[House Hearing, 111 Congress]
[From the U.S. Government Publishing Office]

ELIMINATING THE
SOCIAL SECURITY DISABILITY BACKLOG

=======================================================================

HEARING

before the

COMMITTEE ON WAYS AND MEANS
U.S. HOUSE OF REPRESENTATIVES

ONE HUNDRED ELEVENTH CONGRESS

FIRST SESSION

__________

MARCH 24, 2009

__________

Serial No. 111-9

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Printed for the use of the Committee on Ways and Means

----------
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SUBCOMMITTEE ON SOCIAL SECURITY

JOHN S. TANNER, Tennessee, Chairman

EARL POMEROY, North Dakota SAM JOHNSON, Texas, Ranking Member
ALLYSON Y. SCHWARTZ, Pennsylvania KEVIN BRADY, Texas
XAVIER BECERRA, California PATRICK J. TIBERI, Ohio
LLOYD DOGGETT, Texas GINNY BROWN-WAITE, Florida
RON KIND, Wisconsin DAVID G. REICHERT, Washington
JOSEPH CROWLEY, New York
LINDA T. SANCHEZ, California
JOHN A. YARMUTH, Kentucky

SUBCOMMITTEE ON INCOME SECURITY AND FAMILY SUPPORT

JIM MCDERMOTT, Washington, Chairman

FORTNEY PETE STARK, California JOHN LINDER, Georgia, Ranking
ARTUR DAVIS, Alabama Member
JOHN LEWIS, Georgia CHARLES W. BOUSTANY, JR.,
SHELLEY BERKLEY, Nevada Louisiana
CHRIS VAN HOLLEN, Maryland DEAN HELLER, Nevada
KENDRICK B. MEEK, Florida PETER J. ROSKAM, Illinois
SANDER M. LEVIN, Michigan PATRICK J. TIBERI, Ohio
DANNY K. DAVIS, Illinois

Janice Mays, Chief Counsel and Staff Director

Jon Traub, Minority Staff Director

Pursuant to clause 2(e)(4) of Rule XI of the Rules of the House, public
hearing records of the Committee on Ways and Means are also published
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C O N T E N T S

__________
Page

WITNESSES

The Honorable Michael J. Astrue, Commissioner, Social Security
Administration................................................. 12

______

The Honorable Patrick O'Carroll, Inspector General, Social
Security Administration........................................ 74
Dan Bertoni, Director of Disability Issues for the Education,
Workforce & Income Security Team, U.S. government
Accountability Office.......................................... 80
Peggy Hathaway, Vice President, United Spinal Association, Silver
Spring, Maryland; on behalf of Consortium for Citizens with
Disabilities Social Security Task Force........................ 104
The Honorable Ron Bernoski, administrative law judge, Milwaukee,
Wisconsin; and President, Association of administrative law
judges......................................................... 131
James Fell, Hearing Office Director, Social Security
Administration Office of Disability Adjudication and Review,
Cincinnati, Ohio; and Immediate Past President of the Federal
Managers Association Chapter 275............................... 122
Rick Warsinskey, District Office Manager, Cleveland, Ohio; and
Immediate Past President, National Council of Social Security
Management Associations, Inc................................... 139

SUBMISSIONS FOR THE RECORD

Cary L. Bartlow, Ph.D., Statement................................ 174
Dorothea Bawks, Statement........................................ 175
Earl Tucker, Statement........................................... 176
Georgina Huskey, Statement....................................... 180
James F. Allsup, Statement....................................... 185
John Yent, Statement............................................. 187
Joyce R. Shoop, Statement........................................ 190
Linda Fullerton, Statement....................................... 191
National Association of Disability Representatives, Statement.... 202
National Council on Disability, Statement........................ 205
Renee B. Jubrey, Statement....................................... 211

ELIMINATING THE
SOCIAL SECURITY DISABILITY BACKLOG

----------

TUESDAY, MARCH 24, 2009

U.S. House of Representatives,
Committee on Ways and Means,
Washington, DC.

The Subcommittee met, pursuant to call, at 10:37 a.m., in
room 1100, Longworth House Office Building, the Honorable John
S. Tanner [Chairman of the Subcommittee on Social Security]
presiding.
[The advisory of the hearing follows:]

ADVISORY

FROM THE
COMMITTEE
ON WAYS
AND
MEANS

SUBCOMMITTEE ON INCOME SECURITY
AND FAMILY SUPPORT

CONTACT: (202) 225-9263
FOR IMMEDIATE RELEASE
March 17, 2009
SS-1

Congressmen Tanner and McDermott

Announce a Joint Hearing on Eliminating
the Social Security Disability Backlog

Congressman John S. Tanner (D-TN), Chairman, Subcommittee on Social
Security, and Congressman Jim McDermott (D-WA), Chairman, Subcommittee
on Income Security and Family Support, today announced a joint hearing
on the Social Security Administration's (SSA's) large backlog in
disability claims and other service delivery declines, including
backlogs in program integrity activities. The hearing will take place
on Tuesday, March 24, 2009 in the main Committee hearing room, 1100
Longworth House Office Building, beginning at 10:30 a.m.

In view of the limited time available to hear witnesses, oral
testimony at this hearing will be from invited witnesses only. However,
any individual or organization not scheduled for an oral appearance may
submit a written statement for consideration by the Committee and for
inclusion in the printed record of the hearing.

BACKGROUND:

In recent years, SSA's backlog of claims for Social Security and
Supplemental Security Income (SSI) disability benefits has reached
unprecedented levels, with more than 1.3 million Americans currently
awaiting a decision on their case. The problem is particularly severe
at the hearings level, where the backlog has more than doubled since
2000--from about 310,000 to more than 765,000--and the average waiting
time is now almost 500 days.

These backlogs have resulted from years of underfunding as SSA's
workload increased due to the aging of the population and additional
responsibilities given to the agency. Resource shortages have also led
to service delivery declines in other areas. SSA has significantly cut
back on program integrity activities such as continuing disability
reviews and SSI redeterminations, even though these activities have
been demonstrated to generate considerable savings, as much as $10 in
program costs for every $1 in administrative expenditures. In addition,
service to the public has declined in SSA's field offices, as noted in
a January 2009 report from the Government Accountability Office (GAO),
and the backlog problem is of such severity that GAO included it in its
biennial ``high risk'' list of federal programs.

In the past two years, Congress has provided additional funding to
begin to address these problems, and SSA has begun to implement a plan
to eliminate the hearings level backlog by 2013. However, the agency
continues to face new challenges. Disability and retirement claims are
increasing due to the economic downturn in combination with demographic
changes. From FY 2008 to FY 2009, initial disability claims are
projected to increase by more than 12 percent and retirement claims by
more than 8 percent, and both are expected to increase even further in
FY 2010 and FY 2011.
Finally, two provisions designed to increase access to professional
representation for disability claimants are scheduled to expire during
the 111th Congress; and legislative proposals have been offered
relating to the disability determination process, such as changing how
claimants give consent to release medical records.

In announcing the hearing, Social Security Subcommittee Chairman
Tanner said, ``Today thousands of Americans with severe disabilities
must wait months--and sometimes years--to receive benefits. We are
committed to ensuring that the Social Security Administration is on top
of this problem and receives the resources it needs to eliminate the
huge backlog in disability claims. We must also ensure the agency has
the necessary resources to handle increased workloads associated with
the economic recession, perform program integrity reviews, and provide
the highest-quality service to the American people.''

Income Security and Family Support Chairman Jim McDermott said,
``Far too many of our most vulnerable elderly and disabled citizens are
waiting too long to get the benefits that they deserve and are entitled
to under the law. Congress has responded to this crisis by providing
the Social Security Administration with increased funds in order to
begin to actively address this problem, but it is time for the agency
to take more action to significantly reduce the waiting period before
an individual gets the benefits and services they need, while also
ensuring the integrity of the process. I look forward to hearing about
the initiatives that the agency is taking to address this problem and
what additional steps Congress can take to help.''

FOCUS OF THE HEARING:

This hearing will focus on SSA's large backlog in disability
claims. The Subcommittees will examine the impact of the backlog on
applicants with severe disabilities and SSA's plans for eliminating the
backlog, including how the agency intends to use the additional funding
that Congress has provided for the current fiscal year. The hearing
will also examine the impact of resource shortages on other agency
responsibilities, including SSA's substantial backlog in program
integrity activities, and SSA's plans for addressing these challenges.
The hearing also provides an opportunity for comment on legislative
proposals or expiring provisions relating to disability determination.

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Chairman TANNER. If we could, please, come to order.
This is a joint Subcommittee--the Subcommittee on Social
Security and the Subcommittee on Income Security and Family
Support--hearing this morning to talk about the backlog that
all Americans know about with regard to Social Security
disability claims, as well as looking at the ability from the
resource standpoint to reevaluate people who have been on
disability and who may have improved to the point where their
case needs to be re-evaluated.
Mr. Johnson, who is the Ranking Member on the Social
Security Committee, is going to be arriving soon. He has been
in Texas, I understand. He is coming back.
So we welcome Mr. Linder.
I will try to keep my opening statement short, and I would
hope that the other Members could see their way clear to do as
well.
We will be talking about a lot of numbers today. But, you
know, behind the numbers are real people with real problems out
there across the country who are waiting sometimes over a year.
In my case, in Tennessee, it is an average waiting time--in
Memphis, it is 16 months; in Nashville, it is a little more
than that, 18 months; and all of us have anecdotal experiences
with constituents who have been waiting to the point that many
of them have died actually while waiting on an evaluation of
their claim. So as we go through these numbers, I think it
would be wise for us to keep in mind that there are real people
out there that are in need, and so we will look at all of those
questions that I have outlined.
The prepared statement of Mr. Tanner follows:

[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

Chairman TANNER. So, at this time, I would ask Mr. Linder
if he has any opening comments.
Mr. LINDER. Thank you, Mr. Chairman.
Today's hearing is really about two things. The first is
the large backlog in Social Security and SSI disability claims
and efforts to reduce it. That is a big problem, which we
should work to fix.
The second and the long-run, more important thing this
hearing is about is the plummeting credibility of our ability
to propose solutions for this country. There seems to have been
adopted the axiom that anything that is wrong can be fixed by a
big government program. We are here to talk about one that is
failing, and we expect to vote this year on a government-run
healthcare system that will also fail.
I have a suggestion for our guests and viewers. Take the
press release announcing today's hearing and substitute the
words ``healthcare service'' for Social Security disability
wherever they appear. The title of the hearing would be
Eliminating the Health Care Service Backlog; the background
would discuss how the backlog of claims for healthcare services
has reached unprecedented levels and focus on the hearing would
be on the large backlog in healthcare services.
The reality is that the backlogs and ultimately rationing
of services plaguing Social Security's disability claims system
will be repeated or worse in a government-run healthcare
system. To deny that is to deny the existence of problems that
we will hear about today. Only the backlogs of the future won't
just mean people don't get disability checks on time. It will
mean people will die waiting for treatment or after receiving
inadequate treatment.
I ask unanimous consent to insert in the record an article
published last week about one hospital in England where between
400 and 1,200 more people died than would have been expected in
a 3-year period at the National Health Service hospital. This
led Prime Minister Gordon Brown to apologize to all of those
who have suffered from the mistakes that have been made.
[The information follows:]
Mr. LINDER. Some mistakes the article notes is how visitors
saw patients drinking out of flower vases. They were thirsty.
I would like to remind you that about 30 years ago, the
British National Health Service approved the use of
administrative failure as an acceptable cause of death for a
death certificate.
Today's hearing is a cautionary tale for those who think a
government-run healthcare system will efficiently deliver
medical services in a timely fashion. It won't. If the
government cannot adequately serve the 2.6 million Americans
who annually apply for disability benefits today, what makes us
think it will provide adequate healthcare services to 300
million Americans tomorrow? Those who trust in this Congress to
allocate just the right amount of social policy medicine to
cure what ails us deserve the poor service they will surely
get.
Last, let me point out that the two largest budget problems
that we face as a Nation are Social Security and Medicare. Need
we create more? Will the same Congress that has, in the
unanimous opinion of today's testimony, underfunded Social
Security's disability process be generous with the government
healthcare bureaucracy or its doctors, nurses, and specialist
employees? What is the evidence of that? There is none.
Thank you, Mr. Chairman.
Chairman TANNER. Thank you, Mr. Linder.
Mr. Johnson has arrived. So, Mr. Johnson, you are
recognized, sir.
Mr. JOHNSON. Thank you, Mr. Chairman, and congratulations.
I look forward to the good work we can accomplish together.
I also want to welcome our new Members, our colleagues from
the Income Security and Family Support Subcommittee. We all
share a real concern about the delays our constituents face
when they visit or contact a local Social Security office, call
the 800 number or wait over 16 months for a decision in their
disability appeal before an administrative judge.
Mr. Astrue, I know you have done good work to try to fix
that. At the same time, efforts to address program waste,
fraud, and abuse have been curtailed, costing billions in
improper payments, while reducing taxpayer confidence that
their hard-earned tax dollars will provide the services they
pay for and deserve.
This Committee has worked on a bipartisan basis to obtain
needed funding for the Social Security Administration. In the
last 2 years, Congress sent an additional $275 million to the
agency, above the President's request. In the economic stimulus
plan, Social Security received an additional $1 billion for a
new computer center and to help process a growing number of
applications for retirement and disability benefits.
Now it is time for you guys to step up and account for how
the money is going to translate into real results. In the short
term, Social Security must answer their phones, reduce the wait
times for people in local Social Security offices, and tell
people sooner whether their application for Social Security
benefits has been granted or denied at all levels in the
process.
Whether Social Security can get the job done depends in
large part on our having state-of-the-art computers driven by
the latest proven software. Far from state-of-the-art, Social
Security's main computer systems are stuck in the past. Social
Security's main database still operates using 1950's
technology, including COBOL programming language. Social
Security is working to replace this language, but that project
is not estimated to be completed until 2014.
Last year, we learned the agency's 30-year-old computer
center will be unable to carry its load after 2012. We are not
so far from there. In the meantime, a second data center has
been built in Durham, North Carolina, to run some of the
agency's daily work and temporarily step in to keep basic
operations running if needed. However, Durham is not going to
be fully operational until 2012. They may not be able to cover
all the agency's computing needs, at the same time now facing
the difficult task of purchasing a new computer center using
the $500 million they just received.
Going forward, Social Security cannot get this wrong. So I
would like the Commissioner to tell us his plan for maintaining
agency computer operations while finishing the Durham data
center and building a new computer center.
I hope we can solve this problem, because we are worried to
death about some disaster befalling that building and the only
site that contains information goes defunct.
I thank our witnesses for being here today and look forward
to hearing their testimony.
Thank you, Mr. Chairman.
Chairman TANNER. Thank you, Mr. Johnson.
I would like to now ask Dr. McDermott, who is the chairman
of the Subcommittee on Income Security and Family Support, for
his statement and then----
Mr. MCDERMOTT. Thank you, Mr. Tanner, for including us in
this hearing.
There are nearly six million disabled individuals who wait
for SSI to provide them with a helping hand. This program
really serves as a safety net to provide very modest cash
assistance and medical coverage through Medicaid programs to
those who have little or no income or assets.
Disability benefits, either through Supplemental Security
Income or Social Security programs, serve as a lifeline really
for a number of people. The cash assistance and the healthcare
coverage provided to these individuals gives them the help that
makes it possible for them to make ends meet.
Now, many are not in a position to wait months to receive a
decision on their eligibility for assistance, particularly
those with very limited resources who are seeking assistance
through the SSI Program. You can imagine the clamor we would
have if we had this kind of wait in our unemployment insurance.
Yet, today, the average waiting time to secure a hearing for a
disability claim at SSA is roughly 500 days, 16\1/2\ months.
That is simply unacceptable. There must be a better way to
serve the American public.
To be fair, the Social Security Administration has operated
in an insufficient funding level, as you heard, for a number of
years. The agency did not have the resources it needed to keep
pace with the normal volume of applications for assistance in
Social Security and SSI, much less respond to rising claims
that are associated with the aging of the baby boomers.
The agency has received new responsibilities as part of the
Medicare Modernization Act of 2003 and the Medicare
Improvements for Patients and Providers Act of 2008. As a
result, SSA has experienced severe staffing shortages, which
led to a decline, actually, in service delivery.
In response, the Committee has worked with our colleagues
on the Appropriations Committee over the last 2 years to
provide SSA with additional funding to allow them to begin to
reduce the disability backlog; and the American Recovery and
Reinvestment Act provided the agency with additional funds to
address the recent increase in workload.
We will continue to work with our colleagues and the
Administration to assure the agency has the resources it needs
to respond to individuals who need care. But it is now time for
the agency to take bold steps to expeditiously reduce the
length of time that a disability claimant must wait for a
hearing, and it is imperative that this is done in a manner
that firmly upholds the program's integrity so that benefits
are only given to those who are eligible to receive them.
It is also critically important that, while SSA adheres to
all the necessary program integrity measures, it remains
mindful of the precarious circumstances facing a disabled
applicant who is awaiting a decision on its application. Many
go hungry or lose their homes as they wait for a hearing and
subsequent decision. Others go without desperately needed
medical assistance and prescription drugs as they wait. And
others see their health and medical conditions deteriorate. All
of us in our district offices see these cases on a human basis.
Meanwhile, a significant number of these applicants will
eventually be determined to be rightfully eligible for benefits
under the supplemental security act of Social Security. Most
are judged to be eligible.
Clearly, more need to be done to get these benefits out to
the severely disabled Americans in a more efficient manner. The
1.3 million people who are waiting for a decision to be made on
their application deserve better.
I am pleased to see you here, Mr. Astrue; and we are eager
to hear your testimony. Thank you.
Chairman TANNER. Thank you, Dr. McDermott.
[The prepared statement of Mr. McDermott follows:]

[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

Chairman TANNER. The Chair would ask that unanimous consent
for anyone, any Member who wishes to submit a statement, an
opening statement to the record, that be allowed without
objection; and also the witnesses' testimony will be in the
record in their entirety.
We would ask, Commissioner, if you could hold your
testimony to 5 minutes. We would appreciate it, and I will try
to ask the Members to do the same.
You are recognized, sir.

STATEMENT OF MICHAEL J. ASTRUE, COMMISSIONER,
SOCIAL SECURITY ADMINISTRATION

Mr. ASTRUE. Chairman Tanner and Chairman McDermott, Members
of the Subcommittee, thank you for this opportunity to talk
about the Social Security Administration's most important
mission, service to the American people.
Just over 2 years ago, on my second day as Commissioner, I
testified here before you. Your frustration with mounting
backlogs and service delivery issues was palpable; and, to your
credit, you recognized not only that the agency needed to be
more efficient, but that Congress needed to provide more
resources. I pledged to work with you toward that goal; and
together we have made progress even in these difficult economic
times, although not as fast or as far as any of us would like.
Here are some examples of service improvement:
AT the DDS level, we have reduced processing time by about
4 percent in each of the last 2 years. New electronic triaging
systems accelerate payment to those who clearly meet the
medical listings.
This year, for about 4 percent of all claimants, 100,000 to
125,000 Americans, the DDSs will approve their claims in about
10 days.
New support tools for examiners, such as the e-Cat System
that is being tested in Michigan, Virginia, and Connecticut,
are improving consistency and accuracy.
We are expanding a highly successful pilot to access
electronic medical records. An enormous amount of time, cost,
error, and delay comes from chasing down scattered paper
medical records. A new paradigm for receiving medical records
will allow us to make exponential improvements in the speed and
quality of our decisions.
We are working hard to update regulations on our medical
listings, and we are on schedule to update all of them every 5
years.
We are also expanding the listings to include rare diseases
and conditions that clearly represent permanently disabling
conditions.
We hired and trained 190 new ALJs last year, and we expect
to hire 157 more in the coming months. We plan to maintain a
national average ratio of about 4.5 support staff per ALJ.
At the hearing level 2 years ago, we were facing stubborn
increases of about 70,000 more cases each year with no relief
in sight. Due to a misguided effort to hold that number down,
ODAR had been giving priority to the newest, easiest cases. So
the predictable happened and the number of what the agency
calls ``aged'' cases skyrocketed.
At the start of fiscal year 2007, we had about 65,000
``aged'' cases which were then defined as 1,000 days or older,
and some were as old as 1,400 days, which is simply obscene. We
cleared out all but a handful of them that year.
For fiscal year 2008, we redefined the ``aged'' as 900
days; and we resolved about 135,000 of those cases. We lowered
the ``aged'' definition again this year to 850 days, and we are
ahead of schedule to process those 165,000 cases. As difficult
a challenge as this is, it is the right thing to do. So next
year we will raise the bar on ourselves again.
This decision is paying off. Two years ago, the Atlanta
hearing office had the worst average processing time in the
country of about 900 days. Today, nobody is waiting that long;
and the time in Atlanta is 550 days. In fact, the worst average
processing time in the country is now 726 days; and we have
improvement plans in place for the 30 most backlogged offices.
For example, we are providing relief to hearing offices with
the most pending cases by transferring cases to the National
Hearing Center; and we are expanding the number of National
Hearing Centers dramatically in the next few months.
We are also adding 10 new hearing offices. We are adding
additional satellite offices, and those new hearing offices are
already well into the GSA site selection process.
In some of our field offices, as the GAO reports, service
has deteriorated because funding has not kept up with
workloads. The key source of relief has been the public's use
of our much-improved electronic services. We have the three
most user-friendly electronic services in the Federal
Government, as measured by objective surveys; and the public
has embraced them enthusiastically.
For instance, so far this year, about 33 percent of our
retirement applications are filed online, up from only 10
percent 2 years ago. Without this choice, wait times in many
offices would have been longer.
Other efficiencies such as replacement of our antiquated
telephones are under way, but the GAO is right that,
ultimately, there is no substitute for adequate staff.
Fortunately, passage of the Recovery Act and our annual fiscal
year 2009 appropriation will allow us to hire over 5,000 people
by the end of the year. Please keep in mind, though, that
productivity suffers while we hire and train this many new
people, and, for the most part, these new employees will not
fully contribute until next year.
Your recent legislative action will make a huge difference
going forward, and timely passage of President Obama's
recommended appropriation for fiscal year 2010 will make an
even bigger difference.
Lastly, I am pleased to report that we will send more than
$13 billion in one-time recovery payments to eligible
beneficiaries beginning in early May and continuing throughout
the month, 3 to 6 weeks ahead of the statutory deadline.
Again, thank you for your support. It has meant a lot to
the agency. I look forward to continuing to build on our strong
and productive working relationship.
I would be pleased to answer any questions you may have.
Chairman TANNER. Thank you very much, Commissioner, for
that timely presentation; and your statement will be submitted
to the record.
[The prepared statement of Mr. Astrue follows:]
Statement of The Honorable Michael J. Astrue, Commissioner,
Social Security Administration
Thank you for inviting me to appear before you today to discuss the
current state of the Social Security Administration and our plans for
the future. We are grateful for your long-standing support of our
programs and for providing us with additional funding for fiscal years
(FYs) 2008 and 2009. Social Security is indispensable to the disabled,
seniors, and survivors and is one of the most important and most
successful Federal programs that our country has ever established.
The programs we administer pay nearly $60 billion in benefits each
month--they are an integral part of the American economy. We have a
proud history of excellent service to the public, and I reiterate my
promise to do everything in my power to continue that tradition.
I would also like to thank you for providing us with additional
funding in the American Recovery and Reinvestment Act (ARRA) of 2009 so
that we can process our increasing workloads, replace our aging
National Computer Center (NCC), and issue economic recovery payments.
We are working with the Department of the Treasury to enable Treasury
to issue the $250 one-time economic recovery payments as soon as
possible. As required by law, a total of about $13.25 billion in
economic recovery payments will be issued to nearly 55 million Social
Security and Supplemental Security Income (SSI) beneficiaries. Although
implementing the legislation requires extensive coordination with other
Federal agencies, we are on track to ensure that these payments to our
beneficiaries are issued in May--about 3 to 6 weeks earlier than the
statute requires.
Since I last testified, we published the first Agency Strategic
Plan during my tenure. It outlines our strategies to meet the
challenges we face and to deliver the level of service the public
expects and deserves. Over the past 2 years, we have made significant
progress in implementing initiatives to better serve the public and to
reduce the hearings backlog. We could not have done so without your
help. As a result of the funding that you provided in FY 2008, we were
able to hire and train 190 administrative law judges (ALJs) and staff
to support them. We are on track to hire an additional 157 ALJs and
over 700 support staff this year. This additional staff will allow us
to hear more cases and render more decisions. We have already seen a
slight reduction in the number of cases awaiting hearings, a reduction
which would have been even greater if we had not received more requests
for hearing than we had anticipated.
Unfortunately, but not surprisingly, we are not yet where we need
to be. Despite our progress, we have significant challenges ahead. The
economic downturn, combined with the retirement of the baby boomers,
and the fraying of our physical and technological infrastructure have
diminished our ability to address our rising workloads and backlogs.
The uncertainty of our annual appropriations, which often leaves the
agency without full-year funding at the start of the fiscal year, adds
further complexities. Adequate and sustained funding is essential for
providing high level service to the American public. Nevertheless, with
your continued support, we will eliminate the hearings backlog by 2013.
The Services We Deliver
We administer the Nation's social insurance programs and one of the
Nation's largest means-tested income maintenance programs. Each year we
send benefits totaling about $700 billion to approximately 60 million
persons. Social Security and SSI benefits play a significant role in
the Nation's economic security.
The Old-Age, Survivors, and Disability Insurance beneficiaries
programs benefit workers, their dependents, and survivors at critical
junctures in their lives: when they retire, when they become disabled,
and when a family's wage-earner dies.
Through the SSI program, we assist the most vulnerable persons in
our society. These payments provide a safety net for aged, blind, and
disabled adults and children who have little or no income or resources.
In addition to administering our own programs, we also assist the
public in applying for food stamps and Medicare, including low-income
subsidies under the Medicare Prescription Drug Plan. These programs
also play a significant role in the economic security of the Nation's
elderly and disabled.
How We Serve the American Public
We administer our programs and services through a network of over
1,400 offices that directly serve the public in communities throughout
the country. About two-thirds of our over 60,000 employees deliver
direct service to the public or support the services provided by these
front-line workers. Field offices are our front door and the primary
points for face-to-face contact with the public. Our employees also
work in teleservice centers, card centers, processing centers, hearings
offices, the Appeals Council, regional offices, and our headquarters in
Baltimore.
I am particularly proud of our dedicated workforce, and I am
pleased that Equal Opportunity Magazine recently named Social Security
the top government employer. We also received high marks from our
employees in the 2008 Federal Human Capital Survey, with especially
high marks for Job Satisfaction and Leadership and Knowledge
Management, ranking among the top 10 Federal agencies in both
categories.
Recently, a leader in the customer service industry contacted one
of our field offices for service. He praised the claims representative
who helped him as one of the most personable, customer-oriented
employees whom he had ever met, either inside or outside government. I
am never surprised when I hear stories like this one; I know our
employees are dedicated to our mission and to serving the public to the
best of their abilities each and every day.
Field Offices
I would like to take a few minutes to describe the demands our
employees face during a typical day in one of our field offices. Our
field offices are extremely busy, and our employees are pulled in a
variety of directions every day.
Employees have only about an hour each day before the office opens
to prepare the daily schedule of appointments, attend training, read
policy updates, and process pending claims and post-entitlement
actions. Once the office opens to the public, employees have little
time to process pending work because much of their day is spent serving
visitors and processing time-sensitive actions, such as issuing
immediate payments for lost checks.
The two most common reasons for visiting our field offices are to
file a claim for benefits or to obtain or replace a Social Security
card.

About 9 percent of field office visitors file claims for
benefits, including retirement, disability, survivors, spouses, and
children. Field office employees give this work their highest priority.
Disability claims, much more complex than retirement claims, are
particularly time intensive because our employees help claimants
complete detailed forms about medications, treatment, medical testing,
work history, and daily activities.
About 30 percent of field office visitors seek new or
replacement Social Security cards for employment or tax purposes, to
replace lost or damaged cards, or to obtain State and local government
benefits. This work is critical to preventing identity fraud and has
become more complex and labor-intensive because of legislative changes
and heightened national security.

Once the office closes to the public, employees may have only a few
minutes to take care of all remaining business. For example, employees
often must gather additional data to verify allegations of resources
and income, such as child support, unemployment benefits, or workers'
compensation, in connection with the claims they had taken during the
day.
Our field office employees work extremely hard and handle a wide
variety of services. To give you a sense of the volume and variety of
work the field offices routinely handle, in FY 2008, we:

processed over 18 million applications for Social
Security cards;
verified Social Security numbers (SSN) about 1 billion
times;
provided about 19 million benefit verifications;
processed 3.7 million retirement and survivor claims,
nearly 500,000 Medicare applications, over 1 million Medicare subsidy
applications, and 62,000 food stamp applications; and
processed over 22 million status changes for our
beneficiaries, such as changes of address and requests for direct
deposit.

Teleservice Centers
Our other major point of contact with the public is through our 35
Teleservice Centers (TSC). The TSCs provide agent assistance to the
public from 7 a.m. to 7 p.m. Eastern Time on normal business days, as
well as automated telephone services 24 hours a day, 7 days a week. TSC
employees handle a variety of inquiries, such as changes of address and
telephone number, and requests for direct deposit and replacement
Medicare cards. They schedule appointments and answer inquiries about
payments and claim status and allow field offices to concentrate on
workloads which require face-to-face interviews, additional
development, or resolution of complex issues.
Social Security Card Centers
We currently have seven Social Security Card Centers located
throughout the country. The card centers streamline and improve the
integrity and stewardship of the Social Security number assignment
process. Because of their specialized expertise, card center employees
process applications for original Social Security numbers and
replacement cards with a high degree of integrity, efficiency, and
expertise. Applicants for a new or replacement card have shorter wait
times in the card centers than in the field offices. Moreover, because
the card centers handle much of the card-issuing workload, nearby field
offices can focus on other critical activities, which results in
quicker, more efficient service in field offices located in proximity
to card centers.
Our card centers are located in Brooklyn and Queens, New York; in
Las Vegas, Nevada; in Downtown and North Phoenix, Arizona; in Orlando,
Florida; and in Sacramento, California.
DDSs, Hearings Offices, and the Appeals Council
Each month, we pay about $12 billion in disability benefits to more
than 13 million disabled beneficiaries across the Nation. The State
disability determination services (DDS), our hearings offices, and the
Appeals Council are integral to processing disability claims. These
components, like our field offices, struggle with workload increases
while they try to drive down backlogs created by years of understaffing
and inadequate resources.
The disability claims process begins when a disability claimant
completes an interview with a field office employee. We then forward
the claim to 1 of 54 DDSs. These State agencies develop the medical
evidence and make the initial determination of whether the claimant is
disabled. We could not perform our disability adjudication process
without the State DDS employees.
A claimant who is not satisfied with the DDS's initial
determination may request that the DDS reconsider it. If the claimant
is dissatisfied with the reconsidered determination, he or she may
request a non-adversarial hearing before an ALJ. At the hearing, the
claimant may appoint a representative, testify, and call and question
witnesses. (In the ten States in which the reconsideration stage has
been eliminated, the claimant may request that an ALJ review the
initial determination.) A claimant who is not satisfied with the ALJ's
decision may request review by the Appeals Council. If the Appeals
Council agrees to review a case and issues a new decision, a disabled
claimant may appeal that decision to Federal district court. If the
Appeals Council declines to review the decision, the ALJ's decision
becomes the final administrative action, and it may then be appealed to
the Federal district court.
Our Service Delivery Challenges
We are an agency comprised of specialized staffs, but our common
goal is to provide high-quality service. We face many challenges in
meeting this goal, and we plan for those we can anticipate. For
example, we knew that the demographics of the baby boomer generation
would affect workload volumes across the agency. We also knew that our
most experienced staff could soon retire because many of them are baby
boomers themselves. In fact, according to our most recent estimate, we
may lose 44 percent of our current employees by 2016.
We also work carefully to forecast, to the best of our ability, the
effect of other workloads on the agency. For example, we could not have
predicted the new non-core workloads required by legislation, such as
the Medicare Modernization Act, E-Verify, or the new Children's Health
Insurance Program (CHIP) verification requirements. We use the
additional targeted funding provided by Congress or reimbursement from
other agencies for these specific workloads. We know from recent
experience that more employers are using E-Verify voluntarily, and we
will update through our established process with DHS reimbursement for
these activities. In addition, we are now working to accommodate States
that may choose to follow new CHIP rules for benefit eligibility
determinations.
Certainly, we could not have predicted the current weakened state
of the American economy or the high unemployment rate, factors that
contribute to an increase in the number of applications for benefits.
These unexpected events hit at the same time our workloads were
significantly increasing due to the baby boomer retirement wave.
These additional and unexpected workloads are not our only
challenges. Although we fully fund the State DDSs, they operate under a
myriad of State personnel and budget rules. For example, due to budget
constraints this fiscal year, some States have instituted statewide
staffing freezes and furloughs. Some States have excluded DDS staff
from these restrictions because they recognized the negative impact
such restrictions would have on their disabled residents. Other States,
though, have, over our vehement objections, chosen to treat DDS
employees like other State employees and subject them to State
restrictions, including furloughs.
Our information technology infrastructure is outmoded and
inefficient, but improving dramatically. For example, we are converting
the agency's master files from an in-house developed data base
management system, created over 25 years ago, to a modern industry
standard data base management system. We have already migrated our
enumeration master file, which is our largest in terms of number of
records. This year we plan to do the same with our next largest file,
which houses earnings information.
During the 2 years I have been Commissioner, we have also started
each year without a full-year appropriation. We spent all of FY 2007,
almost one-third of FY 2008, and nearly one-half of FY 2009 operating
under a continuing resolution. As you well know, during continuing
resolutions, we must restrict our spending levels to that of the prior
year's appropriated funding. This year it meant we operated through the
beginning of March with nearly $300 million less than the President's
budget. Even if our workloads remained level from year to year, the
annual inflation in our fixed costs, such as building maintenance,
security, and salary increases, while necessary to maintain our
operations, would reduce the amount we have available for taking
retirement and disability claims and providing the other services the
American public requires.
Workloads, though, have not remained level. In the past few years
we have experienced a steady increase in the number of visitors to our
field offices. Field offices averaged 800,000 visitors per week in FY
2006; 826,000 in FY 2007; and 854,000 in FY 2008. So far, in FY 2009,
we have helped, on average, over 852,000 visitors each week, but that
number appears to be rising. In February 2009 alone, we helped an
average of over 940,000 visitors per week; we expect this upward trend
to continue throughout FY 2009. (See Appendix A for average daily
visitors per month.)
Even with all available field office employees and managers devoted
to serving visitors, waits are long--31 percent of visitors without an
appointment, about 5.8 million visitors, wait more than 30 minutes to
be seen by staff; and 6 percent of visitors with appointments, about
1.1 million visitors, wait more than 30 minutes. Not only is this
unacceptable to you, to the public, and to us, it is also demoralizing
to our employees, who have dedicated their careers to providing
outstanding service to the public.
There is also a clear connection between our inability to hire
staff and the deterioration in service at our TSCs. Nearly 15 percent
of callers who call our 800 number receive a busy signal. As a result,
many of our customers who were unable to conduct their business over
our 800 number chose to go to their local field office. This increase
in visitors to field offices contributed to the higher field office
waiting time I have described.
Moreover, we now project a dramatic increase in workloads due to
the economic downturn. This increase is a cause for concern. Recent
projections indicate that we will receive over 300,000 more retirement
claims in FY 2009 compared to FY 2008, an increase of nearly 9 percent.
The current recession has also affected our disability workloads.
Studies suggest a correlation between increases in unemployment and
increases in disability filings, and we have seen a sizable increase in
filings so far this year. We currently anticipate more than 2.9 million
disability filings in FY 2009, an increase of over 300,000 cases over
FY 2008. This number represents more than a 12 percent increase in new
applications and is 13 percent higher than the amount assumed in the
2009 President's budget.
In addition, although it is difficult to project with precision, we
believe we may receive approximately 50,000 more hearing requests in FY
2009 than in FY 2008. We also expect to receive nearly 40,000
additional requests for reconsideration and more than 20,000 requests
for Appeals Council reviews in FY 2009 compared to FY 2008.
We have paid the price for the growth in workloads and tight
budgets in recent years. We have been forced to defer performing full
medical continuing disability reviews (CDR) and other critical
stewardship workloads, such as adjusting payments, correcting earnings,
and processing wage reports and overpayments. We do not want to defer
this work; these are critical workloads that ensure we are paying the
right beneficiary the right amount at the right time. In addition, we
know that for each dollar we spend performing CDRs, we recoup over $10
in program funds. However, we have had to focus our limited resources
on processing our initial claims workloads and getting eligible
claimants paid, at the expense of performing this important work.
As a result of this workload deferral, we estimate that we had a
backlog of 1.4 million full medical CDRs at the end of FY 2008, and we
expect the backlog to grow by another 100,000 to 150,000 in FY 2009.
However, we expect to process significantly more CDRs in FY 2009 than
in FY 2008 in large part because of the additional dedicated funding
provided by Congress for FY 2009.
In analyzing our challenges, our mission, and the public we serve,
we have come to understand that simply working harder is not enough to
overcome the workload challenges we face. Last fall, I outlined four
key goals for the agency in our Strategic Plan: (1) eliminate our
hearings backlog and prevent its recurrence, (2) improve the speed and
quality of our disability process, (3) improve our retiree and other
core services, and (4) preserve the public's trust in our programs. To
move forward amidst our rising workloads, we must focus our attention
on these key areas while modernizing the way we deliver service. We
realize that achieving these goals will require sustained commitment
and timely resources. If we are required to take on additional work, we
will need sufficient funding to cover our full costs, as well as
adequate time to implement any necessary regulatory, policy, process,
training, or system requirements.
Investing in Our Agency Produces Results
Despite our growing challenges, we have made real progress within
the past few years. We have begun the hiring and work that--if not for
the economic downturn--would have produced more visible results for the
American public, not just in terms of reduced backlogs and processing
times, but also in terms of shortened field office wait times and fewer
busy signals. Although it may not be readily apparent in these
challenging times, we have achieved measurable successes.
Service Delivery at the DDS Levels
We are committed to a disability process that is fair, accurate,
and as prompt as possible. Currently, though, our pending levels are
too high, and claimants wait too long for a determination. Every day
spent waiting for a determination creates additional burdens for many
claimants who are already among the most vulnerable members of our
society. This is simply unacceptable.
The initiatives outlined below will modernize the disability
process and improve our timeliness, accuracy, and efficiency.
We must improve the beginning of the administrative process, even
before a hearing is requested. Using new rules and technology, we can
allow claims earlier in the process and improve service for disability
claimants. I am pleased to report today that at the DDS level, we have
reduced processing times by about 4 percent in 2007 and in 2008.
Policy Initiatives
We are currently using two processes--the Quick Disability
Determination (QDD) process and Compassionate Allowances--to fast-track
about 4 percent of all disability cases, a significant increase from
the 2.6 percent of cases fast-tracked last year. This year we will find
100,000 to 125,000 Americans with the most severe disabilities eligible
for benefits in about 10 days, instead of the 3 to 4 months it
typically takes for an initial determination.
Under QDD, a predictive computer model analyzes specific data
within the electronic file. This model identifies cases with a high
potential that a claimant is disabled and medical evidence is readily
available. Through Compassionate Allowances, the model identifies
claims for applicants with medical conditions so severe that their
conditions by definition meet the required standard. These fast-track
systems increase the efficiency of the disability process and free up
resources.
We have expanded our efforts to revise and update the medical
listings. These listings allow us to make a favorable determination or
decision for certain claimants without the need to consider that
person's age, education, or work experience. When I became
Commissioner, the medical listings had not been updated for decades.
Some listings had last been updated in the 1970s, others in the 1980s.
That is far too long. So, in the last 2 years, we have published final
regulations for 3 of the 14 adult body systems, so they now reflect the
updated advancements in medicine and technology. We are on schedule to
update all of our medical listings every 5 years, and, in the future,
we plan to update these listings as often as every 3 years. We are also
in the process of expanding the listings to include rare diseases and
conditions that clearly represent permanently disabling conditions.
To improve consistency and accuracy on complex policy issues, we
have instituted a process for resolving disagreements between DDS
disability examiners and Federal quality reviewers. In cases where the
two components disagree on substantive issues, staff experts review the
case and reach consensus. We anticipate we will resolve our most
complex cases through this Request for Program Consultation (RPC)
process. In addition, the RPC enables us to quickly pinpoint training
needs and clarify or modify policies where necessary
Systems Initiatives
We are always looking for ways to use technology to improve our
disability process. For example, we are on the forefront of the move to
electronic health records and are primed to take advantage of the new
and exciting possibilities related to health information technology
(HIT).
We began working with Beth Israel Deaconess Medical Center (BIDMC)
in Boston last spring to determine how we could use HIT to make our
disability decision-making more efficient and timely. Currently, when a
claimant treated at BIDMC files a disability application, the Medical
Evidence Gathering and Analysis through Health Information Technology
(MEGAHIT) system automatically sends an electronic request for his or
her patient's medical records. Almost immediately, the hospital
electronically transmits back to us the individual's medical record
through MEGAHIT. We receive these records in seconds and minutes,
rather than the usual weeks and months.
As part of our HIT initiatives, we are a leader in the development
of the Nationwide Health Information Network (NHIN), the nation's
electronic network of health information. On February 28, we took part
in the first exchange of data across the NHIN as the healthcare
provider MedVirginia forwarded records to us in connection with a
disability claim. We will be tracking the flow of data from MedVirginia
providers to us by way of the new system. This initiative will
revolutionize the way we process disability claims by allowing us to
automatically request and receive the medical records needed to make
disability determinations. Yet we realize that this is a time of the
great change in the HIT area and thus we remain committed to
participation in the standards and certification process, as well as to
the protection of the privacy of these records.
We also continue to develop and improve our Electronic Case
Analysis Tool (eCAT). This tool helps disability adjudicators work
through the policy aspects of claims adjudication to yield consistent,
policy-compliant outcomes and better service to claimants. We expect
the use of eCat will produce well-reasoned determinations with easy-to-
understand explanations of how we reached our decision.
We plan to develop and implement a common case processing system
for the DDSs. Currently, each of the 54 DDSs has its own unique
processing system. A common system will help us take advantage of
rapidly changing healthcare industry technology and provide the
foundation for a seamless electronic disability case processing system.
Our DDS partners agree that we need a common system, and we are working
closely with them to develop requirements. This essential improvement
will modernize and streamline our disability process, and we can only
make important improvements on a timely basis, such as eCat, if we have
a common system.
Service Delivery at the Hearing Level
As I have said many times, eliminating the hearings backlog is a
moral imperative. Despite the additional workloads caused by the
economic downturn, we have adjusted to changed circumstances and are
still on track to eliminate the hearings backlog by 2013. Although it
is difficult to project with precision, we believe we may receive
approximately 50,000 more hearing requests in FY 2009 than in FY 2008.
We have already taken preparatory actions in anticipation of this surge
in hearing requests. We have moved to improve our processes, add new
staff, and utilize new technologies.
Through the hard work of our employees and with the support of
Congress, we are making positive strides toward driving down the
hearing backlog and providing Americans with disabilities the prompt
service they deserve. In fact, we have already seen a slight reduction
in pending hearing cases. These cases have dropped in the past two
months. Furthermore, in the spirit of the President's directive for
transparent government, we will post the backlog numbers on the
internet quarterly along with a clear explanation about the hearing
backlog.
In May 2007, I announced my plan to eliminate the backlog of
hearing requests and prevent its recurrence. This backlog reduction
plan centers on:

fast-tracked initial determinations;
improving hearing office (HO) procedures;
increasing adjudicatory capacity; and,
increasing efficiency with automation and improved
business processes.

