Disparities Among ALJs

The full story from The News Journal of Delaware has been posted. Much of it concerns the Hearing Office Chief Administrative Law Judge (HOCALJ) in the Dover hearing office, Judith Showalter, who denies 56% of the cases she hears. The newspaper also looked at the numbers for other Administrative Law Judges (ALJs), noting that "Baltimore judge Louis J. Pucci denied fewer than 1 percent of his cases during those four years [the newspaper examined], while Houston judge Richard J. Abrams denied 93 percent of his cases."

Addendum: The News Journal published nine separate stories. In addition to the one linked above these were:

• A lifetime of hard labor leaves Delaware man's body and mind beaten up
• Delaware woman felt like a 'beggar trying to get something'
• With a family full of suffering, Delaware woman's benefits don't go a long way
• Hopeless situation sends Delaware mom to depths of despair
• Social Security Administration refuses to release information about complaints
• Dual roles of judges a source of tension for Social Security disability benefits
• Who's eligible for Social Security Disability Insurance
• An audio slidshow of five claimants

A Delaware Teaser

From The News Journal of Delaware:

If a serious ailment keeps you from working, your claim for Social Security disability benefits should be handled the same way everywhere, whether it’s decided by an administrative law judge in Dover, Denver or Des Moines. But those who live in Delaware will face tougher judges.

Through a Freedom of Information request, The News Journal examined four years of Social Security disability claim data and found some startling inequities.Read the full story in the Sunday News Journal and at delawareonline.com. You can browse our database of denial rates now.

The database compares hearing offices, not individual Administrative Law Judges. The Dover, Delaware hearing office has one of the lowest allowance rates in the country.

Update: A reader correctly points out that if one clicks on the location of a hearing office in the database, a list of ALJs assigned to that office comes up, showing the rate at which each denies claims.

Some Thoughts On That Press Release

Some thoughts on Social Security Commissioner Michael Astrue's press release about the allegations that state Disability Determination Service (DDS) agencies in California and Hawaii were sending Social Security disability claimants a long tedious form to complete and then denying them if they did not return the form promptly, leading to many illiterate, mentally ill claimants being denied on technical grounds:

• For those reading this blog who may not have dealt directly with Social Security disability claimants, let me make it clear that I think that everyone who has dealt directly with this population would agree that what is alleged is wrong, wrong, wrong. Social Security disability claimants are terribly vulnerable, especially when they are unrepresented, which would be the case here. Deliberately setting traps for confused, poorly educated, mentally ill people would be despicable.
• I have trouble believing that one state DDS would do this without notifying Social Security's regional office in advance. Social Security cannot control personnel matters at a DDS, which means that Social Security cannot prevent a hiring freeze or furlough at a DDS, but Social Security controls just about everything else at a DDS. Just as an example, j.doe@ssa.gov could be the e-mail address of a DDS employee. I would be astonished if two DDS's in one region did this without the advance approval of the regional office. The heads of these state DDS's may be quickly pointing the finger of blame back at Social Security.
  
• Astrue's press release came out just after 5:00 Eastern time on a Friday afternoon. Social Security does not operate on a 24 hour news cycle like the White House. I think that someone really wanted to get this out before the weekend. My guess is that the reason is that Social Security is getting questions about this from the news media. There may be major news stories on this subject about this coming out this weekend.
• Everyone at Social Security has been under enormous pressure to do something about the backlogs. I have seen many signs that the pressure is out of hand. If what is alleged here happened, in my mind it is a sign that the pressure on Social Security and DDS employees is too much. It is time for Social Security to dial this pressure back before there are multiple scandals.
  

The Commissioner Wants An Investigation

A press release from Social Security:

Michael J. Astrue, Commissioner of Social Security, today asked the agency’s Inspector General to investigate allegations that the states of California and Hawaii have recently implemented practices that deny applicants the right to receive full consideration of their Social Security disability claims.

In a memo to Patrick P. O’Carroll, Inspector General, Social Security Administration, Commissioner Astrue writes, “As you know, Gov. Schwarzenegger has insisted on furloughing California Disability Determination Service (DDS) employees, despite the fact that we fully fund both their salaries and overhead. According to Congressman Robert Filner, the State is attempting to find ways to improperly circumvent the effects of the furlough at the expense of some of the State residents who are in the greatest need.”

