The beneficiary rolls of the Social Security Disability Insurance (SSDI) program are increasing rapidly, as is public and legislative scrutiny over the process. The Social Security Administration (SSA) is making major changes. A recent article on the Wall Street Journal’s blog outlines six changes currently underway for the SSDI.
Occupations: When considering an applicant for SSDI, the agency must evaluate the applicant’s employment prospects. Currently, it tasks vocational experts to match the applicant with potential occupations. But these experts are supposed to use a “dictionary” of occupations that has not been updated since 1991. It still includes anachronistic occupations like “blacksmith,” and, more importantly, it does not reflect the technology boom of the past twenty years. Numerous jobs working with computers are well-suited to physically disabled individuals. Rewriting the dictionary is a huge job that may not be completed until 2016 at the earliest.
Grid Use: Administrative law judges who rule on SSDI applications use a decision-making tool known as the “grid” to help them decide whether an applicant qualifies for benefits. It accounts for age, education, disability and other factors. But like the occupation dictionary, the grid has not been updated in years, and it does not reflect the ability of some people to work productively into advanced ages. Additionally, some judges believe it is too easy for lawyers and other experts to tailor applications to the grid so that an award of benefits is more likely.
Disclosure: Currently, SSDI attorneys may withhold medical records that weaken a client’s case for disability benefits from submissions. Many believe that this practice should not be allowed, and some claim the SSA has backed down from pressure against implementing a rule against it in the past. An agency official recently stated the SSA would soon propose a rule preventing the withholding of relevant information from applications, but the official would not elaborate on the nature of the proposal.
Caseload: To deal with large case backlogs, some judges have, in recent years, handled upwards of 1,000 cases per year. Many judges claim due diligence on so many cases is impossible. The agency has now placed a cap of approximately 800 cases per year for each judge.
Third-Party Groups: The SSA and its inspector general are investigating whether doctors and lawyers are facilitating fraud in disability applications. This investigation only began recently, and no targets or findings have yet been identified.
Judges’ Job Description: It is very difficult for SSA judges to be removed from their positions. For some, the post amounts to a lifetime appointment. But the agency is changing the job description to clarify that judges are subject to supervision and to oversight from various parties. The SSA has also intensified scrutiny over the judges’ casework and can recommend additional training for those whose results (e.g. the percentage of applications approved) fall outside the norm.
As the SSDI continues to grow, it is important to keep the program modern and to remain vigilant against fraud so that the benefits of future, worthy applicants are not endangered.
In American politics, partisan gridlock is the norm. It is therefore not terribly surprising that Congress has so far delayed reforming Social Security for retirees. After all, reforms to extend the program’s solvency would require increases to payroll taxes, cuts to benefits, or both – all politically toxic proposals. And the program’s trust fund is forecast to be solvent until 2035 – a virtual eternity in the political world.
Social Security Disability Insurance (SSDI) is another story altogether. That program draws from a separate trust fund – one that is forecast to be depleted in 2016. If that happened, benefits could only be paid to the extent they were covered by incoming payroll tax revenue. That would mean an immediate benefit cut of some 20 percent to each and every disabled beneficiary.
One temporary solution is actually quite simple. A small portion of revenues from payroll taxes could be reallocated from the retirement program to disability. Reallocations are nothing new – Congress has enacted them at least six times already, most recently in 1994. According to Social Security Administration chief actuary Stephen Goss, shifting just one tenth of 1 percent of revenues would bring the forecast depletion date of both trust funds in line with each other.
To be clear, this would accelerate the depletion of the retirement program’s trust fund, and thus it is not necessarily a politically simple fix despite being logistically simple. But the reallocation itself would not result in any workers having to pay more in taxes, nor any beneficiaries – retired or disabled – suffering a cut in benefits. This should spare the measure from significant controversy, as past reallocations have been.
The SSDI program has recently faced intense scrutiny and criticism because of its rapidly swelling roll of beneficiaries. There is a sense among some that fraud is rampant in the program and that unemployed baby boomers who do not yet qualify for retirement benefits are freeloading despite being physically capable of work. This makes disabled Americans pawns in games of political brinksmanship as Congress argues over fiscal policies and debt ceilings.
The reality is that while examples of fraud may be found in the SSDI program, its growth was predicted by simple demographics. Baby boomers are nearing retirement age. The rate of physical disability among those age 40 is half that of 50-year-olds, which itself is half that of 60-year-olds. Moreover, women’s increased participation in the labor force over the last several decades means they are increasingly eligible for disability benefits.