Earlier, I discussed our initiative to fast-track initial cases. I
will now highlight some of the key components of the plan's other three
elements.
Improving Hearing Office Procedures
We remain committed to improving our hearing office procedures. We
have significantly reduced the inventory of the most aged cases, those
that have been pending the longest. Clearing these cases normalizes our
hearing work flow and more importantly, claimants who have waited far
too long for a hearing decision finally receive one. We defined aged
cases in FY 2008 as those cases that would be at least 900 days old by
the end of that fiscal year and cleared all but 281 of the more than
135,000 we identified. For FY 2009, we raised the bar and redefined
aged cases as those cases which will be at least 850 days old by the
end of this fiscal year. There were 166,838 aged cases at the beginning
of FY 2009, and we are ahead of our target and are more than halfway
toward clearing all of them. We are looking to continue to attack the
aged cases, and our probable goal for FY 2010 is to work the 825-day-
old cases, approximately 179,000 cases.
We are also finding ways to expedite favorable decisions. We
reinstituted the Attorney Adjudicator program to allow our most
experienced attorneys in appropriate cases to make on-the-record,
favorable decisions without a hearing. This program brings eligible
applicants onto the disability rolls more quickly than if they had to
wait for a hearing. Through the first five months of FY 2009, Attorney
Adjudicators had issued 13,462 favorable decisions and are on target to
meet our year end goal. We have also instituted a DDS remand process,
special Federal Quality Reviewer screening units, and a Medical Expert
Screening process to help identify cases that may be allowed without
the need for a hearing.
Increasing Adjudicatory Capacity
We are working to maximize our ability to issue decisions at any
given point in the disability process. In collaboration with State
DDSs, we are using the informal remand process to send pending cases,
which have been profiled as likely to be allowed, back to the DDS for
review and possible favorable determination. As a result of this
initiative, we were able to dismiss 16,838 requests for hearing due to
favorable DDS decisions in FY 2008. We are on target to meet our year-
end goal for DDS remands. All States are now able to process electronic
informal remands, which will enable us to more easily transfer these
cases to the DDSs.
Our first National Hearing Center (NHC) is performing well. Located
in Falls Church, Virginia, the NHC plays a crucial role in increasing
our adjudicatory capacity and giving us the flexibility to address the
areas of highest pending without waiting years to build or expand
hearing offices. For example, transferring cases to the NHC from some
of the offices with the highest number of pending cases has contributed
to an improved average processing time in the hearing offices in
Atlanta, Georgia; Cleveland, Ohio; and Flint, Michigan. The ALJs in the
NHC hold hearings remotely using video conferencing and provides us the
flexibility to better balance pending workloads across the country. In
FY 2008, the NHC issued 2,151 decisions. We will open another NHC site
in Albuquerque, New Mexico this month and plan to open one in Chicago
in the upcoming months. We also plan to open a site in Baltimore early
next fiscal year.
We are also working with the General Services Administration (GSA)
to expedite opening 10 new hearing offices. (See Appendix B for a map
of the planned hearings offices.) We are adding centralized centers for
case pulling and decision writing in the regional offices to more
quickly accommodate our needs.
We are also hiring new employees. In FY 2008, we hired and trained
190 ALJs We have received a new certificate of eligible ALJ candidates,
and we expect to hire 157 new ALJs this year. We have already hired 140
new support staff in our hearing offices so far this year, and expect
to hire over 700 additional support staff. This hiring will allow us to
achieve a national average ratio of about 4.5 support staff to every
ALJ.
We are on target to eliminate the hearings backlog by 2013. We
expect to reduce the number of pending hearings to 466,000 by FY 2013,
which is the number of cases we will have when we reach our goal of an
average processing time of 270 days. We are focused on hiring enough
ALJs and support staff to achieve these goals given our current receipt
and productivity projections. Our current estimate is that we will need
1,400 to 1,450 ALJs to achieve our goals, and we are expanding our
physical infrastructure, to the extent we can, so that we can reach
that level. We expect to hire 208 ALJs in FY 2010, while maintaining a
national average ratio of about 4.5 support staff per ALJ. We will
continue to work with GSA Headquarters and the Regional GSA offices to
ensure we have adequate space to handle this significant increase.
Finally, we are seeking to increase our adjudicatory capacity by
ensuring that our ALJs are providing the service the public deserves.
At the beginning of FY 2008, our Chief ALJ issued a letter asking all
ALJs to strive to issue 500 to 700 legally sufficient decisions a year.
About 50 percent of full-time experienced ALJs are meeting this
expectation. Productivity in our Office of Disability Adjudication and
Review (ODAR) increased substantially for two consecutive years, in FY
2007 and FY 2008. In FY 2008, ODAR conducted nearly 15,000 more
hearings than in FY 2007; average dispositions per ALJ also increased.
But we were not able to sustain that level in the first few months of
FY 2009 due, in part, to the hiring and training of a large number of
new ALJs late in FY 2008. It takes about 2 years to fully train and
mentor newly hired ALJs and support staff. Thus, we expect these new
judges to become increasingly productive throughout the year, and we
have already seen a significant improvement in productivity in both
January and February.
The increase in adjudicatory capacity at the hearing level will
generate increased workloads at the Appeals Council. To address this
rising workload, we will hire additional administrative appeals judges
and support staff for the Appeals Council, and make additional overtime
available. In FY 2009, we expect to add a total of 135 new staff at the
Appeals Council, while replacing losses due to attrition.
Automated/Improved Business Processes
We have also taken steps to ``work smarter.'' In FY 2008, we made
significant progress in eliminating the remaining backlog of paper
folders and transitioning to an electronic environment.
We are preparing more cases for hearing (``pulling cases'') this
year. This increase in cases ready for hearing will give the ALJs more
cases to hear and decide.
We are expanding the use of video equipment and have initiated the
Representative Video Project. Under this project, representatives of
disability claimants may use their personal equipment to participate in
hearings from their own offices. We are using desktop video units in
claimant-only hearing sites in addition to the traditional video
equipment used in hearing offices.
We will be implementing an in-line quality review of the claim
file, scheduling process, and decision writing to ensure timely and
legally sufficient hearings and decisions.
To balance pending workloads nationally, last fiscal year we
realigned service areas and moved workloads from regions with heavy
workloads to regions that had the capacity to process additional work.
We continue to monitor our workload numbers and make additional
adjustments as needed.
Our plan is working--we have improved our hearing level
performance. In FY 2008, we had an impressive 5 percent increase in our
hearing dispositions and made important gains in reducing aged cases
and average processing times in the most backlogged offices. But for
the increase in filings due to the economic downturn, the number of
pending cases would have dropped for the first time this decade.
However, because of the increased workloads, we ended up with a 14,000
case increase in pending cases. Yet, this is well below the annual
increase of 70,000 cases we have seen in the years preceding the
hearing backlog reduction plan.
So far in 2009, our pending level rose in first 3 months, but
dropped by 1,294 cases in January and by another 1,719 cases in
February. Our pending level is currently up 4,700 cases over the level
at the end of FY 2008. If we continue our present concerted effort,
combined with the increased productivity of our recently hired judges,
I am hopeful we can drive the hearings backlog downward this fiscal
year.
We have a unique opportunity to significantly improve our service
to our disability claimants. Taken together, our initiatives address
every aspect of the hearings backlog problem. If all of these
initiatives are successful, there is light at the end of the tunnel.
Improving Retirement and Other Core Services
We simplified our policies, improved our technology, and automated
business processes to deal with our other significant workloads. As the
Government Accountability Office recently indicated in its January 2009
report on service delivery and the baby boomer retirement wave, our
agency's service delivery has suffered because funding has not kept up
with increasing workloads. The only way we have managed to hold our own
is by offering the public the option of secure, user-friendly,
electronic services.
Perhaps the most dynamic and successful model illustrating how we
plan to improve service in the future is our Ready Retirement project.
In FY 2008, we began putting the key features of this transformational
initiative into place by simplifying and further automating the
processing of online retirement applications. We will continue to
implement this initiative over the next few years using a multi-faceted
approach: simplified enrollment, streamlined adjudication, and public
education.
The first key feature of Ready Retirement focuses on simplified
enrollment. In December 2008, we introduced a new Internet application
(iClaim) for retirement, disability, and aged spouses benefits. The new
online claims application asks claimants questions that are pertinent
to their own personal situation, relies on information already housed
within our records, and contains navigational tools that make the
application easy to use. As a result, iClaim not only simplifies the
current process, but also shortens the time it takes to file online and
eliminates the need for most online filers to visit their local field
office. We have had incredible success with our launch of the iClaim
media campaign featuring our spokesperson Patty Duke.
The simplified enrollment process also hinges on efforts to update
our policy. After thorough study, analysis, and vetting with agency
components, we have simplified a number of policies that support Ready
Retirement and other online initiatives. Future releases of iClaim will
include authentication protocols to provide two-way online
communication with online applicants while safeguarding personally
identifiable information. We also are exploring new data exchanges and
matching agreements to verify claims information online.
Our efforts to streamline policy apply to both online claims and
claims filed in person. For example, we know there have been concerns
about our policy on advising claimants about their options for electing
when to start receiving benefits. Our policy instructs employees to
discuss all benefit types for which a claimant may be eligible,
including options for when to start receiving benefits and does not
prohibit employees from advising claimants about their benefit election
options. The same policy holds true for Internet claims: claimants who
file online have access to agency publications that explain all factors
that they should consider when deciding when to retire; these
publications also explain what other types of benefits are available to
the claimants. Employees processing these online applications screen
for other potential entitlements and contact claimants to discuss these
and month of election options if there are questions.
Our current version of iClaim, which is similar to our prior
Internet application, currently requires manual review and adjudication
because it does not take into account certain factors, such as non-
service months, protective filing, and retroactivity when presenting
month of election options to claimants. I am excited to announce that
in May 2009, we are introducing a new version of iClaim that will offer
election options to claimants filing online based on all of these
factors. This new version of iClaim will give online filers additional
support and will reduce the need for employees to contact them. Our
employees will continue to contact claimants as necessary to ensure
that their benefit elections are clear and that accurate determinations
are made.
The second key feature of Ready Retirement is streamlined
adjudication. The claims adjudication process includes many
determinations, and the streamlined adjudication model is the next step
in automating some of these manual decisions. All retirement
applications require some manual processing, but streamlined
adjudication will automate parts of the process. This automation will
provide valuable efficiencies and administrative savings, while
increasing our ability to provide a fully electronic claims process to
the public. Improvement in adjudication will be implemented only after
there are safeguards in place to protect applicants' rights to all the
benefits to which they may be entitled.
Finally, the last key feature, and really the foundation, of Ready
Retirement is public education. Through our financial literacy
campaign, we are educating the public about making an informed decision
as to when to begin receiving retirement benefits.
In the past year, we implemented several educational tools. We
introduced an online Retirement Estimator to enable the public to get
immediate and personalized benefit estimates, and we created a new fact
sheet and accompanying podcast titled, ``When to Start Receiving
Retirement Benefits.'' We also revised the Social Security Statement to
provide more information to younger workers. For every Statement sent
to a worker aged 25-35, we now include an insert called ``What young
workers should know about Social Security and saving.'' This new
supplement provides additional information about retirement planning
and includes a chart showing how much difference just a little bit of
saving can make.
Our Internet services took top honors on the American Customer
Satisfaction Index (ACSI) scorecard for the fourth quarter of FY 2008.
The ACSI tracks trends in customer satisfaction and allows Federal
agencies to benchmark their performance against comparable best-in-
class entities. Our Retirement Estimator and iClaim applications were
the highest scoring applications in the ACSI's ``top performers''
category.
The public has responded enthusiastically to the new iClaim
process. So far this year about 33 percent of our retirement
applications have been filed online, up from only 10 percent just 2
years ago. Taken at face value, this increase alone is impressive. But
to truly understand the importance of Ready Retirement for our field
operations, let me explain to you what just one aspect of service in
the field would look like today if Ready Retirement did not exist.
In the first quarter of FY 2009, 161,000 applicants started their
retirement applications online. Without Ready Retirement, those
claimants would have visited their local field offices or filed by
telephone. If all of these claimants had filed in their local field
office, we estimate wait times would have increased by 5 percent and
busy signals by 6 percent.
We will continue to analyze customer satisfaction and the
performance and usability of iClaim. It is more critical now than ever
that we are able to continue to fund this important project. As I
mentioned earlier, recent projections show that we now expect to
receive over 300,000 more retirement claims in FY 2009 compared to FY
2008. We must, to the greatest extent possible, push forward with our
efforts to automate these applications. If our Ready Retirement
initiatives are successful, we will not only be able to more
efficiently and effectively handle the increase in applications from
both baby boomers and the economic downturn, but also we will be able
to expand these new processes to automate and streamline other high
volume workloads.
Protecting America's Investment
We are proud of all of our recent accomplishments, and I expect our
momentum will continue. The additional funding in the ARRA together
with our FY 2009 appropriation puts us in a much better position to
deal with our fraying infrastructure and the current service challenges
created by the economic downturn.
Use of American Recovery and Reinvestment Act of 2009 Funds
Our NCC houses data critical to providing outstanding service and
to paying benefits promptly and accurately. Because the NCC is over 30
years old, it will soon no longer be capable of supporting the growing
demands of our computer systems and computer-based services. Replacing
the NCC will allow us to provide service 24/7 and avoid outages and
slowdowns that disrupt service delivery.
Now that we have the ARRA funding, we are continuing to work
closely with the GSA--which manages federal construction projects--on
all aspects of the pre-planning for the new NCC. The formal planning
process with GSA will include formulating criteria for the new data
center, selecting a site, and developing a detailed construction
timeline. In consultation with us, GSA will be responsible for
completing most of these steps.
The ARRA also calls for a one-time payment of $250 to certain
Federal beneficiaries, including Social Security and SSI beneficiaries
and provides the administrative funding necessary to ensure that these
critically needed payments are infused into the economy as quickly as
possible. We are on track to make these payments in May, ahead of the
statutory deadline.
The ARRA also provides an additional $500 million to process our
rising retirement and disability workloads, as well as the backlogs
resulting from the economic downturn, and to invest in related
information technology projects. Unlike annual appropriations, which
must be used within a fiscal year, we will be able to use this $500
million over the next 18 months.
Use of FY 2009 Appropriation
We are handling workloads far above what we anticipated just 6
months ago. Our full year appropriation, which supplies $126.5 million
more than was included in President's FY 2009 budget, as well as the
additional funding in the ARRA, will allow us to invest in information
technology, to hire 5,000 to 6,000 new employees before the end of the
year, and to allot additional overtime to process critical workloads.
In addition to replacing all of our losses in FY 2009, we will assign
new employees to our front-line operations where they will have the
greatest impact--approximately 1,200 employees to our field offices,
900 employees to our hearings offices, and 600 employees to State DDSs.
Hiring new employees is critical to us, but operating under a
continuing resolution, as we have this year, has impeded our ability to
bring on new hires and have them fully productive before the end of the
year. (See Appendix C for the effect of continuing resolutions on
staffing trends.)
Unfortunately, our new employees will not have an immediate impact
on our current or backlogged workloads as hiring and fully training new
employees is a lengthy and resource-intensive process. Hiring requires
posting vacancies, reviewing applications and resumes, conducting
interviews, conducting background checks, and offering positions.
Often, new employees must relocate to their duty stations or give their
employers sufficient notice so that they can seek a replacement.
Once they report to work, training lasts from 13 to 17 weeks
because of the complexity of our programs. After this initial training,
new employees are assigned a mentor to act as a resource and to assist
in learning the intricacies of processing our work. This ``on-the-job''
training for new employees typically lasts a full year. At the end of
the year, though not fully proficient in all parts of the job, these
employees would be making a significant contribution to workload
processing. The time spent mentoring, however, reduces the time our
more experienced employees have to process their own work. When we have
significant increases in staffing levels, the time put into training
and mentoring result in reductions in productivity in the short run.
Our Commitment for the Upcoming Year
We made a commitment to the American public to work down the
hearings backlog. We continue to improve productivity each year and to
process more work. In FY 2009, we plan to process over 300,000 more
retirement claims, 30,000 more initial disability claims, and
approximately 70,000 more hearings than in FY 2008. The additional
funding will also help us handle increasing visits to our field offices
and calls to our 800-number.
The FY 2010 President's budget proposes an increase of 10 percent
above the FY 2009 level. This amount includes resources to increase our
staffing levels in FY 2010, which will enable us to further increase
our productivity.
Stewardship & Program Integrity Work
Preserving the public's trust in our programs is one of the key
aspects of our Agency Strategic Plan. We take pride in our ability to
protect and carefully manage the resources, assets, and programs
entrusted to us. We must ensure that we pay beneficiaries the correct
amount of benefits and that they continue to be entitled to those
benefits. Due to the budget constraints and increasing workloads,
however, we have been forced in recent years to scale back these
program integrity efforts. Our primary program integrity tools are CDRs
and redeterminations of income and resources in the means-tested SSI
program. The FY 2010 President's Budget includes $759 million for our
program integrity efforts, an increase of $255 million from FY 2009.
This will allow us to complete a total of 794,000 CDRs, of which
329,000 will be full medical CDRs, and 2,322,000 SSI redeterminations.
This funding will ensure that taxpayer dollars are being spent properly
in the major entitlement programs.
Continuing Disability Reviews
We conduct work and medical CDRs to determine whether or not
beneficiaries continue to meet the definition of disability. We
initiate CDRs based on work activity when a beneficiary voluntarily
reports that he or she is working, when wages are posted to a
beneficiary's earnings record, or when a beneficiary has completed a
trial work period. In FY 2008, we conducted about 170,000 work CDRs,
which resulted in cessation determinations in 850 cases.
Generally, the law requires us to conduct medical CDRs on a
periodic basis to ensure that only those who continue to be disabled
receive benefits. We conduct medical CDRs using one of two methods. We
periodically review cases when we expect that a beneficiary's condition
will improve, and we have a DDS perform a full medical review. We also
conduct medical reviews when we receive voluntary or third-party
reports of medical improvement. In some cases, we send questionnaires
to beneficiaries, whom we have identified using a statistical model,
and evaluate their responses to determine if they remain disabled.
In FY 2007, we began using a new statistical model to select cases
with a higher likelihood of medical improvement. That year, we
processed 747,170 periodic medical CDRs of which 189,955 required full
medical reviews. We spent $281 million to process these CDRs. Of the
CDRs processed, we notified 52,490 beneficiaries that we would be
ceasing their benefits because they no longer met our definition of
disability. We estimate that, after all appeals are exhausted, we will
stop paying benefits to about 36,000 beneficiaries, along with their
eligible dependents. We estimate that the present value of future
benefits saved from this activity is $3.3 billion. Historically, the
ratio of program savings to administrative costs for these cases is
about $10 to $1. Fluctuations in the year-to-year savings-to-cost ratio
may occur, however, due to changes in the distribution of CDRs
processed under the disability or SSI programs and the percentage of
cases where there is a high likelihood of medical improvement.
Since FY 2002, however, we have processed fewer CDRs than come due
in each year because of limited funding and the need to balance our
service and stewardship efforts; we continue to face a significant
backlog of initial claims and hearing requests. (See Appendix E for
CDRs processed over the last several years.)
In FY 2008, we processed 240,000 full medical CDRs, an increase of
about 50,000 over FY 2007. The FY 2009 Omnibus Appropriations Act
provides an upward adjustment to the discretionary caps to fund program
integrity activities such as CDRs. At this level, we will be able to
process 329,000 full medical CDRs this year, an increase of 89,000
compared to FY 2008. Despite these increases, at the end of FY 2008, we
had a backlog of 1.4 million full medical CDRs, and we project the
backlog to grow by another 100,000 to 150,000 in FY 2009.
SSI Redeterminations
We must also ensure that we pay SSI in the correct amounts. Due to
the complexity of the SSI program and the large number of factors that
can affect a recipient's eligibility and payment amount, these
redeterminations can be particularly challenging. One of the ways we
ensure accurate payments is by periodically completing redeterminations
to review all the non-medical factors including income, resources, and
living arrangements of SSI eligibility, such as resource and income
levels and living arrangements. Based on this review, we determine
whether a recipient is still eligible and still receiving the correct
payment amount.
There are two types of redeterminations: scheduled and unscheduled.
Except for certain institutionalized recipients, we periodically
schedule all recipients for a redetermination at least once every 6
years. Moreover, using a statistical model to estimate the likelihood
of overpaying SSI recipients, we target the most error-prone cases each
year. We conduct unscheduled redeterminations on an as needed basis
when recipients report, or we discover, certain changes in
circumstances that may affect the SSI payment amount.
In FY 2008, we conducted 1.221 million SSI redeterminations. We
estimate that these redeterminations will produce $2.1 billion in
retroactive payment recoveries and ongoing payment reductions. If we
had the resources to conduct SSI redeterminations on all SSI
recipients, approximately $5.7 billion in recoveries and ongoing
payment reductions would accrue. In FY 2009, we expect to conduct 1.7
million SSI redeterminations, an increase of nearly 500,000 compared to
last year.
Future Program Integrity Work
In short, we know our program integrity workloads are critical to
ensuring well-run programs and accurate payments, but our ability to
carryout such workloads depends upon resources including the
availability of trained staff to do this work. With the additional
funding we are receiving in FY 2009, we will perform more CDRs and SSI
redeterminations. For FY 2009, we plan to process 329,000 medical CDRs
and 1.711 million SSI redeterminations, an increase of 89,000 and
490,000, respectively, from FY 2008 levels. Even with these increases,
we still processed fewer program integrity reviews than we did earlier
in this decade. Due to the tight budgets of the recent past, we had to
make tough choices between service to the public and stewardship
efforts. We believe that we are beginning to reverse the overall
decline in program integrity reviews, and we expect further increases
in FY 2010 because of the funding included in the President's FY 2010
budget proposal.
Highlights of our Plan to Improve Service Delivery
To keep pace, we know we have to modernize the way we do business,
and we are making great strides to do so. We are searching for
additional policies we can streamline, technologies that we can
introduce or improve, and business processes that we can restructure or
automate. Below are some of the innovations that we plan for the
future. Without sufficient and timely funding, some of these
innovations may be difficult to implement.
Service Oriented Architecture
Historically, our systems were developed at different times to meet
a specific need that arose. This reactive process resulted in a
collection of technologies rather than a cohesive, fully integrated
system. Our current strategy introduces seamless Service Oriented
Architecture (SOA) to replace our aging online and in-office benefit
applications. We will build our information services so that the core
data and components can be shared rather than duplicated in many
different systems. Without the need to consider multiple stove-piped
systems, systems development of new business processes under SOA will
be more efficient.
Disability Direct
Although still in the planning stages, the Disability Direct
initiative will automate the processing of online disability claims
resulting in a much more efficient route from application to payment.
It will improve the online disability claim and appeals process by
collecting information once and re-using it rather than requiring
applicants to complete the same information repeatedly, which will help
offset our labor-intensive disability workload. This streamlined
process will provide more time for employees to handle other workloads
and help with field office and telephone traffic. It will also fulfill
the public's expectation of convenient, effective, and secure
electronic service delivery options.
Quick, Simple, and Safe SSN
We are developing strategies and an implementation plan for
reducing Social Security number related workloads so that we can
improve service to the public while maintaining the integrity of the
SSN. The goal of the Quick, Simple, and Safe SSN initiative is to find
new ways to assign SSNs, update SSN information, and issue replacement
Social Security cards using efficient and secure methods.
Additional Social Security Card Centers
In addition to the seven current Social Security Card Centers, we
plan to open four additional centers: two in Houston, Texas, one in
Minneapolis/St. Paul, Minnesota, and one in Philadelphia, Pennsylvania.
Telephone Infrastructure and Automation Improvements
We handle over 57 million calls on our national 800 number each
year. The underlying telephone system structure is antiquated so we
must make infrastructure improvements to ensure that our telephone
service is convenient, accessible, and efficient.
Over the next several years, we are replacing nearly all of our
phone systems with Voice-over Internet Protocol (VoIP) technology. A
project of this scope is initially costly, and we have moved cautiously
so that we can address concerns that inherently arise with any new
system. We believe the end result will improve customer service and
lower long-term costs.
VoIP gives us flexibility to route calls from busy sites to less
busy sites when necessary. We also will be able to collect management
information that will allow us to identify and make adjustments to
improve service including some customization like language preference
that may be prevalent in certain geographic locations.
We plan to continue to add automated applications that are
responsive to the public's needs. Callers who use our automated
services can conduct a variety of transactions as well as listen to a
variety of informational messages addressing frequently asked
questions. Improving our telephone operations will allow callers the
convenience they want while freeing us to work more complex workloads.
SMART Service
After visiting several field offices, in January 2008, I asked my
staff to examine our field office layouts and develop ways to improve
field office reception areas so they are more efficient for conducting
business. The ultimate goal of this initiative, known as Space
Modernization and Reception Transformation Service (SMART Service), is
to lay the groundwork for the ``SSA Office of the Future.'' In our
field offices, we are currently piloting new technology that allows us
to deliver service to rural areas through video, the public people
about interacting with our agency by watching a Social Security
satellite broadcast, and providing self-help computers to visitors who
want to do business over the Internet with us but many not have access
to a computer at home.
Conclusion
Next year, our agency will celebrate its 75th anniversary of
providing critical services to nearly every American. Over the last
three-quarters of a century, our programs and responsibilities have
continued to expand. Unfortunately, for too many years, we have not
received sufficient and timely funding to allow us to keep pace with
our increased workloads.
You have started to change that pattern. Therefore, once again I
want to acknowledge our appreciation for the funding you provided for
FY 2008 and 2009 and in the ARRA. We will continue to use this money to
reduce our backlogs by hiring and training new employees and expanding
our use of technology. We will also protect the information we house
and maintain the services we provide by building a much-needed new
National Computer Center. Of course, we will work with Treasury to
issue the $250 one-time economic recovery payments sooner than
required. I am acutely aware that our Nation is in economic crisis, and
we take the responsibility associated with the Administration's and
your investment in our agency seriously.
With your support, I am confident that we can successfully address
our challenges, but it will take several years. I am compelled to
stress that we will continue to need timely, adequate, and sustained
funding beyond FY 2009. Last year, I testified that we were facing an
avalanche of retirement and disability claims at the same time we were
addressing large backlogs due to years of increasing workloads and
limited resources. That situation has been exacerbated by the economic
downturn and we are experiencing an increase of applications over what
we projected.
We did as much as we could to be ready to act when we received our
budget. We are currently hiring thousands of new employees who we will
need to train. Many of them will not become proficient this fiscal year
delaying the positive effect they will have on our workloads. Our
greatest opportunity for success is directly tied to timely and
sustained funding.
We are committed to working with Congress and the American people
to address our challenges and improve service for the years ahead. We
are confident that with your support, the support of our stakeholders,
and the necessary resources, we can achieve our goals.
Appendix A
Average Daily Visitors Per Month

[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

Appendix B
Office of Disability Adjudication and Review: Regional and Hearing
Offices and Remote Sites

[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

Appendix C
Continuing Resolutions (CRs) Cause Erratic Staffing Trends

[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

Appendix D
CDRs Processed by Fiscal Year

[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

Chairman TANNER. I just have one question, and then I am
sure that members will elaborate.
You mentioned the electronic filing about 33 percent. I
generally applaud efficiencies that can be achieved through
electronic means otherwise. Do you have any data with regard to
the error rate? Because, as we know, when an application is not
in order, then not only is it delayed, but it causes even more
work. And so as we try to go and streamline the system with
electronic online, et cetera, I think we have to be sure that
the error rate is not unacceptable? Do you have any data on
that?
Mr. ASTRUE. We do, And I appreciate that question, because
it is an important one.
Our quality office has looked very carefully at the online
applications versus the applications taken in the field office,
and there is no statistical difference between the quality of
the ones done in the office and the ones that are taken online.
To the extent that there is a difference, the error rate is
actually slightly higher for the ones that are taken in the
office. So we are confident about that.
And one should also keep in mind that this is not a fully
automated process, that in every case, even on something taken
online, there is an individual in the office who is looking at
that application and who does call people back if there is
anything on the face of the application that would trigger any
additional interaction with that person.
Chairman TANNER. One other question then. When do you
expect your plan to begin to take effect? You said 2 years ago
that you had a plan to reduce it, and now it is as bad or
maybe, in parts of the country, worse. With the additional
revenue, can you give us a timeframe as to what we can expect?
Mr. ASTRUE. We have adjusted the planning. Clearly, with
the sudden deterioration in the economy, we needed to go back
and revisit the assumptions of the original plan. And there are
some small differences, but the big one is we need an increase
in capacity.
So when we first developed this plan and when I first
testified before this committee, we had embraced the figure of
1,250 administrative law judges as what we needed to drive the
backlog down; and we were down at one point to just barely over
1,000. In order to meet the targets for driving the backlog
down over the next 4 years, we are going to need more capacity.
So we are targeting 1,400 to 1,450 judges.
Right now, the budget assumption is that when we finish the
fiscal year 2010 hiring--assuming we get the appropriation that
we hope from the Congress consistent with the President's
budget and that we expand our space quickly enough--we will
have enough space for the hiring of the new judges. Now it is a
close call that we will be getting as much as we need for
fiscal year 2010, but we are working hard on that. But if we
hit the mark on the appropriation, we hit the mark with the GSA
work, we should have, I believe, 1,452 judges at the end of
that hiring.
We lose about 60 judges a year to attrition, and the losses
are not even over the course of the year. The departures tend
to be toward the end of the year. So we will actually be
momentarily over that target at the end of the hiring if
everything goes according to the projection, and we need that
additional capacity to hit the original goals. Otherwise, we
are not going to make it.
Chairman TANNER. The judges are fine. What about the staff
assistants that prepare the cases? The judges--that is a
problem, too, I am told.
Mr. ASTRUE. It is indeed. And we will have a higher support
staff ratio than we have had during most of this decade. We are
targeting not only a national average of 4.5 per ALJ, but we
are trying to keep to a floor of 4. There has been, in my
judgment, too much variation in hearing office support from
hearing office to hearing office. So, in addition to taking it
up a tick to the 4.5, we are going to try to keep a floor of 4.
Again, a couple of people will leave. The numbers will vary
from time to time in offices for brief periods of time. But the
goal is a floor of 4 and an average of 4.5, which should be
adequate.
Chairman TANNER. I may have some other questions to submit
in writing to you. I don't want to take too much of my time.
Mr. ASTRUE. Thank you, Mr. Chairman.
Chairman TANNER. Mr. Johnson.
Mr. JOHNSON. Thank you, Mr. Chairman.
You know, along that line, how many judges are hearing less
than five cases a year?
Mr. ASTRUE. Less than five cases a year?
Mr. JOHNSON. Yeah.
Mr. ASTRUE. I don't think any now. We had one judge that
hadn't heard a case in 6\1/2\ years, and we have been working
on counseling him. He is hearing about 50 a year now. I believe
he is just largely allowing all those cases.
Mr. JOHNSON. So we don't have anybody that is not pulling
their weight right now?
Mr. ASTRUE. We have certain judges pulled off for
administrative work, and the president of the union by the
contract is allowed to work full time on union business.
Although, to his credit, he does hear some cases.
Mr. JOHNSON. When you say ``some''. how many?
Mr. ASTRUE. I don't know. I would have to check. We are now
making that kind of information public which we haven't in the
past.
Mr. JOHNSON. Different subject. Why did we learn just last
year that the NCC had to be replaced? The center is apparently
30 years old, and surely somebody told you the problems that
were existing there or were coming.
Mr. ASTRUE. Certainly coming in I was not aware that this
was a problem, and I was not aware that this was a problem
until a bit into 2007. And I actually picked it up through our
strategic planning process, where we said we have got to look
at what we need to plan for the future, and it was clear that
this was a major issue for us.
It took a little while to get a handle on it. There had
been a part of the organization that had started to look at
this, and there was a study pending that came in in January of
2008, and it took a little time to push back and look at the
options. Because, you know, the first time someone comes in and
says, ``I would like to spend three-quarters of a billion
dollars for a new facility''. you don't say, ``Oh, fine''. So
we spent several months going back and forth, seeing whether we
could in any way extend the life of the existing facility, look
at other options; and, finally, we came to the conclusion that
we really did need to replace it. It took a little while.
We communicated that to the Congress after the May----
Mr. JOHNSON. Let me interrupt you, because we understand
what the problems are. I mean, I have seen pictures of some of
the facilities over there, and it seems to me it is a big fire
hazard. If that building burnt down today, if the NCC failed,
what are the chances of you recovering the information that
would be destroyed?
Mr. ASTRUE. The chances of recovering the information that
is destroyed are extremely high. We run backup tapes daily and
take them to an offsite location every day except Sunday. So
restoring the----
Mr. JOHNSON. I was told you didn't have any backup. Where
do you take them?
Mr. ASTRUE. There are two types of backup here. And there
has been confusion, even when I was talking to computer people
recently, they got confused about it. And it is probably my
fault in terms of communication.
So there are two types of backup. There is the computer
power that actually runs the system, and then there is the
storage for the data. So we take the data----
Again, if I am making a technical error, we will correct
this for the record.
But, basically, we take the data on a daily basis, except
Sunday, from the National Computer Center to a separate offsite
location. So if there is a data storage type of problem, we can
restore the data. The data doesn't disappear. We always have
recent data.
The issue is if there were a problem with running the
National Computer Center. Right now, we do not have an adequate
backup facitlity. We rely on a commercial facility in New
Jersey that would only allow us to run most of our critical
workloads at 30 percent capacity, so the agency would have to
ration availability among the regions. It would be catastrophic
until we came back online.
Mr. JOHNSON. Well, if you copied those to discs and your
computer system is so old, are there any computers that will
run those discs after you copy them?
Mr. ASTRUE. We can run on the commercial facility in New
Jersey. The problem is our system is so huge there just isn't a
commercially available facility that has the capacity to run
all the transactions of the Social Security Administration.
Mr. JOHNSON. What you are saying is we would have a
failure. Would people fail to get their checks?
Mr. ASTRUE. All of our current beneficiearies would
continue to receive their checks. However, there would be a
delay in new beneficiaries getting their checks.
Mr. JOHNSON. Are you confident that we have a plan in place
to rectify that problem? And it seems to me that 2012 for
Durham is an awful long way off, and I don't know how long it
is going to take us to build a new facility.
Mr. ASTRUE. Let me give you some good news on Durham.
I was just down at the facility about 2 weeks ago. The
shell is up and completed. The first group of equipment is on
the site and is being installed. It will take us about 6 months
in all likelihood before we will get Durham up to where it will
be the equivalent of the New Jersey facility, and then we will
be adding additional capacity month by month after that.
In about 6 months, month by month, it will get better than
the status quo. It won't be perfect. IWe are moving a little
faster than before. I would say probably about another 18
months before we have Durham up to full recovery capacity.
So with the additional resources, I have approved some
amendments, some additional changes to Durham that will add
capacity at Durham, too. So we have that coming, too. So it is
getting better. We have to hold on for approximately 6 months,
and at least it will be better than the status quo every month
after that.
Mr. JOHNSON. Thank you.
Thank you, Mr. Chairman.
Chairman TANNER. Thank you, Mr. Johnson.
Dr. McDermott.
Mr. MCDERMOTT. Mr. Astrue, I assume you are on the side of
the clients in this issue. So the question I ask really, or to
try to understand what is going on, have you spent all the
money that we gave you last year for additional people and
space?
Mr. ASTRUE. Absolutely. We went out and we had $148 million
over the President's request and most of that went into backlog
reduction. The most expensive part of that is hiring new
judges. We hired 190 new judges. The Inspector General at our
request did a study of the fully loaded cost of an
administrative law judge. An administrative law judge fully
loaded is about three-quarters of a million dollars a year. So
you can see that for that $148 million, most of that went into
the additional judicial capacity.
Mr. MCDERMOTT. Have they been working full time for the
last----
Mr. ASTRUE. They have.
Again, I know this isn't easy, so I have to plead for
patience. The system is so complicated that it takes people a
long time to become fully productive.
We are thrilled by this class of judges. I think we did a
better job in selection. We did more careful background checks.
These people are working very hard. They are getting very high
grades on how they are treating people.
But in terms of productivity--I looked at the numbers just
a couple of weeks ago. After about 9 months on the job for most
of them, they are at about three-quarters of what a more
experienced administrative law judge does. The good news is the
trend line is up. They are going to get there. But it is
probably going to take them 12 to 15 months before----
Mr. MCDERMOTT. Isn't the trend line about the numbers of
days waiting is exactly the same for the last 2 years? It is
over 500.
Mr. ASTRUE. With all due respect, Mr. Chairman, we are down
to 488, I think, right now. Again, it is not dramatically down,
but the average processing times are down.
Mr. MCDERMOTT. The source of this data is from you guys,
Social Security Administration. Those two columns over here are
the same, basically; and I am not sure--I don't want to argue
hours or days or whatever, what I want to understand is what is
it that holds up--why somebody is 75 percent productive; why
not 100 percent?
Mr. ASTRUE. Because I think that----
Mr. MCDERMOTT. You have had a year.
Mr. ASTRUE. The complexity of the system is mind-blowing.
They have to learn our rules about every possible medical
disease or condition known to man, and our systems, which take
time to learn too, because we are increasingly automated, but
the systems aren't perfect yet.
We have got terrific people. I have no qualms about the
effort that they have put in. I think a lot of these new judges
are working extremely hard. And almost all of them are on a
satisfactory track of productivity. There are a couple who are
having some issues, but it just takes time.
And it is the same thing with claims representatives, tele-
service representatives. They are not productive immediately.
Mr. MCDERMOTT. Anybody can see the trend of the line for
the last 8 years. You don't have to be even close or have a
reading test to see that trend. And the fact is that you are
going to have 44 percent of your people retire by 2016. What is
the planning for the future? Are we going to go into another
climb in--because we lose all the people who have been there a
long time and take this knowledge out the door with them, and
we get these new people in that have to learn the system from
the ground up.
Mr. ASTRUE. And in the good news, bad news category, with
the economy changing, the retirement rates have slowed down a
little bit. So it does buy us a little time.
Again, I wouldn't wish that on anybody who doesn't want to
stay.
Mr. MCDERMOTT. You are not wishing against Mr. Geithner and
the President, are you?
Mr. ASTRUE. No, no. But we are trying to hire as many
people as fast as we can. We have broadened and moved faster
our SES development candidate pool. We have brought 14s in for
the first time so that we have a little bit broader pool. We
will have a slightly younger age distribution than what we had
before to try to maintain some continuity.
We are doing what we can. But, at the end of the day, I can
only hire as many people as we have the money to hire. We have
moved extremely quickly.
Mr. MCDERMOTT. How about space? Do you have problems with
space? Somebody says it takes 24 months to get space out of
GSA?
Mr. ASTRUE. It does.
Mr. MCDERMOTT. What is the reason for that? The military
can put 500,000 people in Iraq inside of 3 months. Why can't
GSA move a few people and get some offices open?
Mr. ASTRUE. I hear this with some regularity. I actually
think the people who are working for us have made this a top
priority; and they are trying. But we have several issues.
First of all, we have to negotiate sometimes with as many
as four different unions before we can go to GSA, because we
have to have a plan that is going to work under the collective
bargaining agreements. That takes some time. And then GSA has a
process to try to make sure the bidding is fair and objective.
The kind of space that they choose--which I don't get to
decide, they get to decide--makes a big difference. If they get
space that is already existing, that fits our needs, that
doesn't have to be redone, then we can often beat that 24
months. But sometimes they build space from scratch. Sometimes
they will renovate. Sometimes they find space that is in move-
in condition.
We try to expedite this as much as we can. They have an
inventory of excess space, and we have been all over that list.
And we will sometimes change where we want to be if it doesn't
make that much difference, if we actually think we can get into
the space faster.
So we have moved from having too much physical space,
because we lost so many employees that we were awash in space.
When we all of a sudden are trying to hire 5,000, I think we
are going to be okay for this fiscal year, but it is a
potential limitation, particularly getting the space in the
right places. Because, for 20 years--and I don't know why this
was true--the agency underallocated in the Midwest and the
Southeast. And if you look at where the most backlogged hearing
offices are, almost all of them, with all due respect to some
members to whom this generalization won't apply, they are
mostly in those parts of the country, and that is where the new
hearing offices are going. We are pushing to get them open as
quickly as we can, and we hope there will not be a limitation
next year.
Mr. MCDERMOTT. Thank you. I apologize for taking more than
my fair share of time.
Chairman TANNER. We will go, with the permission of the
Committee, to two over here, since we have a great attendance
this morning and a very highly interesting subject here.
So may I call on Mr. Stark.
Mr. STARK. Thank you, Mr. Chairman. Mr. Astrue, thank you.
If I could just switch to a topic that has been a concern
of mine for some time, and that is the issue of 30,000 children
who receive SSA benefits and are in foster care. I don't want
you to go auditing this, but, as someone who receives this form
for his own children each year, I am aware of how closely you
keep track of what my children receive and what I do with that.
But I am afraid that you don't keep as close track of the money
that these children receive.
For the benefit of my colleagues, children who for one
reason or another, SSI or because of disability or because of a
parent who is disabled or dead, often receive Social Security
benefits, a couple hundred bucks a month. And if they happen to
be in foster care, I think it is fair to say that almost
automatically this money goes to the State.
And States vary in how they use that money. I suspect there
are a few States which just dump it into the general revenue
and could not account for the fact that it is used for these
children. And there are arguments. Some say, why should foster
children, who are entitled to a Social Security benefit because
of a disability or lack of parenthood, have to pay out of
basically their funds for foster care when other children
don't? And I was going to see if I could ask Mr. Astrue if they
are doing anything to review this.
There is a system by which the representative, I guess it
is called, is selected. But I doubt very much if you audit the
States to see that each kid is entitled to some of this money.
And the end result is that these are foster children who in
many cases have mental disabilities, other--wherein a few
thousand dollars when they mature out of foster care could be a
great advantage, either a way to get to college or a way to get
their first apartment for independent living.
And I guess my question is, are you doing anything now to
study or consider how the States apply this money--I know
California does a good job and other States, too. But, as I
say, I think some States take the money and pop it into general
revenue. Is there any program going on now in Social Security
that is reviewing either how a representative is selected or
what they do with the money?
Mr. ASTRUE. We know your interest, and I think it is a fair
point, and it is on our list to talk to OMB. They are only up
for business recently for anything but emergency issues, and we
have a fairly long list of things that we would like to talk to
them about. But we are prepared to look at that.
I think, as with all questions with rep payers, we do have
to go carefully, because we want to make sure that we don't
discourage people from being rep payees or state agents. We do
have difficulty in a lot of the country getting qualified rep
payees.
Mr. STARK. It is a very small amount for most States, but
these are, it seems to me----
Mr. ASTRUE. Again, I give you credit for your leadership in
this area, because you did encourage us also to talk to
California about the issue of seamless continuation. There were
foster care children getting lost in the cracks when they were
re-reviewed under the adult standards.
Mr. STARK. When they age out.
Mr. ASTRUE. We actually worked with Secretary Wagner in
California on that. We have an improvement. It is a little
awkward, but I think they are pretty happy with it. And we are
now using that in other States.
But part of what we want to do when we talk about foster
care more broadly with OMB is to identify ways to make that a
little bit more elegant and a little bit more efficient, too.
So we are looking at that as well.
Mr. STARK. Thank you very much. And I want to particularly
thank your employees in both the Oakland and San Jose office
for the wonderful service they give our--thank them for me.
Mr. ASTRUE. Thank you. I will do. Thank you, Mr. Stark.
Chairman TANNER. Thank you, Mr. Stark.
Mr. LINDER.
Mr. LINDER. Thank you, Mr. Chairman.
Commissioner Astrue, you mentioned an administrative law
judge who in his contract doesn't hear any cases because he is
a labor union leader and he is full time on the labor union.
How many are there such as that?
Mr. ASTRUE. I believe the contract is a little complicated,
but my understanding is that there is one who clearly does not
have to hear cases, and that is the president of the union.
There are, if I remember correctly--and I apologize if I
don't do this correctly from memory--I believe there are 125
other union officers who at least under some circumstances do
reduced time and how much reduced time gets a little
complicated. So what I would prefer to do, rather than make a
mistake on this, is double check that number and give you the
full details of the collective bargaining agreement in that
regard.
Mr. LINDER. All right. Thank you very much.
[The information follows:]