At a hearing before the House Ways and Means Subcommittee on Social Security yesterday, Congressman Filner (D-CA) testified that the California DDS is denying the claims of disability applicants who fail to return a 25-page report within 20 days – a practice which has been adopted since the institution of furloughs. He reported that one office had closed 30 percent of its cases due to the applicants’ failure to return the completed form within 20 days. In addition, he testified the California DDS may be manipulating its service numbers by assigning claims to fictional examiners or supervisors. According to the Congressman, this scheme would allow the DDS to hide the fact these cases are not actually being reviewed.

“I am concerned about the State of Hawaii DDS, which is furloughing its DDS employees for as many days as California, and which has made statements about new business efficiencies that closely track statements made by California officials,” Commissioner Astrue writes to the Inspector General. “Accordingly, I ask that you also review that agency to ensure they are also fully adhering to all SSA rules and policies.”

The text of Commissioner’s Astrue’s memo is below:

At yesterday’s hearing before the House Ways and Means Subcommittee on Social Security, I testified about some disturbing practices the State of California has instituted that aggravate, rather than help, in response to its budgetary situation. As you know, Gov. Schwarzenegger has insisted on furloughing California Disability Determination Service (DDS) employees, despite the fact that we fully fund both their salaries and overhead. According to Congressman Robert Filner, the State is attempting to find ways to improperly circumvent the effects of the furlough at the expense of some of the State residents who are in the greatest need.

Congressman Filner indicated that since the furloughs began, the California DDS has begun denying the claims of those disability applicants who fail to return a 25-page report within 20 days. This practice, if true, places applicants in an untenable position because the substantial amount of information required must often be gathered from third parties. If an applicant fails to return complete information within the time set by the State, the DDS deems the applicant to have failed to cooperate and closes the file, thereby depriving that applicant of fair and full consideration.

I am also greatly concerned by Congressman Filner’s report that the California DDS may be manipulating its service numbers by “staging” claims, assigning them to fictional examiners or supervisors, rather than to actual examiners. According to Congressman Filner, this practice would allow the DDS to claim that the cases have been assigned, rather than indicate that they are still in queue, thus minimizing the effects of the furlough.

If true, these practices are, of course, very disturbing. Therefore, I am asking you to undertake a full review of the practices of the California DDS to determine the scope and breadth of any inappropriate practices.

I am also concerned about the State of Hawaii, which is furloughing its DDS employees for as many days as California, and which has made statements about new business efficiencies that closely track statements made by California officials. Accordingly, I ask that you also review that agency to ensure they are fully adhering to all SSA rules and policies.

Thank you for your assistance.

Not So Many Vets At Social Security

The Office of Personnel Management (OPM) has issued a report on the employment of veterans by the U.S. government. Vets comprise 25.5% of the federal civilian workforce but only 9.6% of Social Security's workforce.

House Social Security Subcommittee Hearing

The House Social Security Subcommittee held a hearing today on the backlogs in adjudicating disability claims. Here are a few excerpts from the written remarks:

Bob Filner, Congressman from California:
While some states have exempted Disability Determination Service (DDS) employees from the furloughs at the urging of the Social Security Administration, the State of California has not exempted DDS employees. This is despite the fact that DDS employee salaries are fully funded by the Federal Government. ...

The unnecessary furloughs for California DDS employees are pushing back the decisions on individuals’ benefits by months and harming thousands of disabled residents who are needlessly waiting for their claims to be processed. ...

Current federal law allows the Social Security Administrator to federalize DDS employees if a state “substantially fails” to live up to its responsibilities to process claims. I will soon introduce The Don’t Delay Services Act, which is intended to prevent state furloughs of DDS employees.

My bill would deem furloughs of DDS employees a “substantial failure”, triggering the provision of existing federal law that allows SSA to federalize DDS. As drafted, the Don’t Delay Services Act would not change any provisions of federal law concerning the rights and protections of these workers.

Michael Astrue, Commissioner of Social Security:

During this difficult economic crisis, Americans are turning to us for help more than ever before. In FY 2010, we expect to receive 1.2 million more claims than we received in FY 2008. I weighed the risks of an uncertain budget against the need to sustain our progress and decided to authorize our components to continue hiring and working maximum overtime during the continuing resolution (CR). Therefore, we are using the multi-year Recovery Act funding to help sustain our momentum this fiscal year during the CR. ...

By the middle of next year, seven new [hearing] offices will open in Michigan, Ohio, Georgia, North Carolina, and Indiana, our five most congested states. With plans for 25 new hearing offices, 7 new satellite offices, and scores of office modifications and expansions, we are adding the space we need to address the cases that continue flooding in. ...

We are testing a new, more sophisticated screening tool to identify cases for senior attorneys to review. We used predictive modeling to help us determine the proper balance between the number of attorneys screening cases and the number who are writing decisions for ALJs. Based on our analysis, we are identifying 100 senior attorneys to work in a virtual screening cadre to review the disability hearing backlog for potential allowances. ...