Millions of Americans depend on disability benefits to make ends meet, and many more depend on retirement benefits for the same. Reforming both these programs in order to make them solvent long into the future may be a lengthy political process. In the meantime, reallocating funds to SSDI is the right thing to do to protect the livelihood of those who depend on it.
The Social Security Administration is working on new initiatives that could cut down on wasteful overpayments, disincentives to work and costly labor time to investigate payments.
The Work Incentives Simplification Pilot is a legislative proposal being considered by Congress that could replace well-intentioned but complicated laws meant to incentivize disability beneficiaries to return to work. The work incentives proved too burdensome for an agency already fighting funding cuts.
Carolyn Colvin, deputy administrator for the Social Security Administration spoke to the U.S. House Ways and Means’ Subcommittee on Social Security in late January.
She explained that the new legislation could kill regulations like trial work periods and the extended period of eligibility that are overcomplicating the work of the administration.
The law now says people on Supplemental Security Income, or SSI, are on a sliding scale as they return to work. So, for every $2 an SSI beneficiary earns, $1 is removed from their SSI benefit, she said. Improper SSI payments happen when beneficiaries fail to notify the administration of new work, new assets or a raise or reduction in salary.
Each beneficiary is a different case with a different employer and a different income. Each case has to be individually handled, which often means contact with the employer. Most cases are complicated and require small bits of work and starting and stopping until enough information is gathered to make a decision, she said.
This type of work takes considerable expertise and training and the administration simply does not have the resources to do it well, she said.
There also are plenty of crossover beneficiaries who qualify for SSI and Social Security Disability Insurance C as many as 30 percent of SSI recipients also get SSDI between 18- and 64-years-old. Because the two programs are guided by two sets of rules, the labor for the Social Security Administration is overly burdensome, she said.
Officials hope the new WISP plan will address a disincentive to work by eliminating a beneficiary’s fear that if they get a job, they will lose their benefits.
The work incentive policies are difficult for beneficiaries to understand and for the administration to oversee, Colvin told the subcommittee.
The goal of WISP is to test some simplified work rules that would still be subject to tight evaluation. Officials hope the WISP will encourage people to work while reducing administrative costs, she said.
WISP also would count beneficiaries’ earnings when they are paid instead of when they are earned so that SSDI and SSI rules would be better aligned.
A qualified attorney can represent clients in Social Security cases to help make sure they fully explain their case.
Federal administrative law judges who hear Social Security Disability appeals have widely ranging records that may indicate unfairness in the appeals process.
The Social Security Administration is commissioning a review of the entire disability system to make sure it is not awarding benefits to those who do not deserve it and to make sure the agency is not denying benefits to those who do deserve them.
The SSA will review the work of about 1,500 disability appeals judges across the country whose rates vary significantly from the norm. Some judges award benefits less than 20 percent of the time while others award benefits almost 100 percent of the time, according to a story in the Wall Street Journal.
The Administration has already decided to stop notifying applicants who their judge will be in their appeal to discourage shopping an appeal to a more lenient judge.
The Administrative Conference of the United States will take on the review. The independent government study organization hopes to make recommendations for updating the appeals process in 2012.
The Social Security Disability Insurance program provides financial assistance to Americans who cannot work. The Wall Street Journal reported that the program paid $130 billion in 2011 to 10.6 million people.
If a case comes before a federal Social Security judge, it has already been denied twice at the state level. There is a tremendous backlog of cases at the federal level.
In September of 2011, there were more than 771,000 people waiting for their appeal to be heard. The SSA has been working to address the backlog issues and it has cut down on the number of people who die while they wait for their appeal to be judged, according to the WSJ.
The hearings usually last about an hour. Some critics have said judges pushing cases through much more quickly than that are cutting corners and not doing thorough reviews. The conference plans to factor how much time judges look at cases into its review.
The SSA’s commissioner told Congress in the summer of 2011 that judges awarding disability benefits more than 85 percent of the time cost the agency another $1 billion a year. The Wall Street Journal reports that there are more than 100 judges whose award percentages are that high.
Overall, the federal court system is finding errors or overturning about half of the decisions made by Social Security judges. The independent study will review how the federal courts are looking at the cases to make sure it is interpreting the SSA’s rules consistently, according to the WSJ. A qualified Social Security Disability attorney can help clients file appeals with the agency.