[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

Mr. LINDER. Why do you need for labor unions to approve
space with the GSA?
Mr. ASTRUE. The working conditions are covered under
collective bargaining agreements. So we have to, as a general
matter, as I understand it, go through and make sure that
everything in the proposed space is compliant with the various
collective bargaining agreements. And, again, ODAR, where we
are doing the hearing office expansion, has all four unions
that are representing ODAR. So it is probably more complicated
at ODAR than it is at most of the rest of the agencies.
Mr. LINDER. Why isn't that just administerial duty?
Mr. ASTRUE. Because that is the way the Federal Labor
Relations Act is written, is my understanding. We are just
complying with the statute.
Mr. LINDER. The Federal Labor----
Mr. ASTRUE. That is my understanding. I don't purport to be
an expert on it, and it does get highly technical. We have an
office that deals with those issues. But it is my understanding
that those are the types of issues that we are required to
bargain.
Mr. LINDER. I share Sam Johnson's concern about your
computer capabilities and the age of the technology. Have you
done any studies as to whether it would be less expensive to
outsource it?
Mr. ASTRUE. We did. And, actually, this study was, I
believe, commissioned under Commissioner Barnhart's watch.
There was a Lockheed Martin study that took a look at the
options and concluded that we really needed to have our own
facility.
I think part of the issue is we have enormous constraints
in terms of the sensitivity of the private information of the
public that is in there. It makes it awkward to share with
other facilities. We need a huge facility because of the scope.
There just aren't data centers like that sitting around.
Mr. LINDER. You don't think Google and Microsoft have that
kind of capacity?
Mr. ASTRUE. Actually, not for what we need. No, I don't
think so. Even the great Microsoft I don't think has what we
need on the shelf.
And you know, we live in an age where it is not just the
physical attacks of terrorists, but there is an enormous--and I
don't think the public really appreciates the--concerted and
constant effort there is to commit cyber-terrorism. I don't
know whether the Committee has had a recent confidential
briefing on that issue, but it may be a good idea. And that
also makes it very difficult to go the private-sector route
with everything that I think we need to do in order to meet
those kinds of defenses. I think we did make the right choice.
Again, I didn't like the answer in the beginning either;
and we spent several months going back and forth looking at
alternatives and seeing whether there was another way to do it.
But I think we reluctantly concluded this was the best path
forward. I know we got a lot of those same questions from
Congress and tried to be as transparent as possible. We are
very grateful that the Congress came to the same conclusion and
so quickly, and it is going to make a huge difference for us
going forward.
Mr. LINDER. Thank you, Mr. Commissioner.
Thank you, Mr. Chairman.
Chairman TANNER. Thank you, Mr. Linder.
The Chair will be pleased to recognize Mr. Levin.
Mr. LEVIN. Thank you. Thank you, Mr. Chairman.
Welcome.
Mr. ASTRUE. Thank you, Mr. Levin.
Mr. LEVIN. It is tempting for me to spend time talking
about the problems in the district I represent, and these are
immense problems, and we have talked about them. But I want to
go beyond the vital local issues and get to the nub of this
issue, and some of the discussion from the minority I think
illustrates that. We have in recent times acted to raise the
amounts of money that are available to you, right?
Mr. ASTRUE. Yes. In the last 2 weeks we have a real break
from past practice, and I think it is going to make a big
difference going forward.
Mr. LEVIN. So let me ask you this. You have been involved
in this work for how long?
Mr. ASTRUE. It depends a little bit on how you look at it.
Off and on for 30 years, probably 10 to some extent.
Mr. LEVIN. And involved with just this government entity,
right?
Mr. ASTRUE. I was with HHS for 6 plus years, some of it
entirely at Social Security but all that time at least
partially doing Social Security work before I came back as
Commissioner.
Mr. LEVIN. I want to ask you this. If the organization has
adequate resources, do you believe that it is able to carry out
the function of handling disability cases in an effective way?
Mr. ASTRUE. I do.
And let me add a couple of caveats to that. We have, I am
persuaded, some of the very best people in government, and I
include the people that do the work for us in the State
Disability Determination Services. I don't think it is a
question of the people. I think it has been a question of the
resources.
We are facing all kinds of challenges now, particularly--
you know, one of the things I am working very hard on--and I
got bad news from New Jersey this morning on the way to the
hearing--is that more and more of the Governors are furloughing
DDS employees or putting hiring restrictions on, which is
crazy. Because we pay the fully loaded cost. We pay their
salaries. We pay for the overhead.
They are not saving any money by doing this to DDS
employees. What they are doing is slowing up the processing of
disability cases and keeping money out of their own States. And
it is a real frustration to me. Again, we have persuaded a
number of Governors not to do this. But we had another one in
New Jersey who apparently decided to go ahead.
Mr. LEVIN. So you said, if the resources are there, you
have no question about the capability of this governmental
entity to do the job well?
Mr. ASTRUE. Yes, that is right, sir.
Mr. LEVIN. So what we heard earlier--and I want to look
ahead, but this has to be very clear cut--that this institution
under its leadership for a number of years that provided
inadequate resources are essentially attacking the entity
because it failed to provide the adequate resources. What you
are essentially saying--and somehow it wants to hopscotch into
healthcare--that SSA, you are not capable of doing this because
you are a governmental agency.
Who appointed you?
Mr. ASTRUE. I was nominated by President Bush, and it was
confirmed in the Senate in February of 2007.
Mr. LEVIN. And we welcome your efforts. And I really think
that those who fail to provide adequate resources should not be
the ones who are throwing the dagger at this agency. We in the
last months have provided more resources instead of
underfunding requests from the Administration. At times, we
have gone beyond.
And I just say this because there is a real crisis in
almost every place in this country. It is utterly disgraceful
that people have to wait years--most of them clearly disabled,
as it turns out--they have to wait years in order for a
response. And the problem has not been because it is SSA
running the show, the problem in good measure has been because
of the failure of this institution under previous leadership to
provide you the resources, as you say, that are necessary to
carry out your work.
We are going to step up to the plate, and I hope we do that
on a bipartisan basis, and we have done that.
Mr. Johnson has been strong. He hasn't thrown arrows at
SSA. He has been working with us to provide the moneys that you
need.
And the sad thing is, even though--and I finish with this--
we provide more resources, it is going to take you years to
begin to catch up. We have to step up to the plate here, not to
try to use this problem as an argument over something totally
unrelated. We will argue healthcare some other forum. We have
got to give you the equipment, the resources, et cetera, that
you need to end this disgrace.
Chairman TANNER. Thank you, Mr. Levin.
The Chair will go to Ms. Berkley, and then we are going on
the rule of who was here when the gavel went down and then to
Mr. Brady after Ms. Berkley.
Ms. BERKLEY. Thank you very much, Mr. Chairman, for calling
on me; and it is very nice to see you again.
Last year, I shared with you the problems that I was having
in my district, which encompasses Las Vegas; and you were very
responsive to my concerns and my problems. As you are aware,
with your help, Las Vegas ranked about seventh out of 143
offices nationwide last year with a wait time of about 325
days. It wasn't anything to write home about, but it is far
better than what has happened this year when we have--where we
have slipped to 60th with a wait time of 458 days.
I am asking you on behalf of the people I represent, and
you know I have a very large senior population and growing
population. And with the latest economic downturn, Las Vegas
has suffered disproportionately; and it shows in the number of
claims that continue to rise on a daily basis. What can you do
and what can I do to help you ensure that Las Vegas doesn't
slip any further? And what can we do to improve not only the
quality of service but the number of people we have hearing
these claims?
Mr. ASTRUE. Las Vegas, as you pointed out has been one of
our better offices. But you are also correct that there has
been some slippage this year. That is not uncommon. This is why
it is so hard to keep up on space, because the demographics
change so quickly.
For the three judges who are there, you have one of the
higher support staff ratios in the country. So I don't think it
is that. But I am looking at your pending--your judges are
staying productive, but the pending is going up. It is just a
function of caseload.
So what we try to do if it gets really much worse than
this, what we are trying to do is to take that pressure off of
offices by moving cases electronically; and we will have
substantial additional capacity in the coming months.
The Albuquerque National Hearing Center, which is actually
designed to help offices in the western part of the country, if
I remember correctly, should start to be operational next week.
We have a much larger one in Chicago that will open up over the
summer, and then we will have another one in Baltimore.
Right now, we don't have enough capacity in that way to
help out those offices such as yours when there is a surge in
cases. We will have that infrastructure in place to do an awful
lot better in about 6 months. So I would say hang on. We will
do the best we can.
We will look at it as well. We are looking at a potential
expansion of additional hearing offices. It may be that if
these numbers hold up that you need at least a fourth judge and
we need to look at the space situation in Las Vegas. I suspect
that somebody has already done that, and I am not aware of it.
So let me do this. Let me supply for the record a little bit
more detail, but we will be on it. We will get back to you with
more information.
[The information follows:]
Ms. BERKLEY. I appreciate that.
Let me ask you something. You just stated, ``if it gets
much worse,'' how much worse does it have to get to be red-
flagged? Because it is going to get worse in Vegas. It is very
bad.
Mr. ASTRUE. So I have to be candid here. Even at 364 days,
which is the most recent month, that is still significantly
better than our National average.
Ms. BERKLEY. Well, I have 458 days. It was 325 days last
year when we were seventh. We are in 60th place now with a wait
time of 458 days.
Mr. ASTRUE. If you just have the October numbers, those
numbers, for reasons I could take up the whole hearing
explaining, are atypical. But what I have in front of me is
FY09 through February, and what my staff is telling me is 364
days. I will check and verify that.
I will be honest with you, normally 364 is not a place
where we intervene. We still have offices with this rate that
are helping out others around the country. But as you get close
to the median, we start looking--and the median right now is
about 488, and we start looking at the possibility of
additional help.
But I will be honest with you, it is not a science. It is
an art. We are trying to do the best we can with what we have.
We will have more ability to help offices. We should have about
30 additional National Hearing Center judges shortly.
Ms. BERKLEY. My time is up. Thank you very much.
Chairman TANNER. Mr. Brady.
Mr. BRADY. Thank you, Mr. Chairman, for holding this
hearing.
And before I begin my questioning, I would point out that I
think this is a bipartisan problem. Pending cases and the
backlogs have not materially improved over the last 2 years
under Democrat control of the House and the Senate. I think
looking at Mr. Tanner and Mr. Johnson, we have bipartisan
support for significant actions to reduce those backlogs and
are committed to working with you to do that.
I want to turn to the issue of fraud in the disability
system. By some estimates, it may be as much as $11 billion in
fraud. It is hard to quantify that, but that is one of the
estimates. I think we all have a responsibility to taxpayers
and the truly disabled to make sure these precious dollars
aren't lost to fraud and those who are gaming the system.
Recently I had the opportunity to meet with the Inspector
General O'Carroll down in Houston with our Cooperative
Disability Investigative Program. I got to look at, first hand,
the teamwork.
On the front end of disability fraud, those who are
applying for benefits and maybe feigning impairments,
concealing medical improvement, and other fraudulent
activities, it seems to me, at least in the Houston region in
Texas, there seems to be a good job--we do a good job of
catching fraud at the front end of the disability system.
On the back end, though, it appears to be just the
opposite; that the backlog of continuing disability review,
especially medical review cases, continues to grow. It is about
1.4 million today. It is anticipated it will grow another
100,000 to 150,000 cases next year. Those investigations on the
back end take more time, more resources, and they are both the
medical issues as well as those concealing work. At the end of
the day, though, fraud occurs.
When we do launch these investigations, as Congress did,
funded the 7-year program from 1996 to 2002, we made progress
on that, dedicated funding to do that. Since then, Congress has
not dedicated funding to those investigations and the backlog
has grown and the funding recoupments have decreased or leveled
off. It seems to me that studies show that we are saving
between $10 and $14 for every dollar we invest in those
fraudulent--investigations of fraud.
So the question is, Commissioner, what is the game plan for
attacking that growing backlog of continuing medical reviews,
disability reviews? And what are the resources you need to
successfully investigate and prosecute those fraud cases?
Mr. ASTRUE. Thank you. Two questions. Let me deal with the
CDI cases first. The Inspector General's office has done some
great work with these units. It is a very high return to the
taxpayer. The problem that we have with those units is the
dollars compete against everything else that everybody wants us
to do, and it is directly competing against service dollars. I
think, until there is some sort of funding mechanism so that it
refreshes itself, that it probably is going to be the case
that, in the grand scheme, those efforts are going to be
underfunded.
Mr. BRADY. Would a dedicated stream of funding help provide
continuity and certainty when building those teams, because it
is a team effort, in actually pursuing them?
Mr. ASTRUE. Absolutely. We have discussed this type of
thing with OMB. I think they are interested in this and for
program integrity work, generally looking for other ways so
that this work doesn't diminish over time. You know, for most
of this decade, not only did the backlogs get worse, the amount
of program integrity work plummeted. So we have not only made a
first dent in the backlogs, but we have also started increasing
the program integrity work.
But we have some real issues in gearing up in that a lot of
our capacity has been lost and it will take time to get up to
where we need to be. So I think you will see in the more
detailed President's budget that is coming next month, the
proposal for fiscal year 2010. My sense is that they see that
as a transition and they want to do more and better the year
after, but they realize that we need to buildup some capacity
to get there. So my sense is that this new team at OMB is very
concerned on the program integrity side.
Mr. BRADY. Would you present to at least to the Social
Security Subcommittee and perhaps to the Income Support
Subcommittee a plan for tackling that backlog and estimates of
resources to do that? Because I think the subcommittee ought to
take a look at what it is going to take in real terms as we
weigh recommendations on budget issues and resources.
Mr. ASTRUE. What I would propose is, I think this will be a
better conversation in about a month, after the President's
budget is fully released, and we can see what the full
assumptions are for next year and then we would be delighted to
come up and have that conversation.
Mr. BRADY. I appreciate that.
Thank you, Mr. Chairman.
Ms. BERKLEY. Mr. Chairman, if I could state for the record,
I have got a national ranking report average processing time,
month ending 2-27-2009, which shows that the Las Vegas
processing time is 458. So if you have something different, I
would appreciate seeing it. Thank you.
Mr. ASTRUE. Mr. Chairman, if you give me just a moment; let
me just talk here for a moment.
Chairman TANNER. Sure.
Mr. ASTRUE. Okay I think we have sorted it out. What I have
in front of me are the statistics for this fiscal year, and I
have been reassured that 364 is correct for the fiscal year.
What you have is for the most recent month, which is February,
and there are some reasons why, particularly when they are
tackling older cases, there tends to be bizarre fluctuations
from month to month. Month-to-month comparisons can be fraught
with danger.
But you are correct that for the month of February, the
average processing time was 458. What that may reflect is that
they moved from run-of-the-mill cases to going back to hit some
of the aged cases. I don't know, but we will give you a more
detailed analysis. So I would like to say, I think we are both
right.
Chairman TANNER. Commissioner, you told me something I was
unaware of. I thought that the IG and the antifraud sector had
its own budget. You said it was in competition with service
dollars.
Mr. ASTRUE. They do, but----
Chairman TANNER. Am I incorrect in that?
Mr. ASTRUE. They have their own separate budget, but we
also have the capacity with our administrative budget to spend
more on antifraud if we choose to do so, and we could if we had
the resources to do it. And I think a lot of us would like to
do that. But right now, you know, you have to take that away
from telephone service or CDRs or backlog reduction, and we
just don't have the option of doing that.
In fact, there has been some concern as to some of the IG
recommendations over the years. We have accepted about 2,500 of
his recommendations in recent years of the 2,700 that he has
made. And a lot of the ones we have not accepted, we just don't
have the resources to do what they are recommending, usually
from an antifraud point of view.
Chairman TANNER. On the CDR evaluations, I am told that
that runs around 90, 95 percent, and 5 percent are found to be
improved to the point where they are no longer eligible. Is
that--am I in the ballpark?
Mr. ASTRUE. Let me double check. I think it is a little
smaller than that.
No, you are correct, Mr. Chairman, that is about right.
Chairman TANNER. But CDR is different from fraud; is that
correct?
Mr. ASTRUE. Yes, that is right.
Chairman TANNER. Basically which means you are doing a
pretty good job on the front end of determining who is
permanently disabled and who is not.
Mr. ASTRUE. Yes, that is right. And there are a fairly
small number of cases where there is a possibility of medical
improvement or it was borderline in the beginning. Probably
about half the applicants, you don't realistically expect that
there is any real chance that they will come off the rolls.
Chairman TANNER. All right.
Ms. Schwartz, you are recognized.
Ms. SCHWARTZ. Thank you, Mr. Chairman, and thank you for
this hearing.
And I actually recall a similar hearing, I guess was it
last year or 2 years ago----
Mr. ASTRUE. Last year.
Ms. Schwartz [continuing]. Where we had some of the same
conversation, I have to say, about backlog, and I realize you
are making some progress.
But certainly all of us in our districts hear from
constituents who are very frustrated by the number of days and
obviously that they have to wait, and they are all in some dire
straits and feel that way.
I specifically wanted to ask you about something you
mentioned in your opening comments which should help this
process, and that is the use of technology and information
technology, particularly transmission of the medical records
and helping to expedite that situation. A couple of questions,
if I may, on this because I have great optimism, if I want to
put it that way, in the fact that technology in the healthcare
field can make a very big difference in streamlining time and
savings for all of us within healthcare delivery and personal
healthcare, but in this situation as well, the ability to get
that information and to review it quickly.
Now, there are some stumbling blocks on this, and one of
them is your own system and the degree to which you can receive
this information. But the other, of course, is the providers
and whether they actually have the capacity at this point to
provide you with that information and adequate information. So
I want you to speak to that and the timing on, again, not only
your preparation but those who are submitting that information.
The second question is the issue of consent and the role
the applicant has in providing that consent. I assume they do
it now in releasing the information, but making sure that that
is secure. You again pointed out the degree to which there are
opportunities for concern about privacy, but I would suggest
that it is dealt with in healthcare situations, but maybe you
want to speak specifically to how you handle very sensitive
information that is now sent electronically and might be more
readily available to others or not.
And the third question, if you would, is to speak to, you
are not over-anticipating the good use of technology by
reducing the number of people you need, the personnel you need,
because in fact, we are not quite ready to do all of this and
whether in fact you still have the adequate personnel to handle
the applications in a timely fashion. And while I will say that
Philadelphia is not worst on the list by any means, in fact, I
think we actually do, I understand, a pretty good job with the
offices in Philadelphia and the surrounding areas; we still are
looking at almost 400 days, 377. Now you are reducing those
number of days. That is a lot of days for people to wait.
So if you kept track of those questions, if you would speak
to them. And if not, I will----
Mr. ASTRUE. If I miss one, remind me----
Ms. SCHWARTZ. I am very supportive of the use of technology
and health IT. I think this is all to the benefit of my
constituents and to those who are applying and can really help
streamline the process for you and for your staff, but I do
want to make sure you are prepared, that doctors' offices can
get you that information, that you haven't reduced personnel
too quickly in handling that, and that you have dealt with the
issues of privacy.
Mr. ASTRUE. First of all, let me reassure you, there is no
substitution of technology for people. I think a lot of the
staff here will back me up. I have been up here regularly and
often complaining about the fact that I don't have enough
people and that the continuing resolutions have forced us to do
some very damaging reductions in staff. And that is why we
added, for the first time in the back of the written testimony,
I know it is long and it is dull, but look at the end at
staffing patterns and the effect of the continuing resolutions.
They really have been devastating for us. So we need as many
people as we can reasonably get. I don't think there is any
likelihood Congress is going to give me more than we can
productively use anytime soon, but we also need to use the best
technology because we need to do both. We need to simplify our
procedures when we can, too. We need all three in order to
provide the best service that we can at any point in time.
Now, you are absolutely right that the health information
technology could be incredibly important for us, and I want to
give Deputy Commissioner Gray, who runs systems for us, credit
because, of course, he takes heat every time a computer blows
somewhere in the 60,000-employee agency. But he was very
forward-thinking in realizing how important this could be for
us. We expend an enormous amount of effort chasing down medical
records from multiple sources, and often we make decisions on
the basis of incomplete medical records, which is a source of
error. People do the best they can as fast as they can, but
there is a misunderstanding of HIPAA, too, and they don't want
to, or they just simply don't, turn over records to us easily.
So this is a big deal for us.
Ms. SCHWARTZ. That may be an issue that maybe we could be
helpful if you are not getting the kind of response you need
from a different department, a Federal agency. Maybe that is
something, particularly as there is new administration, a new
health IT, a head of that office who may be more responsive on
this and be able to work with you on that.
Mr. ASTRUE. The key is, and maybe we should come up and
brief you in more detail, that systems did a pilot with Beth
Israel Deaconess Hospital in Boston, which because of John
Halamka, who is now on our new Systems Advisory Board, is right
in the forefront of health IT, and they have got more done
there. We have had a pilot where we were working out the
technical issues, privacy, security over the Internet, all
those types of things that are raised by our using health IT
and getting to a point where if there is a Beth Israel patient
who authorizes us to get the records, we can push a button, and
we have got it, and we have got a complete record. And it is a
thing of beauty. It increases accuracy. It cuts down on
administrative time. It cuts down on costs. And we are going to
try to get as much of the country moving in this direction as
quickly as we can, and it is still a work in progress. We are
talking to 10 healthcare systems around the country to try to
take the Beth Israel Deaconess model and use it as quickly as
we can. And we have made some progress, I know, in Virginia. We
have got other States as well.
Ms. SCHWARTZ. I am running out of time here, but I just
want to say, there are a number of healthcare systems across
this country. Obviously we have made a major commitment
financially in the recovery package to scale that up to 70
percent of hospitals and 90 percent of physicians in this
country within 10 years, but I realize that takes a while. But
there are major health systems that do have electronic medical
records that probably would be ready, willing, and able to help
if they----
Mr. ASTRUE. Most of them are not quite there yet, but we
think they are getting there very quickly. And you know, if we
could, for instance, duplicate Beth Israel Deaconess with one
of the ones that are further ahead, like Kaiser Permanente,
which is a huge operation, it would be huge for us. We have
worked out a lot of the technical issues. Again, there is still
some fine-tuning of what needs to be done. I don't want to
oversimplify the tasks that we have ahead of us.
Ms. SCHWARTZ. But you did get $40 million in the recovery
package. I am assuming that is going to help you move ahead----
Mr. ASTRUE. We can spend up to $40 million of our $500
million on health IT. We would----
Chairman TANNER. I hate to interrupt, but we have got many
Members here, and we have got some time constraints.
Mr. Reichert, you are recognized.
Mr. REICHERT. Thank you, Mr. Chairman.
In my previous life, I was in law enforcement for 33 years,
so I dealt with a lot of people that were attempting to get
their Social Security checks and their Social Security
benefits. And this was a long time ago, as you can tell by the
color of my hair, unfortunately.
Mr. ASTRUE. At least you have hair.
Mr. REICHERT. Good point, sir.
I just want to give a little bit of a historical
perspective. It seems to me, and not being very experienced in
this whole--this is my first visit here to this Committee, and
I am very fortunate to be here. But I think most American
people look at IRS and Social Security, and it is a long
history of problem after problem after problem. I don't think
the backlog issue is something that has just occurred within
the last 2 years or the last 4 years or 6 years or 8 years, as
we might be led to believe by some Members here, but this is an
issue that has been going on almost since Social Security
began. Don't you agree?
Mr. ASTRUE. Yes. We had hearings on this issue, if I
remember correctly, in the 1980s, when I was with the agency,
and it is a tough one. I think part of what is going to be
important for us to communicate more clearly is what we think a
proper baseline is. It does take claimants some time to get
legal representation and to accumulate their medical records,
and then to give them time to do their job.
And we have had a good discussion with the advocacy groups
about how much time that is, and they said, you know, the
preparation time you give us is too short. So we are looking at
270 days as the baseline for delivering a hearing, and part of
what is factored in is probably 60 to 75 days for the
claimants' representatives to get ready and a little time on
the front end for them to get organized. So it is giving us
less than 6 months to do what we need to do.
Mr. REICHERT. When it comes to the hearing, and I am from
Washington State, and I think our wait time is about a year and
a half, 507-plus days or so. One of my constituents who is a
Social Security lawyer from my district who helps people
navigate through the disability claims process said that there
is kind of a perception that there is a bias against deciding
claims favorably at the early stages of the process. His view
is that a majority of the claims will be denied at the early
stages, and then the ALJ will later give a favorable decision.
He says, there is a sense in the community that this is
purposeful because it prolongs the system, and it encourages
people to drop out, and it saves money have. Have you heard
this before?
Mr. ASTRUE. Oh, yes. This was a charge made in a CBS
evening news piece a couple years ago. Interestingly, the woman
that coined the phrase ``culture of denial'' in that interview
cornered me last weekend in a meeting to commend us on how much
better we were doing in the Atlanta area where she works.
But I understand what it looks like on the other side. You
know, you have a lot of people who, even if they don't qualify,
are very sympathetic people, and the system is slow, and people
get frustrated. A lot of times it gets very toxic in terms of
how they feel toward the agency. So I understand that on a
human level, but if anything, I think if you talk to the people
in the DDSs there is a presumption toward allowance, not the
other way, in these cases.
Mr. REICHERT. Do you keep track of the dropout rate? Do you
know----
Mr. ASTRUE. I am not sure what you mean by the dropout
rate.
Mr. REICHERT. If there are people who are actually just
giving up, falling out of the system, and saying, I just can't
go through this any longer.
Mr. ASTRUE. Yes, we do.
Mr. REICHERT. Do you know what that rate is?
Mr. ASTRUE. It depends on the period of time, and it
changes very rapidly; so why don't we supply you with some
information for the record----
Mr. REICHERT. Please. And then do you attempt to extend a
hand to these people who are dropping out, to search them out
and bring them back into the fold? You don't have time to do
that probably----
Mr. ASTRUE. No, we don't do that. What we are trying to do
is look at some places the people who don't qualify can go to
get help. We can't have that conversation efficiently one by
one, but we are looking through our notices and electronically
to see whether we can provide more information to help people
in those situations.
Mr. REICHERT. Mr. Chairman, I yield back.
Chairman TANNER. Thank you.
Mr. Higgins, we are glad to have you here.
Mr. HIGGINS. Thank you, Mr. Chairman.
Commissioner, can you help us, you have touched on it a
little bit, but for the sake of context, just kind of walk us
through, generally and briefly, the process of making an
application for Social Security disability and what follows
that?
Mr. ASTRUE. Sure. There has been an uptick recently. About
22 percent of the people now file online as opposed to about 5
percent a few years ago, and we have not improved that form
yet. We have an improvement that is coming. It is a few months
away. We also want to have a Title XVI application form. Now if
you are filing for Title XVI, you have to actually come to the
office and go there through the process.
Typically, though, people still come into the office. They
have an interview. Intake is done in a field office, and then
that information is transmitted to the State DDS. We have about
15,000 employees who are State employees but work full time for
us deciding these cases.
And most of those States have two levels of review: an
initial decision and what we call reconsideration. There are
parts of about 10 States, some States in total, some States in
part, that from an initiative of 10 years ago, don't have
reconsideration, called prototype States. So sometimes there is
recon, sometimes there is not.
When a State has made a final decision, it goes up for a
full hearing before an administrative law judge. We get about
650,000 of those a year. We get about 3 million disability
applications.
And then there is a relatively small number of cases that
are appealed to an agency appellate board, and then they go up
to the Federal court from there.
Mr. HIGGINS. It sounds very bureaucratic. Is it necessary?
Could the process be streamlined?
Mr. ASTRUE. Well, it is a bit of a Holy Grail in the
agency. And one of the problems with a lot of the efforts to
make it better is that the law of unintended consequences kicks
in, and it has made it worse. So we are constantly looking at
efforts to streamline.
Some of the most dramatic streamlining probably would have
to come from this room. Right now, I try to work within
consensus and try to make the system within the consensus work
as compassionately and quickly as possible. A lot of the things
that you would need to do in order to cut out a lot of that
would require legislative change.
Mr. HIGGINS. You indicated you went from 5 to 22 percent
for those applying online?
Mr. ASTRUE. For disability, that is right.
Mr. HIGGINS. Ideally what is the goal there relative to
online?
Mr. ASTRUE. There is no goal. My feeling is it is a choice
for individuals, and that we should provide the best service in
the office and the best service we can online. We are not where
we want to be online with the disability yet, but we will be
fully at some point next year.
Mr. HIGGINS. Assuming you were fully funded, what would be
the likely time from one's making an application to a final
disposition on said application?
Mr. ASTRUE. Well, I think that the biggest opportunity for
collapsing the time up front for the biggest number of people
is exactly what Congresswoman Schwartz mentioned. An enormous
amount of time, effort, and money is spent chasing down
scattered amounts of medical records on paper in lots of
different locations, a lot of the time the claimant doesn't
know where the medical records are, and our people do fairly
heroic work trying to chase those down for the claimants. If we
can eliminate that and go to a centralized single record for
most Americans it would be huge.
We have been cutting down the time in the DDSes, but
ballpark a little under 100 days first go round; probably a
little under 100 days for recon. We might be able to cut that
by two-thirds if we can really integrate with electronic
medical records in the way we think we can in the next 2 or 3
years.
Mr. HIGGINS. And the shame is, I mean, this is obviously,
this is a systemic problem, but it hits probably the most
vulnerable population of folks. And we have a situation in
Buffalo that is unacceptable on its face, and while some good
progress has been made, it is only within the context of a
horrible situation that we started with. Progress is being
made, which I think is good, but obviously, this is not a
problem unique to Buffalo but obviously hits a place like
Buffalo particularly hard as well.
Mr. ASTRUE. The other thing that is important, I think the
agency historically had a fairly high threshold for defining in
its rules whether someone was disabled or not. We had to see a
lot of cases of that, and my view is that that is wrong, that
cumulatively there are an awful lot of cases that we weren't
giving guidance on, and that is where an awful lot of the error
and an awful lot of the delay was.
So we are not just making the medical listings more
current; we are trying to drive them down into a lot more rare
diseases and conditions. We know a lot of those are
automatically disabling. We are trying, with electronic
screening to just pick those out and allow those. And as I said
in my testimony, we are about at 4 percent now. We have gone
from 2.7 to 4 percent in the last year. We were at zero the
year before. We think we can get 6 to 9 percent of the cases
decided in that way. Right now, it is an average of about 10
days. We are hoping we can do that a little quicker. We have
got some old rules that are process rules that we are looking
at getting rid of, and so we might even be able to take that 10
days and make it 5 days, and if we can do that, we will.
Mr. HIGGINS. Thank you, Commissioner.
I yield back.
Chairman TANNER. Mr. Lewis, you are recognized.
Mr. LEWIS. Thank you very much, Mr. Chairman. And, Mr.
Chairman, I want to thank you for holding this hearing today.
Mr. Commissioner, how long have you been commissioner?
Mr. ASTRUE. A little over 2 years.
Mr. LEWIS. Over 2 years.
Mr. Commissioner, as you know, I represent metro Atlanta.
The Atlanta and Atlanta North hearing offices have some of the
worst backlogs in the Nation. Although there has been some
improvement, not much since the last time that you were here.
Mr. ASTRUE. Actually, Mr. Lewis, I think I would disagree
with you. When I had my first hearing here just over 2 years
ago, Atlanta and Atlanta North were the two worst in the entire
country. Atlanta was at 900 days, and Atlanta North was a
little bit south of that. Today we have cut almost a full year,
in 2 years, off the Atlanta times, and we are at about 667, if
I remember correctly, for Atlanta North.
I agree with you that that is not acceptable, but we have a
new office coming that we are calling Atlanta South, and it is
centered in the Covington area. When that office opens, we
ought to have all the offices in the Atlanta area, I would
think, better than the national average. So we are making a lot
of effort in Atlanta, a big effort with the National Hearing
Center. We put four electronic hearing rooms into the Marietta
field office to try to accommodate that. We have put an
extraordinary effort into trying to improve what was 2 years
ago the worst situation in the country, and it is not now.
Mr. LEWIS. Mr. Commissioner, in Atlanta, I believe people
are waiting 561 days. In Atlanta North, they wait 668 days for
a hearing. People shouldn't be waiting that long.
Mr. ASTRUE. I agree with that, but it is significantly
better than 2 years ago and----
Mr. LEWIS. I am not going to argue with you. It is better.
But it is not much better. Waiting that long is too long.
What has been done in Atlanta to address the issue? I am
frustrated. I keep hearing talk about the union, GAO, OMB. Have
you asked for more money during the past 2 years, more
resources?
Mr. ASTRUE. Absolutely.
Mr. LEWIS. Do you get it?
Mr. ASTRUE. Not very promptly. I mean, you have to
remember, for the first 6 months of this year, we have been on
a continuing resolution. Last year we got $148 million over the
President's budget. I went back to OMB to ask for authority.
That budget was not mine; that was Commissioner Barnhart's
budget. But to argue for $100 million over the President's
budget, it is very unusual to get that permission, and we got
it.
So I have been fighting for this agency's resources, and we
have been trying to put them where they should have been for
decades. And Atlanta has always been number one on my list.
And, you know, in the first group of new hearing offices we
approved was Atlanta South to take the pressure off of the
Atlanta downtown and Atlanta North offices.
So it is going to take time for the permanent solution. But
in the meantime, we are using Office of Quality people to prep
cases. We have had the National Hearing Center, the first test
of the National Hearing Center with Atlanta downtown cases. We
have put in an extraordinary effort in the short run to
bringing those horrendous numbers down. We have made progress.
I agree with you; it is not good enough. But there is more
coming, and we are doing the best we can as fast as we can.
Mr. LEWIS. As you take a long hard look, what are you doing
about planning for the future in terms of resources, dollars,
people, space?
Mr. ASTRUE. We try to have, I think, a much more
disciplined strategic planning process than we have had before.
I think, in the past, the agency's strategic plan, which was
required by OMB, was not much more than a revision of the
budget document. We didn't do that. We went through a very
serious process to say, what are our long-term needs? What are
we not looking at that we need to plan for? And there are a
number of things that we are doing now over the long run that
are only going to make my life harder in the short run because
I am not going to be here to get the benefit: replacement of
the National Computer Center, and replacement of the Dictionary
of Occupational Titles, which the Department of Labor stopped
updating in 1991.
So we are tackling a number of things where the agency had
not been focused on what we needed to do over the long run to
deliver service to the American people, and we have tried to
identify those through our planning process and suck it up to
make the investment even though there is a lot of pressure to
put money in a lot of other places in the agency right now. We
are trying not to forfeit the long-run future of the agency.
Mr. LEWIS. Is there anything that can be done to make the
decision in the front end rather than at the back end?
Mr. ASTRUE. Yes. We are doing that as best we can. And,
again, we have new systems in place to try to define those
cases that ought to be automatic up front. That has gone from a
small pilot with a handful of cases in 2 years to, now, 4
percent of the country is benefiting from that, and our goal is
to get that from 6 to 9 percent in the next few years. So that
is a matter of updating and being much more specific and much
more detailed about the medical listings, and we have been
doing that, and we have been doing that extremely quickly. So
that is one example of what we are trying to do.
We also have some new computer systems in place that are
promising in terms of queuing and reminding examiners on the
front end what they need to do and what they need to document
to lift the quality of the cases. Not quite ready for prime
time, and we have a problem right now in that we have 54
separate IT systems for the States. And it means, every time we
have something that can improve processing, it is long, slow
and expensive to roll it out. So what we are trying to do, and
we have got the States behind us now---this failed once before
10 years ago--is to develop a common IT system to get away from
the COBOL, to get away from the legacy systems, and to get to a
Web-based system for all the States that, when we have things
that will improve things for claimants, we can roll it out very
quickly.
Right now, I can't. The money and the technology won't let
me do it. So that is why it is really important that for these
IT improvements, we get as much support as possible and the
States stay behind this. Otherwise, the improvements that the
smart technical people can make aren't going to get out there
very quickly to help people, and that is what I want to do.
Mr. LEWIS. Thank you, Commissioner.
Thank you Mr. Chairman.
Chairman TANNER. Thank you.
Mr. Meek, then Mr. Davis, and Mr. Becerra.
Mr. MEEK. Thank you, Mr. Chairman. And I am glad we have
the witness back once again.
I was here 2 years ago when you testified before us. And as
you know, I am from Florida, and actually, your office is right
across the parking lot from my office, so I do get a firsthand
dose of individuals that are very concerned with the lack of
movement.
I was handed a national ranking report here, average
processing time, and I am looking at this, and I can't help but
notice, and I will start with Orlando, it says, in region 4, we
have 476 days to process, and I would even go beyond that,
because if you look at it from days, you really can't get a
full appreciation for the time that people have to wait. So
that is 111 days over a calendar year. You look at
Jacksonville, region 4 again, it is 492 days. That is 120 days
over a 12-month calendar year. You look at Tampa, 532, which is
167 days over a calendar year. And the offices right across the
street from mine, right across the parking lot from my office,
has 674 calendar days, which is almost 2 years, just short of 2
years, 309 days over a 365-day calendar year.
When you are dealing with individuals, and as you all know
and everyone over at the department knows, you are dealing with
folks that 9 times out of 10 are dealing with the muddiness of
life, and they are trying to make a claim, and guess what? A
super majority of those individuals that come to my office end
up winning their appeal. And I can't help but think that this
has to be a major concern of yours and the department.
Now, I know you are here asking us to do things, and I
believe we have and we will continue to do things as we make
life better for the agency. But I can tell you it is just truly
hard for Members, for them to repeat what you have already
said, that we understand, we understand we have a problem; we
understand, we are trying to work through it, but there has to
be a way that we can look at these appeals at a faster rate,
especially now in this bad economy.
So I wanted to ask you, as it relates to our financial
situation, our present footprint right now in this economy and
the individuals that are filing that are being denied, that are
being placed in the appeal process, has there been any change
whatsoever, any consideration taken by Social Security as it
relates to these claims that have been made of understanding
the financial strain that these applicants are under right now?
Mr. ASTRUE. We do understand the strain that people are
under, and that is why we have more and more mechanisms for the
people who are truly entitled to try to identify them on the
front end and pay them their benefits as close to immediately
as possible. It is still a very difficult statutory standard.
There are a lot of very sympathetic people who don't qualify
for benefits, and that is your choice. It is a very expensive
one. What we try to do is implement the statute as fair and
square as possible. It has been difficult with the resource
levels.
Now, Florida is one of the States, as with Georgia,
Michigan, and Ohio, that has been systematically under-
resourced over the years, and we are moving to address that. So
in the first round of new hearing offices there was
Tallahassee, and in the second round we sent to GSA was the
Tampa-St. Petersburg area. So there is help coming,
approximately 15 additional administrative law judges for the
State of Florida.
I think it is a credit to the people in this agency that,
with this economy, they are still making service improvements
and that we haven't had a significant deterioration in
service--we have been making small progress. And that has also
been in a time of very tight dollars. Until 2 weeks ago, I was
well into my 3rd year as a Commissioner with one appropriations
bill. I have spent the majority of my time managing this agency
under a continuing resolution and that forces hiring freezes.
That chokes off the very people who can help the people that
you want to help.
Now, again, I am not criticizing this Committee. This
Committee and the Finance Committee have been extraordinarily
useful in making the case to your colleagues, but I think a lot
of your colleagues in the Congress still don't understand what
they have been doing to this agency, and we need you and the
others on this Committee to continue to be our advocates. We
can't do it without your help. If we are back on continuing
resolutions, you are just going to see the quality of the
service go down.
Mr. MEEK. Thank you, Mr. Chairman.
I just wanted to make sure that the witness was able to
share with us what we may need to know, maybe not necessarily
what we all want to hear. But I think, at the same time, we are
properly motivated; I know I am, because many of our cases
outside of immigration cases in Florida that come from my
district offices are dealing with the very claims that we are
talking about here today, and I just wanted to make sure that
there was maybe more license to be extra sensitive in these
very hard times.
Thank you, Mr. Chairman.
Chairman TANNER. Thank you, Mr. Meek.
Mr. Davis, I am pleased to recognize you, sir.
Mr. DAVIS OF ILLINOIS. Thank you very much, Mr. Chairman.
And let me just agree, Commissioner, that continuing
resolutions do hamper movement into projected budget activity
for the coming year or even the year that we might be in.
When I look back, though, it seems to me that decreased
funding back during what I would call the Bush Senate kind of
started us to escalate in relationship to a backlog. I was also
thinking that we have had a lot of conversation in relationship
to increased applications due to the recession. Let me ask,
what specifics do you plan to put in place or do you have in
place to make use of the stimulus money that is going to come
to the agency? And how do you view that helping to reduce the
backlog?
Mr. ASTRUE. So here is the good news and the bad news. We
need more people. As of a couple weeks ago, we had the money to
do it. We are working as hard as we can to go out and try to
hire about 5,000 people before the end of the fiscal year, and
we will probably fall a little bit short. That is huge for us.
We have had to move people around just to put the
infrastructure back in to hire at that level. So we are trying
to do that. We are also assuming, and you know I may hang on to
regret this, that Congress will accept that we need more of
this infrastructure in the baseline in the hearings office. And
if we end up being told we have overbuilt and we are back, you
know, on level funding again, then there will be consequences
for having built up that infrastructure. But we have decided to
take the leap of faith that Congress is sufficiently concerned
about the backlog, that when you say we need 15 percent more
capacity than we had a couple years ago, that Congress will
continue to support that, and that is pretty critical for us.
Mr. DAVIS OF ILLINOIS. I couldn't help but perk up a little
bit when I heard my friend from Atlanta, Mr. Lewis, indicate
that he was frustrated. And I said to myself, if he is
frustrated, then I must be devastated because when I look at
the Chicago experience and I look at the fact that we have
actually gotten worse by 95 additional days, then when I hear
that there are plans to open some new offices in the Midwest
region or in the Chicago land area, but those offices are not
scheduled for Chicago. As a matter of fact, they are scheduled
for other locations, and it is my understanding that the
decision is based upon under-allocations or the fact that they
may have not been adequately staffed earlier. But it seems to
me that if we have gotten 95 days worse in terms of a waiting
period in Chicago, something must already exist or something
must be going on that caused this discrepancy.
Mr. ASTRUE. Sir, the way we are doing this is the way that,
if we could all get in a room, we would agree is the right way
to do it. We are trying to work down from the places where the
wait is the worst and come down. So we still have a placeholder
for two more, possibly three more hearing offices. The staff
came up with the four recommendations. I took a quick look at
that, and I looked at the national numbers, and I am concerned.
This next round, the Chicago area is one of the ones that we
need to have a discussion about. There is a placeholder for
discussion. The straw man right now is for Gary, Indiana,
because ODAR doesn't respect State lines. Chicago is supporting
Indiana across the state line, and we are trying to have a
conversation about, if we do do it in the Chicago area, what
makes the most sense? How does that line up against the other
four?
So I can't tell you that we have made the decision to do
that, but I don't disagree with you that you are in the next
tier of offices where we need to think about additional
support, and we may make that decision within the next few
weeks. So we are close, but we are not there yet.
Mr. DAVIS OF ILLINOIS. Well, let me thank you very much.
And let me thank you, Mr. Chairman.
And let me say, I certainly empathize with Gary a great
deal, but I always, my mother, who told us that charity begins
at home and spreads abroad, so I have got to be concerned about
Chicago. Thank you very much.
Mr. ASTRUE. Thank you.
Chairman TANNER. Mr. Becerra.
Mr. BECERRA. Mr. Chairman, thank you for holding this
hearing.
Commissioner, thanks for being with us again. Let me just
repeat a few things. One million three hundred Americans
waiting for a decision on their application for disability
benefits; taxpayers, seniors, people who have contributed to
the system that makes it possible for you and I to be here to
talk about a disability system for Americans who have worked
and now have become disabled. One million three hundred
thousand of them waiting for a decision on whether they can
finally receive benefits for which they paid when they were
working. Total wait time on an appeal of a decision, as long as
2 to 4 years. Since 2000, the number of people waiting for a
hearing on their disability claim has more than doubled from
310,000 to more than 765,000, as of February 2009.
For far too many years, Commissioner, this government had
disrespected taxpaying Americans, American seniors, who have
earned the right to have a disability claim adjudicated. And I
am not here to blame you or anyone within Social Security. What
I am here to say is this: We can't do this anymore. You cannot
come and testify and not ring the bells if you are not getting
the resources you need. We are now trying to play catchup. We
have a new President, a new Congress, and we are now trying to
play catchup after years of underfunding the work you need to
do to give Americans who pay taxes their right to a decision,
yea or nay, on whether they qualify for disability benefits
which they helped make possible through their taxpayer dollars.
You need to speak up. You can't allow the administration,
and I know you are constrained because the White House in years
prior, the Office of Management and Budget, which handles the
budget that the President submits, in years prior has made it
difficult for you to speak. I hope with this new administration
it will be different and you will be able to speak a lot louder
because you can't catch up in 1 year for years of neglect of
this agency for services people are entitled to. You need to
speak up.
Secondly, never again should we allow a White House and the
administration or any Congress to tell seniors they have got to
wait 2 to 4 years to have a disability claim adjudicated. Last
year, actually 2 years ago, we finally got you more money than
the President had requested in his budget for the Social
Security Administration, but that was after several years of
the President's not even seeking the money that you needed and
you had told him you needed. So it is ridiculous for us to
believe that this new President with a new Congress can undo
years of neglect, but we have got to start.
So when we come to you and say, by the way, you are going
to do disability claims, you are going to adjudicate those, and
on top of that, we are going to ask you to also administer the
Medicare prescription drug program, we need to give you
personnel because you can't ask someone to be doing
adjudication and then be pulled off of that to go do Medicare
prescription drug management of a program. When we say to you,
you need to verify the work status of all people who want to
work in this country to make sure that they are entitled to be
in this country and work and to go through the E-Verify system
and ask you to handle some of that load, you have got to then
say, well, then you have got to give me some personnel and
resources because, otherwise, I am pulling people away from
disability claims for Americans who are waiting to hear whether
they are going to get their assistance or not to do the work of
verifying individual status to work in this country, which we
must do. But you have got to shout and say, don't expect me to
do all these things without getting the money.
I think it is unfortunate that we have underfunded you $1.3
billion for close to the last 10 years. It wasn't until, as I
said, 2007 that you got, in fiscal year 2008, $150 million
extra, but your staffing levels by the end of 2007 had dropped
to levels not seen since 1972. And in that time since 1972, the
population you are dealing with has more than doubled. So we
have got to do something. You have got to be forceful.
When we ask you a question, do you need resources, you have
got to give us a straight answer. And I know you are limited,
but this is just not right. You have got people who are
disabled, who are waiting to hear on their claim, and it is
frustrating because it is not your fault. It is not the good
people who work for the Social Security Administration's fault.
It is the fault of this Congress and the fault of previous
administrations for not giving you the resources you needed. We
shouldn't shortchange people because politically here in D.C.
the tough decisions are not made.
I have consumed all of my time, Mr. Chairman. I apologize.
I don't know if the commissioner wanted to respond to anything.
But it is just very frustrating because you can't just nod
your head one way or the other if we ask you, do you need
resources, and you know you are crying for more and you say we
think we can make due or we are going to try to do the best we
can with what you give us. That is not good enough.
Mr. ASTRUE. If I can just try to take a minute, Mr.
Chairman, to respond to that.
So I understand that you are trying to help me here. My
view is I have spoken up loud and hard for this agency. I don't
grandstand because----
Mr. BECERRA. Have you told us how much you need for this
year? How much you need, not what you requested.
Mr. ASTRUE. You are talking about fiscal year 2010?
Mr. BECERRA. Yes.
Mr. ASTRUE. Fiscal year 2010, my request, it gets
complicated. I made two requests. We did one in September, and
I wanted to go in September so it would be bipartisan so no one
would say, it is an Obama budget or it is a McCain budget. The
world changed between September and January. I redid the
budget. I asked for substantially more money on the basis of
the economic conditions and submitted it a second time. We have
even informally tweaked it up a little bit since then.
And you are right, I am constrained. I will say that we are
very much in sync with this administration in what we think
needs to be done in this agency. This is a 10-percent increase
in terms of what the President has recommended. And I remind
you that, when I got here, we had 15 straight years where the
Congress was under the President's budget. When I started here,
there was a furlough warning. There was a continuing resolution
the whole year, and I spent an enormous amount of time
groveling to get money from the pool for the emergency release
so I wouldn't have to furlough my people.
That is the baseline where I started; 2008 had already been
submitted. I went back and got informal permission to go for
$100 million more, and we ended up with $148 million more, and
there was no veto threat on that. And I try not to grandstand
and take credit. And a lot of people deserve credit for
improving the situation in the agency. In fiscal year 2009, we
got a 6.5-percent increase at a time when the domestic agencies
were almost all at zero or cut. So we got a significant
increase last year, and this year, we are in sync at a 10-
percent increase with this administration. So, you know, I may
not get up and yell at public events about the--I don't think--
--
Mr. BECERRA. What about privately then----
Mr. ASTRUE. Well, I have been known to have a temper
occasionally.
Mr. BECERRA. Just defend your people and your mission. We
want to be there for you.
Mr. ASTRUE. And I agree with you, and I believe that I have
tried to do that. And at some point, the question of your
effort and your competency is the outcome, and I think we have
had good outcomes the last 2 years. These are the 2 years that
I have had to influence the budget.
Mr. BECERRA. Thank you very much.
Thank you, Mr. Chairman.
Chairman TANNER. Mr. Commissioner, I am going to thank you
for your time and your testimony, and I hope you will be
receptive if any of the Members have a written follow-up.
Mr. ASTRUE. Absolutely. Thank you, Mr. Chairman.
Chairman TANNER. Commissioner, thank you.
We have about an hour left in this room, so I appreciate
the panel's being so patient with us. If they would, please.
We have the Honorable Patrick O'Carroll, who is the
Inspector General of the Social Security Administration. We
have Mr. Dan Bertoni, the Director of Disability Issues,
government Accountability Office; Ms. Peggy Hathaway on behalf
of Consortium for Citizens with Disabilities Social Security
Task Force. We have the Honorable Ron Bernoski, the Association
of Administrative Law Judges from Milwaukee; Mr. James Fell,
Federal Managers Association Chapter 275; and Mr. Rick
Warsinskey, the National Council of Social Security Management
Associations, Incorporated, from Cleveland.
What the Chair chooses to do is call on the panel in the
order in which I have introduced them for their statements. All
of you will have any statement you wish to submit for the
record included in its entirety without objection.

[12:36 p.m.]

Chairman TANNER. If you could hold your comments to 5
minutes, the panel would very much appreciate that.
So, with that, Mr. Johnson, do you have an opening
statement?
With that, Mr. O'Carroll, welcome and thank you for being
here. You are recognized.

STATEMENT OF THE HONORABLE PATRICK O'CARROLL, JR., INSPECTOR
GENERAL, SOCIAL SECURITY ADMINISTRATION.

Mr. O'CARROLL. Good morning, Chairman Tanner.
Good morning, Mr. Johnson.
Let me first thank you for this invitation to testify
today. It is a pleasure to be here in front of both
Subcommittees. With so many new members, I want to take just a
moment to introduce SSA's Office of the Inspector General. We
are 600 auditors, investigators, attorneys and other
professionals. Our mission is to prevent and detect fraud,
waste, and abuse.
In February, Chairman Tanner was gracious enough to meet
with me to discuss issues of mutual concern.
Mr. Chairman, you mentioned a constituent who contacted you
wanting an assurance that disability benefits are paid only to
those entitled to them and that the stimulus funds provided to
SSA are spent well and wisely. My testimony today is directed
at that constituent and at the millions of others just like
her.
I would also like to thank Congressman Brady. Last week,
Mr. Brady was kind enough to visit one of our offices that best
illustrates the partnership we have forged with SSA and with
State and local agencies to combat fraud.
Our Houston Cooperative Disability Investigative Unit, or
CDI, is one of 20 such units around the country that we formed
in partnership with SSA more than a decade ago. CDI Units
detect fraud at the initial application stage before any
benefits are paid. With a return of $14 for every dollar
invested, CDI units make sound fiscal sense. I thank Mr. Brady
for his interest and his visit, and extend to all of you the
same invitation to visit any of our CDI units. We will show you
firsthand why there should be more.
Both fraud and improper payments in the Title II and Title
XVI disability programs are the focus of many of our efforts.
Before I address the backlog, I would like to briefly mention
some of our work in this area. Recent and ongoing audits
looking at improper payments resulting from unreported wages
and assets, unreported changes in living arrangements, and
recipients residing outside of the United States are
representative of our integrity work in the SSI area. And
audits like the current one, reexamining how well SSA reacts
when earnings are reported on a disability beneficiary's
account, are representative of our integrity work in the Title
II program.
Since our inception in 1995, we have worked to ensure that
SSA strikes an appropriate balance between its world-class
service and stewardship. For this reason, our work is not only
integrity-based, but conducted with the full awareness that
service is just as important.
The disability backlog, about which I testified twice last
year, is currently the IG's highest priority, just as it is
SSA's. We recently published an audit examining the entire
disability process from the claimant's perspective and found
that, while decisions on initial claims are made within 131
days and decisions made on reconsiderations take 279 days,
requesting a hearing before an ALJ means, on average, a wait of
over 800 days. These numbers make it clear that much more needs
to be done.
As a result, we are conducting multiple audits aimed at
providing SSA and Congress with information and recommendations
to reduce the disability backlog. For example, at a hearing
last year, a Subcommittee Member raised valid concerns about
the effect of these long waits on disabled claimants. We are
now conducting an audit in which we are interviewing 550
disability applicants to learn about their experiences. Another
current audit is examining the effects of States' decisions to
furlough DDS employees. Five States have already implemented
such furloughs, creating further delays in the disability
determination process.
In other ongoing audits, we are looking at optimum staffing
ratios and skill sets in hearing offices; SSA's e-Pulling
pilot; reasons why four particular types of disabilities create
a disproportionate number of ALJ reversals; and the
effectiveness of video hearings on productivity.
Also, the American Recovery and Reinvestment Act provided
SSA with $500 million to process disability and retirement
workloads. As soon as SSA presents its plan for its use of
these funds, my office will begin a series of audits to assess
that plan.
Mr. Chairman, you can tell your constituent we will be very
thorough. I thank you again for this invitation to testify
today, and I will be happy to answer any of your questions.
[The prepared statement of Mr. O'Carroll follows:]
Statement of The Honorable Patrick O'Carroll, Inspector General,
Social Security Administration
Good Morning, Chairman Tanner, Chairman McDermott, Congressman
Johnson, and Congressman Linder. Let me first thank you for your
invitation to testify today. Your committees are staunch supporters of
the work of the Office of the Inspector General, and I look forward to
working with all of you on the many critical issues of great concern to
us all.
Of the 27 members of the two subcommittees, I am testifying before
20 of you for the first time. While I won't take up much time with
background information, I do want to take the opportunity to introduce
the Social Security Administration's (SSA) Office of the Inspector
General, or OIG, to those of you new to these committees. In business
since SSA became an independent agency in 1995, the OIG is currently a
team of 600 auditors, investigators, attorneys, and other professionals
dedicated to our statutory mission--preventing and detecting fraud,
waste, and abuse in SSA's programs and operations. Over the years, our
audits and investigations have uncovered billions of dollars in fraud,
improper payments, and Federal funds that can be put to better use. I'm
extraordinarily proud to head an organization that works so tirelessly
to protect the integrity of these government programs that touch the
lives of nearly every American.
In February, Chairman Tanner was gracious enough to meet with me
and discuss issues of mutual concern. During that meeting, Mr.
Chairman, you mentioned a constituent who had contacted you, wanting an
assurance that disability benefits are paid only to those entitled to
them, and that the stimulus funds put to that use are spent well and
wisely. My testimony today is directed at that constituent, Mr.
Chairman, and at millions more like her.
While I'm always pleased to testify before the Social Security
Subcommittee, I'm particularly pleased to be here before the
Subcommittee on Income Security and Family Support as well. The Title
XVI Supplemental Security Income program has been off the Government
Accountability Office's high-risk list for years now, but this has not
slowed the OIG's work on SSI issues. In addition to the audits related
to the disability backlog that I will discuss today--most of which are
equally applicable to Title II and Title XVI disability applicants--we
have conducted several recent audits focused on the integrity of the
SSI program.
Last week, Congressman Brady was kind enough to visit one of the
offices that best illustrates the partnership we have forged with SSA
to combat fraud. Our Houston Cooperative Disability Investigation unit,
or CDI, is one of 20 such units around the country that we formed in
partnership with SSA more than a decade ago. Each is composed of an OIG
Special Agent who acts as team leader, employees from SSA and that
State's Disability Determination Service (DDS) who act as programmatic
experts, and State or local law enforcement officers. Tapping the
skills of each member, the CDI units receive benefit applications
flagged as suspicious by the DDS and, where appropriate, investigate.
Designed to detect fraud before benefits are ever paid, the CDI
units have been an overwhelming success. Several years ago, the
Government Accountability Office recommended expansion of the CDI
program to all 50 states, and I share their enthusiasm. With a return
of $14 for every dollar invested, CDI units make sound fiscal sense. I
want to thank Mr. Brady for his interest and his visit, and extend to
all of you the same invitation to visit any one of our 20 CDI units.
The issue we're discussing today, however, is primarily one of
service to the American public. Service is SSA's hallmark, and for
fourteen years, we have urged SSA to strike an appropriate balance
between that service and the stewardship incumbent upon a program that
pays out over half a trillion dollars a year. Over that time, the OIG
has always been there to help correct the Agency's path when its focus
on service has threatened to overtake its commitment to stewardship.
While the disability backlog is first and foremost a service issue, it
also carries important integrity issues over which my office keeps a
careful watch.
Therefore, I will address both service and integrity aspects of the
backlog in my testimony today. I'll be discussing the work that the OIG
has completed, and the work we have underway, that is designed to
provide information and recommendations to the Agency and to Congress
with respect to improving the entire disability adjudication process.
To do so, I'll speak first to the overall processing time for
disability claims, then to factors related specifically to the hearing
process, and finally, to a number of related audits in which the focus
is on integrity, rather than service alone.
OIG Reviews Involving the Overall Processing Time for Disability Claims
Our December 2008 report, Disability Claims Overall Processing
Times, examined for the first time not merely the appeals process--
where most of the backlog exists--but the entire process of
adjudicating a disability claim. Looking at the process from soup to
nuts, we sought to determine SSA's average overall processing time for
disability claims decided at the initial DDS level, upon
reconsideration at the DDS, by an Administrative Law Judge, by the
Appeals Council, or by a Federal Court--all of the stops at which a
claim can be decided. This, we felt, would give a true claimant's-eye
view of the entire process from when the claimant filed an application
until SSA issued benefits or the claimant stopped appealing.
We found that the average claim adjudicated in 2006, when decided
initially by a DDS, was concluded in 131 days, but that if a claim was
adjudicated upon a request for reconsideration, that time more than
doubled, to 279 days. If a claim was appealed to an ALJ, the 279-day
wait almost tripled, to 811 days, or 2.2 years. A trip to the Appeals
Council (the last step under SSA's control) increased the total time to
1,053 days, while a Federal Court appeal stretched the wait to just
under five years: 1,720 days.
We recommended that SSA publish this measure to show disability
waiting time from the claimant's perspective, to better inform Congress
and the public.
We also have two audits underway that address overall claims
processing time. The first, Impact of the Claims Process on Disability
Applicants, stems from an issue raised by the Social Security
Subcommittee during my testimony at a September 2008 hearing. The
Subcommittee was concerned about the effect of the arduous disability
adjudication process on already-disabled claimants. I share those
concerns, and to address them, we are conducting a review in the course
of which we will interview 550 randomly-selected disability
beneficiaries. Of the 550, 250 had claims adjudicated at the DDS,
either at the initial or reconsideration stage, another 250 were
adjudicated by ALJs, and the remaining 50 were decided by the Appeals
Council or a Federal Court. Our interviews are designed to elicit from
these individuals information about their experiences in obtaining
benefits and the effect those experiences had on them. We anticipate
publication of this report in August of this year.
Our second ongoing project in this area is a Quick Response
Evaluation entitled Impact of State Employee Furloughs on SSA's
Disability Programs. As you are aware, several States have implemented
furloughs of their employees. In some of these states, the furloughs
include employees of the State's DDS. The Commissioner sent a letter to
each of the relevant Governors, reminding them that SSA, not the
States, pays 100 percent of the costs of processing these disability
workloads. In addition, SSA's Regional Commissioners urged their States
to exempt DDSs from hiring restrictions and furloughs. Nevertheless,
our preliminary findings indicate that of the 52 DDSs, five were
experiencing furloughs, three were still under furlough consideration,
and 44 either were not furloughing employees, or the DDSs had been
exempted. Unfortunately, the five States that decided to furlough their
DDS employees--California, Maryland, Massachusetts, Oregon, and
Connecticut--comprise 15 percent of the national DDS workload each
year.
The impact of these furloughs on beneficiaries is apparent in our
report, which will be issued shortly. For example, we found that
California will encounter a shortfall of capacity of 10 percent due to
furloughs. We estimate that this will delay over 2,300 applications
from being processed, of which we estimate 776 would result in
allowances. Those 776 beneficiaries will be forced to wait to receive
their $648,000 in monthly benefits as a direct result of the furloughs.
Since January 1, 2009, California's initial claims pending have
increased by 9.7 percent and its reconsideration claims pending by 16.1
percent as a result of increased applications and the State furloughs.
OIG Reviews Related to the Hearings and Appeals Process
While issues surrounding the DDSs and the processing of both
initial claims and requests for reconsideration are material to the
overall backlog, the findings in our soup-to-nuts review establish that
the real delays begin when an appeal is filed--it was at this stage
that the processing time jumped from 279 to 811 days. As a result, the
majority of our work related to the disability process focuses on this
stage of the claim.
In recent years, we have conducted a number of reviews in this
area, studying ALJ productivity, hearing office performance, timeliness
of medical evidence, and other factors. Our past work in this area can
be viewed online at http://www.ssa.gov/oig/office_of_audit/
issuesmanage.htm, or I'd be happy to provide any of the Members with
hard copies of any report.
Today, however, I'd like to look ahead by sharing some information
about the work we have in progress in these areas, in addition to the
aforementioned audit on the impact of the process on disabled
beneficiaries, which bridges the initial adjudication and the appeals
processes.
Electronic File Assembly, often referred to as e-Pulling, is a
pilot initiated by SSA and designed to improve the process by which
disability claim files are assembled and prepared for an ALJ hearing.
Customized software, piloted at seven locations in the summer of 2008,
is being evaluated by SSA to determine when e-Pulling should be
implemented nationwide. The OIG is assessing the results of the pilot,
as well as whether SSA's assessment procedures are effective with
regard to making decisions about a nationwide rollout.
In another review, we are studying the age of pending claims caught
in the disability backlog and identifying obstacles that have prevented
the oldest claims from moving forward. Our review, which includes
hearing offices with the most aged cases and those with the fewest, is
designed to identify best practices and make recommendations for
reducing the number of aged cases.
Hearing office performance and staffing is an issue we touched upon
in our 2008 audit, ALJ and Hearing Office Performance. In that audit,
we found that staff ratios and staff performance were ignificant issues
in determining a hearing office's processing time.&n an audit now
underway, we are delving deeper into these specific issues.&ur goal, to
be accomplished through extensive field work in hearing offices across
the country, is to identify optimum staffing ratios and staff skill
sets to maximize hearing office performance.
In an earlier analysis of DDS determinations, we determined that
there were four impairments that, when denied by the DDS, were most
likely to be reversed by an ALJ: disorders of the back, osteoarthritis
and allied disorders, diabetes mellitus, and disorders of muscle,
ligament, and fascia. A review now underway will, within the context of
these four impairments, analyze multiple variables to include claimant
age, the State in which the claimant resides, the hearing office that
heard the case, whether the claimant was represented, claim processing
time, and other factors. Our goal is to provide SSA with information
that will be useful in considering changes that will allow these cases
at the initial level, instead of being consistently denied and
reversed, using limited resources.
Video hearings are another initiative SSA has employed to reduce
the disability backlog. By reducing ALJ travel to remote locations,
SSA's intention was to increase ALJ productivity. As of fiscal year
2008, SSA had procured and was installing 558 video teleconferencing
units, and was planning to obtain and install another 112 units in
fiscal year 2009. SSA is also installing smaller video units, called
Desktop Video Units, which will not require a hearing room and will
thereby expand the capacity of hearing offices. We have fieldwork
underway on an audit designed to assess whether the use of these video
units increases hearing office productivity and provides claimants with
more timely service.
Finally, the American Recovery and Reinvestment Act of 2009
provided $500 million to SSA to process the additional disability and
retirement workloads created by increased benefit applications brought
about by the economic downturn. As stated in the Joint Explanatory
Statement of the Committee of Conference accompanying the legislation,
``These additional funds will allow SSA to process a growing workload
of claims in a timely manner and to accelerate activities to reduce the
backlog of disability claims.'' The OIG is charged with oversight of
this and all SSA stimulus spending. In early April, as SSA provides the
Office of Management and Budget with its plan for the use of these
stimulus funds, our office will initiate an audit that will assess the
Agency's spending plan.
All of these ongoing audit efforts are designed with a single goal
in mind: to help SSA and Congress in their efforts to improve service
to disability beneficiaries. As I stated at the outset, however,
service is only one side of the equation, and while the disability
backlog is first and foremost a service issue, I would be remiss if I
didn't also mention our integrity-based efforts in the disability
arena.
Integrity is at the very heart of the OIG's mission, and our
efforts in this area take on myriad forms. From criminal investigations
to complex audits, and from government-wide task forces to the CDI
units I mentioned earlier, integrity is our bread and butter. The
programs administered by SSA pay some half a trillion dollars a year to
50 million beneficiaries and recipients nationwide and around the
world. That money comes from the Social Security Trust Fund, the
solvency of which affects every American, and from the general fund of
the U.S. Treasury--all of it representing taxpayer dollars. We take our
role as protectors of those funds very seriously, and while our work
aimed at service issues, such as reducing the disability backlog, is
every bit as important, service cannot be administered without
safeguards adequate to ensure integrity. Thus, our work with regard to
SSA's disability programs is by no means focused solely on service.
Integrity-Based Work Related to Disability
Our work with respect to the integrity of the disability programs
encompasses both improper payments and actual fraud. In both instances,
the majority of these integrity issues are relevant with regard to both
Title II and Title XVI disability, but the SSI program has unique
characteristics stemming from its nature as a resource-based program
that merit separate attention.
For example, last year, we conducted an audit designed to detect
both improper payments and fraud due to the failure of SSI recipients
to notify SSA that they had been married, an event that impacts both
eligibility and payment amount under SSI. We estimated that about 2,000
recipients were overpaid about $25 million, and that by stopping these
incorrect payments, SSA could save about $7 million over the following
12 months.
In another 2008 audit of the SSI program, we obtained bank data for
a sample of SSI recipients to determine if it was cost-effective to use
this type of information to identify SSI recipients who were no longer
eligible by reason of being outside the United States. We analyzed the
data to identify recipients with Automated Teller Machine withdrawals
outside the country. Although we estimated a significant amount of
overpayments--about $226 million--the audit was labor-intensive, as the
bank provided paper, rather than electronic, records. SSA does not
intend to pursue the use of this type of data due to resource issues.
While these audits were SSI-based, we also conduct integrity work
that by its nature is limited to Title II disability. In a review
currently underway, we are following up on an earlier audit that
examined SSA's treatment of Title II beneficiaries who had earnings
reported to SSA, an event that is at least indicative that the
individual may no longer be eligible for benefits. In 2004, we found
that $1.37 billion in overpayments resulted from SSA's failure to
identify about 63,000 disabled beneficiaries whose work activity
resulted in earnings being posted to the Master Earnings File between
1996 and 2000. In 2004, SSA implemented an automated system called
eWork to assist in controlling and processing work-related Continuing
Disability Reviews, or CDRs. Our current review revisits this issue,
and assesses the success of SSA's efforts in this area over the past
five years.
We found that while SSA has made efforts to reduce these
overpayments, there remains cause for concern. Based upon the sample
population we reviewed, we are estimating that approximately $3 billion
was overpaid to about 170,000 beneficiaries who had earnings reported
between 2001 and 2006. While SSA identified $1.8 billion and 141,000 of
these beneficiaries, the remainder ($1.2 billion to 45,000
beneficiaries) went undetected. We believe that 21,000 of these 45,000
beneficiaries are no longer eligible for benefits, and estimate that
SSA will pay $346 million to them over the next 12 months if corrective
action is not taken. Our report is currently with SSA for review.
Finally, much of our integrity work covers both Title II and Title
XVI disability. Like the Title II work-related CDRs, medical CDRs
(Title II) and redeterminations (Title XVI) are a critical tool used by
SSA to maintain the integrity of disability programs and processes. In
recent years, resource limitations and other factors have resulted in
fewer and fewer medical CDRs being conducted by the Agency. The
Contract with America Advancement Act of 1996 provided funding for CDRs
from 1996 to 2002, during which time SSA eliminated its entire backlog
of CDRs and redeterminations. Since that funding expired, however,
medical CDRs have decreased over 60 percent--from more than 679,000 in
2003 to fewer than 250,000 in 2008. The backlog, as of the end of
fiscal year 2008, was reported at 1.4 million CDRs, and SSA estimates
that the backlog will reach 1.6 million by the end of this fiscal year.
Redeterminations decreased more than 50 percent during the same period.
We have initiated audits to determine the financial impact to the
Social Security Trust Fund and the General Treasury as a result of the
decrease in the number of medical CDRs and redeterminations being
conducted, as well as the amount of funding that would be needed to
eliminate the current backlogs.
This brings us full circle, to the CDI units I mentioned at the
outset. When a DDS suspects fraud in the course of conducting a CDR or
redetermination, they will frequently refer such a case to the CDI unit
for investigation and, where indicated, criminal prosecution. Both CDRs
and CDIs are invaluable integrity tools and represent wise investments.
Conclusion
The work I've detailed today, encompassing both integrity and
service-related aspects of SSA's disability processes, is only a brief
glimpse of the many ways in which our auditors are providing
information and recommendations to SSA and keeping Congress and the
public informed. I look forward to working with your Subcommittees in
the coming years in this area, and in all aspects of the OIG's efforts,
both audit and investigative, as we join together to prevent and detect
fraud, waste, and abuse in SSA's programs and operations.
Thank you again for the invitation to testify today, and I'd be
happy to answer any questions.