As we increase our capacity to hear and decide cases, we must consider the resulting workload for the Appeals Council (Council). The Council’s receipts are outpacing dispositions, with an almost 16 percent increase in receipts in FY 2009 over FY 2008. We expect that receipts will continue to increase by another 12 percent in FY 2010. ...

We expect nearly 700,000 more initial disability claims in FY 2010 than we received in FY 2008. We simply do not have the capacity to process all of the incoming applications with the same timeliness of the past year. ...

Recently, however, we have paid the price for the growth in workloads and tight budgets. Resource limitations have reduced the number of CDRs and SSI redeterminations we can handle. ...

With the President’s FY 2010 budget, we plan to hire a total of about 7,500 employees, which will allow us to maintain our staffing levels in our front-line operational components and add 1,400 employees in the DDSs and 1,300 employees in our hearing offices.

Barbara Kennelly, Acting Chair of the Social Security Advisory Board:

It is only a matter of time that the surge in initial claims is felt in ODAR. If the traditional waterfall of appeals occurs, about 45 percent of those denied at the initial level will request reconsideration, and then approximately three-quarters of the individuals who are denied at the reconsideration level will appeal to the ALJ. It takes about 250 days, on average, for an initial claim that has been appealed to reach ODAR and then several more months before the case is on an ALJ’s desk. This means that the increased caseloads in the DDSs will begin to materialize in ODAR in the second half of 2010 or in early 2011.

Beth Bates, attorney from Jackson, TN, on behalf of the Consortium for Citizens with Disabilities:

I am honored to testify today but am saddened that the reason is because my clients have waited so long and endured many hardships before receiving the disability benefits to which they are entitled.

Patrick O'Carroll, Inspector General, Social Security Administration:

The Commissioner has made significant efforts to limit the impact of furloughs, and was able to make some progress. He contacted all of the State Governors and many State legislators. Vice President Biden wrote to the National Governors’ Association, and there was even litigation in California that sought to preclude furloughs.

As a result of these and other efforts, two States exempted their DDSs from State employee furloughs, and three States partially exempted DDS employees, saving another 11,000 cases and $24.4 million from being delayed. Several more States fully or partially exempted DDSs from hiring restrictions. Additionally, SSA hired 192 new staff for Federal units that process initial claims, and transferred cases facing delays from States to those Federal units to ensure timelier processing.

Ann Roberts, Vice President National Council of Disability Determination Directors:

Transferring work from state to state or to other components is both politically sensitive and frequently a technologically challenging venture that needs to be considered cautiously.

Larry Auerbach, Administrative Law Judge, on behalf of the Federal Bar Association:

Our testimony today advances five recommendations:

1. State Disability Determination Services should be provided significantly enhanced resources.

2. SSA should continue to hire Administrative Law Judges and support staff, and add needed hearing offices.

3. SSA should continue to develop and implement improved technological and other initiatives.

4. New efforts are needed to accomplish the Commissioner’s goal of making the right decision at the earliest possible stage.

Press Release On Compassionate Allowance Hearing

A Social Security press release:

Michael J. Astrue, Commissioner of Social Security, today hosted the agency’s fifth public hearing on Compassionate Allowances. Commissioner Astrue was joined by Philip Wang, M.D., Dr. P.H., National Institute of Mental Health, National Institutes of Health, and Social Security executives. They heard testimony from some of the nation's leading experts on schizophrenia about possible methods of identifying and implementing Compassionate Allowances for young adults with schizophrenia.

"Schizophrenia is a devastating disease that affects more than two million Americans, primarily individuals in their teens and twenties," said Commissioner Astrue. "The onset of schizophrenia has life-changing consequences, which can include unemployment and homelessness." This hearing will help us to potentially identify the most severe cases and consider bringing them under our Compassionate Allowances umbrella."

In October 2008, Social Security launched Compassionate Allowances to expedite the processing of disability claims for applicants with medical conditions so severe that their conditions by definition meet Social Security's standards. To learn more and to view a web cast of today's hearing, go to www.socialsecurity.gov/compassionateallowances.

"Our Compassionate Allowances and Quick Disability Determination processes are making a real difference by ensuring that Americans with devastating disabilities quickly receive the benefits they need," Commissioner Astrue said. "This fiscal year, we expect to fast-track about 150,000 cases and we plan to add more diseases and impairments to these expedited processes in the coming months."

Poll

Free Web poll for your Web site - freepolls.com