Social Security Disability Problems

I recently read a press release that made some interesting points. The points were not new, but reference was made to congressional testimony given by the social security administration's inspector General. That's what made them interesting.

What did the inspector general's testimony refer to? The fact that there is an incredible disconnect between what happens to social security disability and SSI claims at the initial claim and reconsideration appeal levels (where cases are decided by DDS disability examiners) versus what happens to claims at the hearings level (where cases are decided by federal administrative law judges).

For those who aren't aware, the large majority of disability claims are denied by disability examiners, while the majority of cases pursued to the administrative law judge hearing level are approved.

Why does this this happen? Why do so many claims that are initially denied later approved by judges? Is it because medical conditions get so terribly worse over the course of two or more years (the time spent waiting to get to a hearing date)?

Actually, a lot of it has to do with external quality control that results in multi-level discouragement of disability claim approvals. Some of it also has to do with the fact that while the social security disability and SSI disability system is a federal one, the disability examiners who decide initial and reconsideration level claims are state employees, working at state agencies.

In other words, many many many state disability determination agencies across the country are processing disability claims for the social security administration.

"Too many cooks in the kitchen" usually makes for too many variations of even old and well-established recipes.

Now for the interesting part. Apparently, the SSA inspector general indicated that the current system--that takes in disability claims at federal social security offices, sees them processed at the first two levels by state-employed disability examiners, and later sees them heard by federal administrative law judges--wastes limited resources due to the fact that so many claims that have been denied by disability examiners are later approved by judges (I think its reasonable to assume that there's a lot of unnecessarily wasted time and duplicative effort, as well as a great waste of the precious financial resources of applicants).

The inference is: if a claim that was denied twice by a disability examiner (initial claim and reconsideration levels) is later approved by a judge, what was the point?

More specifically, what was the point of so needlessly wasting so much agency time and money, otherwise known as taxpayer dollars, in this fashion.

And, further, what was the point of forcing so many tens of thousands of individuals who were initially denied but were likely to get approved later at a hearinginto a needlessly drawn out wait often resulting in bankruptcy and home foreclosure?

Answer: there was no point. And there was probably no need. How do you fix this? Generally, grandiose plans to "fix" structural problems in the social security disability SSI system have tended to crash and burn. But, to many observers, such failures have occurred because SSA top management as well as members of Congress were somewhat clueless as to how the disability claim system actually works at the nuts and bolts, or ground, level.

In my opinion, federalizing the disability determination services agencies would go far toward fixing the system. How?

1. State governments that are strapped for cash would no longer be able to furlough disability examiners. This would be a change welcomed by many, particularly since the states receive their funding for disability examiner salaries from the federal government (making the furloughing of disability examiners tantamount to theft).

2. Adjudicative standards for disability claim processing could be enforced throughout the country. This seems to be sorely needed judging by the disparity in approval rates between various states.

3. Disability examiners could actually receive salaries commensurate to what they do. This would help combat the significant turnover in jobs that robs social security of an experienced initial claim adjudicator workforce. It would also raise the average age of examiners who, for the most part, tend to be younger individuals who have yet to experience significant pains or health problems (I would contend that this makes them less able to intuit and conceptualize some of the medical record documentation they evaluate, that and the fact that their training is, at best, thin).

4. Federalizing the individual state agencies would provide a path toward getting the decisional behavior of disability examiners more in line with the decisional behavior of administrative law judges. This, of course, would mean more approvals at the initial claim level, a decreased need for appeals, faster resolutions for appeals, and fewer instances of disability claimants becoming destitute due to a backlogged and slow system.

Why can't anybody in Congress ever figure this stuff out? Because they usually don't what their dealing with or talking about.

Return to the Social Security Disability SSI Benefits Blog




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