Chairman TANNER. Thank you very much for your timely
opening statement.
Mr. Bertoni, we are pleased to recognize you.

STATEMENT OF DANIEL BERTONI, DIRECTOR, EDUCATION, WORKFORCE,
AND INCOME SECURITY, U.S. GOVERNMENT ACCOUNTABILITY OFFICE.

Mr. BERTONI. Mr. Chairman, Members of the Subcommittee,
good morning. I am pleased to be here to discuss challenges
facing SSA with respect to disability workloads and field
office customer service. SSA provides services that touch many
lives, including millions who apply for disability benefits
each year and those seeking retirement benefits and a host of
other critical services.
For years, the agency has faced difficulties managing
disability workloads and making timely decisions. In fact, over
the last decade, the disability backlog grew to over half a
million claims, and many claimants are waiting years for a
final decision.
In other mission-critical areas, SSA has also experienced
service declines, with millions of customers waiting longer to
be served and millions more having their phone calls go
unanswered.
My testimony today is based on our prior work and focuses
on two areas, factors contributing to SSA's service delivery
challenges and actions the agency is taking to better serve
those who apply for disability benefits and other services. In
summary, two key drivers have contributed to disability
backlogs and other service delivery challenges, rising numbers
of claims and staffing shortfalls.
By the start of fiscal year 2007, backlog claims reached
576,000, A growth rate of 120 percent over 1997 levels. And
over the years, spikes in benefit applications due to economic
downturns, aging baby boomers, referrals from other benefit
programs, changes to program eligibility requirements and
increased outreach have contributed to the backlog of claims.
While backlogs have occurred at all stages of the process, they
are most concentrated at the hearings level for 7 of the 10
years that we reviewed.
In concert with the growth of pending claims, processing
times at most levels also increased. And for claims that were
repealed, 30 percent, it took between 600 and 1,000 days to
process. The rise in disability backlogs has coincided with
high rates of turnover and attrition of experienced disability
examiners, as well as shortfalls in a number of administrative
law judges and hearing office support staff, such as decision
writers, attorneys, claims technicians and others that prepare
cases for review.
Beyond the challenges associated with disability claims,
SSA field officers face similar pressures driven in part by
increasing workloads. Last year we reported that field office
waiting times increased by 40 percent, and they had 3 million
customers waiting more than 1 hour to be served. Moreover, 51
percent of those calling SSA's field offices had at least one
earlier call that had gone unanswered.
Over the years, SSA has undertaken several initiatives to
improve the disability process and address other challenges.
Unfortunately, as we have noted in several prior reports dating
back more than a decade, some initiatives have faltered for a
variety of reasons, including poor planning and execution.
Others improved the process but were too costly and
subsequently abandoned.
In 2006, SSA introduced a new set of comprehensive reforms
to improve the accuracy, consistency and timeliness of the
claims process called the Disability Service Improvement
Initiative or DSI. However, this also yielded mixed results due
to rushed implementation, poor communication and higher-than-
anticipated costs, and many aspects were ultimately suspended.
In light of the considerable investment at DSI, we
recommended that SSA conduct a thorough evaluation to determine
what, if any, aspects should be continued. We also recommended
that, going forward, SSA should develop a systematic planning,
risk analysis and evaluation framework to increase the
likelihood that future initiatives will succeed.
In 2007, SSA outlined its current plan, which focuses on
breaking the hearings-level backlog. Key initiatives include
updating SSA's medical criteria, expediting cases for which
approval is likely and improving hearings office capacity
through hiring and other means.
SSA has also received $500 million in stimulus funds to
assist in processing key workloads. We currently have work
underway assessing the plan's potential to eliminate the
hearings backlog by 2013 as targeted. To address field office
customer service challenges, the agency is redistributing work
to offices at capacity, using managers to perform work
typically conducted by lower-graded staff and deferring some
program integrity workloads, such as continuing eligibility
reviews. Unfortunately, this can result in some beneficiaries
receiving payments who are no longer eligible.
At present, it is unclear how SSA will meet future service
delivery demands given its current organizational configuration
and business processes. The volume of work conducted at SSA's
field offices has increased markedly over time while staff
turnover and losses persist. Moreover, projected staff
retirements over the next several years will further tax the
agency. And we have recommended that SSA develop a
comprehensive service delivery plan to better position itself
to serve changing customer demographics and service needs.
Mr. Chairman, this concludes my statement, and I am happy
to answer any questions you or others may have. Thank you.
[The prepared statement of Mr. Bertoni follows:]

[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

Chairman TANNER. Thank you, Mr. Bertoni.
Ms. Hathaway, we are pleased to recognize you.

STATEMENT OF PEGGY HATHAWAY, CO-CHAIR, SOCIAL SECURITY TASK
FORCE, CONSORTIUM FOR CITIZENS WITH DISABILITIES

Ms. HATHAWAY. Thank you for inviting me here to testify
today on behalf of the Consortium For Citizens With
Disabilities. We bring the voice of the consumer to this
debate, this discussion.
Social Security Title II and SSI benefits, as well as the
accompanying Medicare and Medicaid coverage, are the means of
survival for millions of people with severe disabilities. They
rely on SSA to promptly and fairly decide on their claims for
disability benefits. Your constituent services staffs have
likely reported the heartbreaking stories and consequences of
intolerable delays in the backlogs.
When a decision is appealed, people often wait years for a
hearing, longer for a decision and even longer for actual
payment of benefits. And as others have pointed out, that is
even after they have gone through the several-months-long
initial procedure. Behind the statistics, people's lives are
unraveling. Families are torn apart. Homes are lost. Medical
conditions deteriorate. Financial security crumbles, and many
individuals die before a decision is made.
This month, the National Organization of Social Security
Claimants' Representatives, a CCD Member, conducted a quick
survey of its Members to update how the backlogs are affecting
claimants. Our written statement includes stories from a number
of states. I just want to summarize a few of them briefly here
for you.
Ms. A from Tennessee filed her application for benefits in
2007. She was forced to file for bankruptcy and lives on very,
very little income. No hearing has been scheduled, and there
has been no response to her request for an on-the-record
decision.
Mr. D from Georgia has terminal hepatitis C and depends on
his girlfriend for all of his support. After his March 2007
initial claim was denied, he filed for a hearing in October of
2007 and a request for an on-the-record decision as a terminal
case. A year and a half later, there is no hearing scheduled
and no decision.
Mr. A from Texas filed his application in September 2003,
was denied, and requested a hearing in February of 2004. After
several additional procedural steps, no decision has been
issued 5\1/2\ years after the initial claim. In the meantime,
Mr. A's house burned down, and he had to file for bankruptcy.
Mr. L from Oklahoma, I am sorry to report, committed
suicide when his case was denied consideration in May of 2008.
His widow is awaiting the yet-to-be-scheduled hearing.
Ms. S from South Carolina illustrates the importance of
this determination for health coverage. She had no health
coverage and no Medicaid because SSA had not yet found her
disabled. After unhealing sores from diabetes went untreated,
she died from complications of diabetes. At a posthumous
hearing, the ALJ stated it was obvious that Ms. S had been
disabled and issued a fully favorable decision. The medical
care and Medicaid coverage that Ms. S did not receive due to
the hearing delay most likely would have saved her life.
Then there is Mr. H from Iowa who has multiple sclerosis
and has had a claim pending since September of 2007. He sent a
letter to his attorney, part of which I would like to read to
you because it is so touching.
He says, ``I am writing this brief letter to tell you about
a few of the examples of what this disease has caused. Besides
the day-to-day struggle just to live, it has caused my wife and
me, along with our two children, financial ruin. My mortgage
payment is as much as my wife makes. I receive no other income
and worry day to day how to exist . . . as bad as this may
sound, I have actually tried to end this with a suicide attempt
in November of 2008. There isn't any way to describe this
except to say it feels hopeless.''
The primary reason for the increasing backlogs and
reductions in other key services is that, as you have heard,
until quite recently, SSA has been persistently underfunded
over many years. For years, the Commissioner's budget came in
at X dollars; the President's budget came in below that; and
Congress appropriated even less than the President's budget,
until, that was, fiscal year 2008.
So on top of the retirement and disability applications
from baby boomers, along comes the economic crisis with a huge,
unexpected surge in both retirement and disability
applications. We are encouraged and grateful for Congress's
appropriating recent funds for SSA in the economic stimulus
bill, in the 2009 appropriation, and in the President's 2010
budget, including funds for program integrity. We also
appreciate Commissioner Astrue's commitment to what he rightly
calls the ``moral imperative'' to reduce the disability
backlog.
SSA must also find ways to operate more efficiently. Our
written testimony has a number of recommendations.
A note of caution: SSA must take care to determine how new
initiatives will affect the very people for whom the system
exists, people who meet the strict criteria for disability.
These people face a host of personal, family, and financial
circumstances that make it difficult or impossible to navigate
the complex disability determination system without substantial
assistance. SSA must continue to ensure that each individual's
claim is fully developed before a decision is made.
To prevent tragedies similar to those that I have
described, CCD urges Congress to continuously provide SSA the
resources necessary to carry out its mandated responsibilities
and substantially improve its service to the public. Thank you.
[The prepared statement of Ms. Hathaway follows:]
Statement of Peggy Hathaway, Vice President, United Spinal Association,
Silver Spring, Maryland; on behalf of Consortium for Citizens with
Disabilities Social Security Task Force
Chairman Tanner, Chairman McDermott, Ranking Member Johnson,
Ranking Member Linder, and Members of the Subcommittees, thank you for
inviting me to testify at today's hearing on Eliminating the Social
Security Disability Backlog.
I am Vice-President for Public Policy of United Spinal
Association.\1\ I am here in my capacity as a Co-Chair of the
Consortium for Citizens with Disabilities (CCD) Social Security Task
Force. CCD is a working coalition of national consumer, advocacy,
provider, and professional organizations working together with and on
behalf of the 54 million children and adults with disabilities and
their families living in the United States. The CCD Social Security
Task Force (hereinafter ``CCD'') focuses on disability policy issues in
the Title II disability programs and the Title XVI Supplemental
Security Income (SSI) program.
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\1\ United Spinal Association is an organization with members in
all 50 states that has been securing equal rights and access for all
Americans with spinal cord injuries and disorders since 1946 when it
was formed by veterans paralyzed by World War II injuries. United
Spinal Association is also an authorized VA Veterans Service
Organization serving veterans with disabilities of all kinds.
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The focus of this hearing is extremely important to people with
disabilities. Title II and SSI cash benefits, along with the related
Medicare and Medicaid benefits, are the means of survival for millions
of individuals with severe disabilities. They rely on the Social
Security Administration (SSA) to promptly and fairly adjudicate their
applications for disability benefits. They also rely on the agency to
handle many other actions critical to their well-being including:
timely payment of their monthly Title II and SSI benefits to which they
are entitled; accurate withholding of Medicare Parts B and D premiums;
and timely determinations on post-entitlement issues that may arise
(e.g., overpayments, income issues, prompt recording of earnings).
We recognize and appreciate that Commissioner Astrue has made
reduction and elimination of the disability claims backlog a top
priority. However, despite increases in productivity, the backlog in
disability determinations continues to grow, at least in part due to an
unexpected increase in the number of appeals.\2\ People with severe
disabilities are experiencing increasingly long delays and decreased
services in accessing these critical benefits to which they are
entitled. We believe these problems have been caused primarily by
persistent under-funding of SSA over many years. We are encouraged by
recent additional funding for SSA but we caution that it will be offset
at least in part by the unexpected surge in both disability and
retirement claims due to the economic crisis.
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\2\ Plan to Eliminate the Hearing Backlog and Prevent Its
Recurrence, Annual Report FY 2008, SSA Office of Disability
Adjudication and Review (``SSA Backlog 08 Report'').
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THE IMPACT ON PEOPLE WITH SEVERE DISABILITIES OF INSUFFICIENT FUNDING
FOR SSA
We must recognize the real-life impact of the backlog and the
ensuing delays for individuals with disabilities who must file claims
for disability benefits and wait for a decision. Behind the numbers are
individuals with disabilities whose lives have unraveled while waiting
for decisions--families are torn apart; homes are lost; medical
conditions deteriorate; once stable financial security crumbles; and
many individuals die. Numerous recent media reports across the country
have also documented the suffering experienced by these individuals.
The National Organization of Social Security Claims Representatives
(NOSSCR), a member of the CCD Social Security Task Force, recently
conducted a quick survey of NOSSCR members for an update on the impact
of the backlog on claimants waiting for decisions on their claims. The
stories are located at the end of this testimony beginning on page 11.
Your constituent services staffs are likely to be well aware of the
situations faced by people living in your districts and provide
valuable assistance and help, where possible. An attorney in Jackson,
TN, told us:

We hear on a daily basis how the claimants are struggling to
keep their homes, obtain their needed medications, and seek
proper medical attention. When we hear our clients' stories,
the first thing we suggest to them is to contact Congressman
Tanner's office. We inform them that his office is there to
help them. Sometimes our office seeks assistance from
Congressman Tanner's office on behalf of our clients. The staff
at [his] office is always willing to assist. . . . However,
despite efforts of Congressman Tanner's office, there is still
a long wait time for our clients. Our clients are experiencing
an average of 18 months from the time we file for their
hearings until one is actually scheduled. For some of our
clients, it has been three (3) years between the date they
filed for their benefits and their hearing before the
Administrative Law Judge. This delay has put an extreme
hardship on all of our clients, but some are struggling more
than others.''

Many other claimants' representatives have similar stories about
the impact of the long waits on their clients. Because many claimants
have no access to health insurance while they wait for a decision,
their health deteriorates because they cannot obtain necessary medical
treatment, sometimes as simple as antibiotics. For those who can afford
COBRA coverage, the lengthy wait goes beyond the period when they can
extend the coverage. Sadly, many individuals die unnecessarily or
commit suicide. One attorney in Georgia had at least six clients die
over the last year while waiting for decisions. Appropriate family
members are more frequently substituted as the claims proceed following
the deaths of their loved ones.\3\ Foreclosures have increased with
claimants losing their homes and vehicles.
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\3\ If a claimant dies while a claim is pending, the SSI rule for
payment of past due benefits is very different--and far more limited--
than the Title II rule. In an SSI case, the payment will be made in
only two situations: (1) to a surviving spouse who was living with the
claimant at the time of death or within six months of the death; or (2)
to the parents of a minor child, if the child resided with the parents
at the time of the child's death or within six months of the death. 42
U.S.C. Sec. 1383(b)(1)(A) [Section 1631(b)(1)(A) of the Act]. In Title
II, the Act provides rules for determining who may continue the claim,
which includes: a surviving spouse; parents; children; and the legal
representative of the estate. 42 U.S.C. Sec. 404(d) [Section 202(d) of
the Act]. Thus, if an adult SSI claimant (age 18 or older) dies before
actually receiving the past due payment and if there is no surviving
spouse, the claim dies with the claimant and no one is paid.
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PERSISTENT UNDER-FUNDING OF SSA Despite Increased Workloads
In recent years, SSA's workload has increased dramatically due to
an increase in the number of retirement and disability claims and
addition of new SSA responsibilities. During the 5-year period from FY
2004 to FY 2008, retirement and survivors applications grew by 22
percent and Social Security disability claims grew 7 percent.\4\ During
the same period, applications for SSI disability/blindness grew by 11
percent and SSI aged applications grew by77 percent.\5\ Additional
duties have been imposed on SSA, including implementation of new
Medicare programs and verification for employment eligibility.\6\
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\4\ Social Security Administration: Workloads, Resources and
Service Delivery, p. 10, Kathleen Romig, Congressional Research
Service, R40207, 2/6/09 (hereinafter CRS 2/6/09 Rpt), p. 3.
\5\ Id. p. 4.
\6\ Id. p. 6-8.
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Even though workloads increased from FY 2004 through FY 2008, SSA's
staffing level decreased by 4 percent.\7\ SSA's staffing level is
currently about 61,000 Full Time Equivalents (FTE's) the lowest level
since the early 1970's.\8\ Moreover, many SSA employees have already
taken early retirement and many more are eligible to retire.\9\ SSA
could soon be deprived of its most experienced and knowledgeable
employees.
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\7\ Id. p. 11.
\8\ Id. p. 11 and SSA Major Strategic Accomplishments FY 2008, p.
5.
\9\ CRS 2/6/09 Rpt., p. 11.
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Despite the increase in workloads, SSA's administrative expenses
(known as LAE--Limitation on Administrative Expenses) have, until
recently, been persistently under-funded.\10\ Every year from 1998
through 2007, the President's Budget requested less than the
Commissioner's requested budget, and Congress appropriated even less
than the President's request.\11\ Between FY 2000 and 2007 alone, the
resulting administrative shortfall was more than $4 billion. The
dramatic increase in the disability claims backlog coincides with this
period of under-funding the agency, leaving people with severe
disabilities to wait years to receive the benefits to which they are
entitled.
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\10\ Id. See also OMB, Budget of the U.S. Government: Appendix, FY
1996-FY 2009; SSA Budget Justification FY 2002-FY 2009. SSA Major
Strategic Accomplishments, FY 2008, p 5.
\11\ CRS 2/6/09 Rpt, p. 10.
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In 2008, the tide finally changed for the first time in a decade,
when Congress appropriated $148 million over the President's
budget.\12\ This additional amount allowed the agency to hire some new
Administrative Law Judges (ALJs) and other staff. However, given the
many years of under-funding and the need for a $400 million annual
increase just to keep up with fixed costs,\13\ additional funding is
required to reduce and eliminate the backlog and to provide essential
services to the public.
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\12\ Id. p. 9.
\13\ Id. p. 10.
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Building on the FY 2008 appropriation, three recent developments in
funding for SSA's administrative expenses are encouraging:

Economic Stimulus legislation. Pursuant to the American
Recovery and Reinvestment Act of 2009 (ARRA), SSA received $500 million
to handle the unexpected surge in both retirement and disability
applications due to the economic downturn. SSA also received badly
needed funds to replace its aged National Computer Center.
FY 2009 appropriation. The FY 2009 omnibus appropriations
bill, just enacted this month, provides SSA with more than $700 million
over the final FY 2008 appropriation. With this increase and the ARRA
funding, SSA expects to hire 5,000 to 6,000 new employees.
President's request for FY 2010. President Obama's Budget
Overview for FY 2010 provides $11.6 billion in administrative expenses
for SSA, a 10 percent increase over the FY 2009 appropriation.

These developments come at a critical moment because the economic
downtown has led to an unexpected surge in benefit applications. The
result has been an increase of 17 percent in retirement claims over one
year ago (28 percent over two years) and a 10 percent increase in new
disability claims through March 13 of this fiscal year. Pending initial
disability claims are up 12.5 percent so far this year and hearings
filed are up 9.5 percent, with numbers increasing as the recession
deepens.
We urge support for the full $11.6 billion FY 2010 appropriation
for SSA's LAE. These increases will help SSA not only to significantly
reduce the backlog, but also keep local offices open and better
staffed, provide adequate telephone services to the public, and
maintain the integrity of its programs by performing more continuing
disability reviews and SSI redeterminations.

Performing Program Integrity Activities. The processing of
continuing disability reviews (CDRs) and SSI redeterminations is
necessary to protect program integrity and avert improper payments.
Failure to conduct the full complement of these activities has adverse
consequences for the federal budget and the deficit. According to SSA,
every $1 spent on CDRs yields $10 in program savings, and every $1
spent on SSI redeterminations yields $7 in program savings.\14\
However, the number of reviews actually conducted is directly related
to whether SSA receives the necessary funds.
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\14\ CRS 2/6/09 Rpt, p. 23 and 24.
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President Obama's FY 2010 budget request includes $759 million for
SSA program integrity work. We support this request, but it is
important to note that there is a tradeoff between program integrity
efforts and efforts to reduce the disability backlog and process new
claims, given the limited capacity of the state Disability
Determination Services (DDSs). DDS workers are trying to keep up with
the unexpected surge in applications due to the economic downturn, and
some of the same DDS personnel process CDRs. An increase in staff
attention to one function is likely to result in decreased performance
in the other, which could lead to more delays in the processing of new
claims.
IMPACT OF UNDER-FUNDING ON SSA FIELD OFFICES AND THE STATE DDSs
SSA field offices. In addition to concerns regarding the disability
claims backlog, SSA field offices are experiencing significant
increases in the volume of their work and service difficulties. A
recent Government Accountability Office (GAO) study found that the
number of field office staff fell 4.4 percent from FY 2005 to2008.\15\
GAO found that at least 51 percent of customers calling field offices
had at least one previously unanswered call, and in FY 2007, over one
million customers waited for over an hour to be served.\16\
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\15\ SSA Service Delivery Plan Needed to Address Baby Boom
Retirement Challenges, Government Accountability Office Report GAO-09-
24, January 2009, p. 2 and 3 (hereinafter ``GAO 1/09 Report'').
\16\ Id.

State DDSs. The state Disability Determination Services (DDSs),
which determine whether a claimant is disabled, experienced a 7 percent
increase in disability applications for the last quarter of 2008,
compared to the last quarter of 2007.\17\ Yet during the 5 year period
from FY 2004 through FY 2008, the number of DDS staff declined by 8
percent.\18\ To make the problem worse, even though DDS salaries,
offices and overhead are fully funded by SSA, due to severe state
budget problems, some states are imposing hiring restrictions and
furloughs of employees including DDS workers.\19\ Commissioner Astrue
has written to Governors asking them to exempt DDS from these hiring
freezes and furloughs--which exacerbate staffing shortages and severely
affect the processing of disability claims.\20\
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\17\ NADE, Statement for the Record Regarding Possible and
Previously Imposed Furloughs of DDS State & Consideration of the
Potential Impact of Hiring Freezes on DDS Services, 1/15/09 (``NADE
Stmt 1/15/09'')
\18\ CRS 2/6/09 Rpt, p. 13.
\19\ NADE Stmt 1/15/09. Some or all DDS employees have been
furloughed in California, Massachusetts, Maryland and Oregon. Hiring
freezing are affecting DDSs in Indiana, Maine, Washington and
Wisconsin. Florida is considering a pay cut.
\20\ Commissioner Astrue Asks Governors to Exempt State DDS
Employees from Hiring Restrictions, SSA Press Release 2/3/09.
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THE HEARING LEVEL: PROCESSING TIMES HAVE REACHED INTOLERABLE LEVELS FOR
CLAIMANTS
The most significant delays in SSA's disability determination
process are at the hearing level. The average processing time for cases
at the hearing level has increased dramatically since 2000, when the
average time was 274 days.\21\ In the current fiscal year, SSA
estimates that the average processing time for disability claims at the
hearing level will be 506 days,\22\ or nearly 17 months. We appreciate
the effort by SSA to reduce the processing time, but an average of 17
months--close to one and a half years--is still too long for
individuals waiting for a hearing decision. In addition, the average
processing times at the initial and reconsideration levels have grown
over the last ten years by about 20 days at each level, with some cases
taking much longer.\23\
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\21\ Social Security Disability: Better Planning, Management, and
Evaluation Could Help Address Backlogs, GAO-08-40 (Dec. 2007)(``GAO 12/
07 Report''), p. 22.
\22\ Social Security Administration: Fiscal Year 2009 Justification
of Estimates for Appropriations Committees (``SSA FY 09 Budget
Justification ''), p. 6. Available at: http://www.ssa.gov/budget/
2009cjapp.pdf.
\23\ GAO 12/07 Report, p. 20.
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The current processing times in some hearing offices are striking,
and much longer than the 506 days targeted by SSA in FY 2009. Through
February 2009, SSA statistics for 149 hearing offices \24\ indicate
that the average processing time was 499 days. It is important to keep
in mind that this is an ``average'' and that many claimants will wait
longer. However, the average processing time at 61 offices--41
percent-- was above the 499 day February 2009 national average, with 26
offices over 600 days and 7 offices over 700 days.
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\24\ ``National Ranking Report by Average Processing Time''
(Hearing Offices) for the Month Ending February 27, 2009.
---------------------------------------------------------------------------
Hearing offices more than one month over the current national
average include: Tampa, FL (532 days); Minneapolis, MN (536 days);
Nashville, TN (547 days); Los Angeles, CA-West (554 days); Bronx, NY
(590 days); Milwaukee, WI (594 days); Birmingham, AL (614 days);
Detroit, MI (643 days); Columbus, OH (640 days); Atlanta, GA-North (668
days); Miami, FL (674 days); and Oak Park, MI (714 days).
Other hearing office statistics reflect the lengthy waits that
claimants must face. The ``average age of pending'' cases at nearly
one-third of the offices is above the national average of 313 days,
with wide variation. Perhaps even more disturbing is the extremely
large disparity in the average caseload of ALJs--currently ranging from
around 300 to 1442 cases per ALJ, with an average of 670.

Is the Hearing Backlog Improving? The number of pending cases has
increased dramatically since 1999, reaching an all-time record high of
768,540 cases in December 2008. Through February 2009, the number
dropped slightly to 765,527, but has not dropped below 760,000 since
June 2008. In a recent report, the Government Accountability Office
(GAO) noted that the hearing level backlog was ``almost eliminated''
from FY 1997 to FY 1999, but then grew ``unabated'' by FY 2006.\25\ The
number of pending cases at the hearing level reached a low in FY 1999
at 311,958 cases.
---------------------------------------------------------------------------
\25\ GAO 12/07 Report, p. 20.
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We remain concerned about the impact of the current economic
downturn on the backlog. The number of hearing requests has increased
9.5 percent during the first 5 months of FY 2009, compared to the same
period in FY 2008. This hearing level increase does not yet reflect the
additional and unexpected 9.6 percent increase this year in the number
of initial applications over the same period last year. As a result, we
can expect to see an additional surge of hearing requests when the new
application cases, attributable to the recession, reach the hearing
level.

The impact of staffing on the hearing backlog. Over the last
decade, concurrent with the marked increase in the disability claims
backlog, we have noted the loss of ALJs and support staff in hearing
offices around the country. Former Commissioner Barnhart had planned to
hire an additional 100 ALJs in FY 2006 but due to cuts in the
President's budget request, she was able to hire only 43. The real
impact of the burden on the current ALJ corps can be seen by comparing
statistics from 1998 and 2006. In FY 1998, there were 1,087 ALJs
available to conduct hearings. This number dropped to 1,018 in FY 2006,
while the number of pending cases more than doubled.\26\
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\26\ GAO 12/07 Report, p. 31.
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SSA received funding in FY 2008 to hire approximately 190 new
Administrative Law Judges and some additional support staff. However,
productivity is not related solely to the number of ALJs, but also to
the number of support staff. According to the GAO: ``By the close of
fiscal year 2006, SSA saw the highest level of backlogged claims and
the lowest ratio of support staff over this period [FY 1997 to FY
2006].'' \27\ While SSA senior managers and ALJs recommend a staffing
ratio of 5.25,\28\ in 2006, the ratio of support staff to ALJs was
4.12. The actual ratio represented nearly a 25 percent decrease from
the recommended level, at a time when the number of pending cases had
increased dramatically. When the support staff to ALJ ratio was higher
(FY 1999 to FY 2001),\29\ the number of pending cases older than 270
days was much lower.
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\27\ GAO 12/07 Report, p. 32.
\28\ Id.
\29\ Id.I21In a recent report, the SSA Office of Inspector General
(OIG) found that ALJs with higher disposition levels were more likely
to be in hearing offices with staffing ratios above the FY 2007
national average of 4.46 staff members per ALJ. The OIG found that
hearing offices ranked in the top half for productivity were ``much
more likely to exceed the national average staff ratio than hearing
offices ranked in the lower half for productivity.'' \30\The quality
and composition of staff also must be considered. As the OIG points
out: ``[A]n office may have an ideal staff ratio, but if it does not
have enough writers to prepare decisions or if the writers do not
prepare quality decisions, the hearing office's productivity may be
impacted negatively.'' \31\This concern may account for the February
2009 statistics that show a mounting number of pending cases for
decision writers, about 9,000 more pending cases waiting for a decision
than one year ago, despite a significant increase in the number of
decision writers.
\30\ Congressional Response Report: Administrative Law Judge and
Hearing Office Performance, No. A-07-08-28094 (Aug. 2008) (``OIG 8/08
Report'') (available at: www.ssa.gov/oig/ADOBEPDF/A-07-08-28094.pdf).
This report was requested by the previous Chairman of the Social
Security Subcommittee, Rep. Michael McNulty, and by Ranking Member Sam
Johnson.
\31\ OIG 8/08 Report, p. 6.
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IMPROVING THE DISABILITY CLAIMS PROCESS AND ELIMINATING THE BACKLOG
Money alone will not solve SSA's crisis in meeting its
responsibilities. Commissioner Astrue is committed to finding new ways
to work better and more efficiently. CCD has numerous suggestions for
improving the disability claims process for people with disabilities.
We believe that these recommendations and agency initiatives, which
overall are not controversial and which we generally support, can go a
long way towards reducing, and eventually eliminating, the disability
claims backlog.
Caution Regarding the Search for Efficiencies
While we generally support the goal of achieving increased
efficiency throughout the adjudicatory process, we caution that limits
must be placed on the goal of administrative efficiency for
efficiency's sake alone. The purposes of the Social Security and SSI
programs are to provide cash benefits to those who need them and have
earned them and who meet the eligibility criteria. While there may be
ways to improve the decision-making process from the perspective of the
adjudicators, the critical measure for assessing initiatives for
achieving administrative efficiencies must be how they affect the very
claimants and beneficiaries for whom the system exists.
People who find they cannot work at a sustained and substantial
level are faced with a myriad of personal, family, and financial
circumstances that will have an impact on how well or efficiently they
can maneuver the complex system for determining eligibility. Many
claimants will not be successful in addressing all of SSA's
requirements for proving eligibility until they reach a point where
they request the assistance of an experienced representative. Many face
educational barriers and/or significant barriers inherent in the
disability itself that prevent them from understanding their role in
the adjudicatory process and from efficiently and effectively assisting
in gathering evidence. Still others are faced with having no ``medical
home'' to call upon for assistance in submitting evidence, given their
lack of health insurance over the course of many years. Many are
experiencing extreme hardship from the loss of earned income, often
living through the break-up of their family and/or becoming homeless,
with few resources--financial, emotional, or otherwise--to rely upon.
Still others experience all of the above limits on their abilities to
participate effectively in the process.
Proposals for increasing administrative efficiencies must bend to
the realities of claimants' lives and accept that people face
innumerable obstacles at the time they apply for disability benefits
and beyond. SSA must continue, and improve, its established role in
ensuring that a claim is fully developed before a decision is made and
must ensure that its rules reflect this administrative responsibility.
Technological Improvements
Commissioner Astrue has made a strong commitment to improve and
expand the technology used in the disability determination process. CCD
generally supports these efforts to improve the disability claims
process, so long as they do not infringe on claimants' rights. Some of
the technological improvements that we believe can help reduce the
backlog include the following:

1. The electronic disability folder. The initiative to
process disability claims electronically has the prospect of
significantly reducing delays caused by the moving and handing-
off of folders, allowing for immediate access by different
components of SSA or the DDS, and preventing misfiled evidence.

2. Expanding Internet access for representatives. Electronic
Records Express (ERE) is an SSA initiative to increase the use
of electronic options for submitting records to the electronic
folder for disability claims. Registered claimant
representatives are able to submit evidence electronically
through an SSA secure website or to a dedicated fax number,
using a unique barcode assigned to the claim. While this
initiative holds great promise, significant problems with the
current process exist. Under the current process,
representatives are to be provided with a CD of the exhibited
or ``pulled'' file shortly before the hearing and earlier in
the process after the appeal has been filed. Due to staffing
shortages in hearing offices, representatives have frequently
had problems obtaining the CDs and often find that all of the
medical records they have submitted are not part of the
exhibited list of evidence used at the hearing. This can cause
significant delay both during and after the hearing.
We hope that these problems will be resolved in the near
future. A group of representatives is involved in an SSA pilot
that allows them to download the contents of electronic folders
through the ERE website. Once SSA resolves security and
authentication issues, we hope that the agency will begin to
rollout this initiative. It should make the hearing process
more efficient for all parties involved.

3. Use of video hearings. Video hearings allow ALJs to
conduct hearings without being at the same geographical site as
the claimant and representative and have the potential to
reduce processing times and increase productivity. We support
the use of video teleconference hearings so long as the right
to a full and fair hearing is adequately protected; the quality
of video teleconference hearings is assured; and the claimant
retains the absolute right to have an in-person hearing as
provided under current regulations.\32\ However, we have
received complaints from representatives that, in some cases,
ALJs are discouraging claimants from exercising their right to
an in-person hearing. A new SSA pilot allows representatives to
participate in video hearings from their own private offices,
with their clients present in the representative's office. The
representative must agree to the terms established by SSA. This
pilot provides claimants with another option for their
hearings.
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\32\ 20 C.F.R. Sec. Sec. 404.936 and 416.1436.

Other Improvements at the Hearing Level
1. The Senior Attorney Program. This program allows senior staff
attorneys in hearing offices to issue fully favorable decisions in
cases that can be decided without a hearing (i.e. ``on the record'').
We are pleased that Commissioner Astrue decided to authorize the
program for at least the next two years.\33\ In FY 2008, senior
attorneys decided 24,575 cases. Through February 2009, the program is
on pace to exceed last year's total, with 13,462 cases decided through
the first five months of this fiscal year.\34\
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\33\ The interim final rule reinstating the program was published
in August 2007 and became effective on October 9, 2007. 72 Fed. Reg.
44763 (Aug. 9, 2007). The final rule was published at 73 Fed. Reg.
11349 (Mar. 3, 2008).
\34\ ``National Caseload Analysis Report: ODAR Workload and
Performance Summary for the Month Ending Feb. 27, 2009.''

2. Informal remands to DDSs. Under this initiative, SSA screens
pending hearing level cases according to a profile and remands the
cases to the DDSs for possible favorable decisions. In FY 2008, hearing
offices remanded more than 50,000 cases and the DDSs reversed their
prior decisions and allowed 16,838 cases, about 32 percent of the
remanded cases,\35\ with the remainder returned to hearing offices for
a hearing and decision. Claimants do not lose their place in the queue
if the remanded case is sent back to the hearing office. When the FY
2008 informal remand allowances are combined with the senior attorney
allowances, more than 41,400 claimants received favorable decisions--
and the benefits to which they are entitled--in a more timely way.
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\35\ Plan to Eliminate the Hearing Backlog and Prevent Its
Recurrence: Annual Report Fiscal Year 2008 (SSA, ODAR). Available at:
http://www.ssa.gov/appeals/Backlog_Reports/
Annual_Backlog_Report_FY_2008-Jan.pdf.
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Generally, we support this initiative. However, the procedures used
by DDSs have not been uniform and vary from state to state, with some
representatives reporting that they are not notified that a remand has
taken place so that they can assist with development of evidence.

3. Findings Integrated Templates (FIT). FIT is used for ALJ
decisions and integrates the ALJ's findings of fact into the body of
the decision. While the FIT does not dictate the ultimate decision, it
requires the ALJ to follow a series of templates to support the
ultimate decision. Representatives can use the FIT template, which is
available on the SSA website, to draft proposed favorable decisions.
Many representatives are now using the template either when requested
by the ALJ or on their own initiative. When the draft proposed decision
is submitted to the ALJ, it can lead to a speedier decision.

4. Increase time for hearing notice. We have previously recommended
that the time for providing advance notice of the hearing date be
increased from the current 20 days to 75 days. This increase will allow
more time to obtain medical evidence before the hearing. The 75-day
time period has been in effect in SSA's Region I states since August
2006 \36\ and, based on reports from representatives, has worked well.
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\36\ 20 C.F.R. Sec. 405.315(a).
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Improvements at the Initial Levels
CCD supports initiatives to improve the process at the initial
levels so that the correct decision can be made at the earliest point
possible and unnecessary appeals can be avoided. Improvements at the
front end of the process can have a significant beneficial impact on
preventing the backlog and delays later in the appeals process.

1. New Screening Initiatives. We support SSA's efforts to
accelerate decisions and develop new mechanisms for expedited
eligibility throughout the application and review process. We encourage
the use of ongoing screening as claimants obtain more documentation to
support their applications. However, SSA must work to ensure that there
is no negative inference when a claim is not selected by the screening
tool or allowed at that initial evaluation. There are two initiatives
that hold promise:

Quick Disability Determinations. We have supported the
Quick Disability Determination (QDD) process since it first began in
SSA Region I states in August 2006 and was expanded nationwide by
Commissioner Astrue in September 2007.\37\ The QDD process has the
potential of providing a prompt disability decision to those claimants
who are the most severely disabled. Since its inception, the vast
majority of QDD cases have been decided favorably in less than 20 days.
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\37\ 20 C.F.R. Sec. Sec. 404.1619 and 416.1019.
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Compassionate Allowances. In July 2007, SSA published an
Advance Notice of Proposed Rulemaking (ANPRM) on a proposed new
screening mechanism to be known as Compassionate Allowances.\38\ SSA is
``investigating methods of making `compassionate allowances' by quickly
identifying individuals with obvious disabilities.'' While there is no
definition of disabilities that are considered ``obvious,'' there is
emphasis on creating ``an extensive list of impairments that we [SSA]
can allow quickly with minimal objective medical evidence that is based
on clinical signs or laboratory findings or a combination of both. . .
.'' SSA has published an initial list of 50 conditions on its website,
with more to be added at a later date. Unlike the QDD screening, which
occurs only when an application is filed, screening for compassionate
allowances can occur at any level of the administrative appeals
process.
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\38\ 72 Fed. Reg. 41649 (July 31, 2007).

2. Improve development of evidence earlier in the process. In
previous testimony, CCD has made a number of recommendations to ensure
that disability claims are properly developed at the beginning of the
process. Claimants' representatives are often able to provide evidence
that we believe could have been obtained by the DDSs earlier in the
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process. Our recommendations include:

Provide more assistance to claimants at the application
level. At the beginning of the process, SSA should explain to the
claimant what evidence is important and necessary. SSA should also
provide applicants with more help completing the application,
particularly in light of electronic filings, so that all impairments
and sources of information are identified, including non-physician and
other professional sources.
DDSs need to obtain necessary and relevant evidence.
Representatives often are able to obtain better medical information
because they use letters and forms that ask questions relevant to the
disability determination process. However, DDS forms usually ask for
general medical information (diagnoses, findings, etc.) without
tailoring questions to the Social Security disability standard. SSA
should review its own forms and set standards for state-specific forms
to ensure higher quality.
Increase reimbursement rates for providers. To improve
provider response to requests for records, appropriate reimbursement
rates for medical records and reports need to be established.
Appropriate rates should also be paid for consultative examinations and
for medical experts.
Provide better explanations to medical providers. SSA and
DDSs should provide better explanations to all providers, in particular
to physician and non-physician treating sources, about the disability
standard and ask for evidence relevant to the standard.
Provide more training and guidance to adjudicators. Many
reversals at the appeals levels are due to earlier erroneous
application of existing SSA policy. Additional training should be
provided on important evaluation rules such as: weighing medical
evidence, including treating source opinions; the role of non-physician
evidence;\39\ the evaluation of mental impairments, pain, and other
subjective symptoms; the evaluation of childhood disability; and the
use of the Social Security Rulings.
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\39\ This evidence is often given little or no weight even though
SSA's regulations provide that once an impairment is medically
established, all types of probative evidence, e.g., medical, non-
physician medical, or lay evidence, will be considered to determine the
severity of the limitations imposed by the impairment(s).
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Improve the quality of consultative examinations. Steps
should be taken to improve the quality of the consultative examination
(CE) process. There are far too many reports of inappropriate
referrals, short perfunctory examinations, and examinations conducted
in languages other than the applicant's.

ADDITIONAL RECOMMENDATIONS
In addition to addressing the backlog and SSA's funding issues,
there are several other legislative proposals that the Subcommittee may
be considering this year.

Protecting claimants' privacy rights. We understand that
it can be cumbersome for SSA to obtain medical records, as it is for
claimants and their representatives, and that SSA is exploring more
efficient ways to secure the necessary evidence. While we support ways
to make this process more efficient, we believe that claimants' privacy
rights must be protected. We will work with SSA to find a way to
obtain, as efficiently as possible, a claimant's authorization for
release of medical records to SSA, while protecting the individual's
privacy rights.
Extension of the fee demonstrations in the SSPA. Access
to experienced and qualified representatives through the lengthy and
complex application process is critically important to claimants. To
this end, we support allowing claimants to enter into voluntary
agreements with representatives for fee withholding and direct payment
procedures whether under Title II or Title XVI. The Social Security
Protection Act of 2004 (SSPA), P.L.108-203, established two
demonstration projects that we believe should be made permanent because
they have proven to be effective in increasing claimants' access to
effective representation: (1) Extension of the Title II attorney fee
withholding and direct payment procedures to claims under Title XVI
(SSI); and (2) Allowing non-attorney representatives to qualify for fee
withholding and direct payment provided they meet certain requirements.
Unless they are extended or made permanent, the demonstrations will
sunset March 1, 2010.
Increase and indexing of the fee cap. Rep. John Lewis has
introduced H. R. 1093, which contains two provisions regarding the
current $5,300 fee agreement fee cap: (1) Increase the current fee cap
to $6,264.50 (which represents the figure if it had been adjusted for
inflation since the last increase in 2002); and (2) Index the fee cap
for future years to the annual COLA. We support these changes since
they ensure that there will be a knowledgeable, experienced pool of
representatives available to represent claimants.
Work incentives. The Ticket to Work and Work Incentives
Improvement Act (TWWIAA) was enacted nearly ten years ago and is
overdue for evaluation of its effectiveness in employment of those
receiving Title II and XVI disability benefits. We urge renewal and
permanent extension of expired/expiring provisions including (1) SSA's
Title II demonstration authority to test promising approaches for work
incentives and related provisions; (2) Demonstration to Maintain
Independence, set to expire this year, to provide Medicaid buy-in
coverage to working individuals whose conditions or disabilities are
not yet severe enough to qualify them for disability benefits; (3)
Protection and Advocacy for Beneficiaries of Social Security, set to
expire this year, to protect the rights of beneficiaries as they
attempt to return to work; and (4) Work Incentives Planning Assistance,
set to expire this year, which provides state grants for outreach and
education to individuals with disabilities about supports and services
regarding employment.
Caution about e-Verify. E-Verify is an automated system
for employers to verify the name/SSN/citizenship/work authorization of
new hires by checking against SSA and Department of Homeland Security
databases. SSA's workload has expanded rapidly due to demand by
employers and new state laws mandating requiring use of this
system.\40\ The problem is that the e-Verify system is hampered by
inaccuracies in the DHS and SSA records. Mandating large numbers of
employers to use it would require in an unknown but substantial number
of U.S. citizens and legal immigrants to interact with SSA to verify
their employment eligibility status and provide documents to prove that
they are eligible to work. The additional burden of this labor-
intensive work could divert resources from SSA's core duties including
making disability determinations within a reasonable time. It is
essential that any proposal that would increase the use of e-Verify
should only be enacted if it fully funds the resulting increased
administrative burden on SSA and if the databases are accurate
regarding employment.
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\40\ GA0 1/09 Report, p. 10.
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Staffing shortages cause serious post-entitlement
problems for beneficiaries. When beneficiaries faithfully notify SSA of
earnings or other changes that may reduce their benefit payment
amounts, due to staffing shortages \41\ it may be months or years
before SSA sends an overpayment notice to the beneficiary, demanding
repayment of sometimes tens of thousands of dollars of accrued
overpayments. It is shocking to beneficiaries to receive these notices,
when they reasonably assumed that SSA had processed the information
they submitted, and it is challenging if not impossible for someone
subsisting on benefits alone to repay the overpayments. It would be
helpful for SSA to develop a better reporting and recording system and
promptly adjust benefit payments--thus preventing these overpayments.
It is important to note that. in and of themselves, overpayments do not
indicate fraud or abuse as beneficiaries are encouraged to work if they
are able. The problems arise when reported earnings are not properly
recorded and monthly overpayments are not properly adjusted.
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\41\ GAO 1/09 Report. P. 10-12
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CLAIMANT STORIES PROVIDED BY REPRESENTATIVES IN MARCH 2009
FLORIDA
Mr. O was a 53 year old Wal-Mart cashier in Bradenton,
Florida. He developed HIV in the mid 1980s, and continued to work until
2006 when his condition deteriorated and he was diagnosed with AIDS. He
filed his application for Title II and SSI disability benefits soon
thereafter in early 2006. While waiting for his hearing, he suffered a
brain aneurysm and died in 2008. An estate was opened and the estate
representative was substituted on the disability claim. The ALJ denied
the request for an on-the-record decision, despite the numerous medical
reports documenting that Mr. O's condition clearly met the impairment
listing for HIV. In the meantime, the autopsy report showed that the
brain aneurysm was most likely caused by Mr. O's deterioration due to
AIDS and its complications. They are still waiting for a hearing date.
Mr. M is a 57 year old man who worked as a Vocational
Rehabilitation Specialist for over 20 years in Florida. He developed
severe arthritis throughout his body, wears bilateral hand splints,
knee splints, has developed severe joint degeneration, spinal cord
degeneration, is agoraphobic, depressed, and anxious. He cannot take
care of himself and he has no family to help him. He is about to lose
his home. Mr. M has exhausted his savings and his attorney writes
monthly letters to his mortgage company asking for extensions on his
payments while he is waiting for his hearing. Nevertheless, the company
is about to foreclose on his home.
GEORGIA
Mr. C lives in Kennesaw, GA. Despite having only a 9th
grade education, he has worked all of his adult life. He had back
surgery many years ago, but continued working. His back pain became
worse and worse until he was unable to work. He has degenerative disc
disease throughout his back and herniated discs, some of which press on
nerve roots, and depression. As a result of his back disorders, he has
severe back pain, which radiates down into his legs. He must walk with
a cane and can only obtain relief with narcotic medications. Mr. C
filed for a hearing in November 2006 and a request for an on-the-record
decision was filed by his attorney. Despite numerous attempts to
follow-up with the hearing office, no decision has been reached and no
hearing has been scheduled, 27 months after the hearing request was
filed. Not only is Mr. C's condition adversely affected by this great
delay, but he is unable to support his children.
Mr. D lives in Doraville, GA. He was diagnosed with
chronic hepatitis C with cirrhosis. He continued working, but became
increasing symptomatic with severe fatigue, bone pain, and numbness and
tingling in his legs and feet. He also has severe depression and
anxiety. As early as June 2007, his doctor stated Mr. C was suffering
from very advanced and terminal hepatitis C. Mr. C is now bedridden and
must depend on his girlfriend for all of his support. Mr. C filed an
application for Social Security and SSI disability benefits in March
2007. The claim was denied and a request for a hearing was filed in
October 2007. Mr. D's attorney filed a request for an on--the-record
decision as a TERI (terminal) case. Despite numerous follow-ups to the
hearing office, the only response has been to transfer his case to the
National Hearing Center. To date, no hearing has been scheduled.
IOWA
Mr. H lives in southeast Iowa and has been diagnosed with
multiple sclerosis. He has a number of lesions in his brain, has
difficulty walking, and suffers from debilitating fatigue. He has not
been able to work since July 2007, and his claim has been pending since
September 2007. He sent a letter to his attorney, which states:

To Whom It May Concern: I am writing this brief letter
to tell you about a few of the examples of what this disease
has caused. Besides the day to day struggle just to live it has
caused my wife and me, along with our 2 children, financial
ruin. My mortgage payment is as much as my wife makes. I
receive no other income and worry day to day how to exist. As
far as what this has done to my state of mind, I am finding it
impossible to keep fighting this and feel like giving up. As
bad as this may sound, I have actually tried to end this with a
suicide attempt in November 2008. There isn't any way to
describe this except to say it feels hopeless and wonder if
there's any hope.

