Social Security Administration to Implement Major Changes to Disability Insurance

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.

Posted on Thursday, January 30th, 2014. Filed under Social Security Disability.

Social Security Audit Shows Agency Has Overpaid $1.3 Billion in Disability Benefits

According to the Government Accountability Office (GAO), the Social Security Administration (SSA) has made significant overpayments to some recipients of Social Security Disability Insurance, causing some of those individuals a great deal of trouble. The SSA is reluctant to admit the mistakes, but worker advocacy groups and beneficiaries’ attorneys say the agency is to blame.

The GAO recently conducted an audit that shows the SSA overpaid $1.3 billion in benefits over a two-year span. While some portion of that figure may be attributed to fraud, many innocent beneficiaries have received erroneous payments and have either tried to stop them or have not realized what was happening.

Steve Lord, a director at the GAO in charge of investigations and audits, says that the SSA should reallocate its resources to prevent such mistakes.

“Right now getting people off the [disability] rolls is secondary,” Lord told CNN. “They have to balance their resources between getting people off the rolls and getting people on the rolls.”

The SSA touts the accuracy of its accounting as nearly perfect, despite tight funding and an increased workload. The agency has lost approximately 11,000 employees since 2011. Meanwhile, as Baby Boomers age and become more prone to disability, the beneficiary rolls and applications have swelled.

Recent high-profile stories by media outlets such as NPR’s “This American Life” and CBS’s “60 Minutes” have highlighted limited instances of fraud within the Social Security Disability Insurance program. It is possible that these programs have left the public with a skewed understanding of the scope of the problem. Unfortunately, the SSA’s own response to concerns about the overpayments may be contributing to a narrative of widespread fraud and abuse.

Cheryl Bates-Harris of the National Disability Rights Network says the agency is quick to attribute the errors to malicious intent on the part of beneficiaries.

“It doesn’t want to admit it’s culpable, so it throws the responsibility on the beneficiaries . . . but there are critical failures within its system,” Bates-Harris told CNN.

In cases where the SSA makes an overpayment, the administration is likely to catch the mistake at a later date and then tell the recipient they must pay back the difference. This can be a serious setback for financially struggling families, who are very likely to have spent all available income on their living expenses already.

To avoid overpayments, be sure to report a change of income or a new job to the SSA right away. If you know you are being overpaid, notify the agency and keep a careful record of the amounts overpaid. If possible, keep the funds in a separate account.

If you receive a notice of overpayment that you believe to be erroneous, you may request a reconsideration. If you know you were overpaid, but you believe you were not at fault or you cannot repay the money, you can request a waiver. Whatever decision the agency renders in these procedures may be appealed, which is often a lengthy process. In all cases, when in doubt, consult with an experienced Social Security disability attorney.

Posted on Monday, November 25th, 2013. Filed under Serious Injury, Social Security Disability.

Social Security Judges File Lawsuit Alleging They are Held to Quotas

Claims for Social Security Disability Insurance take a long time to be processed and decided these days. An increase in the number of claims in recent years has caused wait times for some applicants to stretch into the hundreds of days. It is in everyone’s best interest for this backlog to be eliminated so that every new application can be decided in a timely manner.

To that end, the Social Security Administration (SSA) encourages its administrative law judges (ALJs) to hear between 500 and 700 claims each year – they call the numbers a “goal.” But some judges claim that the numbers constitute an unlawful “quota.” And now the judges are taking the SSA to court.

The Association of Administrative Law Judges (AALJ) recently filed suit on behalf of 1400 of its members, claiming that the SSA’s expectations cause them to have to improperly rush evaluations. It also creates an incentive to approve cases because approvals are faster than denials. This leads to the potential approval of claims that should be denied, which results in greater fraud, abuse, waste, and expense to taxpayers, the judges say. Their specific legal allegation is that the agency’s directive violates the Administrative Procedure Act and the Social Security Act. They also claim, contrary to the agency’s statements, that judges who do not hear enough cases are subject to reprimands, “counseling,” and “threats and intimidation,” according to the lawsuit.

SSA Commissioner Michael J. Astrue, who was appointed by President Bush, stepped down in February, 2013. President Obama has not yet named a successor – the agency is currently headed by acting commissioner Carolyn Colvin, a former secretary of the Maryland Department of Human Resources. Judge Randall Frye, president of the AALJ, says a lack of permanent leadership may be contributing to the problem.

“One way to protect the treasury and help deserving claimants is to end the quota system,” Frye said. “However, an acting commissioner may not feel that she has the authority to make the necessary changes and correct problems.”

Meanwhile, the Disability Insurance Trust Fund, from which disability benefits are paid, is currently paying out more than it is taking in. It is projected to reach zero in 2016. If that were to happen, it would result in an immediate 21 percent cut in benefits to nearly 11 million Americans with disabilities.

Disability insurance, like most government programs these days, faces intense budgetary pressures. Even in good economic times, ALJs will scrutinize disability claims to make sure taxpayer money is not wasted. If you are disabled, it pays to have an experienced Social Security Disability attorney on your side to get you the benefits you deserve in a timely manner.

Posted on Wednesday, June 12th, 2013. Filed under Social Security Disability.

Social Security Disability Advocates Respond to NPR Story

A story recently aired on National Public Radio (NPR) has sparked a national conversation on a federal government benefit program, including passionate defenses and calls for its overhaul.

The program is Social Security Disability Insurance (SSDI), and as the NPR series “Unfit For Work” described, its payroll, after sharp growth in recent years, now numbers over 14 million. This growth is in spite of medical advances and laws banning employment discrimination based on disability.

NPR reporter Chana Joffe-Walt found that declining real wages, a stagnant economy, and limited employment opportunities create powerful incentives for disabled workers to seek SSDI. She visited Hale County, Alabama, where nearly a quarter of working-age adults are SSDI beneficiaries. There, openings for jobs not requiring physical labor are almost completely unattainable for many due to a lack of education. The states with the highest percentages of disability beneficiaries are also the states with the lowest percentages of college-educated population, including West Virginia, Alabama, and Mississippi.

Joffey-Walt also visited the family of a 10-year-old boy with a learning disability in the Bronx. That disability makes him eligible for $700 per month in Social Security, the family’s primary source of income. If Jahleel were to completely overcome his disability and excel in his education, it would threaten his family’s livelihood. The story illustrated the conflicting motivations some families with benefit income struggle with.

A group of eight former Social Security Administration (SSA) commissioners wrote an open letter to the public responding to the NPR story. The commissioners pointed out that analysts at the SSA had predicted the current uptrend in SSDI’s growth for decades. Two demographic swells combine to account for the majority of the growth in SSDI: the baby boom and the influx of women into the American workforce in the 1970s and 1980s. These groups are now entering their high-disability years.

The letter added that the growth in children receiving Supplemental Security Income (SSI) benefits is due to the nationwide growth in poverty. Less than four percent of low-income children receive SSI benefits – a figure that has held steady, according to the commissioners.

Advocacy group the Consortium for Citizens with Disabilities (CDC) also published an open letter shortly after the story aired. They called attention to the strictness of the eligibility requirements, saying only about 40 percent of adult applicants are approved.

SSDI ensures the livelihood of millions of Americans, but has swelled at an eyebrow-raising rate in recent years. Congress may reform the program in the coming years to help those on the margin remain gainfully employed. But they must take care to ensure the economic security of the most vulnerable Americans.

Posted on Tuesday, May 14th, 2013. Filed under News & Press, Social Security Disability.