Friday, December 28, 2007

Social Security Administration Would like to Stack the Deck Against Disability Claimants

The Social Security Administration has a crisis on its hands with the disability backlog problem and the current SSA commissioner, Michael Astrue, is well aware of it. He has only acknowledged the obvious in stating the following:

1. The average disability claimant who decides to file a social security disability appeal has to wait an astounding five hundred days for a decision.

2. The current backlog of over seven hundred thousand cases is the largest in the agency's history.

These statistics are compelling: A) compelling enough to prompt widespread newspaper attention, B) compelling enough to prompt a major policy change proposal from SSA, and C) compelling enough to convince some people that the proposals for change coming out of the social security administration are in the best interests of the people who file for disability.

However, those individuals who fit snugly into category C are having the wool pulled over their eyes. Here's what I mean. The social security administration is proposing to severely alter the manner in which disability claimants and disability lawyers may submit medical evidence to administrative law judges prior to a hearing. The proposed change is that claimants would be required to submit all medical evidence for a hearing no later than five days prior to a hearing.

On the surface, this doesn't seem like an unreasonable demand. After all, SSA has gone on record in stating "Our program experience has convinced us that the late submission of evidence to the [administrative law judge] significantly impedes our ability to issue hearing decisions in a timely manner".

Who doesn't want to speed up the disability hearing process and reduce backlogs right?

Only thing is, the current practice governing the submission of medical evidence for hearings has nothing to do with backlogs. Backlogs are solely the result of inadequate funding from Congress resulting in the social security administration's inability to hire the appropriate amount of manpower to properly service A) social security retirement claims, B) social security disability claims, and C) SSI disability claims.

My view on backlogs, of course, is mediated by own perspective. I am, myself, a former disability examiner. My wife is a former disability examiner and is currently a field office claims rep (claims reps are the individuals who take disability applications). Her current experience in working in a chronically overworked and for-years-understaffed office in which the majority of workers are eligible for retirement says a lot about the cliff that the social security administration is about to go over in the next few years.

What is that cliff?

1) The current crop of workers is being overworked, largely because SSA does not hire replacements for workers who quit or retire.

2) A large percentage of the current crop of workers is eligible to retire.

3) A large percentage of these individuals is getting to the point of saying "the heck with it", i.e. taking retirement.

4. As more workers leave the agency and few to none are hired to replace them, the agency will be hit by a huge loss of institutional experience, i.e., fewer experienced people left to train new workers. This will have a direct impact on the agency's ability to serve its clients (retirees and disabled workers).

In essence, backlogs and inadequate staffing (which includes not enough staff at hearing offices and payment processing centers) are two sides of the same coin. Altering the manner in which claimants or their representatives may submit medical evidence, however, has nothing to do with this coin.

Again, speaking from experience, it is the minority case in which a disability claimant or their representative has been able to obtain the medical records from all their doctors and hospitals by the time of a hearing. In fact, it is quite ordinary and routine that, if you send out eight requests for medical records to various sources, you will probably have at least three unaccounted for by the time of a hearing.

This, of course, is a phenomenon which administrative law judges are familiar with. And, without a doubt, the vast majority of them understand that the inability to get all the records in by the time of a hearing, let alone five days prior to a hearing is not the fault of a claimant. You simply cannot, in many cases, force a doctor's office or hospital records department, to move any faster on processing a request for records than they want to----no matter how many times you call them, leave messages, or fax them (notice that I didn't say "complain to a supervisor" because this is a marvelous way to shoot yourself in the foot if your objective is to get records).

That being the case, why should applicants for disability benefits be penalized, particularly regarding an issue they have no control over? Answer: they shouldn't.

Nancy Shor, of the national organization of social security claimant's represenatives, believes that the proposed changes to the medical evidence submission process are designed to discourage claimants from appealing. And I have to wonder if that is the intent as well.

Clearing the hideous backlog of title II (SSD) and title 16 (SSI) disability claims should be a high priority for the social security administration and for Congress.

But disadvantaging claimants in such a way that some of their medical records, through no fault of their own, are barred from being considered at a hearing is not the right way to go about it.

And its just not right at all.

Return to the Social Security Disability SSI Benefits Blog