MARYLAND
Mr. X, is a 57 year old Army veteran. Once his claim was
allowed, he still had to wait for 120 days to get his retroactive
benefits of $50,000. Each time he called the local SSA field office in
Prince Georges County, Maryland, he was told there was ``nothing we can
do.'' On one occasion, they told him ``do not call any more.''
Meanwhile, the veteran was forced to file for Chapter 13 bankruptcy,
and almost lost his home. It took 16 months from the reconsideration
denial to the hearing decision.
Ms. Y is 50 years old and only speaks Spanish. She waited
90 days to receive her past due benefits and had considerable problems
with the field office, which could not find a Spanish interpreter. As a
result, there was marked confusion about the SSI offset against the
Title II benefits, and she could not obtain a Medicare card. Ms. Y is
indigent and homeless and she is currently living with a relative. She
is in dire need of medical services. From reconsideration to hearing,
it took about 20 months.
Ms. F is a 43 year old Army veteran. Her case has been
pending since 2006. Her hearing was just held but no decision has been
issued. She filed for Chapter 13 bankruptcy. She is in dire need of
medical care and desperately needs Medicare eligibility. She is now
homeless.
MISSOURI
Mr. D, from the Trenton, MO, area, was diagnosed with
multiple sclerosis. His truck was repossessed and his home was
threatened with foreclosure. The local chapter of the MS Society
advanced him six months of house payments to save the home. His hearing
was scheduled but then delayed for two months, even as an ``expedited
hearing'' because the vocational expert's copy of the electronic record
on a CD was corrupted when he received it so he could not prepare to
testify for the original hearing date. Eventually, Mr. D received a
favorable decision and was able to keep his home.
Mr. M, in his mid-40s, committed suicide because of his
inability to afford medical care and take care of his family while
waiting for a hearing. He had suffered horrible burns while pouring
asphalt on his former job.
Ms. N died while waiting for her hearing. Her attorney
had attempted on three occasions to get an on-the-record decision but
received no response from the hearing office. Ms. N died from medical
complications related to her disabling conditions. At her death, she
was virtually homeless, living in dilapidated travel trailer.
Tragically, both her child and husband also died while she was waiting
for a hearing.
NEW JERSEY
Ms. W. lives in Newark, NJ. She previously worked as a
counselor, laboratory technician, and outreach coordinator for various
medical facilities. She has been diagnosed with major depression,
anxiety disorder, and post-traumatic stress disorder. She applied for
Social Security disability benefits in December 2007. She was denied
through the reconsideration level (11 months after she applied) and
requested a hearing in December 2008. Ms. W. has been sued for
foreclosure and cannot afford her mortgage. If she were approved for
benefits, she could afford to stay in her house, but it is not clear
that she will have her hearing before it is too late and she loses her
home.
Ms. L, a resident of New Jersey, is a 57 year old former
junior college instructor who has long-standing problems with arthritis
and depression. Her case has been pending for over three years from the
date the application was filed. As a result, she has been forced to
take out home equity loans of more than $70,000 against her home. She
can no longer borrow against her home as she has no visible means of
repaying her obligations. She has borrowed from every friend or family
member she knows in order to make payments on her loans. Currently, she
has a payment plan for $400 per month that she is unlikely to be able
to meet. She can no longer afford to see doctors or pay for her
medications. Her case has been pending at the hearing level for ten
months. Her attorney has asked that the case be expedited in light of
her imminent homelessness and he is hopeful that will happen. If it is
not expedited, she could wait an additional six months. She calls her
attorney every week and cries.
While waiting for her hearing, a woman in the Atlantic
City, NJ area almost lost her apartment because of non-payment of rent.
She had such severe mental problems that her attorney knew that if the
client was forced to relocate to a smaller apartment, without her
belongings, the client's mental health would deteriorate further. The
attorney has tried to keep the client in her apartment while waiting
for a hearing, which was requested in August 2007. The hearing was not
held until February 2009, and they are waiting for a decision.
OHIO
Mr. N is a 55 year old former maintenance supervisor who
lives in Chillicothe, OH. He has small vessel ischemia, cerebrovascular
disease, lumbar scoliosis, degenerative joint disease, vision loss,
migraine headaches, depression, anxiety, fatigue, memory loss, and
partial paralysis to his left side caused from two strokes. Mr. N filed
his request for hearing in September 2007. While waiting for a hearing,
he has had five liens put on his home, and does not have medical
insurance to receive the medical treatment that he needs. His primary
care physician has discussed his treatment options and has explained
that his health will continue to decline, and that it is crucial for
him to receive treatment as soon as possible.
Ms. L was a 60 year old woman with a 12th grade education
whose past work included kitchen helper and clothing folder. She lived
in Eaton, OH, and suffered from pain and loss of range of motion due to
a 2004 fractured right shoulder and right knee, with three unsuccessful
surgeries which prevented her from working. Ms. L filed an application
for Social Security disability benefits on June 15, 2006, alleging
onset of disability in 2004 when she suffered the fractures. She
developed rectal cancer in late 2006, and died on October 29, 2007, at
the age of 60. A hearing was held with a substituted party on January
8, 2009, 14 months after her death, at which time she was found
disabled as of the 2004 date through the date of her death.
Mr. W, a 37 year old fork lift driver from Columbus, OH,
has a head injury and bipolar disorder, which prevent him from working.
He filed his application for disability benefits in November 2006.
While waiting for a hearing, he and his family were evicted from their
apartment and his wife left him. He is living in a house with a friend
and is unable to pay rent. However, when he is awarded benefits, he
will owe back payment for the rent and continues to fall further into
debt.
Mr. P, a 60 year old data entry person who lived in
Columbus, OH, had back and knee problems, epilepsy, and number of
infections that kept occurring throughout his body. He filed his
application for disability benefits on April 25, 2006. While waiting
for a hearing, Mr. P became increasingly ill due to infection and
chronic lymphedema. He died on December 11, 2007. An on-the-record
favorable decision was made on October 9, 2008, ten months after his
death. Mr. P was found disabled as of May 1, 2002 (four years before he
applied for benefits) through the date of his death.
A 57-year old quality-control inspector in Ohio with
severe macular degeneration and uncontrolled high blood pressure
applied for disability benefits in February 2008. He has exhausted all
of his savings and, out of desperation, had to take in a boarder, but
that income is not enough to keep the heat and lights on. His attorney
filed his request for a hearing in November 2008, and told him to be
prepared for an 18 to 24 month wait in the Cleveland, OH area, unless
the ALJ issues an on-the-record decision or there is an informal remand
to the DDS.
Mr. S, who lives in the Cleveland, OH area, has
peripheral vascular disease and severe arthritis in his right shoulder
requiring surgery. While waiting 27 months for his hearing, he lived
with various relatives, including his ex-wife and mother. Without any
source of funds to purchase prescriptions, he used the $25 jury duty
pay, after being called for jury duty. This allowed him to afford the
$5 co-pay on his prescriptions at the county hospital where they have a
sliding scale. A fully favorable bench decision was issued by the ALJ
on the day of his hearing.
Ms. T, from the Cleveland, OH area, waited 29 months for
her hearing. She has been diagnosed with borderline intellectual
functioning and epilepsy. While waiting for a hearing, she exhausted
her time limit for TANF benefits and nearly lost her home. Her mother
used her own income tax refund to save it from foreclosure, and then
tried to make small payments on the utilities so that Ms. S and her
children, aged 5 and 7, would have lights and heat.
Mr. C, a 48 year old men's clothing salesman from the
Cleveland, OH area, struggled for years with severe rheumatoid
arthritis. He had undergone one hip replacement and needed another.
When his savings ran out while trying to afford COBRA premiums, he
would regularly call his attorney to help him. He applied for benefits
in April 2007. He was fortunate enough to win ``quickly'' at the
reconsideration stage, 13 months later, but it was too late to save his
house, which he lost to foreclosure.
Mr. A, a factory worker, lives in the Cleveland, OH area
and is 46 years old. He had returned to work for 10 years after a rare
but successful kidney/pancreas transplant. But finally, he applied for
disability benefits because his gout and joint pain, requiring multiple
knee and shoulder surgeries, plus weakness after a mild stroke, became
too much for him to bear. His wife was diagnosed with cancer herself
while his case was pending and she could no longer work or take care of
him. Thanks to an expedited hearing, he won his case 19 months after he
applied in August 2007.
Mr. G is a 34 year old graphite factory worker with
severe mental illness and Hepatitis C. He calls his attorney frequently
to let her know that he is at the mental health crisis center again or
staying with someone he met there. He was evicted last summer and has
no regular place to live. His attorney worries that he may harm himself
out of sheer desperation. His attorney filed a request for hearing in
October 2008, but must continually tell him that he must steel himself
for what could be the full 18 to 24 month wait that the Cleveland
hearing office warns about in its notice.
Ms. C is a 50 year old cook who tried to hold onto her
part-time job at a tavern, but even the 10 hours per week got to be too
much. Her back, leg and bladder problems finally led the owner to let
her to go. She was so ashamed that she cried when she resorted to
asking the local probate court for a loan against the funds being held
for her son (based on a court settlement years ago). She did this in
desperation because she did not know how else to hold onto her house.
Her 16 year old son agreed that the court should allow her to access
the funds, because he could not bear to see his mother under the
stress. Ms. C was eventually allowed disability benefits and she repaid
the money right away after she received her past due benefits.
Mr. F is a 35 year old factory worker with borderline
intellectual functioning. He worked for years as a laborer, then stayed
home with his children while his wife went to school. He fell off a
ladder while trying to clean out his father's gutters and shattered his
heel, requiring surgery. He now has an MRI showing multiple fractured
vertebrae, probably also a result of the fall a year and a half ago.
The family has already lost their house. When his attorney filed the
request for hearing last summer and told him it could be another year
or two before his hearing, he and his wife and their three small
children were sleeping in a tent in his parents' backyard. They hoped
that when the weather got too cold, they would be able to move into the
living room to sleep on the floor at night.
OKLAHOMA
Mr. L lived in Norman, OK, and obtained representation in
April 2008, upon receiving the initial denial of his Social Security
disability claim. His attorney immediately requested reconsideration.
His attorney explained to him that it most likely would be at least two
to three months before he would receive a decision on the request for
reconsideration; that most reconsideration requests result in another
denial; and, if denied on reconsideration, it would be about one year
before a hearing would be scheduled. The attorney obtained and
submitted additional hospital records of the claimant's emergency
treatment for acute exacerbation of asthma which occasionally required
intubation.
A mere two weeks after the appeal was filed, Mr. L's claim
was denied at reconsideration in May 2008. Upon learning of the
denial, the claimant committed suicide. His surviving spouse
has been substituted and they are presently awaiting a hearing
on the request for hearing that was filed in June 2008. In late
February 2009, the hearing office notified Mr. L's attorney
that the claim was ``ready for review.'' The attorney responded
that all evidence has been submitted and that the claim should
be scheduled for a hearing. To date, no hearing has been
scheduled. The individual's medical records do not reflect
treatment for any mental disorders.
OREGON
An attorney in Eugene, OR, received a call in 2006 from
Mr. E who lived in a rural Oregon town and was chronically mentally
ill. He had heard from a social worker that the attorney coordinated a
federally funded project called HOPE that helped chronically homeless
disabled people apply for benefits. (Unfortunately, this project ended
in 2008 and has not been re-funded.) He had been living outdoors for at
least 10 years. He heard voices that told him to do bad things,
including stealing from stores, which lead to multiple terms of
incarceration. He also was in terrible physical pain. The attorney
arranged transportation to her office and assisted him in filing for
SSI disability benefits. His claim was denied at the initial and
reconsideration levels because of a lack of evidence. Meanwhile, Mr. E
spent another winter in the snow and rain, in terrible pain. He finally
had a date set for hearing but a few days before his hearing, his
stomach hurt so much that his brother persuaded Mr. E to go to the
emergency room. He was diagnosed with end-stage pancreatic cancer. He
brought a letter to the ALJ from the emergency room doctor verifying
that he had less than 6 months to live. The ALJ immediately approved
the claim without a hearing, but the claimant died three days later,
before he ever received a check.
PENNSYLVANIA
Mr. D lives in Dalmatia, PA. He is a veteran of the
Vietnam War and is a victim of Agent Orange and has other war-related
health and mental problems. He had obtained a favorable decision on his
Social Security disability claim. However, because of a mix-up at SSA,
it was nearly two years until his attorney was able to straighten out
his payments. He has a son with the same name and the SSA system had
the two individuals mixed in with each other. While waiting for his
payments, Mr. D's house went up for a Sheriff's sale, after
foreclosure. Two days before the sale, he called his attorney, crying,
and said that he had no more reason to live. Out of sheer desperation,
they called Rep. John Kanjorski's office, which was able to help get
the Sheriff's sale postponed. Further, within two weeks, someone at SSA
was trying to straighten out the mix-up. Within two months, the
payments started. Mr. D's attorney notes that he does not believe this
would have been accomplished if Rep. Kanjorski's office had not
intervened.
Mr. W lives in Wilkes-Barre, PA, and is waiting for an
expedited hearing. He has Stage III colon cancer, yet his disability
benefits claim was denied. He is undergoing infusion therapy at home.
He called his attorney to say that he has no money to pay his rent and
does not know where he will be living next month. Despite repeated
requests for an expedited hearing, no hearing is scheduled.
A little girl from Plymouth, PA, was the victim of sexual
abuse at the age of 2 and was left with both mental and physical
problems that will stay with her for her entire life. She cannot
function in school due to anger issues and fear of men. She has had to
undergo surgery for injuries related to the sexual abuse and will
probably have additional surgeries throughout her life. Her parents
applied, on her behalf, for childhood SSI disability benefits. They
received a favorable decision, but it took nearly 17 months.
Ms. L is 50 years old and lives in Pennsylvania. She has
been diagnosed with cirrhosis of the liver caused by Hepatitis C.
Although she has finally received a hearing date, the wait has been a
struggle for her. She has had her utilities shut off, her car
repossessed, and her health has worsened. Ms. L's medical care is very
costly. She has been non-responsive to certain treatments for her
cirrhosis and is now on the liver transplant list.
SOUTH CAROLINA
Ms. S was 38 year old woman who had uncontrolled
diabetes. Ms. S lived in her sister's home with her own two teenage
children. She did not qualify for Medicaid under South Carolina
guidelines because she had not yet been found disabled by SSA. Since
she had no treating physician, every time her blood sugar went too high
or too low, her sister took her to the local emergency room (ER) where
she was given treatment. She continually complained to the ER staff
that she had a sore on her right foot that would not heal. No one
evaluated her for this because they were concerned with getting her
blood sugar under control. Every ER visit had notations of her
unhealing sores but provided no treatment.
Eventually, the unhealing sores on her right foot got so bad
that one night at the ER, she and her sister insisted that the
doctor look at her foot. Once the doctor saw her foot, she was
immediately admitted and the next day her leg was amputated
below the knee. However, the surgeon who amputated her leg
stated he could not remove all of the leg that needed to be
removed as it would be too much of a shock to her system and he
wanted to wait until the following week. The sores were so bad
that even with the amputation, osteomyelitis had set in and
before the surgeon could perform the next amputation, Ms. S
died. The cause of death on the Death Certificate said
``Complications of Diabetes''.
Records for every ER visit to that hospital and other
hospitals were submitted for consideration to the ALJ. By the
time the case was set for hearing, Ms. S's sister was the
substituted party. By the time all the Exhibits were labeled,
there were 52 ER visits and 14 inpatient visits in 18 months.
Yet no on-the-record decision was granted even though it was
requested. At the hearing, Ms. S's sister described the pain
and agony her deceased sister had gone through. At the hearing,
the ALJ stated it was obvious that Ms. S had been disabled as
of her alleged onset date and he issued a fully favorable
decision. However, there were no family members who could
receive the past due benefits. As a result, the family had to
find the money for Ms. S's funeral costs. Neither the hospitals
nor the surgeon will be paid for their services, because there
was no Medicaid coverage due to no SSI benefits being paid.
The hearing delay led to a lack of medical care for Ms. S
under the Medicaid program (based on SSI eligibility), which
most likely would have saved Ms. S's life.
Mr. C was 42 years old client with a long history of
coronary artery disease and morbid obesity. It took 22 months to get a
hearing and by the time the hearing took place, Mr. C had died from a
massive heart attack. Mr. C's mother was substituted. Mr. C's
representative provided records at the hearing level from 15 ER visits
where Mr. C had been taken, unconscious, by ambulance. In addition, the
attorney provided over 30 ER and inpatient admissions for coronary
artery disease with chest pain, shortness of breath, and the inability
of the medical staff to find pulses in various parts of Mr. C's body.
Mr. C was prescribed 7 cardiac medications for hypertension, chest
pain, and hypercholesterolemia. At the ALJ hearing, his mother
testified there were other ER visits that her son had forgotten to
mention to anyone, including the attorney, because he could not keep
track of all of them. One of the reasons for this memory problem was
that his hypertension caused such severe headaches that sometimes he
simply forgot that his family or emergency services had taken him to
the ER. Despite all of this evidence and Mr. C's cause of death, the
ALJ denied the claim. The ALJ denial has been appealed to the Appeals
Council.
Mr. O has been waiting 19 months for a hearing in South
Carolina. He has a multitude of orthopedic problems as well as post-
traumatic stress disorder. Six months ago, Mr. O was bitten by a brown
recluse spider and was admitted to the local hospital for 8 days where
he was put on IV antibiotics and then told to follow up with his
regular treating physician. [These spiders have a powerful poison in
their bite which can cause necrosis of soft tissue and more serious
symptoms.] Mr. O has no money or insurance and is not eligible for
Medicaid. Because he cannot obtain medical care, including antibiotics,
Mr. O has been trying to take care of the wound himself. It is getting
worse and he has been told that if he does obtain antibiotic treatment
soon, he will lose his entire left leg as the infected wound is only
inches from his left hip. If his hearing had been held sooner, he could
have obtained the treatment he needed for the bite and he could have
received treatment for his orthopedic problems and possibly returned to
work.
TENNESSEE
A 50 year old man who lives in Alamo, TN, has non-
alcoholic steatohepatitis, advanced hepatic fibrosis, cirrhosis (end
stage liver disease), esophagus varices, chronic obstructive pulmonary
disease, and myeloproligerative disease. He lost his TennCare insurance
in November 2008. He is not able to obtain his needed medication or
seek the proper medical treatment needed to monitor his impairments. He
was also recently diagnosed with four bulging discs that are impinging
on nerves. He filed his application for disability benefits on February
13, 2007, and his attorney requested a hearing on May 28, 2008. His
attorney anticipates that this client will have to wait until the end
of 2009 or early 2010 before his ALJ hearing.
A 47 year old woman who lives in Milan, TN, is now in a
wheelchair because she is unable to obtain the medical testing to
determine what is wrong with her knees. The biggest roadblock to the
necessary testing is that she has no medical insurance. She filed for
disability benefits in February 2007 and a hearing was requested in
February 2008. This is an extremely long period of time between the
application date and the hearing request date. In this case, her
attorney requested reconsideration (the first administrative appeal) in
June 2007. However, the paperwork was lost. When her attorney's office
called to check the status in October 2007, there was no record that
the reconsideration request was filed. This caused an additional four
months of delay.
Mrs. J., from Camden, TN, applied for widow's disability
benefits in October 2007, when she was 50 years old. She has chronic
obstructive pulmonary disorder (COPD). Before the loss of health
insurance, she was able to have oxygen at home. At her husband's death,
she had no income, no health insurance, no car, and no telephone. She
lived far away from her treating source, the Carroll County (TN) Health
Department. Mrs. J. was denied at reconsideration in June 2008 and
filed a request for an ALJ hearing the same month. In November 2008,
during a very cold period, she had no heat and a neighbor gave her a
wood stove. However, she put her health at even more risk as her former
lung specialist did not want her to be around wood smoke, but Mrs. J
had no choice. She also had no gas money for a trip to the health
department. Her attorney requested an on-the-record decision, which was
granted, and the ALJ issued a favorable decision in January 2009.
Mrs. B. lives in Dyersburg, TN. She stays with an
alcoholic, abusive husband because she has little choice for
alternative housing. She obtained representation in November 2006. She
had a hearing in February 2007. The ALJ denied the claim and she
appealed in March 2007. The Appeals Council remanded the case for a new
hearing more than 18 months later in October 2008. Her attorney called
the hearing office about the status of the new hearing in February
2009. The hearing office claimed it did not know about the remand
order. Her attorney immediately faxed the order to the hearing office.
Since then, her attorney has called the hearing office and left two
messages to confirm receipt of the remand order but no one has returned
the calls.
Mr. T. is homeless. Relatives and friends in the
Dyersburg, TN, area allow him to occasionally stay with them. He
obtained representation for his disability claim in May, 2005. He
formerly lived in another state and a hearing request was pending in a
third state. His attorney was able to request a transfer but the claims
file was mistakenly sent to the Selmer, TN SSA field office and was
eventually forwarded to the Memphis hearing office. His first hearing
was held in October 2005 and denied in December 2005. He filed an
appeal to the Appeals Council in December 2005 and the Appeals Council
issued a remand order in August 2006. The remand hearing was scheduled
to be held in Memphis, some 90 miles from where Mr. T is living. He had
great difficulty collecting money for transportation to the hearing.
The remand hearing was held in August 2007 and denied once again. Mr. T
appealed to the Appeals Council for a second time in September 2007. He
is still waiting for a decision from the Appeals Council, 18 months
later.
Mrs. X, a 43 year old radiology/CT scan tech, lives in
Clarksville, TN. She is unable to work due to diabetes, depression,
anxiety disorder, fluid and arthritis in her knees, spondylothesis,
spinal stenosis, degenerative disc disease, broad based disc bulges and
severe pain and weakness in both legs. She filed her application for
disability benefits in June 2007. While waiting for her hearing, Mrs. X
and her family have been evicted from their home. Both of their
vehicles have been repossessed, and they are having extreme
difficulties paying for their day to day living. Her husband is on the
verge of being laid off and, if that happens, there will be no income
at all for this family. Due to the backlog, this claimant and her
family may lose everything before she is able to get a hearing date and
decision.
Ms. A is 61 years old and lives in Milan, TN. She has
Major Depressive Disorder, which prevents her from working. She filed
her application for benefits in 2007. Ms. A's hearing has not yet been
scheduled but her attorney has requested an on-the-record decision. She
and her husband, who is currently employed, were forced to file for
Chapter 7 bankruptcy in order to keep their house. The majority of her
husband's check is going to the bankruptcy trustee each pay period,
leaving them with only $4 to $27 per pay period for all of their other
expenses, such as groceries and utilities
Mr. C was a 57 year old man who lived in Big Sandy, TN.
He was diagnosed with hypertension and renal dysfunction. His
application for benefits was filed in 2006; however, before a hearing
could be scheduled, Mr. C died in June 2007. His widow was substituted
as the party and was able to obtain a favorable decision without a
hearing, but not until August 2008. It took over six months for the
payment center to process the claim and release the funds to Mr. C's
widow.
Mr. S is 36 years old and lives in Madison County, TN. He
has musculoskeletal impairments and obesity, which prevent him from
working. He filed his application for benefits in 2007 and was approved
in late 2008, after his attorney requested an on-the-record decision.
However, while his claim was pending, he lost his home, his wife left
him, and his mother has taken him in.
Mr. D, a 48 year old man who lives in Gibson County, TN,
has musculoskeletal impairments. He filed his application for
disability benefits in 2007. Mr. D's hearing has not yet been
scheduled. He has lost his home and his wife left him. He is
essentially homeless, living with various family members and friends.
Mr. W is 53 years old and currently lives in Haywood
County, TN. He has been diagnosed with musculoskeletal impairments. He
filed his application for disability benefits in late 2004. It was
denied and he had to appeal the case to federal district court. The
court remanded the case, but not until mid to late 2008. After a remand
hearing in 2009, his claim was allowed. However, while waiting for the
decision, he lost his home and has had to live with various family
members.
Ms. M, a 58-year old woman who lives in Dyer County, TN,
has musculoskeletal and mental impairments. She initially filed her
application for benefits in 2004. A hearing was held in September 2005;
however, a decision was not issued until January 2007. The decision was
unfavorable and was appealed to the Appeals Council in February 2007.
More than two years later after the appeal was filed, and five years
after the application was filed, the Appeals Council has not yet made a
decision on Ms. M's claim. She is essentially homeless, living with
friends or family members.
TEXAS
Mr. A is 45 years old and lives with his wife in Mission,
TX. He has degenerative disc disease of the lumbar spine status post
lumbar laminectomy, major depressive disorder, and borderline
intellectual functioning, which prevent him from working. He filed his
application in September 2003. The claim was denied initially in
November 2003 and at reconsideration in February 2004 and he requested
a hearing a few days later. While waiting for a hearing, Mr. A's house
burned down in November 2004. His hearing was finally held in June
2006, more than two years after he filed his appeal. The hearing was
continued in order to obtain a psychological consultative examination
and a supplemental hearing was held in July 2007. The ALJ denied the
claim and on appeal, the Appeals Council remanded the case back to the
ALJ. During this period, Mr. A was forced to file for bankruptcy. He
had a remand hearing in February 2009 before the same ALJ who
previously denied his case. At the remand hearing, the ALJ announced he
would be awarding a fully favorable decision, but Mr. A has not yet
received the decision.
Mr. R is 48 years old and lives in San Antonio, TX. He
has back pain, joint pain, hearing problems, Hepatitis C, and a head
injury, which prevent him from working. He filed his application for
benefits in January 2007. While waiting for a hearing, he became
homeless and cannot receive proper medical attention. Mr. R has to rely
on the kindness of friends for his basic necessities.
WEST VIRGINIA
Ms. M is 42 years old from West Virginia. She has several
conditions that prevent her from working. She has been diagnosed with
bipolar disorder, and neck and back problems. She filed her application
for benefits in the winter of 2007. She struggles daily with worsening
of her health and financial needs. Her medical care is costly. She has
tried to work several times but is currently on assistance. She has
lost her home while waiting for a hearing.
* * * * *
Thank you for the opportunity to testify today. For people with
disabilities, it is critical that SSA be given enough funding to make
disability decisions in a timely manner, improve its process for making
disability determinations, and carry out its other mandated workloads.
We also support changes to improve the disability claims process so
long as those changes do not affect the fairness of the procedures used
to determine disability and the rights of claimants.
ON BEHALF OF:

------------------------------------------------------------------------------------------------------------------------------------------------
American Association of People with
DisabilitiesAmerican Council of the BlindAssociation of University Centers
on DisabilitiesBazelon Center for Mental Health
LawCommunity AIDS National Network
(TIICANN)Easter SealsEpilepsy FoundationNational Alliance on Mental IllnessNational Association of Disability
Representatives
National Council on Independent
National Council for Community Living
Behavioral Healthcare
------------------------------------------------------------------------

Chairman TANNER. Thank you, Ms. Hathaway.
Your testimony reminds me of what I said at the beginning,
that they are real people. It is just not numbers. So thank you
for being here.
Next is the Honorable Ron Bernoski.
Well, we will go to Mr. Fell then.
Mr. Fell, you are recognized.

STATEMENT OF JAMES FELL, IMMEDIATE PAST PRESIDENT, CHAPTER 275,
OFFICE OF DISABILITY ADJUDICATION AND REVIEW, FEDERAL MANAGERS
ASSOCIATION.

Mr. FELL. Thank you, Chairman Tanner, Chairman McDermott,
and Ranking Members Johnson and Linder.
My name is Jim Fell. I am here today representing managers
in the Social Security Administration's Office of Disability
Adjudication Review in my current role as Immediate Past
President of the Federal Managers Association Chapter 275.
Currently I serve as the Hearing Office Director in the
Cincinnati, Ohio, ODAR office and recently accomplished 38
years of Federal service, 35 with SSA. Please keep in mind that
I am here on my own time and my own volition representing the
reviews of FMA, and I do not speak for SSA.
Within ODAR, there are over 765,000 pending requests for a
hearing, an increase of almost 5,000 cases since the beginning
of the fiscal year. Much of the increase in cases this year can
be attributed to the current economic slowdown. It now takes an
average of 499 days to process a request for hearing. As
managers within ODAR, we are acutely aware of the impact this
backlog has on our ability to deliver the level of service the
American public deserves.
I appeared before the Subcommittee just 2 years ago, and I
am here once again to reconfirm that the backlog of cases is
the result of the ongoing lack of adequate staffing levels and
resources. The underfunding of the agency by Congress over the
last decade has worsened the situation. Several years of
untimely budgets further compound the problem. If these delays
and inadequacies continue, clearing the disability case backlog
will be impossible.
We at FMA appreciate the attention the Subcommittees and
Commissioner Astrue are placing on addressing remedies to the
problem. In my written testimony, I discuss the Commissioner's
four-pronged approach to eliminating the backlog. As mentioned,
there are over 765,000 cases pending. In February,
administrative law judges averaged 2.2 dispositions per day.
With 250 work days in a year and 1,142 judges in SSA, ODAR
could reasonably dispose of 628,000 cases in a year. This is
not an unrealistic figure. However, it only allows us to work
on the incoming cases, but it has little impact on the backlog.
It is clear that ALJs will not meet this level if they do not
have the staff to prepare the cases and write the decisions.
Another troubling problem is the vast imbalances from
region to region. Average pending cases per ALJ range from a
low of 477 in the Dallas region to a high of 903 in Seattle.
Five regions average over 700 pending cases per ALJ. Individual
offices range from a low of 288 pending cases to a high of
1,442, and nine offices exceed 1,000 cases per ALJ.
It is our experience that distribution of judges and staff
is often based on physical space and not an office's caseload.
We must find an efficient way too better balance and
redistribute the work if we are serious about tackling the
backlog.
Ultimately, this is a numbers game. None of the
Commissioner's initiatives, whether alone or combined, is the
silver bullet that will eliminate the backlog. We either have
to slow the cases coming from the front end, which would
require significant legislative changes, or we have to increase
the capacity at the back end. The challenge is yours.
To enable SSA to meet its goals, Congress must approve a
sufficient level of funding. In the decade prior to fiscal year
2008, Congress appropriated far less than the President
requested each year. Without a doubt, this has had a
devastating effect on the services provided to the American
public.
Recognizing the needs of SSA, Congress appropriated $126
million above the President's fiscal year 2009 request.
Unfortunately, we operated under a continuing resolution for
the first 6 months of the year, and as a result, ODAR endured
hiring, budget and overtime limitations. Continuing resolutions
have become the norm rather than the exception, and it is
significantly hindering our ability to get the job done. In
order for funds to be properly spent, budgets must be
implemented by October 1st. Not doing so ties the hands of an
already beleaguered organization.
To remedy the backlog situation, Congress should at a
minimum pass President Obama's 2010 budget request of $11.6
billion before the start of the fiscal year. This is a 10-
percent increase over the current fiscal year. We applaud the
President for his commitment to eliminating the backlog problem
and urge Congress to appropriate his request.
I would like to close my statement with a personal story.
In my office, about 5 feet from where I sit, I have a fax
machine which I call the congressional fax. It is dedicated to
the congressional staff, your staffs, for your constituents.
Every day I receive inquiries, most of which are critical in
nature and dire in need. I review heart-wrenching letters about
homes being lost, crucial medications being skipped because
they can't be afforded, college funds which are depleted, and
overall despair. They do not understand why it takes years to
receive a hearing.
With your help, I would like to have no further use for
this fax machine. Thank you for your time and consideration of
our views, and I am happy to answer any questions you may have.
[The prepared statement of Mr. Fell follows:]
Statement of James Fell, Hearing Office Director, Social Security
Administration Office of Disability Adjudication and Review,
Cincinnati, Ohio; and Immediate Past President of the Federal Managers
Association Chapter 275
Chairman Tanner, Chairman McDermott, Ranking Member Johnson,
Ranking Member Linder and Members of the House Ways and Means
Subcommittees on Social Security and Income Security and Family
Support:
My name is Jim Fell and I am here today representing nearly 800
managers in the Social Security Administration's Office of Disability
Adjudication and Review (ODAR) in my current role as Vice President of
the Federal Managers Association (FMA) Chapter 275 and Vice Chairman of
FMA's Social Security Conference. Please allow me to take a moment and
thank you for this opportunity to present our views before your
Subcommittees. As federal managers, we are committed to carrying out
the mission of our agency in the most efficient and cost effective
manner while providing necessary services to millions of Americans.
Currently I serve as the Hearing Office Director in the Cincinnati,
Ohio, Office of Disability Adjudication and Review and recently
accomplished 38 years of federal service, 35 of which were with SSA. I
have been in SSA management for 29 years, the first 12 in SSA
Operations in district field offices and the last 17 in ODAR, first as
a hearing office manager and now as a Hearing Office Director. I was
also an active member of the Hearing Process Improvement (HPI) Steering
Committee created by former Commissioner Kenneth S. Apfel to study the
effectiveness of HPI. I have held the positions of President and Vice
President of FMA Chapter 275, Office of Disability Adjudication and
Review Managers Association (ODARMA) for the past 15 years. Please keep
in mind that I am here on my own time and of my own volition
representing the views of FMA and do not speak on behalf of SSA.
Established in 1913, the Federal Managers Association is the
largest and oldest association of managers and supervisors in the
Federal Government. FMA was originally organized to represent the
interests of civil service managers and supervisors in the Department
of Defense and has since branched out to include some 35 different
federal departments and agencies including managers and supervisors
within the Social Security Administration. We are a nonprofit,
professional, membership-based organization dedicated to advocating
excellence in public service and committed to ensuring an efficient and
effective Federal Government. As the ODAR Managers Association within
FMA, our members and their colleagues are responsible for ensuring the
successful administration of the Social Security Administration's
disability determination process and providing needed services to
American customers.
As you are keenly aware, the Social Security Administration plays a
vital role in serving over 160 million American workers and their
families. Each month, SSA pays out benefits to 48 million
beneficiaries, including over seven million low-income Americans who
depend on the agency's Supplemental Security Income program to stay
afloat in a cost-inflating world and nearly 7.2 million disabled
Americans who receive benefit payments through Social Security
Disability Insurance. These programs amount to the agency paying out
nearly $650 billion in benefits per year. At a February 28, 2008,
hearing before the House Appropriations Committee, Commissioner Astrue
testified that SSA's productivity had increased over 15 percent since
fiscal year 2001. Considering the magnitude of its mission, the Social
Security Administration does a remarkable job administering critical
programs.
In the Office of Disability Adjudication and Review, however, there
are 765,527 pending requests for a hearing, an increase of 4,714 cases
since the beginning of the fiscal year. It now takes an average of 499
days to process a typical request for a hearing and these delays
continue to tarnish SSA's otherwise strong record of service to the
American public. At the beginning of 2002, SSA had 468,262 pending
hearing requests. In seven years, that number increased to over
765,000, despite the fact that dispositions are at record levels. The
files simply awaiting preparation for review by an Administrative Law
Judge (ALJ) at the close of February 2009 totaled 456,442 cases, an
increase of 25,173 cases since the beginning of the fiscal year.
As managers and supervisors within ODAR, we are acutely aware of
the impact these backlogs are having on our ability to deliver the
level of service the American public deserves. I appeared before the
Social Security Subcommittee just two years ago and I am here once
again to confirm what you've heard several times before--the ongoing
lack of adequate staffing levels and resources have directly
contributed to the backlog. The lack of resources can be directly
contributed to the underfunding of the agency by Congress over the last
decade. Several years of untimely budgets further compound the problem.
If these delays and inadequacies continue, clearing the disability case
backlog will be impossible and service delivery will continue to
deteriorate.
BACKGROUND
By way of background, when a request for a hearing is received at a
local Social Security office, it is automatically propagated into our
computer system by a case intake employee in ODAR who adds ODAR-
specific coding such as ALJ assignment, site of the hearing and the
representative involved. Basic screening is done to ensure timeliness
of filing, verify procedural issues are met and determine the need for
critical or expeditious handling. An acknowledgement is prepared and in
some offices, a CD is burned and bar codes are prepared to send to the
claimant or representative.
If staffing allows, ALJs or attorneys will screen the cases for
anything that might qualify it as an ``on the record'' (OTR) decision.
This allows for cases to be decided favorably and paid without a
hearing based on the evidence in file. However, such cases are rare and
if an OTR is not possible, the electronic record will await preparation
for ALJ review. The national average for this period of inactivity is
164 days. In the Dallas region, a file will wait only 66 days on
average, but in the Chicago Region, the wait averages 229 days. In all
but 75 offices, the wait for folder preparations exceeds the national
average. The files simply awaiting preparation for review by an
Administrative Law Judge (ALJ) at the close of February 2009 totaled
431,269 cases, a decrease of 22,729 cases since the beginning of the
fiscal year. We are encouraged by this decrease and the promise it
holds. However, these delays will continue to exist simply due to the
volume of work coming in and the lack of staff to tackle it.
The disproportion of workloads among the regions also continues to
be a cause for concern and must be addressed. Significant efforts were
made to address this situation within the last two years but without
ongoing attention and fine tuning to make the best effort to balance
resources and workload, these efforts will not yield the desired
results. With the promised addition of staff, we will be able to begin
to address these backlogs; however, once again, we are seeing staffing
decisions being made on the basis of where there is physical room to
put the ALJs and employees rather than caseload. Continuing to make
staffing decisions using these criteria only perpetuates the existing
staff and workload imbalances.
Cases are generally worked in hearing request date order. Those
cases deemed critical or in dire need may be given preference. The
``workup'' of the file involves a support person who reviews and orders
the evidence, identifies each exhibit, obtains the jurisdictional
documents and provides a brief summary of the evidence in file. Once
the file is completed and the exhibit list is prepared, it is referred
to an ALJ for review and scheduling instructions. It is then scheduled
for a hearing based on the individual ALJ instructions. Scheduling
requires coordinating the schedules of the ALJ, the claimant, the
representative, medical and vocational experts, a reporter and hearing
room availability. The claimant and representative must be given a
Notice of Hearing at least twenty days in advance of the hearing. These
hearings can be done in person or by video in the local hearing office,
a permanent remote site or a temporary remote site, such as a hotel or
local government office.
After the case is heard, the ALJ can make a decision or order
supplemental records and a consultative examination if necessary. Once
the ALJ has all the evidence and testimony needed to make a decision,
he/she will write instructions for the decision writer. At the end of
February, there were 32,270 cases nationally in which an ALJ had made a
decision but was waiting for an attorney or paralegal to draft the
decision. This number has been growing in part because the Senior
Attorney Adjudicator's availability to address decision writing is
reduced by the time they spend on their adjudication responsibilities,
such as review of existing claims and drafting of on the record
decisions.
When the written decision is completed, it is made available for
the ALJ to review, edit, return for redraft if necessary and
electronically sign. After it is signed, an alert is sent to the
support staff to print, mail and code the case to completion. It is my
understanding that this mailing process will be shortly automated to
send the decision to a central mailing site. Once the decision is
mailed and the coding is complete, we have a disposition.
WHERE WE ARE TODAY
We at FMA appreciate the attention the Subcommittees and
Commissioner Astrue are placing on examining the reasons for the
backlog and addressing remedies to the problem. ODAR began fiscal year
2009 with 456,442 pending cases awaiting preparation for a hearing.
Those cases will wait at least one year before any action is even
initiated to prepare them for review and hearing in front of an
Administrative Law Judge. In February, processing times across the
nation ranged from a low of 346 days in the Boston region to a high of
616 days in the Chicago region. Once again, the large difference in
regions is disconcerting. The American public deserves better service.
Within ODAR, production is measured by the number of dispositions
completed per day by an Administrative Law Judge. In FY05 and FY06,
this record-level figure was 2.2 dispositions per day per ALJ. In FY08,
ALJs went even further by averaging 2.3 dispositions per day. Current
performance through February is back in the 2.2 range and likely
represents the best achievable level of production. This level of
performance will allow ODAR to meet the 500 disposition per ALJ figure
that was requested as a minimum by the Office of the Chief ALJ last
October. At the end of February 2009, SSA employed 1,142 ALJs, which
would allow us to dispose of 571,000 cases if each ALJ worked 500
cases. The problem with this production level is that it's only good
enough to handle the incoming work, not the backlog. For the current
fiscal year through February, receipts totaled 256,831 (an increase of
22,219 during the same period last year), while ALJs completed 237,758
dispositions. As you can see, without significant increases in the
number of ALJs and appropriate support staff levels, the best we can do
is stay even, which means the number of pending hearing requests
remains above 765,000.
Let's take a closer look at the numbers. Five years ago, SSA
leadership determined that a fully productive ALJ could produce a
maximum of 2.5 dispositions per day, a number we have yet to achieve.
With 250 work days, an ALJ should dispose of 625 cases in any given
year. We currently employ 1,142 judges, which under this scenario would
mean ODAR could dispose of 713,750 cases in a year. Even if ALJs
produced only 2.2 dispositions per day, ODAR could dispose of 628,100
cases a year. The math is clear. Without holding ALJs to a stronger
level of production and supply them with adequate staff to prepare
cases, the backlog will never stop being a backlog.
We at FMA believe that it is imperative that both the agency and
Congress recognize the reality of the ALJ production level. It is the
key to the solution. By acknowledging what has been defined as
acceptable and using it to compute the number of potential
dispositions, we can accurately foresee where we can go in terms of
working down the backlog. From there, we can compute what we need to
achieve an appropriate pending case level. With an average disposition
level of 2.2 per day, we will not be able to reduce the backlog without
more judges and staff to support them.
In FY08, SSA hired 190 Administrative Law Judges, which could
translate into an additional 94,500--132,300 dispositions if each ALJ
issued 500--700 dispositions per year, as requested by the Chief ALJ.
However, 68 judges retired during the same period. In FY09, SSA is
planning to hire an additional 157 judges, but is projected to lose 60
to retirement. While this is certainly a step in the right direction,
Administrative Law Judges alone will not solve the problem. Without
additional staffing, the current level of prepared work would be
distributed among more judges, essentially resulting in the same
dispositional outcome. Without adequate support staff to prepare cases
for the judges, both existing and new, we will not achieve an increase
in hearing dispositions. In recent years, however, budgetary
constraints have forced the agency to hire additional Administrative
Law Judges without providing adequate support staff to prepare the
cases for hearing. We recognize that the Commissioner is trying to
address the backlog by adding these judges; however, additional ALJs
without the supporting clerical staff to prepare cases in a timely
manner will not solve the problem.
With the recent increase in funding for SSA from Congress, it is
likely ODAR will be filling 400--500 staff positions. We are encouraged
by this, but in order to maintain an adequate ALJ to staff ratio in
each office, several hundred more staff will have to be hired. The
Commissioner is publicly acknowledging the need for support staff and
hiring authority is coming our way. Unfortunately, we are already half
way through the fiscal year and training staff can take upwards of a
year. As the first six months of FY09 were funded with a continuing
resolution (CR), it is unlikely that we will see much impact from the
current influx until FY10. The untimely passage of budgets is further
tying our hands from getting the job done. While we are grateful
Congress is beginning to recognize the needs of the agency, this feast
or famine approach is hindering the agency's productivity.
As mentioned, adequate clerical support is necessary to prepare
cases for hearing, as well as staff to write a disposition after the
ALJ has made his/her decision. As it currently stands, hearing offices
do not even have the staff to accommodate the current judges, let alone
enough staff to accommodate the new judges and process the over 51,366
new cases the Office of Disability Adjudication and Review receives
each month. If receipts remained flat, over 765,000 cases will remain
pending, 36 percent of which are over 365 days old. At the beginning of
FY09, ODAR had 166,838 cases that would reach 850 days by the close of
FY09. As of March 12, ODAR had disposed of 100,833, or 61 percent, of
the 850 day old cases. We are on target to complete the remaining cases
by the end of the year and the Commissioner and staff should be
commended on their dedication to tackling this portion of the backlog.
With the aging Baby Boom population, as well as the current
economic downturn, it is reasonable to assume that receipts will
continue to out-pace dispositions. In fact, ODAR received almost five
percent more cases than anticipated in FY08 and ended the year with
14,069 more cases than at the close of FY07. Additionally, the first
quarter of FY09 saw receipts higher than expected, mainly due to our
ongoing economic challenges. When the economy slows, disability claims
increase. As the requests for hearings continue to rise, more is
demanded from ODAR staff on all levels. The bottom line is that the
hearing offices lack sufficient staff to process the work on hand, much
less even begin to work on new cases. It is evident that under the best
case scenario, the current staffing levels in ODAR barely maintain the
status quo. That means that the backlog stays the same and processing
times continue at a rate which nears 500 days.
The accepted staff to ALJ ratio is roughly four and one half
production staff per ALJ. However, this only ensures productivity
necessary to handle incoming work, not the backlog. For offices with
heavy backlogs, the four and one half to one standard is inadequate.
Quality and composition of staff also impacts productivity.
Additionally, management and administrative employees should not be
included in these figures, as they are not the employees performing the
production work on hearing requests. It is our experience that
distribution of judges and staff is often based on physical space and
not an office's caseload. This must be addressed if we are serious
about tackling the backlog in the most efficient manner possible.
Average pending cases per ALJ range from a low of 477 in the Dallas
region to a high of 903 in Seattle. Five regions average over 700
pending cases per ALJ. Individual offices range from a low of 288
pending cases to a high of 1,442 and nine offices exceed 1,000 cases
per ALJ. On a national level, processing times range from 346 days in
Boston to 616 in Chicago. At the end of February, 32,270 decisions have
been made by the ALJs but are waiting to be drafted by a decision
writer.
The solutions to the backlog problem start with timely budgets and
adequate staffing levels which will allow us to address the pending
cases. As of last month, just over 765,000 requests for a hearing were
pending. However, it is worth noting that the agency can reasonably
process 450,000--550,000 cases during a given fiscal year. As such, the
actual ``backlog'' at this point is around 300,000 cases.
COMMISSIONER'S PLAN TO ELIMINATE THE BACKLOG OF HEARINGS
SSA has undertaken 37 initiatives to achieve each of the four
aspects of Commissioner Astrue's plan to eliminate the backlog. The
Commissioner should be applauded for his commitment to delivering a
level of service acceptable to the American public and as managers and
supervisors in ODAR, we are dedicated to working with the Commissioner
to reach his goals. A commitment from Congress is also necessary if we
are to succeed in providing a level of service acceptable to the
American people we serve.
Compassionate Allowances
The first point on the Commissioner's plan is to accelerate the
review of cases likely or certain to be approved, otherwise know as
Compassionate Allowances. This concept has been introduced in a variety
of iterations over the years. The idea is admirable; however, we expect
that this will have little impact on ODAR's pending cases, as many of
these are issued at the initial and reconsideration levels.
Improve Hearing Office Performance
The Commissioner also laid out a number of initiatives designed to
Improve Hearing Office Performance, the second of his four-pronged
approach. As previously noted, there are 166,838 cases that will age to
850 days in FY09 and we are on track to tackle this unacceptable level
of service by the close of this year. Additionally, giving adjudication
powers to attorney advisors has the benefit of adding to dispositions;
however, it redirects the work of these very skilled attorneys from
reviewing and advising ALJs on the most difficult cases and makes them
unavailable for decision writing. In many instances, these employees
are not replaced with others to do their original tasks and those tasks
go uncompleted or are redirected to others who are already
overburdened. Improving Hearing Office Performance will never be
achieved without additional staff.
Increase Adjudicative Capacity
The third aspect of the Commissioner's plan is to Increase
Adjudicative Capacity through Streamlined Folder Assembly, which has
made additional folders available for hearings as evidenced by the
52,533 cases prepared using this method in fiscal year 2008. It has
been expanded to the electronic folder, but this process was optional
for ALJs and requires additional review time on their part because of
the ``rough'' nature of the preparation.
The introduction of the National Hearing Center (NHC) has the
potential to greatly expand the agency's capacity to redirect the
resources where the cases are. It is our understanding that installing
video centers in heavily impacted parts of the country so that the
claimant can go to a video center in order to have his/her case heard
by the NHC or other Hearing Office via video is the goal. We believe
the potential for delivery of service with this process is huge.
However, we once again caution that in order to hear these cases, we
still need staff to prepare, schedule and draft decisions. Without
adequate staff support, the NHC will have no cases to hear. In FY08,
the NHC received 4,650 cases, but was able to make decisions on only
2,151 of those cases. In order to even begin making a dent in the
backlog, several thousand more cases will have to be heard at the NHC.
Along the same lines, additional video equipment has the potential
to expand the number of video hearings. In fact, in some impacted
areas, we understand that stand alone video sites are being built that
will allow assistance to be provided from around the country. However,
we must not forget that without adequate staff to prepare cases,
additional electronic capacity is a moot point. Furthermore,
regulations allow the claimants and their representatives to opt out of
the process and our business process also allows the ALJs to opt out.
The practice only works when you have parties that will use it.
Under this section of the Commissioner's plan is an expectation in
place regarding the productivity of ALJs. As mentioned earlier, a
productive, trained ALJ should reasonably be able to dispose of 500--
700 cases a year. Not surprisingly, ALJs conducted 14,733 more cases in
FY08 than in FY07.
Increasing Efficiency with Automation and Business Processes
Increasing Efficiency with Automation and Business Processes is the
final aspect of the Commissioner's plan. There are a large number of
initiatives under this goal. The greatest percentage of case files are
now in the electronic folder format. Increasing our electronic
capabilities will allow us to balance workloads more efficiently.
Although many cultural and training challenges remain, we believe this
will ultimately provide for an efficient process. Acquiring new
buildings and hiring and training staff simply take too long to have
any immediate effect on the backlog. In fact, by the end of FY08,
655,457 cases were filed electronically representing 86 percent of
ODAR's caseload.
Much of ODAR's initial promise of increased efficiency was tied to
the success of the ePulling initiative; however, the pilot program did
not prove successful. We have heard that there is a new iteration of
this program that holds promise. Our ability to pull cases and serve
the public may very well rest on this new program. However, ePulling is
still very much a work in progress and we are unlikely to see any
progress this fiscal year. Implementation of eScheduling would
certainly free up additional individuals whose services could be used
to complete other tasks, including folder preparation. Given the
complicated nature of the scheduling process, which takes into account
many schedules and many individual scheduling preferences, we believe
this will be a difficult challenge.
The temporary service area realignments went a long way to
adjusting some of the imbalances in the workloads. We believe that the
electronic nature of our cases provides us with significant
opportunities to expand this concept to individual work categories. Any
office with excess writing or pulling capacity should have that
capacity redirected to offices with significant backlogs. No office
should be allowed to process their work in an average of under 300 days
when there are 30 offices with processing times of around 400 days and
26 offices with processing times above 600 days. We must find an
efficient way to better balance and redistribute the work.
The Electronic Records Express (ERE) initiative also has
significant promise and a pilot project is currently underway. While
representatives have the ability to submit records using this process,
currently they do not have access to the files via a secure Web site.
This requires the local office to provide CDs with the evidence and we
believe results in significant duplicate submissions since they cannot
confirm what evidence is on file.
Many reports are available to provide enhanced management
information and management training has been improved. These
initiatives are certainly supported by FMA, as management of the
workload is enhanced by trained employees and adequate tools; however,
the critical issue once again is the lack of adequate staff to actually
do the work. We know what needs to be done; we simply do not have
enough people to do it. Furthermore, management is not allowed to hold
employees accountable for production standards, making ongoing
performance measures a challenge.
Ultimately, this is a numbers game. Should Congress define what it
considers to be an adequate level of service, we believe the agency can
define what we need to get there. None of the initiatives outlined
above, whether alone or combined, is the silver bullet that will
eliminate the backlog. We either have to slow the cases from coming in
at the front end, which would require significant changes in
legislation, or we have to provide more capacity on the back end. The
challenge is yours.
WHERE WE GO FROM HERE_INCREASED FUNDING
To enable SSA to meet the goals set forth in Commissioner Astrue's
plan to eliminate the hearing backlog, Congress must approve a
sufficient level of funding for the agency. Between 2001 and 2007,
Congress appropriated, on average, $150 million less than the President
requested each year. The value of this differential is equivalent to
processing an additional 177,000 initial claims and 454,000 hearings.
In the ten years prior to fiscal year 2008, Congress appropriated
nearly $1.3 billion less than the President's request. Without a doubt,
this has had a devastating effect on the services provided to the
American public, as evidenced by the situation we are in today.
Recognizing the needs of SSA, Congress appropriated $150 million
above the President's request for FY08 in an effort to bring down the
backlog. Congress should be applauded for their commitment to serving
the American people in this capacity. In fact, it is this increase
which allowed the agency to hire the additional 190 ALJs. Imagine what
we could have accomplished with adequate staff to provide support to
the additional ALJs.
Unfortunately, for the first six months of FY09, we operated under
a continuing resolution (CR) and as a result, ODAR has had to endure
hiring and overtime limitations. Continuing resolutions have become the
norm rather than the exception and it is significantly hindering our
ability to get the job done. With the passage of the FY09 Omnibus
Appropriations bill (P.L. 111-8), these restrictions have been lifted.
The bill included $126.5 million above President Bush's FY09 request,
which was already six percent over the FY08 appropriation. This will
allow the agency to go forward in hiring staff. However, hiring and
training staff takes time and consequently, we will not see the
benefits of this funding increase until FY10 has started. In order for
funds to be properly spent, budgets must be implemented by October 1st
every year. We simply can no longer afford to pass budgets halfway
through the fiscal year, essentially tying the hands of our already
beleaguered organization.
In addition to the increase in FY09 funding, the economic stimulus
bill (P.L. 111-5) provided necessary and timely funds to SSA in order
to improve its service delivery issues. It is crucial SSA allocate
these funds to the areas that need them the most. Of the $1 billion
provided to SSA in the stimulus, it is estimated the agency will be
able to hire 5,000--6,000 employees with $500 million of the funds. The
remaining $500 million will replace the National Computer Center to
ensure the new facility is functional prior to the time the current
center is no longer operational. We encourage the agency to ensure the
new hires are placed where the agency needs them the most--in field
offices and as clericals in hearing offices.
In his first budget to Congress, President Obama requested $11.6
billion for SSA's administrative expense in FY10. This is an increase
of $1.1 billion or ten percent over the current fiscal year. Without a
doubt, these funds would have a direct impact on the service delivery
of the agency. We applaud the President for his commitment to solving
the backlog problem and urge Congress to appropriate his request.
To remedy the unprecedented backlog situation, Congress should at a
minimum pass the President's 2010 budget request of $11.6 billion for
SSA's Limitation on Administrative Expenses account before the start of
the fiscal year. Under his budget, the agency would be able to process
tens of thousands of more hearings in FY10 than in FY09. It is
estimated that forty percent of SSA's 65,000 member workforce will
retire by 2014. In FY06 and FY07, SSA replaced one worker for every
three that retired. The President's budget will allow for a 1 to 1
replacement ratio and maybe even some additional staff. While this will
not allow us to eliminate the backlog immediately, we will be able to
make significant strides to reducing it. We must reiterate that if we
are forced to endure another CR, service delivery will suffer.
In addition to having an immediate impact on the current backlog,
underfunding the Social Security Administration will negatively impact
every service area of the agency. Staffing at SSA will soon reach its
lowest level since 1972; however, SSA today has nearly twice the number
of beneficiaries it had in 1972. Never has hiring sufficient staff been
more crucial. Reversing this trend is a necessary step to reduce the
backlog.
CONCLUSION
While the President's budget request for FY10 is a start, it is
certainly not a cure all solution. Throwing money at the problem will
not fully solve it without a well-trained, dedicated staff of federal
employees willing to avert a crisis in the coming years. We believe
this is the workforce we have now, strengthened under the leadership of
former-Commissioner Barnhart and Commissioner Astrue. By fully funding
the President's request, we can continue this tradition.
In this era of shrinking budgets, SSA has attempted to maximize its
use of scarce resources to provide the best possible service to the
American public. The challenges faced by the managers and supervisors
are not short term; they are a demographic reality. The same citizens
putting stress on the Social Security trust fund because they are
approaching retirement are also entering their most disability-prone
years. ODAR is struggling to handle the current workload and will be
hard pressed to manage the anticipated increase in hearing requests
without additional staff.
We are the men and women who work with disabled Americans everyday.
We see people of all ages come in and out of our offices seeking the
services they depend on for survival from the Social Security
Administration. We are committed to serving a community of Americans in
need, but we need you to provide us with the necessary resources to
help them. Thank you for your time and consideration of our views and I
am happy to answer any questions you may have.

