fiscal year?] However, in light of an unanticipated increase in filings, we are now considering whether to adjust that target upwards and will keep Congress apprised if we need to hire additional judges and support staff. [Might the election results have something to do with that?] We will be monitoring our workloads and receipts carefully in the coming months so that, budget permitting, we will be poised to hire as many additional judges as circumstances warrant. We lose approximately 60 judges a year to attrition, so to reach our goal of 1,250 judges, we will need to hire about 100 - 125 new judges in FY 2009, as well as sufficient staff to support them.Patrick O'Carroll, Social Security Inspector General:
... we are also developing a quality assurance program for the hearing process. Regional personnel will have responsibility for overseeing the in-line quality process, which will include reviews of attorney adjudicator decisions, decision drafts, case pulling, and scheduling. This program will be implemented in FY 2009 after the necessary system enhancements are put in place.
... it is important to understand that the backlog is not the result of a lack of dedication or commitment on the part of SSA or any of its employees, nor of the Administrative Law Judge (ALJ) corps, though it falls on all of these parties to join in seeking solutions. ...Sylvester Schieber, Chairman of Social Security Advisory Board:We looked again at the 95 ALJs in our study of fiscal year 2007 who issued fewer than 200 case dispositions. We found that of these 95, one was Judge Nancy Griswold, the Deputy Chief ALJ, who certainly had other issues occupying her time. Similarly, five of these 95 ALJs were Regional Chief ALJs.
Another 13 of these 95 ALJs were new to their jobs (and thus had a significant learning curve), were part-time employees, or were on extended leave during the year. And another 54 of these ALJs either retired, separated, resigned, or passed away during fiscal year 2007. This left 22 ALJs who produced fewer than 200 dispositions. Ten of these 22 ALJs were union officials who, under the collective bargaining agreement, had officially authorized union responsibilities. We interviewed the ten union officials as part of our study.
We then interviewed the twelve remaining ALJs, each of whom issued between 150 and 200 dispositions during fiscal year 2007.
Through our interviews, we found that internal factors—unquantifiable factors internal to each ALJ—were significant contributors with respect to disposition productivity. In fact, our interviews with Regional Chief ALJs (RCALJ) revealed that work ethic and motivation were one of the main factors that contributed to high or low productivity. One of these interviews even revealed an ALJ who remained unmotivated despite oral and written counseling, a written directive, and a reprimand.
It is possible, with an appropriate statutory change, to reconcile the interests of the public to receive an independent decision with a process that is consistent and efficient. But this process must have three key features: clear performance expectations, accurate and timely performance measures, and incentives that encourage the judges to reach the performance expectations. ...Ron Bernoski, President, Association of Administrative Law Judges:
We therefore recommend that Congress consider changing the law to permit better performance measurement while also protecting the ALJs’ decisional independence. A key feature of a new law would be well-defined performance criteria set in advance so all parties know what it being expected of them. [Michael Astrue's desire?]
Social Security has consistently over-estimated the benefits of technology at the administrative law judge level and has often implemented the technology before it has been ready for general use. Further, technology does little to assist the judge or reduce the time we spend doing our work. We still need to review the case before the hearing, conduct the hearing, prepare the hearing decision instructions, and edit the draft decision. The Agency is now claiming that technology will reduce the number of staff employees needed to support administrative law judges. This claim has not yet been certified therefore policy cannot be based on hoped for benefits of the new technology. ...
“Shortcuts” such as “Streamlined” folders and scheduling cases before they are worked up are more often counterproductive. A “streamlined” claim file is one which is not worked up, i.e., prepared for hearing. Duplicates of often hundreds of pages of exhibits are not removed. Exhibits are not identified, placed in chronological order or even numbered. This allows the support staff to spend less time in preparing a case record. However it requires that the judge, and the writer, and medical experts and the representative to spend far more time reviewing the record. Scheduling cases before work-up will not alleviate ALJs having insufficient cases for hearing. The cases will still need to be worked up before the hearing.
House Social Security Subcommittee Hearing Today
The House Social Security Subcommittee is holding a hearing today at 10:00 Eastern Time "on the Performance of Social Security Administration Appeals Hearing Offices." You can watch it online.
Social Security Contracting Over The Years
Courtesy of FedSpending.org here is a summary of the total amounts spent by the Social Security Administration for contractors in recent fiscal years (FYs), with the percent change from year to year:
Large Class Action Centified
From a press release:
Judge Certifies Class of Three Million Visually Impaired Beneficiaries in Social Security Administration Lawsuit
On Thursday, September 11, 2008, Judge William Alsup of the U.S. District Court for the Northern District of California granted class certification in a disability rights action in which plaintiffs argue that the Social Security Administration (SSA) fails to provide its communications in alternative formats that would enable people with visual impairments to have equal access to SSA programs as required by federal disability civil rights laws and the U.S. Constitution.
The case is scheduled for trial in April 2009. Attorneys for the plaintiffs include the Disability Rights Education and Defense Fund; Heller Ehrman LLP; the National Senior Citizens Law Center; and Disability Rights Oregon (formerly the Oregon Advocacy Center). ...
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