Social Security disability benefits can be difficult to get. The application process can be time consuming and is heavy on paperwork. Many individuals with signs of pain and fatigue wonder if they can get Social Security disability insurance (SSDI). There are some critical steps to increase your chances of successfully winning your claim with the Social Security Administration (SSA).
Step One: Diagnosis
Social Security looks to have a true diagnosis of an individual’s “medically determinable impairment.” You must have the signs, symptoms, and medical records supporting your situation. A qualified doctor that uses accepted practices to note your limitations and prognosis is critical. Social Security does not know your doctor, so your doctor’s input is very important when you apply for benefits.
Step Two: Qualified Legal Guidance
Having a qualified, Social Security Disability attorney increases your chances of getting your much-needed SSDI approved. An experienced attorney is skilled in getting the documentation completed accurately and has the expertise should your case go to a hearing in front of a federal administrative law judge. The Social Security Administration and its examiners review many claims a day and have little emotional investment to understand the extent of your situation. Having legal representation will help overcome the difficulties in getting SSDI.
Also, most SSDI attorneys work on a contingency basis, so you won’t have to pay any hefty fees up front. When you are granted SSDI benefits, up to 25 percent of it will be taken for the attorney’s fees as approved by the Social Security Administration. If no benefits are obtained, the attorney will not be paid, so the process protects your pocketbook.
Step Three: Periodic Disability Reviews
Continuing disability reviews happen every three to seven years. Even if you were initially given benefits because of a permanent disability, you must still meet the definition of disabled. The SSA will want updated records and documentation to verify your condition. And, should you work and earn more than $1,000 a month, the SSDI benefits most likely will end. If there is a sudden change in your medical or employment status, you will want to contact a qualified attorney to understand your rights.
Overall, Social Security disability attorneys help clients determine their eligibility for Social Security Disability Insurance and, separately, Supplemental Security Income. These two programs are distinct as SSDI pays benefits to you if you have worked long enough and paid Social Security taxes. Supplemental Security Income pays benefits to disabled persons with little to no income.
In Tampa, Social Security Disability attorney Robert Alston has more than a decade of experience successfully representing clients before the Social Security Administration. Even though SSDI and SSI are different programs, he will analyze what is the best course of action given your situation and finances. Alston is skilled in assisting disabled children and adults, veterans, and the aged and blind with their disability concerns.
Zephyrhills, Fla. – Social Security disability insurance is set to pay out close to $124 billion in 2011. Because of the limited resources of the Social Security Administration and the high volume of applicants, a staggering 60 percent of applicants are denied. And when individuals appeal for reconsideration, 80 percent are denied.
“With these discouraging numbers, it can be extremely beneficial to have an attorney handle your application and the potential appeals process,” said Robert Alston, Social Security disability attorney at The Disability Law Firm in Zephyrhills, Fla. “An experienced lawyer will help their client organize the paperwork and medical records, prepare you and witnesses for hearings, and know how to deal with the SSA offices and judges.”
Avoid these common mistakes and pick a qualified attorney to get the benefits you deserve. These errors are repeated so many times, it is worth pointing them out in a short list to increase the prospect of getting SSDI.
Do not file a disability claim while having a job. When applying for SSDI, individuals are claiming that they need benefits because they are unable to obtain or perform substantial, gainful employment. Chances of being awarded disability while working are slim, even though there is no rule against it.
Do not rely only on the consultative exam. Individuals must have enough medical evidence to support their claim. When used in tandem with the consultative exam, a disabling condition is easier to prove. On its own, the consultative exam might not show the truly extensive nature of a disability.
Do not skimp on prescribed treatments for your disability. It does not do any good to stop prescription medicine or therapies to have your disability appear worse. The Social Security examiner will want to see the history of treatments, and how well you have responded to it. And if an individual does not follow the recommendations of his or her doctor, an application can be denied on these terms as well.
Statistics show that individuals who have an attorney represent them during the initial application process are more likely to receive benefits than those who try to do it themselves. “And you should never feel like you cannot afford an attorney for this type of representation,” said Alston, who has more than 10 years experience in Social Security disability claims. “Social Security attorneys work on a contingency basis, so once you are approved for disability benefits only then will your lawyer receive up to 25 percent of your disability back pay as a fee.”