Chairman TANNER. Thank you, Mr. Fell.
Judge Bernoski, you are recognized.

STATEMENT OF THE HONORABLE RONALD G. BERNOSKI, PRESIDENT,
ASSOCIATION OF ADMINISTRATIVE LAW JUDGES.

Mr. BERNOSKI. Mr. Chairman, thank you for inviting us to
testify here today.
As administrative law judges, we are keenly aware of the
disability case backlog because we work with it on a daily
basis. Administrative law judges continue to work hard at
Social Security.
During the past decade, we have been rendering case
dispositions on a record basis. In 2008, we issued dispositions
in about 550,000 cases, which amounts to over 2 cases per day,
per judge. The only agency study that we know of regarding ALJ
production was part of a 1994 agency reform plan. This study
concluded that a judge could efficiently produce about 25 to 55
cases a month. This would have the judge devoting between 3 to
7 hours to each case on an incremental basis. We don't believe
that this is too much time for a case that is worth around
$250,000, including Medicare.
We have prepared a chart, which is part of our statement,
which shows that our judges, our rendering case dispositions in
a bell curve manner, with most of the judges of course being in
the center of the chart. A second chart also shows that the
more cases that a judge issues, the higher the pay rates
become.
Now, these charts were based on information provided to a
newspaper by the agency. This continued increase in case
production has come in spite of the fact that the electronic
files have slowed our work process and e-polling is showing
signs of failure. E-polling is an electronic system to prepare
our exhibit files for hearings, and it eliminates the need for
the manual process.
The failure of this system proves our past comments to this
Committee, that Social Security has a history of overselling
benefits of technology. For example, last year the agency
claimed that e-polling reduced the need for the five-to-one
support staff ratio for judges. Instead, this failure now shows
that we will continue to require this support staff ratio. In
fact, at the last hearing before this Committee last year,
evidence was introduced to support a six-to-one staff ratio for
judges.
The GAO and the IG have both concluded that judges would
decide more cases if the files were available for hearing.
Despite this hard work by our judges and other employees of the
agencies, we continue to fall behind, and the case backlog
continues to grow.
If history remains consistent, the current economic
recession will add to our backlog. The agency is in need of
additional resources to address this problem. The resources are
needed, as has been indicated, to hire additional
administrative law judges and support staff.
Social Security hearings are based on an inquisitorial,
rather than an adversarial, model. The judge is responsible for
ensuring that the hearing record is complete and that both the
claimant and the trust fund receive a fair hearing. This places
more responsibility on the judge and the assistance of staff as
necessary to allow judges to complete their work. We work as a
team with our staff, and the support staff is needed to set up
the file, send a notice of hearing, assist during the hearing,
monitor post-hearing developments and prepare draft hearing
decisions.
Now, in this time of tight budget, additional support staff
could be obtained by closing the ODAR regional offices and
assigning those workers to hearing offices to support the
hearing process.
However, Mr. Chairman, money alone is not enough and
substantive reform is also needed to improve the process. Cases
that meet the standard for disability must be taken out of the
system before they meet the administrative law judge hearing,
before they get to that level. This change can be done by
adopting a system like the Federal that was in the DSI program
or by using our attorneys to achieve this result. Vocational
rules could also be revised to reflect our increased longevity
and our changing workplace.
The initiatives that the commissioner has implemented have
had little impact on reducing the disability case backlog.
Ideas such as the streamlined files, the National Hearing
Center, centralized printing and mailing, and the electronic
filing system have done little and, in many cases, have added
to our workload and have increased the backlog.
Now, we have prepared a white paper with our
recommendations for addressing the Social Security disability
program, and we would offer into the record with the chairman's
content. And----
Chairman TANNER. Without objection.
Mr. BERNOSKI. Thank you very much. And that concludes my
statement.
[The prepared statement of Mr. Bernoski follows:]
Statement of The Honorable Ron Bernoski, Administrative Law Judge,
Milwaukee, Wisconsin; and President, Association of Administrative Law
Judges
Thank you for inviting us to testify at this hearing. My name is
Ronald G. Bernoski. I am an administrative law judge (ALJ) who has been
hearing Social Security Disability cases in Milwaukee, Wisconsin, for
about 28 years. I also serve as President of the Association of
Administrative Law Judges (AALJ), a position I have held for over a
decade. ALLJ represents the administrative law judges employed at the
Social Security Administration (SSA) and some administrative law judges
at the Department of Health and Human Services. One of the stated
purposes of the AALJ is to promote and preserve full due process
hearings in compliance with the Administrative Procedure Act for those
individuals who seek adjudication of program entitlement disputes
within the SSA and to promote judicial education for administrative law
judges. The AALJ represents about 1100 of the approximately 1400
administrative law judges in the entire Federal Government.
The Association of Administrative Law Judges is most grateful for
the oversight of the Social Security disability program provided by the
Subcommittee. We too find it most painful that the American people, who
are in the disability hearing process, have been disadvantaged by long
delays in their cases.
History of Administrative Law Judges
The 1946 Administrative Procedure Act was enacted to protect, inter
alia, the American public by giving administrative law judges
decisional independence. ``Congress intended to make hearing examiners
(now administrative law judges) `a special class of semi-independent
subordinate hearing officers' by vesting control of their compensation,
promotion and tenure in the Civil Service Commission (now the Office of
Personnel Management) to a much greater extent than in the case of
other federal employees''. [Ramspeck v. Federal Trial Examiners
Conference, 345 U.S. 931 (1953)]. The agencies employing them do not
have the authority to withhold the powers vested in Federal
administrative law judges by the Administrative Procedure Act.
The Roles of Administrative Law Judges and Support Staff in Hearing
Offices
The Social Security Administration's adjudication system is in the
Office of Disability Adjudication and Review (ODAR), formerly the
Office of Hearings and Appeals (OHA). It is one of the largest
adjudication systems in the world.
Since much of the disability problem involves staff shortages it is
critical that members of Congress understand the role of staff in the
disability claims process. When case files arrive in a hearing office,
they must be ``worked up'' or ``pulled'', that is prepared for use in
the hearing. This is a significant task requiring skill and one to
three hours of time. The task is done only by Senior Case Technicians.
Whether the claim is a paper file or electronic file, the contents
arrive in random sequence, unidentified, unpaginated, with duplications
and without any numbered exhibits or table of contents to locate the
exhibits. The Senior Case Technician identifies and eliminates
duplications, identifies exhibits from the same source, labels them,
arranges them in chronological order, numbers and paginates the
exhibits and prepares the List of Exhibits. After it is worked up, the
file goes to the assigned judge for review.
The judge reviews all the evidence in the file, an average of
around 400 pages, and many of the administrative pages, then requests
the staff obtain such additional medical evidence as may be needed.
When fully developed the judge then needs to determine whether a
favorable decision can be made on the record presented, without a
hearing. In most cases a hearing is required and the judge then
determines what expert witnesses will be required for the hearing.
After this review, the staff secures the expert witnesses and schedules
the case for hearing. Once the hearing is scheduled, the judge
continues to be involved with the case to review newly submitted
evidence, to consider and resolve prehearing motions and issues.
Typically, a day or two before the hearing, the judge will conduct
another review of the file to insure familiarity with the facts and
issues for the hearing. When the hearing is concluded the judge must
prepare thorough decisional instructions for the writing staff, review
and edit the draft decision and sign the decision.
In courts and other agencies, trials and adjudications are
conducted under the adversarial process. Under this system the case is
developed during trial by evidence introduced by opposing counsel. The
judge studies and reviews the evidence as the trial progresses.
However, in Social Security disability hearings, administrative law
judges preside over an inquisitorial process, in which it is the duty
of the judge to develop the facts and develop the arguments both for
and against granting benefits. This is in large part required because
the Social Security Administration is not represented at the hearing.
Therefore, Social Security judges are required to wear the so-called
three hats (to protect the interest of the claimant, of the trust fund
and to render a decision based on the evidence in the hearing record).
Nearly all the evidence is gathered and entered into the record before
the hearing begins. After reviewing the evidence, the judge often sees
a need for additional evidence which must be obtained. The
inquisitorial system relies more on the administrative law judge and
places more responsibility on the judge. Hearings based on this model
are more time consuming and labor intensive for the judge.
Need for Large Additions to Support Staff
SSA has the lowest staffing level in decades. SSA acknowledges the
need for qualified personnel but not in sufficient numbers, apparently
believing that automation will replace experienced personnel. GAO,
SSA's OIG and numerous other observers have all noted that ALJs could
decide many more cases if only they received more processed claim
files. This is the specific locus of the backlog, the pileup of cases
waiting for the senior case technicians to prepare the claim files. The
judges have not seen these files.
It is critical to understand that currently, of the 765,000 total
pending cases, over 455,000 of them, 60% of the total backlog, are
waiting in the hearing offices to be worked up for a judge to review.
This is the precise location of the blockage causing the backlog.
That blockage in the flow, the lack of Senior Case Technicians, is
upstream from the judges and the hearing process. Adding hundreds of
judges downstream from this blockage will have no effect on the
blockage. It will however actually decrease the productivity per judge;
the number of cases worked up will not increase and will be divided
among a larger number of judges
In 2008, SSA hired about 150 new judges and plans to hire another
150 in 2009. Few staff have been added and many of those have gone to
various headquarters areas. What has been, and is still needed first,
is more staff to support the current judges and then to provide
adequate support to any new judges added.
As the SSA Inspector General correctly noted in testimony before
this Subcommittee, a sufficient number of competent and well trained
staff is critically important to the ability of a judge to process his
or her caseload.\1\
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\1\ Statement of the Hon. Patrick O'Carroll, Inspector General,
SSA, before the Subcommittee on Social Security of the House Committee
on Ways and Means, Sep 16 2008., page 5.
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The number of cases being pulled each month is less than that
requested by the judges for their dockets and less than the number of
dispositions each month. Judges in many, if not most, offices are
unable to get the number of pulled cases to fill the dockets they have
established.
We would like to discuss support staff to judge ratios as these are
occasionally quoted by SSA officials. However, the formula is not
available. Further, managers have informed us that in 2007 SSA changed
the formula for calculating the staff to judge ratio, adding in
administrative and supervisory staff who do not actually support the
adjudication process. The current staff to judge ratios therefore may
show a false increase since 2006 and are no longer a valid measure of
staff support.
The Backlog
Towering over SSA is a backlog of over 765,000 cases claiming
disability benefits under Title II and Title XVI of the Social Security
Act.
SSA has blamed the backlog on insufficient appropriations from
Congress, the aging of the baby boomers and at times on the ALJs who
decide these cases.
A December 2007 \2\ GAO report on the Social Security disability
case backlog concluded that the increases in the case backlog during
the last decade were caused by a substantial growth in initial
applications, staff losses (including administrative law judges), and
management weaknesses evidenced by the number of failed reform
initiatives [emphasis added].
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\2\ Better Planning, Management and Evaluation Could Help Address
the Backlog, (GA O-08-40), Government Accountability Office, December
2007.
---------------------------------------------------------------------------
The SSA OIG has confirmed there are a number of factors outside of
the control of the judge that affect productivity: the ratio of staff
to judge, quality and composition of the staff, State Agency Disability
Determination Service (DDS) allowance rates and quality of case
development, and the availability of worked-up cases for hearings.
Additional factors are continued inadequate funding for Social
Security, the failure of SSA to hire adequate support staff for judges,
the failure of Social Security to manage and forecast the impact of the
baby boomers and increased case receipts during the mid-1990's and the
failure of the agency to implement a plan to address the same and the
failure of many of SSA's reform initiatives.
Higher staff ratios allow a Judge to be more productive. More cases
can be scheduled for hearing in offices where there are sufficient
numbers of support staff to prepare the files; there are times when
ALJs do not have as many hearings scheduled as requested because there
is insufficient support staff to prepare the cases. The Agency's
failure to hire sufficient support staff should be questioned as this
has a direct impact on productivity and increased processing times.
The quality of staff will affect the number of cases a Judge can
handle; some decision writers are attorneys and others are former
clerical employees. Resources may be distributed unequally to the
Judges within an office, which will impact the ability to issue
decisions.
ALJ Productivity History and Overview of ALJ Productivity
The Commissioner of Social Security (COSS) has complained to
Congressional committees that some ALJs are underproductive and a
contributing cause of the backlog. However SSA's own statistics show
SSA's ALJs have each year produced steadily increasing numbers of
decisions with decreasing numbers of staff and of judges. There is no
evidence to support laying the blame for the backlog on the SSA ALJs.
This was confirmed by a recent SSA OIG report \3\ which
specifically addressed factors affecting hearing office productivity.
From FY 2005 to FY 2007 the average number of case dispositions issued
per ALJ increased 13%. Because of this progress, less room remains to
increase the level of ALJ productivity.
---------------------------------------------------------------------------
\3\ Congressional Response Report: Administrative Law Judge and
Hearing Office Performance, Office of the Inspector General, Social
Security Administration, A-07-08-28094.
---------------------------------------------------------------------------
Much is made of Agency ``expectations'' as if these expectations
had any basis in fact. They do not. The Agency's expectation is five
hundred to seven hundred dispositions per year. It is not based on any
time study of how long it takes for a Judge to handle a case.
SSA's last study on the matter, Plan for A New Disability Claim
Process, conducted in 1994, projected a time line for a disability
claim at all levels of the process, including the administrative law
judge level. The study, based on an average month of 4 and \1/3\ weeks,
concluded that a reasonable disposition rate for a judge should be 25
to 55 cases per month. The monthly disposition rate, according to the
study, should average 40, or 480 per year. The judges are averaging
over 500 dispositions per year.\4\
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\4\ See Appendix, Table 2
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The study results revealed that a judge would spend 3 to 7 hours of
time in processing each case. The Agency allows writers to spend four
hours just drafting a favorable decision and eight hours to draft an
unfavorable one.
It is acknowledged that there have been changes in the process
since 1994, but, at the present time, most of those serve to slow down
not speed up the process. The average file size grows every year. The
review of electronic files (eFiles) at present is considerably slower
than use of paper files. Even electronic signing (eSign) of decisions
takes about four times as long as a ``wet signature''.
In considering numerical performance it is important that the
Congress understand a judge must carefully review the voluminous
documentary evidence in the claimant's file to effectively prepare and
conduct the hearing and to issue a correct decision. Each case carries
an average cost to the trust fund of $250,000. A judge hearing 40 cases
per month is entrusted to correctly decide on $10,000,000 of cases per
month, $120,000,000 annually.
AALJ strongly supported the reform effort known as DSI. We still
believe the Federal Reviewing Officer (FEDRO), or a similar reform,
would provide an unbiased method to award benefits earlier in the
process and prevent these cases from going to an administrative law
judge hearing.
The Administrative Procedures Act (APA) seeks to insulate
administrative law judges from their agencies' dictating their
decision-making to satisfy a certain goal du jour. We saw this in the
early 1980's when SSA wanted to cut people off the rolls and we have
seen it again in recent years when various measures have been taken
which create a perverse incentive to pay cases to get them out the door
as quickly as possible without regard to the effect on the trust fund,
known as ``paying down the backlog''. In both periods the judges have
been a moderating influence in not rigidly adhering to SSA's policies,
but rather trying to judge each case on its merits. This has created
tension between the judges and SSA management, with management
complaining that the judges do not follow SSA's current policies. This
was precisely the aim of the APA and it is precisely why the APA must
not be stretched or cut to permit federal agencies to impose policies
on their administrative law judges which would affect decisional
independence and deprive claimants of their right to due process under
the law.
These are not isolated incidents. SSA has a long history of
interference in the functioning of its administrative law judges. In
another instance, in the early 1980's, for political reasons, SSA
embarked on a review of just allowance decisions of just those ALJs who
had a high rate of allowances. The program, called Targeted Ongoing
Review or Bellmon review, was specifically designed to effect
behavioral change in the high allowance judges. If no such change
occurred the judge's file was turned over to the Office of Special
Counsel for ``appropriate action".\5\
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\5\ AALJ v, Heckler, 594 F.Supp 1132, (D.D.C. 1984)
---------------------------------------------------------------------------
ALJs have increased their dispositions thirteen percent from FY
2005 to FY 2007--this in spite of insufficient resources and an
electronic file system that slows the processing of cases for the
judges. This increased productivity comes on the heels of increases in
ALJ productivity for the several years prior to 2005 as well.
Examining the productivity of judges for FY 2007 \6\ shows this in
more detail.\7\ There is variance in the number of decisions issued by
each judge, however, such a distribution is normal in all human
activities, usually graphed as a ``bell curve'' \8\ and here is further
dependent on the numerous factors noted above which are outside of the
control of the judges. Note that most of the judges are in the center
of the curve. Note there are but 12 Judges out of 1,100--1%--who issue
a very low number of decisions and who are full time judges.\9\ Some of
these judges may have had extended illnesses, themselves or in the
family, or may need assistance in the skills involved. This is
discussed further in Standards for Administrative Law Judges, below.
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\6\ Total for FY 2008 show still more improvement, but AALJ has not
yet obtained 2008 detailed data.
\7\ See Appendix, Table 1
\8\ See Appendix, Chart 1
\9\ Statement of the Hon. Patrick O'Carroll, Inspector General,
SSA, before the Subcommittee on Social Security of the House Committee
on Ways and Means, Sep 16 2008.,
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Systemic Problems
Reports of the GAO and SSA's OIG show the Social Security
disability process is plagued with serious systemic problems and that
``silver bullet'' solutions or attempts to scapegoat one or more
classes of employees will not address, let alone solve, the problems
confronting the agency.

Over-reliance on future technology. A careful review of SSA's plans
to reduce the backlog discloses an over-reliance on future gains from
technology. Social Security has consistently over-estimated the
benefits of technology and has often implemented the technology before
it has been ready for general use. Further, technology does little to
assist the judge or reduce the time they spend doing their work. They
still need to review the case before the hearing, conduct the hearing,
prepare the hearing decision instructions, and edit the draft decision.
The Agency has been claiming that technology, ePulling and other
software, will reduce the number of staff employees needed to support
administrative law judges. This claim too has proved false. The
ePulling software, said to be able to do most of the ``pulling'' of
claim files, has not succeeded. Meanwhile the refusal to hire new staff
has now left the Agency with it lowest levels of staff in decades.

Paying Down the Backlog. Several Agency policies actually work to
increase the backlog. The Agency's policies act to encourage ``paying
down the backlog'', that is paying cases to get rid of them as quickly
as possible. Higher producing judges pay a higher percent of
claims.\10\
---------------------------------------------------------------------------
\10\ Statement of the Hon. Patrick O'Carroll, Inspector General,
SSA, before the Subcommittee on Social Security of the House Committee
on Ways and Means, Sep 16 2008., page 5.
---------------------------------------------------------------------------
As one HOCALJ pointed out, If goals are too high the corners get
cut and the easiest thing to do is to grant a case.'' \11\
---------------------------------------------------------------------------
\11\ Id.
---------------------------------------------------------------------------
The first result is that some claims are paid which should not be
paid. For decades judges have paid an average of 65-70% of claims. The
judges doing up to 600 dispositions per year are still in that range.
However the judges doing more than 600 dispositions per year pay
considerably more; 6,500 claims more in 2007 at an annual cost to the
trust fund of 1.6 billion dollars.\12\
---------------------------------------------------------------------------
\12\ Appendix, Chart 2
---------------------------------------------------------------------------
But it does not stop there. If SSA conducted integrity such cases
to cease the benefits, that would add several thousand more cases to
the backlog.
At best, the net result is SSA permits overpaying of claims then
adds to its own burden by adding cessation claims to its case load. At
worst, as in recent years, SSA has not reviewed the cases and the
benefit hemorrhage continues, even though it is well-known that every
dollar spent on integrity reviews returns ten dollars.\13\
---------------------------------------------------------------------------
\13\ Statement of the Hon. Patrick O'Carroll, Inspector General,
SSA, before the Subcommittee on Social Security of the House Committee
on Ways and Means, Sep 16 2008

Top-Heavy Management. Another major problem and irony in ODAR is
that in addition to a chronic shortage of clerical support staff, it is
``top heavy'' with managers. In this time of declining resources, we
recommend that the number of managers in the ODAR regional offices be
reduced and instead be transferred to the hearing offices to work on
disability cases. We have further recommended that the ODAR regional
offices be closed and the staff personnel be transferred to the hearing
offices. There is a hearing office in each regional office city and
this reform will not cause a change of location for any of the
employees. In this electronic age, the functions of the ODAR regional
offices can be more efficiently handled by the Office of the Chief
Administrative Law Judge who can now easily communicate with all
---------------------------------------------------------------------------
hearing offices without delay.

Other Management Problems. Replacing paper files with electronic
files (e-files), begun under former Commissioner Jo Anne Barnhart, is
an initiative that the AALJ endorses and supports. What is
unacknowledged is that the system, like virtually all new systems, has
difficulties. It needs some additions and it is slower to use in
reviewing the file and in conducting a hearing. SSA's expectation is
that once the system has matured it will require fewer people to do the
same work. That may be true some day, but it is not yet true. When the
system will be fully de-bugged and running smoothly is unknown. SSA's
rigid adherence to this doctrine in failing to replace lost staff has
resulted in serious shortage of staff.
While we embrace the use of technology in the future, current
Agency initiatives do little to reduce the disability case backlog. For
administrative law judges, electronic files slow down the process
because pages take longer to ``load'' and view. Electronic organizing
of files has not yet been perfected. Equipment failures cause delays,
some for long periods, because the system is often not strong enough to
handle peak work loads.

Dial-A-Judge. The use of desktop monitors to conduct hearings and
conducting video hearings from the offices of attorneys, termed Dial-A-
Judge by some commentators, is fraught with dangers. The first is that
the claimant can easily be prompted by an unscrupulous representative
out of sight of the camera. Most important is that the administrative
law judge hearing is the first time in the Social Security disability
process where the American citizen has a chance to meet face-to-face
with a high ranking government official and be permitted to explain the
elements of his/her case. A major part of due process is making the
claimant feel that he/she had a day in court and received a full and
fair hearing. This basic reassurance of fairness is essentially lost if
a government official is not present at the hearing site. Is it also
more difficult to assess credibility using a computer monitor and hence
more problematic in delivering a full and fair hearing to both the
claimant and the trust fund.

``Shortcuts'' are more often counterproductive. A ``streamlined''
claim file is one which is not worked up, i.e., prepared for hearing.
Duplicates of often hundreds of pages of exhibits are not removed.
Exhibits are not identified, placed in chronological order or even
numbered. This allows the clerks to spend less time in preparing a case
record. However it requires that the judge, the decision writer,
medical experts and the representative, all of whom are at a higher pay
grade, to spend far more time reviewing the record. There are also
serious questions of whether or not the ``streamlined'' file violates
due process when the claimant is handed an unorganized mass of evidence
and whether or not the ``streamlined'' file preserves an adequate
record for subsequent reviews.
Another Agency initiative, the ``rocket docket'' changes scheduled
hearings to a ``cattle call'' in which unrepresented claimants are told
to appear at the beginning of the day. The purpose is to determine
which ones will not appear. Their claims are dismissed. Those who
appear are told their hearings will be held in the near future. This
discriminates against unrepresented claimants who may have to travel
long distances to the hearing office on more than one occasion to have
their cases heard.
Smoke and Mirrors
Many of SSA's highly publicized ``Initiatives to Reduce the
Backlog'' in fact can have little if any effect on actually reducing
the backlog. A few examples:

The National Hearing Center took five judges from several
offices and put them together in a new office in Falls Church.
Moving five judges does nothing to reduce the backlog.
As explained above, hiring 150 new judges without adding
adequate staff is a hollow gesture. It is equivalent to
purchasing 150 new trucks and fuel for 20.
SSA has expended approximately 50,000 hours of overtime to
aid ODAR in getting its work done. The faults are that the
money was spent on non-ODAR personnel who do not know the ODAR
work and the overtime was viewed as a benefit and thus rotated
among field office personnel. The personnel who learned the job
this week were replaced the following week by new personnel who
did not know the job. With time lost for on-the-job training
plus overtime premium, the cost to SSA has been excessive and
the production sub-standard.
Even the initiative to clear out all cases more than 1,000
days old, while very commendable, did not reduce the backlog.
Dozens of pages in releases and reports have been devoted to
hailing this as reducing the backlog when in fact it merely
shifted the production effort from one group of claims to
another.
SSA's Public Relations machine is endeavoring to convince
Congress and the public that it is reducing the backlog but a
review of the initiatives discloses that, while they may give
the appearance of reducing the backlog, in fact most do not.

Standards for Administrative Law Judges
The judges are not the problem. The judges did not cause the
backlog and as a group have worked hard, with ever-decreasing
resources, to contain the backlog. The Commissioner has at times
acknowledged that the judges in Social Security are ``producing at
record levels'' as they have year after year. Nonetheless criticisms
are being leveled at SSA's judges. It is undisputed that judges work at
different levels of efficiency and varying levels of diligence. That is
equally true of any group of working people including SSA employees
generally.

Accountability. The Commissioner argues that there must be
accountability for the judges. The judges accept accountability but not
simply measured by the number of decisions produced. Judges are
accountable to the claimants to ensure they get a full and fair
hearing. They are also accountable for the trust fund to ensure that it
is not abused.

Pay Rates. Judges must be responsible for the percentage of claims
paid as discussed above under Paying Down the Backlog. Although pay
rates are subject to external variables such as the regional work
ethic, unusually high or low percentages of certain types of cases,
local unemployment rates, among others, pay rates at the very high and
low extremes should be suspect. AALJ is unaware of any effort by SSA to
review this important issue.

Judges with Lower Dispositions. The Association of Administrative
Law Judges has repeatedly offered its assistance to the Social Security
Administration to meet with the judges the agency contends have the
lowest case production to attempt to determine the reasons for the work
production, and to attempt to address any existing problems. SSA has
refused to give us the data to identify judges with lower dispositions.
Recently AALJ was able to obtain the data from the website of a
newspaper which was given the data by SSA. As a result AALJ initiated a
program of contacting those judges with lower dispositions and offering
to provide assistance of other judges to help those judges who may be
having problems handling as many claims as they would like.
The Social Security Administration (SSA) is proposing an amendment
of the current and longstanding regulatory practice that authorizes the
administrative law judge to set the time and place for hearing in an
attempt to force administrative law judges to hear and decide more
cases. Not only do the data show this unnecessary, it is well-
established that production quotas not only violate the APA, but also
are inconsistent with 5 USC 4301& 4302. See Nash v Bowen, 869 F.2d 675
(2d Cir 1989) which holds that while production goals are a permissible
exercise of Agency management, dispositional quotas are not
permissible.

Rules of Conduct for Administrative Law Judges. AALJ has long
recommended that the American Bar Association's Model Code of Judicial
Conduct be adopted for administrative law judges. It should be noted
that the last American Bar Association model judicial code specifically
included administrative law judges. However, since the 1970's, the
Agency has consistently refused to work with us in this effort.
AALJ is concerned with the lack of appropriate standards of conduct
for administrative law judges. Currently some judges are being charged
with ``conduct unbecoming an administrative law judge'' which is
nowhere defined and can mean whatever the Agency wishes it to mean in a
given case.

Needs. From SSA and AALJ, communication and cooperation are almost
absent and both are needed. Carrots and sticks are not needed.
From the Congress, adequate funding to bring the support staff to a
sufficient level before more judges are hired, with oversight to ensure
it is fully accomplished. Additionally AALJ believes more oversight is
needed to ensure that the systemic changes discussed herein are fully
effected including responsibly reducing the number of claims which go
to hearing; conducting integrity reviews; reviewing extremely high and
low pay rates; adoption of the ABA's Model Code of Judicial Conduct;
review of management needs in the Agency, among others.
Conclusion
We thank you very much for this opportunity to address you on these
issues that are literally vital to many Americans. Social Security
judges are working hard to attempt to address the disability case
backlog. The AALJ had an excellent relationship with former
Commissioner Barnhart, and worked hard with her to reform the hearing
process. The AALJ and its members stand ready to do their best to
reduce the backlog, reduce the hemorrhaging of benefits and to adopt
proven new technologies.
We are not the problem and we are prepared to be part of the
solution.

[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

Chairman TANNER. Thank you, Judge.
Mr. WARSINSKEY.

STATEMENT OF RICHARD E. WARSINSKEY, IMMEDIATE PAST PRESIDENT,
NATIONAL COUNCIL OF SOCIAL SECURITY MANAGEMENT ASSOCIATIONS,
INC.

Mr. WARSINSKEY. Chairman Tanner and McDermott, Congressmen
Johnson and Linder, my name is Rick Warsinskey, and I represent
the National Council of Social Security Management
Associations.
Our association represents the Field Office and Teleservice
management from over 1,300 offices nationwide. The Field
Offices are your local Social Security offices that handle
walk-in Social Security business such as applications for
benefits and replacement Social Security cards. The Teleservice
Centers are where the 57 million 1-800-772-1213 calls to SSA
are answered throughout the Nation. We are the frontline
representatives of the agency.
I also help coordinate the activities of the SSA Advocacy
Group, and I have been a manager of the Social Security Office
in Downtown Cleveland for 14 years.
I am pleased to have the opportunity to be here today. We
are very appreciative of the fact that Congress appropriated
$126.5 million more for SSA in Fiscal Year 2009 than the
President recommended. We are also very appreciative of the
funding included for SSA in the American Recovery and
Reinvestment Act. And finally, we are pleased to see the
President recommended a funding level of $11.6 billion for
SSA's administrative funding for Fiscal Year 2010. All of this
is a lot of money, but these funding levels are absolutely
necessary to address the severe challenges facing SSA that are
growing with the deepening recession.
Let me outline several of the key challenges SSA faces:
One, SSA's hearing backlog is at a near record level of
765,000 hearings, up from about 300,000 earlier this decade.
Hearing processing times have stayed in the 500-day range.
Two, the number of hearings received this Fiscal Year has
increased by about 10 percent. These hearings are related to
claims filed before the recession started.
Three, the number of new initial disability claims is
increasing on a weekly basis and is up nearly 14 percent this
calendar year.
Four, retirement claims being filed are up 28 percent from
2 years ago.
Five, the number of customers walking into Field Offices
continues to grow and is at record levels, even though Internet
claims filed have doubled this year. Waiting times are up 61
percent since 2002, and nearly 80,000 people are leaving our
offices without service every week this year due to the long
waits.
Six, the Field Office telephone service is deplorable. I
repeat, deplorable. Nearly 50 percent of the over 54 million
business-related callers who try to contact Social Security
Offices receive a busy signal.
Seven, Field Offices and Teleservice Centers are struggling
to provide training to their staff to keep them updated because
the staff needs to be moving workloads.
Eight, SSA is facing a major retirement wave over the next
few years.
And finally, nine, there is a backlog of 1.4 million CDRs
and 700,000 fewer SSI redeterminations that are being done this
year than earlier this decade. This is costing taxpayers over
$10 billion.
Ideally, it would be wonderful if we could address all of
these challenges in one year. The reality is that the
challenges SSA faces cannot be fixed with 1 year's funding,
especially as the recession is adding so much more work to SSA.
Hard decisions will need to be made where to direct agency
resources as there is both a strong need to address the growing
workloads and backlogs and to address workloads such as CDRs
and SSI redeterminations.
But the funding we receive this year and hopefully next
year will be a major boost to addressing our backlogs and
providing improved service. We ask for your continued support
for adequate funding for SSA. We also ask that you take a hard
look at legislative changes that would reduce our
administrative costs and improve program fairness. These are
outlined in our written statement. We believe that the American
public demands and deserves to receive good and timely service
for the tax dollars they have paid to Social Security. We also
believe the stewardship of the public's hard-earned tax dollars
needs to be at the highest level.
I thank you for this opportunity to appear today and
welcome any questions you may have.
[The prepared statement of Mr. Warsinskey follows:]
Statement of Rick Warsinskey, District Office Manager, Cleveland, Ohio;
and Immediate Past President, National Council of Social Security
Management Associations, Inc.
Chairman Tanner, Chairman McDermott, Congressman Johnson,
Congressman Linder, and Members of the Subcommittees, my name is
Richard Warsinskey. I represent the National Council of Social Security
Management Associations (NCSSMA). I have been the manager of the Social
Security office in Downtown Cleveland, Ohio for nearly fourteen years
and have worked for the Social Security Administration for thirty-three
years.
I also help coordinate the activities of the Social Security
Administration (SSA) Advocacy Group. This group works to improve SSA's
services at all levels. Members include senior citizen organizations
and disability support groups from across the country, SSA and
Disability Determination Services associations, and Federal management
associations and employee unions. On behalf of our membership and in
support of our SSA Advocacy Group, I am pleased to have the opportunity
to submit this written testimony.
NCSSMA is a membership organization of about 3,400 Social Security
Administration (SSA) managers and supervisors who provide leadership in
more than 1,300 Field Offices and Teleservice Centers throughout the
country. We are the frontline service providers for SSA in communities
all over the nation. We are also the federal employees with whom many
of your staff members work to resolve problems and issues for your
constituents who receive Social Security retirement benefits, survivors
or disability benefits, or Supplemental Security Income. From the time
our organization was founded over thirty-eight years ago, NCSSMA has
been a strong advocate of prompt and efficient locally delivered
services nationwide to meet the various needs of beneficiaries,
claimants, and the general public. One of NCSSMA's top priorities is a
strong and stable Social Security Administration, one that delivers
quality and prompt community based service to the people we serve, your
constituents. We also consider it a top priority to be good stewards of
the taxpayers' moneys.
A New Day for the Social Security Administration
Let me begin by saying that we are very appreciative of the support
that the House Ways and Means Committee has provided SSA for so many
years. Your leadership in recognizing the critical need for adequate
resources at SSA has resulted in vital funding that will help bring a
``new day'' to our agency. We greatly appreciate the support for
funding at a level above the President's proposed budget in FY 2009 and
for the $1.092 billion in funding included for SSA in the American
Recovery and Reinvestment Act of 2009. We hope you will also support
the President's FY 2010 Budget Request of $11.6 billion for SSA's
administrative expenses.
Our testimony will focus on the current challenges facing SSA and
why it is essential that the agency continues to receive the resources
it needs from Congress to provide assistance that the American public
deserves. Many of the challenges we will focus on in this testimony
were also highlighted in the recently released January 2009 Government
Accountability Office (GAO) report on SSA entitled: ``Service Delivery
Plan Needed to Address Baby Boom Retirement Challenges.'' Please see:
http://www.gao.gov/new.items/d0924.pdf. We fully support the
conclusions of this report.
Summary of Challenges Facing SSA
SSA's Funding Shortfalls
In FY 2008, Congress appropriated $148 million above the
President's Budget Request for SSA's administrative funding. This
action marked an important milestone related to SSA's administrative
funding. From FY 2001 to FY 2005, Congress appropriated significantly
less per year for SSA's administrative funding needs than the President
requested. It is also important to note that the level of funding
requested by the President was often significantly less than the level
of funding recommended by the Commissioner of Social Security. In FY
2006 the final funding level approved by Congress was $300 million less
than the President's Budget Request and almost $1 billion less than the
Commissioner's Budget Request. In FY 2007 the final level approved by
Congress was $200 million less than the President's Budget Request and
$930 million less than the Commissioner's Budget Request. The
inadequate level of resources available to the agency for so many years
had a direct and negative effect on SSA's services in a number of ways.
Hearing Offices and the Disability Backlogs
The most visible result of this under funding has been the massive
increase in the number of pending disability appeals hearings. The
annual number of pending hearings, as compared to earlier in the
decade, has increased by over 400,000. Currently there is a near record
level of 765,000 hearings pending, and over 80,000 have been filed by
veterans. The average wait time for a final hearing decision has also
increased from about 300 days to about 500 days. The long wait to be
heard by an Administrative Law Judge for many can lead to bankruptcy,
homelessness, the breakup of families and loss of friends, lack of
critical medical care, and sadly, some individuals die while waiting
for a hearing. This is happening in every state and territory in the
nation.
The number of pending hearings has been over 750,000 since December
of 2007 even though the number of available Administrative Law Judges
(ALJs) has increased from 943 in June 2008 to 1064 in February 2009.
This represents a 12.8% increase in available ALJs. Because all of
these new ALJs needed to be trained, their hearing dispositions are
only just now increasing as they gain experience and become more
efficient and productive.
At the same time new hearing requests have increased 9.5% since the
beginning of Fiscal Year 2009. Thus the increased number of hearings
has added to the challenges faced by the Office of Disability
Adjudication and Review (ODAR). This increase in hearings does not even
include a new wave of requests that will start hitting ODAR later this
year.
Beginning in the fall of 2008, disability claims filed in SSA Field
Offices have accelerated and the number is increasing daily. This
increase in the number of claims being filed started just as the major
downturn in the economy hit the nation. Since the beginning of Fiscal
Year 2009 the State Disability Determination Services (DDSs) have
received 10.0% more initial disability claims than they did during the
same period last year. The percentage of initial disability claims
filed each week has increased in every consecutive week of this fiscal
year. In fact the increase per week for Calendar Year 2009 to date is
13.7% versus the 10.0% for Fiscal Year 2009 to date. At the same time
the number of pending claims in the DDSs has increased from 556,670 to
623,349 (as of March 13). This is a 12.0% increase. There are
projections that this workload could climb to 800,000 as the impact of
the recession deepens. One major challenge the DDSs face is whether
they have the ability to expand quickly enough to address this
workload.
It takes on average about 10 months for a new initial disability
claim that is not approved to become a new hearing. As a result, by
late this summer we will see the leading edge of this increasing
disability claims tsunami hitting ODAR.
We are also very concerned about how the furloughs of state
employees working for DDSs will impact the disability backlogs.
California has already implemented a furlough plan consisting of two
days off per month. This is a 10% reduction in the number of hours
worked in the DDSs. This can only exacerbate the backlogs. In Oregon,
the state is proposing 177 DDS employees be furloughed a total of 24
days during the next two years. Reducing the number of disability
claims being processed could scarcely come at a worse time. What is
most perplexing is that the DDSs receive their funding from the Federal
Government. So there is no financial advantage to the states that
furlough DDS employees. In fact, SSA will withhold funds from a state
for DDS employees while they are on furlough.
Baby Boomer Customers
As all of this is occurring, SSA Field Offices are facing a tsunami
of their own: the Baby Boomers. This year applications for Social
Security retirement benefits are up nearly 28% from two years ago and
17% from this time last year.
SSA Field Offices are also seeing a record number of customers as
more and more people are coming to our offices for assistance. The week
ending January 9, 2009 was a record-setting week as 1,067,089 customers
came into our offices. Waiting times in many offices have increased
significantly and the number of people who left without service has
also increased. SSA Field Offices also had 2.5 million more customers
in Fiscal Year 2008 as compared to Fiscal Year 2006.
In Fiscal Year 2008 about 3.5 million customers waited more than 1
hour to be served. This fiscal year to date, the waiting times are 61%
higher than they were in 2002. Some offices such as Houston Southwest
and McAllen, Texas; Chicago Southeast and Chicago Heights; South Bronx
and Brooklyn Flatbush, New York; Norfolk, Virginia; Jersey City and New
Brunswick, New Jersey; and right here in Washington, DC (M Street
Office) averaged nearly an hour or more wait for customers from the
opening of the office in the morning until the closing at the end of
the day during FY 2009. These times are certainly excessive, but they
are not the most extreme. The highest waiting times are in Puerto Rico
where some customers must wait nearly 100 minutes. Note, some of this
is attributable to the fact that Internet applications are not
available in Spanish. In addition, the Orlando Social Security Card
Center which sees nearly 500 people a day averages approximately 43
minutes waiting time per customer this year.
SSA Field Offices are also seeing a significant increase in the
number of people who leave without receiving service. In fact, this
calendar year to date we are averaging nearly 80,000 people a week, or
8.4%, that leave our offices without receiving service. Many Field
Offices have a much higher percentage. Examples of these Field Offices
are:

Memphis South, TN: 10.5%
Seattle Downtown, WA: 12.8%
Charleston, SC: 14.0%
Mobile, AL: 14.1%
Houston Northeast, TX: 14.8%
Chicago East, IL: 15.2%
Austin, Texas: 16.0%
Norfolk, VA: 16.8%
Oakland, CA: 19.8%
Brooklyn Flatbush, NY: 20.1%
Clearwater, FL: 21.7%
Baltimore NE, MD: 27.0%
North Las Vegas, NV: 33.7%

In a Survey of our field management that was conducted in February
of 2009, about 70% of the respondents indicated they had seen an
``increase'' or ``significant increase'' in waiting times in the last
year.
What is alarming about this increased number of customers and
waiting times is that this has occurred while the number of Social
Security claims filed on the Internet doubled from the previous year.
For Fiscal Year 2008 about 14% of all Social Security claims were filed
on the Internet; that number is now approaching nearly 30%.
Part of our challenge is that Social Security Field Offices offer
appointments both for in-office customers and by telephone. As a
result, most Field Office interviewers are often providing assistance
to individuals with appointments and cannot accommodate customers who
come in without appointments. At the same time, many offices cannot
increase the number of available appointments because they do not have
enough interviewers. Quite simply, there are just not enough staff in
SSA Field Offices to adequately serve the American public.
This concern was articulated by a comment we received from an
Assistant District Manager in our recent NCSSMA Survey of Management
Report:

We can't do walk-ins because everyone is interviewing
appointments, and we don't have enough staff to handle the
demands of our service area. We simply are not able to stay
within twenty-one days on our appointments.

Another Assistant District Manager voiced these concerns about
trying to handle all the customers that walk through the doors:

The waiting time in our Field Office for walk-in traffic is
usually anywhere from 1-3 hours. Our waiting room is often
times packed full and extends into the hallway of the building.
Our office has a very high volume of walk-in traffic and this
makes it difficult to anticipate the volume of people who come
in and need to see Claims Representatives each day. There have
been days where we are so busy that we are not able to fully
serve all of the people who walk through the doors. We must
resort to setting up appointments and making them return on
another day. The Field Offices really need additional staff to
be able to handle the volume of walk-in traffic and to be able
to balance this with providing high quality service. Often
times the Claims Representatives are so busy interviewing that
they rush and make careless mistakes which may result in
payment errors, missing entitlements, and possible recontacts.

In order to relieve very overcrowded locations with high waiting
times, there is a compelling need to open new offices and expand the
size of current offices to adequately staff existing locations. This
has become an escalating problem as there have been significant
population changes in certain parts of the country. For example, in
1984 there were 13 million people in the state of Texas. Today there
are 23 million people. This is a 77% increase in population. In 24
years, one new Social Security office has opened in Texas (Mid-Cities)
and one office (Nacogdoches) has closed. The population of Houston
alone has doubled in the last 24 years. Yet, there are the same six
Field Offices with only two-thirds of the staff. The same could also be
said of the San Antonio area.
Field Office Telephone Service
A recent study by SSA's Office of Quality Performance (OQP) focused
on the agency's Field Office telephone service. It stated that in FY
2007, 45% of the approximately 54 million callers who tried to reach a
Field Office by telephone said that they had received a busy signal or
a recording that all lines were busy. Because many of these callers may
have called more than once and on multiple days, the actual busy rate
is likely much higher than the 45% indicated by the study.
In our Survey of Management last month the question was asked:
``What is most needed to improve telephone service?'' 84.6% of
respondents indicated they did not have sufficient staff to answer
their phones and meet other service demands.
The challenges of our telephone service are evident in the
responses received from two District Managers to our recent Survey.

``Most days, we are so short of staff that we don't even
assign a person to answer the incoming lines. What we do
instead is just pick up the phone when it goes to over ring,
which is 20 minutes after it goes to hold. Usually I am the one
who answers it then. Our phone service is deplorable. And we
are so busy interviewing face-to-face or teleclaims or
adjudicating Internet claims that we don't return phone calls
left on voicemail promptly either. It's not that we don't want
to provide excellent phone service but that with our staffing
so low, we just can't!''

``Field Office telephone service is essentially non-existent
in terms of incoming calls. This is due directly to the fact
that Field Offices are generally understaffed. Field Offices
handle more phone calls yearly than does SSA's 800 Number
system, yet for many years the focus in terms of telephone
service has been on the performance of the 800 Number system
and has essentially ignored the prime telephone service
delivery system in SSA.''

The recently issued GAO report on Field Offices recommended that
SSA establish standards for Field Office customer wait times and
telephone service. However, SSA did not agree with this recommendation
as it would create problems for SSA by diverting an already thin staff
away from processing claims and post-entitlement work. This
disagreement shows a core challenge facing SSA. The agency simply can't
do everything, especially reducing waiting times and improving
inadequate telephone service, without the necessary resources. Field
Offices are struggling now to keep up with the large increase in
Internet claims. It is a high priority to move these claims so hard
choices are being made on where to direct resources on an hour-by-hour
basis. One key challenge of the Internet claims is that most require a
telephone contact to go over the application with the individual. This
is to verify proper completion of all questions and to ensure the
proper payment is made. This often requires pulling Field Office staff
from the interviews coming in to make these calls. This not only
increases waiting times but it also ties up the telephone lines
resulting in busy signals for other customers who may be trying to
reach the office by telephone. As a result, Field Office management and
staff are forced to make service delivery choices that are
unsatisfactory to our staff and customers alike.
Training
In our most recent Survey less than half the managers agreed or
strongly agreed that their staffs received adequate training. Of those
who believed that employees in their offices did not receive adequate
training, 63% stated inadequate staffing was the primary reason. And
about 39% said they had insufficient time to prepare and deliver
training.
It is obvious that training is being shortchanged in many Field
Offices due to the lack of resources. These responses from our recent
Survey demonstrate how the lack of resources impacts training in our
offices:

``We must use all of our hours that we are not open to the
public to get the work completed. We are lucky to allow one
hour a week for training. This is a shame for the employees and
the public who will end up with poor service due to this. Lack
of training impacts our wait times as well as repeated visits
to get actions completed if not done properly the first time.''

``The problem in the case of new hires is that we cannot pull
anyone full time to train continuously due to the interviewing
and workloads. In addition, more training could technically be
provided to our staff; however, if we train multiple times per
week before the office opens, the staff does not have adequate
time to process workloads. We try to maximize the training
provided without taking too much ``down time'' away from the
Claims and Service Representatives. It's an unfortunate choice
to have to make.''

It should be noted that the two main public contact positions in
the Field Offices are both highly technical and the half-life of that
technical knowledge spans only a 3-year period. Policies and processes
change routinely and new software improvements are implemented multiple
times per year. When the agency short changes the ongoing training of
its technicians, it is impossible to take advantage of the resource
savings that these process improvements can ultimately provide. When it
comes to training delivery, we are caught in a vicious cycle; we can't
train because we are too busy processing workloads and we can't process
workloads in the most efficient manner because we have not been
trained.
SSI Program Integrity and Quality
In Fiscal Year 2008, 1.2 million SSI redeterminations were
completed. (An SSI redetermination is a review of an SSI recipient's
benefits to ensure that they are being paid properly.) Over the five-
year period from FY 2004 to FY 2008, the number of SSI redeterminations
completed declined by 47%. Over the ten-year period from FY 1999 to FY
2008, the number of redeterminations completed declined by 43%. This
reduction in the number of SSI redeterminations completed was directly
related to the level of appropriated funding received by the agency
during those fiscal years.
The reduction in the number of SSI redeterminations completed was a
contributing factor in the increase of the SSI overpayment error rate
from 6.4 percent to 9.1 percent from FY 2005 to FY 2007. The
overpayment error rate is currently at its highest rate in over 30
years. There is a direct correlation between the increasing error rate
and the decline in the number of SSI redeterminations completed. In FY
2007 the projected overpayments totaled $3.9 billion. These substantial
losses to the Treasury and the trust funds will continue unless the
trend toward completing fewer redeterminations is reversed. It is very
important to note that conducting SSI scheduled redeterminations saves
$10 for every $1 spent in administrative dollars.
In FY 2009 the increased appropriated funding for SSA will allow
the agency to increase the number of SSI redeterminations by an
additional 500,000 cases, but this will still be 700,000 cases below
levels completed earlier this decade and results in 700,000 missed
opportunities to save program dollars.
In our most recent Survey, responses indicated that while 22.5% of
managers felt that the quality of work produced in their office had
improved in the last two years; nearly one-third of managers (33.6%)
reported that the quality of work produced in their offices was worse
or significantly worse. Of those, 65.6% cited two factors as the
principle reasons for the diminished quality--not enough staff desk
time (38.1%) and not enough staff (27.6%).
The responses below from the Survey address the challenges facing
SSA related to quality of work product:

``There are a variety of reasons for quality not being as
high as in the past. Certainly, we need more staffing, but
there is so much work and not enough staff to do the work.
There is not enough time to devote to training to learn new
policies and procedures.''

``The constant pressure to meet appointment goals, coupled
with our walk-in and telephone traffic not only exceed the
limits of our ability to monitor newer employees but also their
capacity to spend thoughtful time researching unfamiliar
issues. There is always a drumbeat: just get it done; just get
it done.''

``The fact that we have no staff to check work that goes out
is frightening.''

Continuing Disability Reviews
SSA has also significantly reduced the number of medical Continuing
Disability Reviews (CDRs) that are completed. (A medical CDR is a
review of a Social Security or SSI disability beneficiary's eligibility
for benefits based on their medical condition. If their condition has
improved enough to show they can work then their benefits will be
terminated.) In Fiscal Year 2008, a total of 235,000 full medical CDRs
were conducted. This is down from 800,000 per fiscal year from earlier
this decade. The reduction in the number of CDRs was directly due to
the level of appropriated funding provided for SSA. SSA has a backlog
of 1.4 million unworked medical CDRs.
The savings realized by completing medical CDRs are substantial. As
of Fiscal Year 2007, for every $1 spent there is a $11.70 savings in
Social Security trust fund assets, SSI funds from General Revenues, and
Medicare and Medicaid payments. In Fiscal Year 2007 the Disability
Determination Service offices spent $281 million to complete CDRs. The
lifetime savings realized by completing these CDRs was an astounding
return of $3.3 billion. Clearly from the stewardship standpoint, it is
imperative that the agency be provided with the necessary resources to
catch up the medical CDR workload and keep it current.
However, the same DDSs that are also dealing with a large increase
in new disability claims would also be called upon to conduct these
additional reviews. In order to meet both of these challenges and to
also assist ODAR in reviewing old disability cases for potential
allowances, DDS capacity must be significantly increased. Such an
increase in capacity may take several years to accomplish, but planning
for this would need to start immediately to meet these multiple
challenges.
The DDSs are also facing a significant retirement wave. Much like
the Field Offices, they did significant hiring in the 1970s when the
SSI program started. DDSs also have a high attrition rate. In fact in
FY 2009, DDS attrition was 8.1% overall and 10.1% for examiners.
Fortunately there is substantial DDS hiring planned for this year
utilizing the Stimulus Bill resources and through the FY 2009 Omnibus
Appropriations funding. But the training of DDS examiners takes up to
six months. And it takes about 18 months before an examiner can do a
full range of work. The DDSs also have to pull a substantial number of
senior examiners to train and mentor the DDS examiners.
The CDR cases are also handled by the most senior examiners. A
concern that must be addressed is how can these examiners absorb an
increase in completing CDRs in FY 2010 while they are also trying to
move a large increase in new disability claims, address the additional
reconsiderations, assist ODAR with their backlog, and finally mentor
all the new hires.
Realistically SSA may not have any capacity to complete additional
CDRs in FY 2010. Many of the DDSs also have significant space issues
and will need to have time to expand their space to absorb a large
increase in hiring. The President's FY 2010 Budget Request calls for an
increase of $255 million in program integrity funding. If SSA increases
the number of redeterminations to the maximum level, this would still
leave at least $150 million unspent. If an additional 200,000 or so
CDRs were completed this could utilize the additional money. With a
backlog of 1.4 million CDRs it certainly would be desirable to spend
this funding as $150 million spent on CDRs would save over $1.7
billion. We suggest that there really needs to be a multiyear plan to
allow the DDSs to ramp up and move the CDR backlog while still
continuing to handle the additional initial claims, reconsiderations,
and assist ODAR. This plan will need to take into account all of the
additional workloads, in addition to the need for increased training
and space and equipment for the DDSs.
New Workloads for SSA
SSA Field Offices have struggled to keep up with new workloads as
Congress continues to add to SSA's list of responsibilities, such as
administering new requirements for Medicare Parts B and D, and
conducting Social Security Number verifications and other immigration-
related activities such as the E-Verify program. However, SSA's
administrative funding has not kept pace with the agency's increased
responsibilities. We are especially concerned about additional
workloads from the E-Verify program that are being discussed. We are
also concerned about the additional work that could result from
increased enforcement of ``no match provisions.'' It is imperative that
the Department of Homeland Security (DHS) reimburse SSA for these
costs.
SSA's Retirement Wave
SSA completed a substantial amount of hiring in the 1970s when the
agency began to administer the SSI program. SSA reduced staffing levels
significantly in the 1980s. The agency did little hiring during this
period. This has created both a doughnut hole and bubble in SSA's
staffing demographics. Additionally, the agency hired new employees on
a very limited basis during the early 1980s through the late 1990s. As
a result, there are only a limited number of mid-career employees. Over
53% of SSA staff is eligible to retire by 2017. Not only is there a
need to increase the number of staff due to rising workloads and large
backlogs, there is a need to get people hired and trained before we
lose so much of our institutional knowledge and experience.
In addition to the issues above, 70% of the SSA management
employees will be eligible for retirement by 2017. This significant
loss of leadership is compounded by the fact that many of our current
management positions are not being filled because of concerns about
supervisory ratios. With the challenges of ever-increasing workloads
and reduced staffing levels, it is extremely important to have
sufficient management to lead SSA employees. Also, a more aggressive
and proactive approach is needed for succession planning to develop our
next generation of leaders.
How Recent Funding Approved for SSA Will Improve the Agency's Services
and Stewardship
Recent legislation approved by Congress has included additional
resources for SSA. Both the American Recovery and Reinvestment Act
(Stimulus Bill) and the FY 2009 Omnibus Appropriations Act include
significant funding for SSA. In addition, the President has proposed a
level of $11.6 billion for SSA's FY 2010 administrative funding. If
approved this would result in a $1.1 billion increase in SSA's
appropriated funding from FY 2009 to FY 2010.
The Stimulus Bill included $1.092 billion for SSA. Roughly half of
the funds, $500 million, provided for SSA in the Stimulus Bill should
result in immediate improvements related to SSA's services and
stewardship. Of this amount, $40 million was included for health
information technology research and activities which should assist in
the adoption of electronic medical records in disability claims. This
technology could improve the disability claims process by shortening
the length of time it takes to render a decision on a disability claim
and improving the accuracy of initial claims decisions. Additionally,
$90 million was included for SSA to administer the cost of the $250
economic stimulus payments to Social Security beneficiaries and SSI
recipients. The remaining funds, $500 million, are allocated for the
much-needed replacement of the National Computer Center, the full cost
of which is estimated to be about $750 million.
If the President's Budget Request of $11.6 billion for SSA's
administrative funding is approved for Fiscal Year 2010 the agency will
be able to continue improving its services and stewardship activities.
SSA must receive at least a $400 million increase just to address the
increased inflationary costs from FY 2009 to FY 2010. Any additional
resources could then be directed toward other SSA workloads.
Some recommendations related to where these resources could be
appropriately and effectively utilized:

1. Resources are needed for the Office of Disability
Adjudication and Review, Disability Determination Services,
Program Service Centers, and Field Offices.
In order to reduce the unconscionable backlog in hearings and
to process the increased receipts of disability claims and
hearings due to the severe recession, additional resources are
necessary. In ODAR many more Administrative Law Judges will be
needed along with support staff. For every one Administrative
Law Judge (ALJ), about 4.5 support staff are needed. If SSA is
able to hire 200 more ALJs, then it would result in the need
for about 900 more support staff to adequately assist them. To
support this additional staff more space and equipment will be
necessary.
The Disability Determination Services (DDSs) are currently
staffed at about 900 fewer positions than they were allocated
three years ago. The DDSs currently have about 13,600
positions. The DDSs are receiving about 10% more disability
claims this year compared to last year, and this number is
growing on a weekly basis. This indicates the need of at least
1,300 more positions plus the necessary costs to support these
additional positions. This increase does not include additional
positions that would be required to complete additional CDRs
(see information above and below on CDRs). Additional positions
could also be used to perform more remands from ODAR. If more
remands could be performed this would reduce the number of
hearings.

2. Field Offices must have additional staff to answer the
telephones and provide quality service to the public when they
visit community based Field Offices. Additional staff would
also assist Field Offices in handling the significant increase
in Internet workloads.
Current telephone busy rates and in-office wait times are
unacceptable. Clearly a busy rate of nearly 50% when you call a
Field Office is an unacceptable level of service. The 61%
increase in waiting times in Field Offices since 2002 is also
unacceptable. In our recent Survey, 77.4% of respondents
reported having insufficient staff to keep workloads current.
Only 20.1% thought that their offices were adequately staffed.
Managers estimated that they would need a staffing increase of
13.5% (over 3,600 positions) to have sufficient resources to
provide adequate levels of service. Managers specifically
attributed the effect of inadequate staffing levels on the
ability of their offices to provide a satisfactory level of
public service.

3. A significant increase in SSI redeterminations and CDRs
could be accomplished with additional resources.
In fact, if an additional 700,000 SSI redeterminations and
470,000 CDRs were completed SSA would be at the same level the
agency was at earlier this decade.
The President's FY 2010 Budget Request calls for spending
about 50% more, or $255 million, on SSI redeterminations and
CDRs in FY 2010 over FY 2009. This additional expenditure of
administrative resources could save taxpayers over $2.5
billion. If more funds were appropriated to SSA in FY 2010 this
savings could be even higher. As mentioned earlier in this
statement, the backlog in CDRs is currently 1.4 million.
In Fiscal Year 2009 the unit cost for completing each CDR was
$847. To work the entire backlog down in FY 2009 dollars it
would cost $1.186 billion. The potential savings would be
$13.92 billion.

Obviously there probably isn't sufficient funding available to
eliminate the backlog in SSI redeterminations and CDRs in one year.
This is especially true considering the enormous backlog in hearings as
well as growing workloads in both Field Offices and the Disability
Determination Services. However, SSA may not be able to increase the
number of CDRs completed at all next year with the growing workloads in
the DDSs. But this analysis shows that SSA desperately needs all of the
resources from the Stimulus Bill, the FY 2009 Omnibus, and at least the
$11.6 billion proposed in the President's FY 2010 Budget Request to
continue to make progress.
Reducing SSA's Costs to Oversee the SSI Program
SSA administers a very complicated Social Security and SSI program.
The agency has been working to streamline policies to reduce
administrative costs. We firmly agree this should be done so long as it
does not disadvantage the public.
In addition, there are many areas where administrative costs could
be saved through legislation. This is especially true of the SSI
program which is very labor intensive and we therefore urge the Ways
and Mean Committee to consider legislative changes that would result in
administrative savings. We offer a few key areas in the SSI program
which are very labor intensive and if modified, could save us
administrative dollars. These are:

1. Simplify the rules on Living Arrangements and In-kind
support and maintenance.
2. Eliminate couple's benefits.
3. Allow payment of retroactive benefits of either Title II
or Title XVI payments first in order to prevent delay of past
due benefits. This proposal would greatly simply the
computation of offset computations.
4. Eliminate the Dedicated Account Provision and
Installments.
5. Simplify the earned income provisions: Increase earned
income disregard to reflect inflation and expand what is
acceptable proof of wages.

There is one other area that we urge the Committee to examine
thoroughly: That is the resource limit of $2,000 for SSI for an
individual and $3000 for a couple. This limit has been in place for 20
years and severely discourages any savings for an SSI individual as
well as practically guaranteeing a life of very minimal means and near
poverty. An increased limit would also reduce a lot of resources
development for Field Offices. It is important to note that the
resource limit for Part D Medicare Income assistance is $12,510 and
$25,020 for a couple.
Legislative Change to Assist In Reduction of the Disability Hearings
Backlogs
Current law requires that 50% of all approved initial and
reconsideration Title II disability cases and Title XVI adult
disability and blindness cases be reviewed before a final approval is
made. The intent of this was to lead to more consistency in approvals
in all states as this review is completed by SSA (a Federal review) as
opposed to being completed by the DDSs. However no more than 5% of the
disapproved cases are reviewed. Thus, at least 95% of the denied cases
are not reviewed. As a result, there is no early opportunity to prevent
some cases from moving to the Hearing Offices. With an increased review
of denied cases, some of these cases will be approved. This will also
result in many claimants who have been denied benefits not having to
wait nearly two years for a hearing. It will also save substantial
administrative dollars in ODAR.
We believe that a truly random review of all initial and
reconsideration disability cases should be implemented instead. The
review would be equally split between approvals and denials. This
increased investment in the disability area would reduce the hearings
backlog, save administrative dollars, and prevent many unnecessary
hardships for claimants. This revised review method might actually be
less expensive in the long run as it could reduce the very high cost
that often results from a hearing on a case.
The SSA of the Future
We firmly believe that SSA cannot stay a static organization. We
believe that the agency should continue to invest in our systems to
process our cases faster and reduce costs. We need to have information
technology that is fully supported by an up-to-date National Computer
Center. Allocating resources to replace the National Computer Center,
which is nearing its capacity, is a wise investment.
SSA is also investing resources to improve our Internet product as
the public demand for this product grows. We also think this is a wise
investment.
We do believe the public should be given a choice in how they will
interact with SSA. This can be in person, by phone, or via the
Internet. In future years, we do anticipate a shift toward the public
using online services more and more. SSA will need to constantly assess
this as the agency considers its expensive infrastructure costs and the
number and location of SSA offices. In the interim, there is a need to
have an adequate number of offices in growth areas such as Texas (as
cited earlier in this statement).
Recommendations
We have these key recommendations to improve services in SSA and
stewardship of funds:

1. Approve at least the $11.6 billion funding level proposed
by the President for FY 2010.
2. Look at multiyear funding to accelerate the number of SSI
redeterminations and CDRs completed to save billions of
taxpayer dollars. It will take a number of years to work down
this backlog.
3. Exclude SSA's administrative funding from any cap that
sets an arbitrary ceiling on discretionary spending. There is a
$2.3 trillion trust fund for SSA to draw on for most of this
funding.
4. Remove SSA's administrative funding from discretionary
budget caps and provide a separate limit in the Budget
Resolution.
5. Pass legislation that withholds funds such as stimulus
funds from states that furlough DDS employees.
6. Pass legislation that would streamline labor intensive
regulations that could save the agency millions of
administrative dollars. This is especially true in the SSI
program.
7. Pass legislation to ensure a more consistent and thorough
review of approved and denied disability cases.

Conclusion
The programs SSA administers are vital to our nation. John F.
Kennedy said this on June 30, 1961:

``It is with great satisfaction that I have signed into law
the Social Security Amendments of 1961. They represent an
additional step toward eliminating many of the hardships
resulting from old-age, disability, or the death of the family
wage earner. . . . A Nation's strength lies in the well being
of its people. The social security program plays an important
part in providing for families, children, and older persons in
time of stress, but it cannot remain static. Changes in our
population, in our working habits, and in our standard of
living require constant revision.''

While we are facing a very severe recession we all want SSA to do
its very best to continue to serve our nation by ensuring all Americans
receive the benefits they paid for or deserve on a timely and accurate
basis.
We are very appreciative of your ongoing support for adequate
resources for SSA. We certainly believe the American public has paid
for and deserves to receive good and timely service from the Social
Security Administration. Consistent and adequate resources for SSA are
essential to ensure this. Increased investment in SSA is money well
spent as the agency has a proven record of effectiveness and
efficiency. In fact, from FY 2002 to FY 2008, SSA's productivity has
increased by about 18.7 percent, which is an average of 2.7 percent per
year. We look forward to your support for SSA funding in FY 2010 of at
least the $11.6 billion proposed by the President.
On behalf of the members of the NCSSMA and in support of the SSA
Advocacy Group, I thank you again for the opportunity to submit this
written testimony to the Subcommittees. NCSSMA members are not only
dedicated SSA employees, but they are also personally committed to the
mission of the agency and to providing the best service possible to the
American public. We respectfully ask that you consider our comments and
would appreciate any assistance you can provide in ensuring that the
American public receives the necessary service that they deserve from
the Social Security Administration.

Chairman TANNER. Well, let me, on behalf of the Members,
thank all of you for your time and your attention to this
matter. Let me assure you that your testimony will be gone over
by the members and our staff in great detail because this
Committee intends to be very active this year, and we may be
asking you to come back in 6 months as we monitor what is
happening.
This is, as I said at the outset, is a national problem
that has dire consequences for real people, and your devotion
to this cause is admirable, and the Committee wants to thank
you.
Judge, you said something that struck me. I asked the
commissioner when he was here if the error rate on electronic
filing, was there was any data to support what I have to
believe would be a higher error rate than if one who is making
application can sit down and talk with a human being who is
knowledgeable in these matters about it. His response was, if
you were here, that they thought the error rate was about the
same. My thought, if that is true, then maybe I don't have a
concern.
But if it is not true, it seems to me that that is in
itself clogging the system with inaccurate or erroneous
applications that have to be pitched out before one can get to
the merits of the case. Do you have a comment on that, sir?
Mr. BERNOSKI. As far as the errors in the application and
the errors of the type that the commissioner referred to, by
the time that claim gets to the administrative law judge level,
we are at the end of the food chain. Those types of corrections
have invariably been made in the file. So we are not being
burdened with that type of problem.
But the electronic file does slow down the process as far
as we are concerned in the way we handle the file. It takes
longer to open up an electronic file than it does a paper file.
It takes longer for the case to boot up when coming to the
screen. It takes longer to turn a page electronically than it
does to turn a page in a file. Also, it is more difficult to
read electronic files. If you are going to--if a judge is
sitting there or a clerk or any type of person sitting there,
reads from a screen all day long, that has an impact on your
eyes; it has an impact on the back of your neck. All of these
problems have impacted on us and, in fact, has slowed down our
ability to handle those files.
Also sometimes the system just breaks down because there is
so much traffic on the network that it can't handle it or it
slows down considerably. All of these things have impacted us.
Now this e-polling is another problem that is going to have
a dramatic effect on us, because that was a system that was
implemented to pull the duplicates out of the file. Before, we
had to do that manually when we had paper files. Clerical
people had to go through and set up the case and remove the
duplicates because we have an inquisitorial system. We get the
evidence rather than the attorneys bringing them in. Now,
electronically, if that system fails and we have to, in fact,
kind of do it manually with an electronic system, it takes a
much longer, longer period of time. And it takes about, I spoke
with some of our people in our office before I left on Friday
because I thought we would be talking about that today, And
they said it takes about twice as long now with the electronic
system as it did manually with the broken process.
Chairman TANNER. Thank you.
Mr. Warsinskey, do you have a comment?
Mr. WARSINSKEY. I think part of your question was directed
at the Internet claims which the Commissioner was referring to.
And he said that the quality on the Internet claims, what you
called electronic claims, is really good. The study I think he
was referring to, indicated a little bit better quality than a
claim that is filed in the office. And the study that they did,
did show that. The Internet claims are usually a little cleaner
than the average case that we get in an office right now.
But the reason why the accuracy is good is because we
review the cases very thoroughly. The claims representative
reviews them before they are actually paid out or adjudicated.
So that is why we have the good quality. We don't have any
claims going through the Internet right now without some kind
of review to make sure it is paid correctly.
Chairman TANNER. Mr. Johnson.
Mr. JOHNSON. Thank you, Mr. Chairman.
I just have one or two questions.
Mr. O'Carroll, how much of the work at local offices and
hearing offices is completed using the Social Security computer
system that he says doesn't work?
Mr. O'CARROLL. Mr. Johnson, the vast majority of the work
in SSA offices is done on computers. We are proponents of
electronic service. We believe that using the Internet for
applications is a wise use of technology. We are monitoring it
all the time in terms of looking at the accuracy rate. We are
finding it is very accurate. When a person is sitting down and
filling out a form, they are putting a lot of thought into it.
They think, they complete their application logically, and we
find that that works very well.
To give you an example, years ago, when somebody was
applying for a Social Security card, they would sit down with a
claims rep with a paper form and go through it. The SS-5 would
be complted, and then it would be transcribed to an electronic
record. Now, with the electronic SS-5 assistant, ieach step is
electronically recorded. And then they ask for the applicant's
identification. This is making the application process for a
Social Security card easier and more accurate, and we applaud
the system.
Mr. JOHNSON. Well, the system is, I mean, you have got old
technology in that computer system. Is that causing a problem,
and does it ever go down?
Mr. O'CARROLL. Well, to a degree, yes it is causing a
problem. And that is one of the reasons for modernizing the
system.
A lot of the front-end process, as an example, the SS-5
assistant, isn't being done using the mainframe. It is being
done using a server, and then that data is put into the
mainframe, which is the old technology. This is one of the
biggest problems. The front end is using the modern technology,
while the older COBOL program is used at the NCC. If the NCC
was updated, the process would be much more streamlined and
quicker.
Mr. JOHNSON. How about telling me what would happen in your
opinion if there were a failure in the system?
Mr. O'CARROLL. Congressman, that is something that is of
great concern to us. We have been looking at it a lot. We are
very concerned. Regarding one of the questions earlier in the
hearing, why has this degradation of the system just recently
been identified? And it is quite significant. Our concern is
that, if the system does go down, it is going to take a long
time to bring it back up again. Yes, the records are kept. Yes,
they are on tapes. Yes, they are in other locations. But it is
going to be such a long process, and I think, as the
Commissioner mentioned, if the tapes are brought to New Jersey,
which is the current location, it takes about a week to 2 weeks
just to bring in all the equipment, get it loaded, and get it
running.
As everybody knows, and one of the reasons we are
concerned, is that the daily process of SSA, which affects many
Americans, would be suspended for several weeks. And then, when
you think about all of these benefit claims, until that system
is up, they will have to be taken on paper forms. Then all
those papers have to be uploaded into the system. So I do
believe that having redundancy, having a second site that is
identical to the Baltimore site is necessary for all of us to
be able to----
Mr. JOHNSON. If it went down at the end of the month,
people wouldn't get their checks; is that true?
Mr. O'CARROLL. No, sir. They would get a check. We have
looked into that. They would use records forwarded from
Treasury the previous month. Maybe some deceased people would
also receive checks. Maybe some people that needed a check
wouldn't get one, but the vast majority would get a check based
on the records of the month before from the Treasury
Department.Mr. Johnson. So the Treasury has a second record; is
that true?
Mr. O'CARROLL. Yes, sir.
Mr. JOHNSON. Okay. Thank you very much. Thank you, Mr.
Chairman.
Chairman TANNER. Dr. McDermott.
Mr. MCDERMOTT. Thank you, Mr. Chairman.
I don't know who to ask, whether it is Mr. Fell or Dr.
Bernoski or Judge Bernoski or whatever. I am reading these
cases that Ms. Hathaway brought in here, and I think that if
you put two or three or four reasonable people around the table
reading the cases, even these one-paragraph synopses that are
given to us, in almost every case, we would say, this person is
eligible for disability benefits.
So when you tell me that there are 999 cases pending in
Seattle for an average of 500 days, I ask myself, why is that
happening? Explain to me--I mean, I was a witness. So I have
been in your courts in the administrative law procedure on
various cases. And what I don't understand is, are they held up
because it is little pieces of paper that aren't there, and
therefore, we don't go ahead with them, and we put them off
another month? Is that what happens? Or is it that these are
such difficult decisions--I mean, if you read the case of Ms. T
was waiting 29 months for a hearing. She had been diagnosed
with borderline intellectual functioning and epilepsy. While
she was waiting for her hearing, she exhausted her time limit
on TANF benefits, lost her income. Her mother used her income
tax refund to prevent foreclosure on the house. It doesn't
sound to me like there is any doubt that that woman is
ultimately going to be judged disabled and eligible for
benefits. So what is the hang-up in this system?
Mr. FELL. The first part of it, probably Judge Bernoski on
the disability part of it.
Some of the hold-up is due to demographics. for instance,
the Chicago region is so inundated where maybe the Philadelphia
region and the San Francisco region are not. The Seattle region
is heavily inundated.
Part of the problem is getting to the files. We do have a
process where claims are looked at when they come in. And if a
flag goes up, they are given to attorneys to look at to see if
there is a possibility of an on-the-record decision. Maybe it
only needs one more piece of evidence.
But what happens on a lot of these, I mentioned there are
over 765,000 requests; of those requests, over 400,000 are
awaiting preparation for the judges to see them. And that--what
Judge Bernoski talked about the length of time it takes to
prepare these for the judge, that can be 4 to 6 hours,
depending on the size of the case. That is where the huge
backlog right now is. If they are not caught at first through
this screening process, where we will often look at cases where
people are 50 or over, then when they are finally discovered is
at the point that the file is prepared or from offices where we
do get something from a congressional liaison stating that,
wait a minute, this person has got a problem. Here is some
updated medical.
So there are a number of things that can happen and we do
have things in process to keep it from going that far. But
there are so many cases in the system. If one gets through,
they are not going to be discovered until they get to the point
of preparation.
Now, as far as the issue on the type of disability and
should that be approved, I am going to turn that over to Judge
Bernoski, the actual medical part.
Mr. MCDERMOTT. We have a thing on welfare claims on
Medicare--Medicaid claims, that if they don't, you know, happen
in a certain number of days, they get paid anyway and they get
money on top of it. They get the--the doctors get additional
money and interest because it hasn't been paid, right? What is
the problem with just letting these cases through and reviewing
them, and then, if there is one, you can call them back? Is it
that you can't reclaim the money? Is that the problem? I don't
understand. Because somebody set up this Rube Goldberg system
to keep from paying benefits. There is no question looking at
it, coming in here again and again, we hear the same thing we
heard last year. Why don't you just--why doesn't the system let
them through?
Mr. BERNOSKI. Well, I guess one of the process--reasons
that we don't have the system that you described is that is not
part of the regulation or the law. So we couldn't do it at
least now.
But the fundamental problem is that our system is
overloaded at this point. We just have more work than we can
possibly handle. That is why we need more judges. We need more
staff. We need more money, as has been said repeatedly during
the course of this hearing.
Also, this is what we suggested in the course of our
testimony, is that it would be helpful if we would have a
mechanism in the system to look at the case more formally
before it gets to the administrative law judge hearing. The
Federal concept of that was part of DSI, where before the case
would come to the administrative law judge, a person would have
a function within the process that would look at that case and
review it and determine whether it could be paid on the record,
maybe a little bit of additional evidence would be needed to
pay that case, but to pull all of these cases out of the system
as early as possible and not allow them to move and progress
until they get to the administrative law judges.
We are doing it the slowest and most expensive way, because
we are hearing all of these cases at the back end of the
process, as Mr. Lewis said, at the back end of the process,
with the employees that are making the most money--
administrative law judges are probably one of the highest paid
people in the system. And so we are--that is the type of system
that we have put together where we are hearing the cases later
by the more highly skilled and more highly paid people. Where
we suggest there should be something earlier in the process to
pull some of these cases out. That would help. That would help,
we believe.
Mr. MCDERMOTT. So you are saying it needs a total rewrite
of the regulations of how the system works? The system is
dysfunctional?
Mr. BERNOSKI. It doesn't take a total rewrite of the
regulations. We could do a Federal system like we have now or
we could build on what we have. We have staff attorneys and
attorneys in the program right now where we could just expand
on what we have got and give them that additional function
where they would be doing this work earlier in the process.
We have a senior attorney program now which does some of
that work, but the problem with the senior attorney program
that we have is that they look at the case and either--they
either award it or it goes forward. The type of benefit from
their expertise to help develop the case is not done. So the
skill that they have and the knowledge that they have acquired
and the analysis that they have put into that case is not
documented to be passed onto the administrative law judge to
help shorten the administrative law judge's analysis. In fact,
we are doing it twice under this current system.
Mr. MCDERMOTT. Thank you, Mr. Chairman.
Chairman TANNER. Dr. Linder.
Mr. LINDER. Thank you, Mr. Chairman.
General O'Carroll, you mention in your testimony that they
are moving to--you said the law units cost about $24,000 each,
and the video conferencing on the desktop video would be about
$8,000 each?
Mr. O'CARROLL. Yes, Mr. Linder. We are doing an audit right
now taking a look at the effectiveness of it, whether the
investment of putting in the video units is worth it. It is
ongoing now. But, yes, it is expensive, and we are monitoring
the costs.
Mr. LINDER. A quick check of the Internet finds that a
nationwide company offers a video conferencing camera that
starts at $9.99 along with a free video conferencing calling to
other network users.
What do you think of that, Mr. Bertoni?
Mr. BERTONI. I am not aware of that particular instance,
but I guess your point is that, to the extent if they can find
cheaper and as useful tools to get this job done, I think that
should be the case. I think there are examples in this agency
and others where, through the procurement and contracting
functions, that hasn't always been the case. But I would--
hearing that, I would say if there is technology that is
similar, does the same job, and it is cheaper, that should be
looked at closely.
Mr. LINDER. The last laptop I bought, it came with the
laptop at no additional cost. Thank you all very much.
Thank you, Mr. Chairman.
Mr. FELL. May I make one comment on that, please? I am
actively involved in that. I have a number of video units in my
office. We are installing a video spoke in Indianapolis, plus I
am putting a desk top video in Madison, Indiana, shortly. We
have a closed net IP. We have security issues, privacy issues.
Also with the administrative law judge, the clarity of this
system has to be as close as it can to an in-person hearing. So
before we go on the cheap to put more in, we really have to
make sure that this is the type of technology that we can use.
The technology we have now on some of the 58-inch flat screens
we are getting in is extremely clear. The desktop videos, true
they are expensive, but the clarity is amazing. My chief judge
has one in his office. He holds remote hearings with it, and he
is very impressed with the clarity of it. So I don't think we
want to sacrifice the clarity and the ability of the judge to
view what he needs and also the privacy, in making sure we have
a closed net system. It would have to be, I think, very careful
analysis before we went out and tried to contract outside. That
would be my opinion.
Mr. LINDER. I think if you looked closely, you could buy
these things pretty secure and very large for a whole lot less
than $24,000.
Thank you, Mr. Chairman.
Chairman TANNER. Your timing is impeccable. We have three
votes, and we were supposed to be out of the room at 1:30.
May I, again, thank all of you very much. Your testimony
will be carefully read. And if we have follow-up, I assume we
may contact you with respect to any question we may have about
your testimony.
Thank you, Ms. Hathaway.
Thank you all for being here.
The meeting is adjourned.

[Whereupon, at 1:31 p.m., the Subcommittee was adjourned.]
[Questions for the Record follow:]

[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

[Submissions for the Record follow:]
Statement of Cary L. Bartlow, PhD
Since 1985 I have been an independent Vocational Expert (VE)
providing expert witness contract services for the Social Security
Administration's Office of Disability Adjudication and Review (aka
ODAR). I am writing to ask for your assistance in getting answers to
what has been, and continues to be a confusing and seemingly
disorganized merry-go-round process affecting our compensation for
Expert Witness services in ODAR Hearings.
As you may know, the current rate for which we are compensated was
set around 1972. There has not been an increase in the amount the
Vocational Experts are paid in over thirty-eight years. In 1972 that
rate of compensation was very fair. Now some thirty-eight years later,
inflation has almost completely eliminated any way to make a reasonable
profit when providing these valuable services. Most of us in the
Vocational Expert field have other job duties, and the work for Social
Security is not essential to our practice. However, it remains
essential to Social Security. The agency requires the use of an
Independent Vocational Expert to provide vocational expert testimony in
Social Security Hearings for many Title II and Title XVI cases. Through
our work cases are expedited and move toward completion much faster
than without our services. I fear some experienced Vocational Experts
will find it necessary to cease their work due to such poor
compensation. If this happens the SSA disability case backlog will
increase ten-fold at a minimum.
In order to do the Vocational Expert work one must have a College
Degree. Most VE's have Master's Degrees. I have a Doctor's Degree. I am
a Licensed Professional Counselor, Certified Rehabilitation Counselor,
Certified Vocational Evaluator, and a National Board Certified
Counselor with over 38 years of experience. Yet we are paid at a piece-
rate wage based on standards of pay established 38 years ago. The
compensation paid by Social Security is not worthy of our training,
education, work, experience, credentials or degrees. We hope you will
agree. Undoubtedly many our your colleagues and staff would not remain
long at a job if your pay was the same as 38 years ago.
A task force headed by two distinguished colleagues, Mr. Scott
Stipe of Oregon and Mr. Tom Dunleavy of Illinois, have worked hard to
bring our request for an increase in pay to light. Finally, in August
2008 Vocational Experts were pleased and excited to learn in writing by
SSA that the VE's would all receive a long overdue and reasonable pay
increase for their vocational expert services. The Vocational Experts
were finally being recognized for their professionalism, patience and
willingness to assist SSA in disability claims.
The August 2008 contract offered for the SSA Vocational Experts,
including myself presented a long overdue increase in compensation. We
were asked to complete an application under the new BPA contract
expeditiously; and VE's across the nation did just that. The new rates
and provisions of the contract were to go into effect October 1, 2008.
Through our association, the International Association of
Rehabilitation Professional, we posted the good news. Medical Doctors
who serve as experts were also included in the long awaited increase.
Curiously, some VE's in other regions did not get the new contract,
but were given yet another extension to the old contract. Everyone
assumed that the new contract with pay increases would soon reach
everyone across the nation. We patiently waited for the good news to
happen in real life. The value of our essential services was finally
being recognized and appropriately rewarded.
On September 12, 2008, SSA sent another urgent message to the ODAR
offices, stating that ``all action should be stopped on the new
contract.'' The message stated that the contracts would be placed on
hold until further notice, and the agency was currently in the process
of assessing some possible changes to the BPA package associated with
security issues. That was the only explanation we received. Another
communication came from the ODAR Regional Offices on September 26, 2008
stating the deadlines had been lifted, and all VE contracts were
extended through December 31, 2008. Nothing was mentioned about taking
away the raises.
A Status Update from the ODAR ME/VE Contractor Workgroup came on
October 9, 2008. The statement given was, ``We want to reassure you
that the new BPA is forthcoming. We must issue a new BPA to include PII
language and fulfill the security requirements. We are also concerned
about the BPA's expiration date of December 31, 2008. We are speaking
with Headquarters' Executive Management and others regarding this
timeline. We anticipate the release of the new BPA by the end of the
month. Your patience in this matter is greatly appreciated.'' Nothing
was mentioned about taking away the pay raise.
The next communication received was an email on January 7, 2009
which stated, ``Greetings, attached is the newly updated BPA
Contract''. VE's were shocked, dismayed, disappointed and angry that
the newly updated contract was rescinded to the old 1972 rates, and
this contract would be in place until September 2010.
This insult was worse than a slap in the face. There was no
explanation other than an email that was forwarded from ODAR stating
that the August 2008 contract had not been approved.
One cannot imagine that the contract had not been approved. One
would naturally assume that it was PRE-approved prior to being offered
to all VE's across the nation. SSA does not just arbitrarily send out
blanket contracts without approval first. The January 2009 contract
made changes in the status of the VE being associated with any
particular ODAR office. Changes were made as to how we report a monthly
contractor invoice and request for travel reimbursement. Still yet
other regional offices did not send out the January 2009 contract, but
extended the VE contract until March 31, 2009. No reason was given for
taking away our pay raise. None at all. And, to add to the insult we
were told we would not be paid mileage for our travel from our office
to the local SSA hearing site (unless it was over 50 miles away??!!!).
It is disconcerting to VE's that we find ourselves left to slowly
swing and die on the limb. Our contract is for a national service
program. We were told that the funding did not come through for our
contract because the SSA agency was under a Continuing Resolution. SSA
knew they were operating on a Continuing Resolution went they sent out
the original contract, the one that had our pay raise. So, this excuse
does not hold water.
Contract hearing monitors and reporters, who take notes and operate
the recording machines, renegotiated their contracts during this same
time interval, and many received substantial increases for this same
period our contract was to cover. Many of them earn more that the VE's;
and they do not require but a high school diploma to do their work.
Whereas, VE's are a group of professional highly skilled people who
have extensive training, education, certifications and years of job
placement and job development experience. Most provide forensic
testimony in state and federal courts.
We strive for excellence in our field and take pride in assisting
the Social Security Administration in carrying out the legal provisions
under the Social Security Act. It is a genuine and reasonable fear that
many VE's will be less available to do this work as the compensation is
no longer commensurate with what we deserve and can be earned
elsewhere. Most VE's are now angered, saddened, frustrated and
disheartened with the recent events.
To add to our distress, it has been learned Attorneys and
Representatives for the Disabled Claimant Applicants are going to see
their compensation increased!!! They do not even have a contract with
SSA.
I returned my BPA application for continuing VE services timely on
the last day of January 2009. Then, get this, on February 15, 2009 I
received a third and NEW packet to complete for the THIRD TIME.
We need your help. I would appreciate any assistance that you can
give me and my Vocational Expert colleagues concerning what is
happening in the Social Security Administration as it relates to
Vocational Expert pay and compensation and when we can anticipate an
increase in compensation.
Yours truly,
Cary L. Bartlow, Ph.D.
Licensed Professional Counselor
Certified Rehabilitation Counselor
Certified Vocational Evaluator
National Board Certified Counselor
Diplomate-American Board of Vocational Experts
Certified Counselor for the U.S. Dept. of Labor
Certified Counselor for Oklahoma Workers Compensation Court

Statement of Dorothea Bawks
The Social Security Administration is inundated by Baby Boomers
with disabilities. SSA employees can not keep up with the pace. They
have not been given the resources to. We all need to cut back on many
things. But one area which causes the SSA system to be continuously
back logged has to do with the burden of unnecessary hearings. The
``Back to Work'' incentives are failing. These incentives have botched
people with disabilities and the SSA system in general from a `simple
to solve' level. It has to do with the monthly amount of money an
individual on SSD or SSI is allowed to earn in order to keep their
benefits. Just to be clear, going back to work enhances persons with
disabilities lives on too numerous levels to mention. However, when all
an individual can manage is part time, the following built in failures
need to be changed:
Waive the earned income ceiling during the 3 months every calendar
year when an employee receives 5 or 3 pay periods a month instead of
the usual 4 and 2.
Recognize that controlling one's income is not always the
purogative of the employee, particularly if the employee is new and has
not yet earned the time off needed to take a week off from work three
times a year to stave off losing their benefits by closely monitoring
their income.
Acknowledge that this restriction is more often than not an
`unknown' by the person with a disability. Who is telling them in
advance? Many people with disabilities end up losing their benefits
permanently because there was an extra pay period in a given month that
caused them to supersede the monthly allowed earned income and had no
idea they were breaking any SSA rules.
Recognize that many of these people end up requesting hearings due
to the fact they never received notice of this rule. As a result they
did not make an informed choice and are miffed as to why their benefits
have ceased.
Recognize that discrimination by employers toward people with
disabilities is still alive and well and that requesting three unpaid
weeks off per year dually jeopardizes an employee with a disability in
terms of employment retention. Many people avoid going back to work
based on the intellectual sophistication of employer/employee
agreements that would have to be in place in order to comply with this
rule, or the fear of what would happen if they failed to acquire such
an agreement.
Choose to accept a third or fifth pay period three times a year
without penalty. This will free up the Adjudicator's schedules not only
due to the lessening of appeals, but also due to the lessening of re-
application for benefits which almost always end up in appeals as well.
Make it retroactive, for people with intellectual or cognitive
disabilities (especially mental illness which is loaded with cognitive
deficits). This alone would free up thousands of people with
disabilities to stop fearing and make choices to go back to work, ease
the SSA burden in processing `earned income' records, and allow the
appeals courts to steadfastly move ahead.
Finally, recognize with this one change there will be far less
American Families who are homeless, or without health coverage, heat,
food, electricity, and/or fuel.

Statement of Earl Tucker
This is an outline of some of AFGE's concerns at the Social
Security Administration and some suggested recommendations to improve
service to the public and reduce the disability backlog.
Underfunding and Understaffing----
SSA is severely underfunded and understaffed. SSA budget is totally
inadequate to provide the benefits that workers are entitled to
receive. SSA budget for FY 2009 should be at least $11.5 billion to
allow SSA the resources it needs to provide timely SSA benefits to
workers that have paid into the SSA trust funds. With the additional
funding, SSA need to hire more staffing in all components (both in
headquarters and all non-headquarters components) of the agency
nationwide. In addition, we need extra staffing for field offices, DDSs
and the Disability Quality Branches. SSA will also need to increase the
size of the DDS Reconsideration Sections.
Disability Improvements
SSA should have dedicated staff specifically trained to handle DIB
interviews. Specialized staff must be trained to better document and to
probe for underlying developmental requirement to correctly complete
DIB interviews done by field office employees. We need to prevent the
grocery shopping attitude that sometimes develop here during the DIB
interview. Without in-depth training, some employees feel that they are
shopping for the cook but would like to specialize and know more about
what is needed to better help the DDSs to properly adjudicate the DIB
claims.
Screening of ODAR Cases--Until the ODAR backlog is manageable,
there should be at least one expeditious screening unit set up in each
component performing disability work to reduce the ODAR backlogs. These
units should screen targeted cases without using ODAR's templates,
written decisions or Staff attorneys to adjudicate the medical aspects
of the cases. While other components are screening cases for potential
disability allowances, it seems premature to apply an ODAR legal
standard when deciding a case at this juncture using the medical
evidence.
Prototype States--End all prototype states and reinstate
reconsiderations in those states so that they will be done by the DDS
instead of ODAR. We must stem the flow of unnecessary cases going to
ODAR in the first place. Ending prototype states would do this and the
DDS would do all reconsiderations. In addition, the DQB should sample
up to \1/2\ of all DDS reconsideration denials.
Administrative Law Judge--Open up the opportunity to get into the
ALJ position to all SSA employees who are not lawyers but have
disability experience. As you know, at one time most of SSA employees
who adjudicated claims were lawyers but SSA found out that they did not
need lawyers to adjudicate initial SSA claims. The same should be true
for appeals. We don't think you need to be a lawyer to hear each and
every appeal. Therefore, employees with disability experience should
have the opportunity to become non-attorney hearing officers.
The above represents our thinking on ways to help clear some of the
disability backlog.
Service Delivery Comments
SSA's new unwritten plans to deliver service to the public can only
be done at the expense of dedicated employees and quality assurance.
Quality has disappeared mainly because of the so called 'budget
constraint'(underfunding and understaffing). It appears, SSA thinks
they can hide behind budget constraints to reduce employees further and
hinder premium progress. Now SSA is developing guises and schemes to
increase production instead of training all employees for one-stop
shopping to delivering quality service to the public.
SSA needs to get back to its mission ``to provide the correct
check, to the correct person in the correct amount.'' SSA needs to
recognize that we do not provide a commodity to the public. We are
providing them with their ``income'' to survive in this turbulent
economic time. SSA was at one time a first class agency who recognized
that we dealt with individuals and their very specific needs and
concerns. Social Security applicants and beneficiaries are not just
anonymous voices at the end of a phone line or internet applications.
Before we go into the guises and schemes, We need to draw a
parallel example. Years ago, when you flew you were served food even in
economy section of a plane. Now you have to buy meals in the economy
section, if food is available on your flight in the first place. AFGE
believes that this is where SSA is headed even though we are not in
business to make a profit like the airline industry.
In order to cope while underfunded and understaffed, some of the
most recent guises and schemes seems to be as follows:

1. SSA's total lack of trust for employees when requesting
unexpected time off--In some components, many employees are not
respected and valued by SSA especially when they need
unforeseen time off work for any personal reason including
emergencies. They are requiring employees to bring some type of
documentation before final approval of the unexpected leave. If
the time is granted, SSA has threaten to investigate the
authenticity of the document that they required the employee to
obtain.

2. Recording 800# calls--SSA is changing the philosophy and
tradition of never recording 800# calls. Now SSA wants to
shorten the length of calls by recording the calls to maximize
production for each 800# agent. In the past, employees were
allowed to take the necessary time and get each call right in
order to provide quality public service. SSA plans to start
recording all calls to the 800# in the near future. For over 20
years, SSA has utilized monitoring and observation of 800#
employees to rate the service delivered by telephone. As a
result SSA has the best 800# system in the world with a 96.7%
accuracy rate for calls affecting payments in answering the
concerns of the public. But according to SSA, 96.7% payment
accuracy is not good enough because they want to utilize the
recordings to shorten the length of calls and to discipline
employees for extended calls. Overall, AFGE sees this as
creating a more hostile work environment and an attempt to
reduce the number of employees and shortchange the public.

3. Internet On Line Applications--SSA plans to have the
public complete their own application for SSA benefits without
human intervention or a face to face interview. The SSA
programs are very complicated. Without SSA experience, the
public can not answer many of the questions on the application
correctly such as month of election, lag wages, onset date,
worker comp, railroad earnings, military service credits,
resources etc. It takes an employee at least three years to
learn any one of the three SSA programs. AFGE believes the
public deserves quality service from experienced employees to
get the correct benefits upfront. In addition, we believe fraud
waste and abuse will run rampant without human intervention in
the internet online application process. Identity thieves and
hackers are major problems in our society and the limited proof
requirements built into the system will not detect fraud,
waste, and abuse. The Agency is ignoring the fact that the
general public is extremely reluctant to deal with either
individuals over the phone or an internet process that they
cannot trust. There have been too many instances of vulnerable
beneficiaries being preyed upon by bogus individuals and
companies both on the phone and online all to ready to divest
them of their limited benefits. The Agency is failing to
realize the value of the frontline Field employees who not only
provide a human face to Social Security but also provide
service, preserve privacy, prevent fraud and instill confidence
in a program that serves a large part of the general populace.

3. Virtual Environment--SSA plans to eliminate the 10
distinctive regional lines in Office of Quality Performance
(OQP) for a virtual environment. This means that a
beneficiary's case in Chicago, Illinois can be reviewed by
employees in any location. This elimination could do away with
the regional validity of our quality performance findings.
Therefore, the findings would most likely be national leaving
out regional findings. AFGE believes that SSA wants to
manipulate staffing with this virtual environment. In locations
that are more productive, SSA will put more staffing in those
locations and less in others creating a hostile environment
everywhere.

4. Pre-effectuation Reviews (PER)--OQP reviews 50% of all
allowances made by the Disability Determination Services (DDS)
before payments are made. This review saves the trust fund over
$600 million per year. SSA is looking for way to reduce DDS
complaints. The DDSs complain about our reversals which in the
end save money in the trust fund. SSA is now doing a cursory
review instead of a complete review on some of these cases. SSA
is investigating new ways to reduce, revise or stop these cost
saving reviews even though they are mandated by Law. The
proposed PER review changes need thorough investigation, and
should be bargained with AFGE. SSA is now doing a cursory
review of some PER cases that may be less likely to have a high
return rate. They want to put the focus on reviewing claims
where, in management's words, they get ``more bang for the
buck.'' Namely, cases where younger individuals might collect
over more years. This is not only discriminatory against
younger individuals in a program that is supposed to serve all
citizens, equally, but it also circumvents the intent of PER
review established by Congress. PER was intended to be a way
for the Agency to protect it's ``integrity'' and the viability
of the funds that it was entrusted to distribute. By conducting
PER reviews the Agency is able to provide a visible savings of
Trust Fund monies and able to demonstrate that it can do a
system of checks and balances on itself. To attempt to ``water
down'' PER and it's proven value over the years by limiting
it's impact is self defeating not only for Social Security but
also for the dwindling Trust Fund.

Staff was told that the time savings in the cursory reviews would
be used to allow OQP to accomplish other agency goals, such as
adjudicating ODAR cases at the ALJ level. This is not even a part of
the OQA mission, and should not be implemented unless employees receive
adequate compensation for performing work that ODAR staff attorneys
often do. Management has circumvented the need for bargaining on this
issue because they claim there is a ``de minimis'' impact on employees.
This is a ridiculous argument since it completely changes the focus of
our work.
Recommendations:

1. SSA's funding and staffing must be increased dramatically.

2. We also strongly recommend more training and promotions--
To improve service delivery to the public, all employees must
be trained to provide ``one stop' shopping. One stop shopping
means that any employee can process an action to completion
without referrals. Currently, one stop shopping does not exist
for some employees because they have not been fully trained. As
a result, many employees have to refer the work to someone else
to process due to lack of training. To train everyone to
provide one stop shopping could be expensive because this will
require some promotions. However, we don't think SSA has much
of a choice in providing one stop shopping if they want to
improve service delivery to the public in an electronic
environment.

3. Ratio of employees to management--The ratio of employees
to management is quite high at SSA. It varies from component to
component. It is lower than 3 to 1 ratio in some components and
as high as 20 to 1 in others. Even officials with such a low
number of employees seldom process initial case work, with the
exception that they evaluate a small sample of the work done by
the 5 employees. The ratio should be much higher in all
components with proportions less than 20 to 1. There should be
a standard, across the board, consistent, management/employee
ratios in SSA. OQP differs wildly from region to region. There
should be delayering of this complicated and inconsistent
management structure, with fewer middle managers especially
program leaders. SSA has about 200 Program Leaders in the
Office of Quality Performance that are suppose to function as
team Leaders or program technical assistants to other
employees. If these employees are, in fact, leaders in the
program then they should be working cases when they are not
providing technical assistant where needed. Since these
employees very seldom work a case from start to finish they are
not leading anybody in the program or performing the public
business as the leaders. These Program Leaders are not in the
bargaining unit even though they do not perform any supervisory
functions. Also, in my opinion they do not perform any other
function that would preclude them from being members of the
bargaining unit. In other components of SSA, program leader
type positions are called team leaders or technical assistants
and they are in the bargaining unit, but not in the OQP unit.
The OQP program leaders should be in the bargaining unit to
process the work of the public instead of performing
unnecessary management related assignments. Basically, the
Program Leaders, rightfully, should be processing actual cases
and leading the team as members of the bargaining unit

4. Flexiplace/Telework--Since around 2001, SSA's has allowed
a few employees to work at home from 1 to 2 days a week. Up
until now, flexiplace had been one of the most productive
programs at SSA. SSA is denying employees the same access to
SSA computer systems that they granting to the public and their
representatives. SSA must expand the number of days to work
from home and allow employees access to SSA computer systems
from home as well.
The restriction of flexiplace does not follow federal
guidelines on federal workforce telecommuting, which were
passed in order to allow for fewer commuters, contributing to
energy savings and greater work productivity

5. Information Technology--SSA's cost for information
technology is steadily rising without any quality reviews to
ensure the health of these system expenditures. The OQP in SSA
should have certified programmers on staff to perform quality
reviews in all areas of information technology especially since
information technology is requiring more and more of SSA
resources. In addition, SSA needs more IT resources to get rid
of COBOL and other antiquated software.

Finally, AFGE believes SSA's management philosophy is that
electronic and technological advances should somehow automatically
eliminate employees and drastically reduce the amount of time that is
needed to process it complex work. AFGE disagrees with that philosophy
which is not supported by objective evidence from the workplace.
SSA should model its service delivery in a similar fashion to that
of those cities that have provided pedestrians with a better method to
cross busy intersections. In those cities walk lights have second
counters on them to let pedestrians know when they are running out of
time to navigate the street crossing. This technology has cleared the
intersection of pedestrians being caught in the middle of the street
after the light changes. It is important to realize that cities
installed these second timers, but did not reduce the amount of time
for pedestrian to cross the intersection. I recommend that SSA take
advantage of these electronic and technological advances without
reducing the amount of time needed to deliver services. If employees
are given the same amount of time to process SSA's work, the efficiency
will become self evident.
It seems to AFGE that SSA is acting like a corporation trying to
make a profit instead of attempting to deliver world class quality
service to the public. To think of ourselves as a corporation where
reviews are supposed to be tailored to bring ``more bang for the
buck'', is totally inappropriate. We are a government agency that is
supposed to deliver to our citizens, applicants, and beneficiaries
information, advice, and benefits that they are entitled to. We believe
management has lost sight of Social Security's mission to serve the
public and administer the program in a fair and equitable manner.
Without proper planning inclusive of employee/union participation,
staffing, training, funding, and management commitment to service of
the public, Social Security will continue to fail in its attempts to
address the problems of rising applications, the backlog of disability
related appeals, and addressing the information technology needs of the
workforce and the public they serve.

Earl Tucker
President
AFGE Council 224

Statement of Georgina Huskey,
National Association of Disability Examiners
Chairman Tanner, Chairman McDermott, Congressman Johnson,
Congressman Linder, Members of the Subcommittee on Social Security and
Members of the Subcommittee on Income Security and Family Support: This
hearing was called for the purpose of reviewing the Social Security
Administration's response in addressing the critical issue of the
increasing backlogs of disability claims and how additional stimulus
funding could improve service. The National Association of Disability
Examiners (NADE) appreciates this opportunity to submit comments on
this important subject. We have had similar opportunities in recent
years to address this subject before your committees and we commend the
Subcommittees, their respective Chairmen, and their Members for their
continuing oversight of this important issue.
Who We Are
NADE is a professional association whose purpose is to promote the
art and science of disability evaluation. The majority of our members
work in the state Disability Determination Service (DDS) agencies
adjudicating claims for Social Security and/or Supplemental Security
Income (SSI) disability benefits. As such, our members constitute the
``front lines'' of disability evaluation. However, our membership also
includes SSA Central and Regional Office personnel, attorneys,
physicians, non attorney claimant representatives, and claimant
advocates. It is the diversity of our membership, combined with our
extensive program knowledge and ``hands on'' experience, which enables
NADE to offer a perspective on disability issues that, we believe, is
both unique and reflective of a programmatic realism.
NADE members--throughout the DDSs, SSA Regional Offices, SSA
Central Office, ODAR offices and throughout the private sector, are
deeply concerned about the integrity and efficiency of both the Social
Security and the SSI disability programs. Simply stated, we believe
those who are entitled to disability benefits under the law should
receive them; those who are not, should not. We believe decisions on
disability claims should be reached in a timely, efficient and
equitable manner. The continuing backlogs in disability claims are an
embarrassment to SSA, to DDSs, to Field Offices, to ODAR, and they are
a nightmare to those waiting for a decision.
NADE members are very appreciative of the support Members of the
House Ways and Means Committee have provided to SSA for so many years.
Your recognition of the critical need for adequate resources at SSA,
and your willingness to accept a leadership responsibility on this
matter, has resulted in vital funding urgently needed for SSA. We
greatly appreciate the support for funding at a level above the
President's proposed FY 2009 budget and for the $1.092 billion in
funding included for SSA in the American Recovery and Reinvestment Act
of 2009. We hope you will also support the President's FY 2010 Budget
Request of $11.6 billion for SSA's administrative expenses.
The Problem
The Social Security Administration is facing an unprecedented
backlog of more than 1.3 million claims for Social Security and
Supplemental Security Income disability benefits. The backlog of claims
seems to be particularly problematic at the hearings stage, where the
backlogs have more than doubled since 2000--from about 310,000 claims
to more than 765,000--and the average waiting time per claim has soared
to nearly 500 days. Even at the DDS level, where few backlogs are
publicly reported and where the average processing time for an initial
claim is nearly 100 days, the stark reality is that there are
tremendous backlogs pending. Just because disability claims have been
assigned does not mean they are being worked and disability examiners
who carry caseloads two, three and even four times the number deemed
reasonable are, in essence, housing a backlog of claims at their desk.
Unfortunately, this backlog of claims can lead to mistakes in case
development and contribute to mistakes in judgment, resulting in the
potential for erroneous decisions. As we have duly noted in our
previous testimony, the time required to process claims grows longer at
each stage of the claims process and claimants who are denied at the
initial level often find themselves waiting years for a final decision
from the Agency on their appeal. No one within SSA, within the DDSs,
within Congress and certainly no one among the public will claim this
represents good customer service.
Addressing the Backlogs
Addressing the backlogs in disability claims is a high priority for
NADE. However, of equal concern is the average time it takes to process
a claim, now 89 days for an initial claim pending at the DDS and nearly
500 days at the hearing level. Both processing times are too long and
many people suffer needlessly as a result of these backlogs and
extended processing times. Individual conditions can worsen during
these lengthy wait times and can even lead to death. It is critical
that answers be found to effectively resolve the persistent questions
surrounding the backlogs and reducing the average processing time at
all levels in the disability claims process.
In April, 2008, Representative Jim McCrery, a former Chairman of
the Social Security Subcommittee and then its ranking member, offered
the observation that constant under-funding of the disability program
by the Congress over the past two decades had contributed heavily to
the current crisis. Other Members of Congress, including Members of
these Subcommittees, have made similar public comments. These comments
underscore a primary source for the backlogs while the other primary
source has been the hard choices made by SSA during these past two
decades to deal with the realities of inadequate funding and
insufficient staffing levels.
Faced with the reality of under-funded budgets and frequent staff
turnover, caused in part by a heavy retirement wave that swept through
SSA and the DDSs, SSA made some difficult policy and personnel
decisions designed to permit the Agency to deal with the increasing
number of claims with decreasing numbers of personnel. Quite frankly,
many of these decisions did not produce the desired result and the
Agency's ability to deal with the increasing number of claims was
diminished even more so.
The growing complexity of the Social Security and SSI Disability
Programs, coupled with the need to produce a huge volume of work,
justifies even more the need for adequate resources in order to provide
the service that the American public has come to expect and deserves
from SSA. We have noted in the past, and we offer this reminder, that
it takes at least two years for a newly hired disability examiner to
become fully trained and proficient to the point they can function
independently, contributing to the process of making timely and high
quality disability decisions. Thus, decisions not to replace productive
personnel when they leave can take two or more years to correct even
after new hires are made. NADE has long maintained that it is critical
for SSA to be provided with the resources needed to hire and train new
staff that can perform these duties. Low salaries, hiring restrictions
and the stress of the job have contributed to high turn-over in some
DDSs. Given the hiring restrictions and inadequate resources placed on
the SSA and DDSs, it is surprising the disability backlogs are not even
higher than they are and that the number of claims processed has
continued to increase despite inadequate funding and resources.
SSA over the past decade has made at least three distinct attempts
to redesign the disability claims process in an effort to create new
processes that will result in more timely and consistent disability
decisions. Our own Association has been consulted on these efforts and
we have, in the past, offered public comment on the various attempts.
Many of our recommendations, and those of other stakeholders, went
unheeded and the result was often poorly conceived designs and/or poor
implementation with the overall results of these redesign efforts
undertaken by SSA being that they have not produced the results
expected. In fact, in many cases, they have only slowed the processing
of claims while employees adjusted to the constant changes. The impact
of these changes has contributed to the inability to manage the high
workloads experienced in the past decade and contributed to decreased
efficiency of operations. We are pleased the current administration at
SSA has shown an increased willingness to listen to stakeholders and to
incorporate their expertise in their management and policy decisions.
We believe this will have an important impact on the Agency's ability
to handle the backlog of claims.
In FY 2008, Congress appropriated more money for SSA's
administrative budget than the President requested. This was the first
time in 15 years Congress had acted so favorably and we are very
grateful for this support. When one realizes the President's budget has
traditionally been much less than the Commissioner had requested, it is
easy to understand how we arrived at this point and why the backlogs
exist. The congressional action of FY 2008 is the first step in a long
road back to management stability for SSA. The action taken by Congress
regarding SSA's FY 2009 budget demonstrate the ongoing commitment
Congress has made to finding a solution to this crisis. It now falls to
SSA, and its components, to utilize these funds for actions that will
produce the desired outcome. On behalf of our members, and all who have
an interest in the disability program, we thank the Congress for its
financial commitment.
We do wish to caution that congressional and public expectations
cannot be set to high initially. Years of constant under-funding cannot
be undone overnight or in one or two budget years. However, we firmly
believe that the additional funding will allow new hiring of staff and,
where possible and where needed, payment for overtime for staff to
reduce the backlogs.
State Furloughs
We also caution further against increased expectations regarding
the value of additional funding provided by Congress because such
positive action may be negated and, in some cases has already been
negated, by actions taken in some states in their efforts to resolve
their own budget issues. NADE has previously pointed out, and SSA and
other witnesses have also pointed out, that some states have adopted
hiring freezes and furloughs of state employees to reduce their
expenditures. DDS employees, who are 100% federally funded and who have
no impact on a state's budget problems, have not, in most states, been
exempted from these drastic actions in spite of heavy lobbying by SSA
that the states should exempt DDS employees. NADE has previously shared
with the Congress our resolution on the matter of furloughs and hiring
freezes (resolution adopted by NADE January 15, 2009--available for
viewing at www.nade.org).
Recent statistics have shown that applications for initial
disability claims have, not surprisingly, increased by 10% since the
beginning of this fiscal year. Each week, the number of initial claim
filings has increased from the week before and the number of new claims
in calendar year 2009 is up 13.7%. The actions, taken by many states
and being considered by others, have the effect of reducing the size of
the workforce processing these claims or reducing the hours available
for the workforce to process these claims. In effect, these actions
will reverse the action taken by Congress to address the crisis in
backlogs and lengthy processing times. If these state actions are not
abated, then the disabled citizens seeking benefits will almost
certainly face the prospect of even longer processing times and
extended appeal times. We also note that the North Carolina State
Treasurer, Ms. Janet Cowell, commented on March 24, 2009 that furloughs
are not a long term solution and can, in fact, harm a state's financial
stability. Actions that can eventually lead to financial instability
should require more long term examination and we call upon Congress to
intercede on behalf of all state employees who are 100% federally
funded. We recognize difficult times require difficult decisions but
difficult times to not require foolhardy decisions.
Potential Solutions to the Backlogs
NADE strongly believes the Single Decision Maker (SDM)
process can help to alleviate some of the backlogs at the initial level
of case processing. This part of the prototype effort has proven to be
successful in producing high quality decisions and a time saver when
processing claims. SSA should expand the SDM initiative to all regions
and to all case types, not only to reduce initial backlogs, but to
lower processing times at the initial level. We believe that, with the
adoption of national standards for SDM and continued improvements in
the availability of ongoing training for disability examiners, the SDM
can represent part of the solution to the crisis of backlogs and
lengthy processing times at the DDS.

NADE absolutely supports the need for the expert medical advice in
the DDS that is provided by DDS Medical and Psychological Consultants.
However, such advice is best utilized on the more complex cases.
Allowing these medical and psychological experts to invest their years
of training and practical experience on cases where it is truly needed,
instead of being used simply to sign off on simple decisions, can have
a truly positive impact on the quality of the decision-making in the
DDS which can have the positive effect of lowering the processing time
for initial claims and diminishing the backlogs of cases pending at
ODAR.

Continued increases in staffing at the Field Office, DDS,
and ODAR are a necessity for any rational expectation that the SSA can
address the backlogs. It is no coincidence the backlogs have occurred
after a period of downsizing within SSA. Some downsizing occurred as
SSA sought to utilize precious financial resources in other areas
rather than filling vacant positions. With the expectation that new
designs in service delivery would allow the Agency to absorb the
workload with fewer staff, SSA chose to invest its limited financial
resources into technology enhancements. The problem became magnified
when the new designs for service delivery failed to produce the results
forecasted and many of the technology improvements equally failed to
produce the desired results. The Agency was literally caught with no
back up plan in place. Recent actions to appropriate new and additional
funding will likely produce positive results toward reducing the
backlogs but these results cannot reasonably be expected until new
staff has become adequately trained in requisite job skills to produce
at the level necessary to make an impact.
SSA and DDSs will have to initiate the development of a
career path for employees and adopt other employee friendly steps to
reduce the increasing attrition rates that have robbed the Agency of
its program knowledge base. As experienced staff walk out the door,
either due to retirement or because of career changing decisions, SSA
and the DDSs have struggled in many parts of the country to attract the
kind of new hires that will keep the Agency at a level of competence
required in its service delivery. Prior to the recent economic
downturn, DDSs were reporting an annual attrition rate approaching 15%
with more than 22% of newly hired disability examiners leaving by the
end of their first year. The result has been an increasing lack of
experienced personnel to process increasingly more complex disability
claims and forcing the DDSs to utilize limited training funds to
continually hire new staff, rather than provide ongoing training for
existing staff. While anecdotal evidence suggests this level of
attrition has diminished as a result of the economic downturn, it is
reasonable to expect that, without proper planning and the development
of proper career paths, the attrition will resume once the economy
rebounds.

NADE believes additional staff is needed in SSA's Field Offices and
tele-service centers. These are the ``Front Doors'' of SSA and people
walking through these doors deserve the kind of service one should
expect from SSA. Allowing phones to go unanswered and/or requiring
people to wait so long in SSA's Field Offices that many give up and
leave because there are insufficient number of people to answer the
phones or help them fill out the proper forms, is not the way
government should serve the people. It is certainly not the level of
customer service the Agency desires to provide. Field Office personnel
also perform a valuable service in maintaining program integrity.
NADE believes additional hiring is needed at the ALJ level, both in
terms of support staff as well as the need for additional
administrative law judges. We are pleased to see SSA has recently
announced plans to hire additional staff at this appellate level and we
caution that these additional hires, while expected to contribute to a
reduction in the backlogs, will need time to become sufficiently
trained and adequately prepared for the task.

SSA's continued investment in technology enhancements
will have an impact on the overall quality of the program and can be
expected to produce a positive impact on reducing the backlogs. New
initiatives in the exchange of health information technology (HIT),
development of a new national computer data center, and other steps to
modernize the Agency's technology infrastructure will be expected to
have a positive impact on the Agency's ability to address the crisis of
backlogged claims.
The increase in applications at the initial level and the
increase in appeal filings can be expected to continue as long as the
economy is in its current state of crisis. However, we believe the
actions taken by Congress and this Administration will lead to a
revitalization of our national economy and will, in turn, lead to a
subsequent decline in the number of disability applications to a more
normal level.
Other actions, such as shifting workloads to less busier
offices, have been made possible by the technological improvements to
date and we expect additional positive action in this regard. With
fewer staff available, SSA has deferred some workloads. Although we
caution this practice can have future negative consequences, it does
enable the limited staff available currently to focus their efforts and
concentrate on the backlogged claims.

One Member of this Subcommittee posed the question, ``We give them
the money, why can't they fix it?'' The obvious answer, which we hope
we have addressed, is that two decades of under-funding cannot be
corrected in one or two fiscal years. We appreciate Congress now
recognizes it has contributed to the problem and has acted to
appropriate additional funding to correct past mistakes. We fully
believe positive change will occur but it will not occur overnight and
we ask that Congress and the American public to be patient while SSA
acts to coordinate new levels of funding with appropriate management
decisions regarding how this funding should be allocated. We encourage
these Subcommittees to continue to provide the necessary oversight
needed to insure that these funds are spent appropriately.
Continuing Disability Reviews (CDRs) and Program Integrity Issues
Limited resources in recent years have forced SSA to reduce the
number of CDRs performed. Of concern to NADE is the past history of
these types of actions and the resultant impact as the agency falls
behind in these critical reviews. When a backlog of CDRs occurred
previously it took a great deal of effort by all components of SSA to
reach a point where CDR reviews were being conducted as scheduled. It
took a significant number of years of dedicated funding solely for the
purpose of conducting CDRs before SSA was current with CDR reviews.
With the decrease in the number of CDR reviews done in the past few
years, there is now a real danger the Agency will, once again, find
itself in the position of having backlogs of overdue CDRs. Thus, it is
possible the Agency will work itself out of one backlog into another.
While there are increased administrative costs (including the
purchase of medical evidence, claimant transportation costs and
increased utilization of contract medical consultants) with the
performance of CDRs, there is a potential for significant savings in
program costs with the elimination of benefits paid to beneficiaries
who are found to be no longer eligible for disability benefits due to
no longer meeting the SSA Disability program requirements. The estimate
is that for every $1 in administrative cost spent on conducting CDRs,
$10 of program funds is saved. This historical ratio of 10-1 was
evidenced most recently when, in FY 2008, SSA spent $281 million to
conduct a limited number of CDRs, with eventual cessation of benefits
for 36,000 individuals, leading to program cost savings of $3.3
billion. While NADE agrees that it was necessary to decrease the number
of CDRs done over the last couple of years given the status of SSA's
budget and the need to utilize staff to process other case types, this
decision has repeatedly been described by many, including a former SSA
commissioner and members of this committee, as ``penny-wise and pound-
foolish''. It is essential to program integrity that CDR reviews be
conducted in a timely manner to ensure that only those who continue to
be eligible are receiving disability benefits. Dedicated funding has
been shown to be the best means of SSA staying current with the CDR
workload. NADE encourages this committee to recommend appropriating
dedicated funding for CDRs to ensure this workload gets the attention
it deserves.
Anti-fraud efforts such as the Cooperative Disability Investigative
(CDI) units which effectively utilize the strengths and talents of OIG,
disability examiners, and local law enforcement, offer a visible and
effective front-line defense for program integrity and serve as a
visible and effective deterrent to fraud. SSA's Inspector General
attributed the success of the CDI units to investigate fraud
allegations to the efforts of, ``. . . those most qualified to detect
fraud--DDS adjudicators.'' NADE supports the continued expansion of the
CDI units to combat fraud and abuse in the disability program. An
experienced disability examiner can be one of the most effective
deterrents to fraud and abuse. NADE urges Congress and SSA to take
appropriate action to ensure the experience level in the DDSs can be
maintained.
5 Month Cash Benefit Waiting Period and 24 Month Medicare Waiting
Period
It is important to note that in Title II disability claims, persons
found disabled under the Social Security Disability program must
complete a full five month waiting period before they can receive cash
benefits. So, a disability allowance decision, even when it is
processed quickly, will not resolve the issue of having to wait five
full calendar months before the claimant will be able to receive any
cash benefits. NADE believes that requiring some individuals (Title II
claimants) to serve a waiting period before becoming eligible to
receive disability cash benefits while not requiring others (Title XVI
claimants) to serve the same waiting period is a gross inequity to
American citizens with disabilities.
We are also deeply concerned about the hardship the 24 month
Medicare waiting period creates for these disabled individuals, and
their families, at one of the most vulnerable periods of their lives.
Most Social Security disability beneficiaries have serious health
problems, low incomes and limited access to health insurance. Many
cannot afford private health insurance due to the high cost secondary
to their pre-existing health conditions.
It has been proven time and time again that earlier medical
intervention could help disabled individuals return to the workforce.
Therefore, NADE supports the total elimination of, or at least
substantial reductions in, the Five Month Waiting Period for Cash
Benefits and the 24 Month Waiting Period for Medicare eligibility.
Summary
The operational challenges facing SSA are substantial and are
expected to become even more acute in the coming years as our society
ages, as baby boomers continue to prove the actuaries correct regarding
their forecasts of the baby boomers most disability prone years, as the
economy continues to offer periodic setbacks, etc. Decades of
inadequate resources for SSA, combined with increased workloads and
less than desirable results from multiple redesign efforts, have not
only caused backlogs in the number of disability claims pending at the
initial and hearing levels, but has allowed existing backlogs to
increase. Processing times, expected to decline with the introduction
of new technology have, instead, increased due to sufficient resources
in personnel.
Recent increases in funding for SSA's administrative budget can be
expected to produce reductions in the Agency's backlogged claims and
lead to improvements in processing times at all levels. However, this
new funding cannot, and will not, overnight, make up for mistakes of
the past. The need to hire, train and deploy new staff will take
several years before any realistic expectation that they will
contribute significantly toward efforts to reduce the backlogs of
claims. A variety of management strategies can be utilized to help
diminish the backlogs and produce the desired improvements in
processing time but these strategies will have future consequences.
No amount of planning by SSA can reverse the negative impact on
production and processing times caused by state hiring freezes and
state employee furloughs that affect DDS personnel. Congress must
support the Commissioner's efforts to force the states to exempt DDS
employees, who are 100% federally funded, from state hiring freezes and
furloughs of state employees.
The crisis of backlogged disability claims, while a significant
problem, cannot be used as a reason to abandon program integrity
initiatives. It remains critically important that the public's
confidence in the disability program not only be restored but
maintained.
A lot of effort has been made to improve the speed at which
disability claims are processed and to eliminate/reduce the backlogs of
claims. NADE agrees improvements are needed. However, we wish to remind
the Members the 5 month waiting period for cash benefits and the 24
month waiting period for Medicare eligibility will negate the positive
impact of faster processing times and reduced backlogs. These waiting
periods should be eliminated or significantly reduced.
No other agency has a greater impact on the quality of life in this
nation and the American public will judge the ability of their
government to meet their needs almost solely by the quality of service
provided by SSA. Social Security can and must do better in fulfilling
its promise to America and NADE stands ready, willing, and able to
assist in fulfilling that promise. People with disabilities, already
burdened by the challenges of their illness/injury, are often in
desperate need of benefits to replace lost income. They deserve, and
should receive, timely and accurate decisions through a fair and
understandable process. Our challenge, and one which must be met, then
is to ensure the disability determination and appeals process meets
those criteria.

Statement of James F. Allsup, President, CEO and Founder of Allsup
Chairman Tanner, Chairman McDermott, and Members of the
Subcommittees meeting in a joint hearing today, thank you for
considering my written testimony regarding the Social Security
Administration's massive disability claim backlog.
My name is James Allsup and I am the founder, president and CEO of
Allsup, the country's largest non-attorney Social Security Disability
Insurance (SSDI) representation company. We have helped more than
110,000 individuals obtain disability benefits since 1984.
The focus of today's hearing is the SSDI system's immense
``official'' backlog, which to date has been ably chronicled by members
of Congress and the nationwide media. To get a true handle on the
situation, however, much more attention needs to be paid to the even
bigger problems that are looming.
A Growing Pre-Backlog Crisis
One way to think of the SSDI backlog is as a backed-up highway
tollbooth plaza. Even if you add more lanes or find technological
ways--like E-Z Pass--to speed cars through the tolls, you won't break
the blockage if too many other drivers are flooding the highway to take
their place.
This is the situation now facing the Social Security
Administration. Almost three-quarters of a million people with severe
disabilities and without jobs are waiting for the hearings generally
required to receive benefits. Unfortunately, behind that group, another
half million applicants were already moving into the system's ``pre-
backlog'' of claims last year. The irony is that after a very, very
long wait with at least one rejection, most eventually will be awarded
the benefits they deserve.
Social Security employees are working as hard as they can to help
people who deserve care, but there is simply no way for them to keep up
when so many individuals with disabilities are ready to take the place
of those who get through the system.
Recession Increases the Challenge
The recession is making things even worse. Allsup recently reviewed
data from recessionary periods during the past 40 years and found that
Social Security Disability Insurance claims typically increase when
times get tough.
The 40-year analysis includes the current recession, which began in
December 2007, according to National Bureau of Economic Research data.
Applications have increased during six of the seven recessions in that
timeframe (January 1980 to July 1980 being the lone exception).
Overall, the number of disabled workers applying for Social Security
Disability Insurance grew to 2.3 million from 725,200 in 1969.
The current period is following that pattern. Commissioner Michael
Astrue stated earlier this year that his agency is facing an
unanticipated 10 percent increase in its disability claims caseload.
That's 250,000 additional cases the SSA needs to review, further
bogging down the system.
At this point, there are those who would write those increases off
as simply a problem of fraud. They ask, fairly, why someone who was
truly disabled did not apply for benefits before the job market slowed
down and it became much harder to find work.
Unqualified applicants certainly can place a burden on the system,
although there is a difference between individuals with disabilities
who do not understand the technical requirements for eligibility, and
out-and-out fraud. This is one way companies like Allsup help the SSA.
Our system pre-screens applicants to ensure likely eligibility before
they submit their claims.
However, it is not true that the recent application increase is
simply an issue of fraud. As tough as the disability application
process is, it's no surprise so many people try to avoid it at all
costs. A process that involves years of tests, hearings and mountains
of complicated paperwork--all for an uncertain promise of help that
could be years away--is not something most people will cheerfully take
on.
But when the economy takes a sharp downturn, new financial strains
can force some people to realize they can no longer afford to live
without the disability benefits they are owed. They may have been
struggling to keep working with a progressive health problem and now
lost their job. Perhaps the spouse who had been supporting the family
suddenly loses his or her job.
The sad truth is that the current economic downturn will affect the
system for years to come. Today's new applicants are tomorrow's
backlog.
Searching For Solutions
Over the long run, additional resources for the SSA are needed to
meet the backlog challenge. Unfortunately, the ``long run'' won't help
many of today's applicants. The good news is that a simple, cost-free
step could make an immediate difference in the problem.
Because applicants often don't know help is available, too many
initial claims are denied for simple mistakes that have nothing to do
with the applicant's disability status. In other cases, applicants who
don't meet the standards for disability--but might if their conditions
worsen over time--bog down the system when a simple pre-screening
qualification process would let them know they aren't ready yet.
Congress and the President should therefore immediately direct the
Social Security Administration to notify applicants that they have
options for getting help in pursuing their claims. This includes
``outside help,'' from organizations like Allsup or attorneys.
This really isn't an unusual concept as expert disability
representatives work very much like professional tax preparers to help
guide applicants through a government approval process, comply with the
rules and laws, and get the benefits they deserve. By the time
applicants reach the hearing level, about 90 percent are receiving
assistance. Disability representatives can help solve the SSA's growing
pre-backlog problem by working to ensure more applicants have help from
the beginning. The Internal Revenue Service has for many years
supported the concept that outside assistance is valuable to both the
individual and the agency. The same approach could work well for the
SSA.
In addition, the SSA could attack the backlog directly by
increasing the use of on-the-record hearing decisions for qualified
claimants, which eliminate the need for oral hearings in two-thirds of
our cases. Allsup pioneered the use of on-the-record hearing decisions
for qualified claimants. When an on-the-record hearing decision is
warranted, we prepare all the evidence, write the legal brief and
submit a well developed and accurate claim to a judge for a decision.
This process has been effective for moving qualified claimants
through the process. Approximately 70 percent of Allsup claims that
reach the hearing level are approved on the record. Judges are able to
make sound, informed decisions and cut off months in the processing
time of an application. Not only does the individual avoid the hearing
backlog, the decision is made quickly.
Collaboration, Not Privatization
I emphasize that this proposal is not a step toward privatization.
It is a way for government to leverage the existing capabilities of
expert disability representatives to immediately and positively affect
the disability backlog.
Literally hundreds of thousands of government worker-hours could be
saved if every application processed by the Social Security
Administration was professionally documented before it was submitted.
Chairman Tanner, Chairman McDermott, and Members of the
Subcommittees, I commend you for holding this hearing to raise
awareness of these issues. Thank you again for the opportunity to
provide testimony. I look forward to working with you to address this
growing crisis.

Statement of John Yent, Louisiana Committee of
Social Security Vocational Experts
My name is John Yent. I want to thank the Subcommittee for inviting
public comment on the record for the March 24, 2009 hearing on the
Social Security Administration's efforts to address the disability
hearings backlog. I am submitting this letter on behalf of the
Louisiana Committee of Social Security Vocational Experts (LCSSVE). The
issues which you will discuss on March 24th are of great importance to
claimants, to beneficiaries, their representatives, Administrative Law
Judges (ALJs) and the independent Social Security Vocational Experts
(SSVEs or VEs) who are an integral part of the disability adjudication
process.
The Louisiana Committee of Social Security Vocational Experts is a
group of independent vocational experts who provide vocational evidence
in proceedings before the Social Security Administration (SSA) Office
of Disability Adjudication and Review (ODAR). Our current membership of
33 VEs in Louisiana, shares the goals and concerns of more than 100 VEs
in Region 6 of SSA and approximately 800 VEs nationwide. We are
committed to the highest quality vocational expert services in these
critical proceedings.
I am the Coordinator of LCSSVE. While recently undertaking this
position, I have also provided vocational expert services to SSA/ODAR
since 1997 and I have provided VE testimony in more than 3,500 Social
Security disability hearings. My experience in private practice
vocational rehabilitation and expert witness services includes
thousands of clients since 1986. I have evaluated and assisted clients
with the full spectrum of vocational rehabilitation services and job
placement in the labor markets of Louisiana, Texas, Mississippi,
Alabama and California. Beyond a Bachelor's and Master's degree, I am a
Louisiana Licensed Rehabilitation Counselor (LRC), nationally board-
certified as a Certified Rehabilitation Counselor (CRC), and Diplomate
of the American Board of Disability Analysts. All of the members of
LCSSVE are similarly qualified and provide services to SSA/ODAR at
hearing offices located in Alexandria, Metairie, New Orleans, and
Shreveport, LA. We are proud partners with SSA.
VEs are closely following developments at SSA, ODAR, and the budget
affecting the disability backlog. We understand the enormity of the
task facing ODAR adjudicating the disability backlog of over 700,000
claims as well as the pressures on Hearing Offices to produce
decisions. Increased utilization of VEs is essential to reducing that
backlog.
As you know, VEs fulfill an important statutory role in the
disability adjudication process \1\ We provide the expert opinion and
testimony at disability hearings which includes assessment of a
claimant's work history, analysis of claimant's transferable skills to
do other potential work, as well as current statistical data on
availability of other work in the national and regional economy. We
offer testimony in response to any number of hypothetical questions
posed by the Administrative Law Judge, the claimant's attorney/
representative, as well as the claimant. We also provide expertise in
the form of interrogatories posed by Administrative Law Judges and
Senior Attorneys with ODAR which expedite claims, often making a
hearing unnecessary. VEs have a substantial impact on the decision-
making process affecting billions of dollars in disability benefits and
are essential for ODAR to accomplish its mission. In order to do this,

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\1\ 20 CFR Sec. Sec. 404.1566(e), 416.966(e); SSR 00-4p.
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Having enough VEs for all of the adult disability hearings ODAR
needs to schedule is a function of VE availability and of VE
compensation. Examining the rosters, VEs are committed to SSA as
evidenced by years--often decades--of reliable service each. VEs still
on the rosters have continued to schedule hearings. The decision to be
available for ODAR work has grown more difficult each year since 1972
\2\ when the current fee schedule was introduced. In the same time
frame of 1970-2008, Congress approved pay increases for itself 21
times.\3\ SSA employees and beneficiaries have received numerous
increases in this period as well, deservedly so. SSA has also approved
compensation increases for claimant representatives several times, with
another approved for June 2009.\4\ The only group not receiving a labor
market cost adjustments as of March 18, 2009 is--ironically--the very
labor market experts SSA retains to provide vocational testimony. For a
VE to be available for ODAR hearings (payable at the 1972 compensation
rates) means that the VE is turning down VE work in other non-SSA
venues payable at 2009 market rates. Each year that market rates climb
further away from SSA rates, highly experienced and exceptionally
qualified VEs leave. The choice to stay is unsustainable long-term.
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\2\ 1972 is an estimate of its introduction. Official SSA
Historian, Mr. Larry DeWitt, has not located this schedule's debut
date.
\3\ See Attachment 1: ``Congressional Pay Raises: 1789-2008''
\4\ National Organization of Social Security Claimant
Representatives website update (nosscr.org) February 11, 2009.
---------------------------------------------------------------------------
The VE/ME Workgroup examined VE qualifications and market rates for
their services. VEs have graduate-level degrees, maintain professional
continuing education, national board certifications in our field, have
state licensure (where required) and are practicing vocational
rehabilitation counselors with ample private sector work (personal
injury litigation, worker's compensation, etc.). The ODAR disability
adjudication process benefits from the knowledge base of VEs both from
their private sector experience as well as experience in typically
thousands of ODAR hearings. As with any occupational group, the number
of individuals who hold themselves out as experts in the field and can
function in a judicial setting to qualify as an expert witness is less
than 1%.
Retention of experienced VEs must become a priority. It is our
understanding that Federal agencies should establish contract pricing
per regulatory guidance using a variety of sources and techniques.
Selected price methods and reasonableness of contract rates must also
be documented.\5\ Further, we understood that the Contracting Officer
and Project Officer are responsible for research and obtaining pricing
data.\6\ Having researched the history of VE fees, we identified only
one report. The Inspector General last produced a report on VE and ME
fees in 2001 referencing FY 1999.\7\ At that time, ODAR (then Office of
Hearings and Appeals, ``OHA'') had BPA contracts with 1,337 VEs
nationwide. Payments to VEs were $21.6 million dollars or about 3.1% of
OHA's then budget of $687 million dollars for FY 1999. ODAR's
administrative budget has expanded vastly since 1999; VE fees are
unchanged.
---------------------------------------------------------------------------
\5\ 48 C.F.R. Sec. Sec. 15.402(a)(1), 15.403-1(c)(1), 15.406-2 and
15.406-3.
\6\ Social Security Acquisition Regulation System, Subpart
H2301.102-4(c)(1)(i).
\7\ See Attachment 3:Inspector General Report A-06-99-51005,
``Vocational Expert and Medical Expert Fees,'' dated 8/21/2001).
---------------------------------------------------------------------------
More recently, a consultant report commissioned by SSA in 2006 and
presented in 2007 suggests that the future direction of the
adjudication process by ODAR involves expansion of the vocational
expert role in a ``medical-Functional/Vocational'' (mFV) model \8\ The
authors of that report opined,
---------------------------------------------------------------------------
\8\ ``Use of Functional/Vocational Expertise'' Project report dated
5/11/2007 (SSA Contract #SS00-06-60072) submitted to Robert Pfaff, SSA
Project Coordinator, by Jennifer Christian, MD, MPH, Project Director
of the SSDC Webility Project Team.
---------------------------------------------------------------------------
``To ensure that enough qualified mFV experts are interested in
participating, and also that a suitable mix of professions is
interested, increase the fees paid to be reasonably competitive with
open market rates. The project panel believes that if fees are set
similar to current VE payment rates, SSA is very unlikely to obtain the
experts needed. Consider varying rates based on profession, expertise
level, tasks done, and prevailing regional fee levels.''
In real terms, the number of VEs has been steadily dropping with
fewer highly experienced VEs choosing to renew their BPA contracts with
SSA due to the stagnation of the VE fee schedule. It is clear that VE
services are statutorily required and are actively sought out by
Administrative Law Judges as VE testimony is essential at Steps 4 and 5
of the disability sequential evaluation process. However, the
disability backlog will continue to grow if fewer experienced VEs are
available to be scheduled for those hearings.
We applaud the leadership of Social Security Commissioner Michael
Astrue to bring funding requests to the attention of Congress. The
testimony last spring of Chairman Sylvester J. Schieber of the Social
Security Advisory Board, to the Committee on Ways and Means, provided
compelling evidence for greater SSA and ODAR funding, and for
improvements to be made.\9\ Also in testimony again before Ways and
Means in September 2008, ODAR's Chief Administrative Law Judge, the
Honorable Frank A. Cristaudo,\10\ further underscored the point that
hearing office productivity is critical and staff attrition at all
levels must be addressed with adequate funding.
---------------------------------------------------------------------------
\9\ Statement of Sylvester J. Schieber, Chairman of the Social
Security Advisory Board, to the Committee on Ways and Means on April
23, 2008 ``Clearing the Disability Backlog--Giving the Social Security
Administration the Resources It Needs to Provide the Benefits Workers
Have Earned.''
\10\ Statement of Frank A. Cristaudo Chief Administrative Law
Judge, Office of Disability Adjudication and Review, Social Security
Administration, testimony before the House Committee on Ways and Means
Subcommittee on Social Security, September 16, 2008
---------------------------------------------------------------------------
VE funding has not been mentioned in any testimony records we
identified.
As Chief Judge Cristaudo made clear, despite the best technology,
and 175 newly hired judges in 2008, hearing offices still require
appropriate staffing levels at all levels. Adjudication requires Judges
to obtain vocational evidence from a VE at sequential evaluation steps
4 and 5, therefore appropriate budgeting for VEs is as important as
funding for Judges, Senior Attorneys, Decision Writers, Schedulers,
Clerks and Hearing Reporters.
The Louisiana Committee of Social Security Vocational Experts
respectfully requests the support and backing of the Ways and Means
Subcommittee on Social Security, the Social Security Advisory
Committee, the Social Security Administration and the Office of
Disability Adjudication and Review to ensure the retention of
experienced and qualified VEs to assist with the disability
adjudication backlog. VE fees commensurate with market rates for VE
services would ensure continued and expanded VE availability.
We enjoy our excellent working relationship with the Social
Security Administration, the Office of Disability Adjudication and
Review, and look forward to continuing that relationship for many years
to come. Your response to these concerns is much anticipated and
greatly appreciated.
In conclusion, we thank you and all members of this Subcommittee
for your interest in these issues. I would be pleased to respond to any
questions you may have.

Sincerely,

John M. Yent, MA, LRC, CRC, CLCP, ABDA
Coordinator, LCSSVE

c.c.:

The Honorable Michael J. Astrue
Commissioner of Social Security
Social Security Administration
6401 Security Blvd.
Baltimore, MD 21235-0001

The Honorable David V. Foster
Deputy Commissioner,
Office of Disability Adjudication and Review
Social Security Administration
5107 Leesburg Pike
Falls Church, VA 22041

The Honorable Robert E. Emrich, Jr.
Associate Commissioner,
Office of Medical and Vocational Expertise
Social Security Administration
Oak Meadow Building
6340 Security Blvd.
Woodlawn, MD 21207

The Honorable Mary Landrieu
United States Senate
328 Hart Senate Office Building
Washington, D.C. 20510-1803

The Honorable David Vitter
United States Senate
516 Hart Senate Office Building
Washington, D.C. 20510-1804

The Honorable Charles W. Boustany, Jr.
United States House of Representatives
1117 Longworth House Office Building
Washington, D.C. 20515-1807

The Honorable Steve Scalise
United States House of Representatives
429 Cannon House Office Building
Washington, D.C. 20515-1801

The Honorable Joseph Quang Cao
United States House of Representatives
2113 Rayburn House Office Building
Washington, D.C. 20515-1802

The Honorable Charlie Melancon
United States House of Representatives
404 Cannon House Office Building
Washington, D.C. 20515-1803

The Honorable John Fleming
United States House of Representatives
1023 Longworth House Office Building
Washington, D.C. 20515-1804

The Honorable Rodney Alexander
United States House of Representatives
316 Cannon House Office Building
Washington, D.C. 20515-1805

Statement of Joyce R. Shoop
I am a Vocational Rehabilitation Counselor working under contract
to the North Dallas Office of Disability Adjudication and Review (ODAR)
to provide Vocational Expert testimony in Social Security Disability
Hearings. I have worked for SSA/ODAR for the past 17 years and have
seen how the expertise of VE's has helped move the cases along toward
resolution. I have noticed that in the past few years there have been
more and more hearings in which the onset dates have been 1995 to 2000.
These cases were still not decided after 8-14 years! In many cases,
there were no experts on the cases when they were originally heard by
the Administrative Law Judges, and had been remanded--in some cases,
more than once. I understand the anguish this causes the applicant for
benefits and the high cost associated with multiple remands. With the
use of Vocational and Medical Experts, these cases can be adjudicated
much more quickly and efficiently. It is my understanding that your
committee is now addressing the problem of the enormous backlog of
Social Security cases in order to decide how to resolve the issue and
get the cases moving.
I would like to suggest that your committee consider how Vocational
Experts can help in resolving this problem, and would like to call to
your attention a situation that needs resolution regarding VE fees,
which should free up our time to work more with the ODAR offices. As
our fees are now, none of us can afford to work for SSA more than a few
days per month because our other work pays two to four times more.
SSA's fee schedule for Vocational Experts has remained unchanged since
1972. A VE in 2009 is paid the exact same amount for services as a VE
was paid in 1972. The current fee schedule is so old that even the
official SSA Historian, Mr. Larry DeWitt, is unable to find the
original ``debut'' date of the schedule. It is truly mind-boggling that
any fee increase has been postponed for 37 years but it remains an
undisputed fact. VEs began to organize a collective response to SSA
approximately six years ago. SSA formed a VE/ME Workgroup to explore
fee issues. By mid 2008, a preview of the new fee schedule indicated
the increase was approved by SSA for the next VE contracting term set
to coincide with FY 2009 (10/1/2008). In August 2008, the VE contract
offer from SSA included the fee increase. I was so pleased, and
completed my packet and submitted it promptly. Sadly, I was told in
September that the fee increase had been put on hold and we would be
getting an extension of our old BPA (Blanket Purchase Agreement).
Realizing that SSA was operating under a continuing resolution with no
approved budget for FY-09, I remained hopeful for the increase to come
through when Congress passed a budget. I did receive an extension of my
BPA for Oct.-Dec., and in December received another extension through
March. Then in January, I received a new BPA application with the fees
back at the old rates from 1972. Before completing the packet, I was
told to disregard it, and wait for another packet (hope returned!).
Then in March 2009, I received another application packet again
reinstating the 1972 rates, and taking away mileage and parking
reimbursement unless we travel over 50 miles--a reduction in our
contract! In addition, language was removed requiring a professional
degree (Master's or above) and licensure or national certification,
which has always been the professional standard for service as a VE.
This is further evidence of the lack of value that SSA places on the
expertise that VE's possess. Without this expertise, judges may make
poor decisions based on poor quality testimony of less qualified
``experts.'' With this ``slap in the face'' for VE's many are deciding
NOT to renew their contracts and discontinue working for SSA/ODAR. In
view of the landmark appropriation which SSA received for FY 2009 and
the further projected 10% increase for FY 2010, there is no excuse for
VEs to go any longer without the appropriate fee increase. I believe
that if this increase is approved, we will see greater availability of
well qualified VE's and faster movement of cases through the
adjudication system. Thank you for considering this recommendation of
the VE/ME fee increases as part of your deliberations in your
subcommittee hearing.

Respectfully Submitted:

Joyce R. Shoop, M.S., LPC, CRC
Vocational Rehabilitation Counselor/Vocational Expert
8350 Meadow Rd., Dallas, TX 75231
joyshoop@sbcglobal.net

Statement of Linda Fullerton
My name is Linda Fullerton, President/Co-Founder of the Social
Security Disability Coalition, and it is with great sadness, anguish
and despair that I submit this testimony to you today. I watched this
entire hearing on the internet and as always, it was a source of major
frustration for me.
Call For Open Congressional/SSA Disability Hearings
I was forced to watch this hearing on the internet, because my
repeated requests over the last several years to testify in person,
have been blatantly ignored. I have made it very clear in previous
written testimony submitted for the hearing record, through faxes, e-
mails and phone calls, to all the Congress people in my district,
others on this Subcommittee, and many others in both the House and the
Senate Committees that affect the Social Security Disability Program in
any way, that I want to testify in person at these important hearings
that directly affect me and others like myself. For some reason beyond
my comprehension, you still will not let me do that. I have been
following these hearings, for over five years now, and I find it deeply
disturbing, and glaringly obvious, that not one panelist/witness
selected to appear, is an actual disabled American who has tried to get
Social Security Disability benefits, and who has experienced this
nightmare for themselves. Unfortunately this continues to be the case
with this hearing as well. While the witnesses you continually rely on
may be very reputable in their fields, unless you have personally tried
to file a claim for Social Security Disability, you cannot begin to
understand how bad this situation really is, and therefore the
panelists you continue to rely on are not fully qualified to be the
only authority on these issues.
As a result of my repeatedly denied requests to testify, it is my
opinion, that you don't want to know what is REALLY going on. I heard
references during this hearing to a CBS news report from January 2008
which tried to expose some of the problems you have come here to
discuss today. What I am sure you are not aware of, is that I
personally was the source that initiated that whole investigative
report, and since due to time constraints my interview air time was so
limited, I plan to release my own video in the coming weeks on the
internet, to alert the American people to the ugly realities of what it
is like to try and get the SSDI benefits that they have been forced to
pay for, and may never survive to actually collect. They need to know
how the Federal Government continually breaks its social contract with
them on a daily basis. It seems to me that if you do not have to face
someone such as myself, that has barely lived through this horrible
nightmare, and has had their whole life permanently devastated as a
result of continued neglect of this program, we remain just a bunch of
SS numbers whose lives can be destroyed without guilt. We are in fact,
your mothers, fathers, sisters, brothers, children, grandparents,
friends, neighbors, and honorable veterans who have served this
country. Something is severely wrong with this picture!
When you question the SSA Commissioner at these hearings, why have
you not ordered him to provide the data on how many Americans have
actually died each year, or have been forced to use state provided
services, while waiting for their SS Disability claims to be processed?
Since the SSA also pays out a one time death benefit to a survivor's
family, and contracts out the medical portion of disability claims to
the states who provide the Social Service programs that disability
applicants often need to use, this data should be readily available if
you bothered to ask for it. These are important questions that need to
be answered, but it seems to me you don't care enough about the
disabled to ask them. How can you get an accurate handle on this
situation without all the facts and appropriate witnesses who wish to
testify? Who better to give feedback at these hearings than those who
are actually disabled themselves, and directly affected by the
program's inadequacies! It seems you have forgotten that WE are the
customers, and the SSA and Congress work to serve us.
I find it hard to believe that these hearings cannot be scheduled
in such a way that different and more appropriate witnesses could be
allowed to testify. If you continue to do the same thing over and over
again, as you have for the past several years, you will continually get
the same poor results, which is exactly what is happening. You ask the
same questions, of the same people, and wonder why there is little to
no, improvement between hearings. There is a major piece of the puzzle
missing--the customers you have been elected to serve--and until you
really commit to getting the ALL the information needed to fix the
Social Security Disability program, you are making decisions based on a
lack of important information, which can be very detrimental, and the
problems are going to continue to escalate, no matter how much money
you put toward fixing them. As an actual disabled American, I ask again
today, as I have in the past, that in future Congressional hearings on
these matters, that I be allowed to actively participate instead of
being forced to always submit testimony in writing, after the main
hearing takes place. I often question whether anybody even bothers to
read the written testimony that is submitted when I see the continued
lack of results after previous hearings. I am more than willing to risk
my very life for the opportunity to testify, should I be permitted to
do so, since I believe so strongly in the importance of this program.
In fact, I ask that you call another hearing, and allow me to be the
sole witness, since the eye opening information I have to share with
you would fill the entire 1-2 hours, since this program is so badly
broken, and filled with corruption at every level. I have also come up
with solutions to all the problems as well, which I would also be
discussing at that time.
I want a major role in the Social Security Disability reformation
process, since any changes that occur have a direct major impact on my
own wellbeing, and that of millions of other disabled Americans just
like me. I also propose that Congress immediately set up a task force
made up of SSDI claimants, such as myself, who have actually gone
through the claims process, that has major input and influence before
any final decisions/changes/laws are instituted by the SSA Commissioner
or members of Congress. This is absolutely necessary, since nobody
knows better about the flaws in the system and possible solutions to
those problems, then those who are forced to go through it and deal
with the consequences when it does not function properly.
Social Security Disability Nightmare--It Happened To Me!
Social Security Disability is an insurance policy which was created
to be a safety net for millions of disabled Americans, and for many
such as myself, it has become their only lifeline for survival. I have
an inoperable blood clot and tumor in my brain, and suffer from several
incurable autoimmune disorders that are too numerous to list, which
have caused me to become permanently disabled and my condition
continues to deteriorate by the day. I currently receive Social
Security Disability Insurance/SSDI and Medicare. You can get even more
detailed information about my personal horror stories, which are not
for the faint of heart, on my websites:

``A Bump On The Head'' http://www.frontiernet.net/lindaf1/
bump.html Social Security Disability Nightmare--It Could Happen
To You! http://
www.frontiernet.net/lindaf1/
SOCIALSECURITYDISABILITYNIGHTMARE.html

I filed an SSDI claim in December 2001, was denied in March 2002 by
the NYS ODTA (Office Of Temporary And Disability Assistance), filed an
appeal, and then had to wait until June 2003, due to the severe hearing
backlog in the Buffalo NY Office Of Hearings & Appeals, before my SSDI
claim was finally approved.
Permanent Devastation Resulting From The SSDI Claims Process
Unbearable stress, severe depression and suicidal thoughts are very
common side effects of the disability claims process. I know this not
only from my own personal experience, but from thousands of others that
have contacted me to tell me their horror stories. The abuse and worry
that applicants are forced to endure, causes even further irreparable
damage to their already compromised health, and is totally
unacceptable. Due to the total devastation on their lives and health as
a result of the SSDI claims process, use of the SS Ticket to Work
program, or any future chance of possibly getting well enough to return
to the workforce, even on a part time basis, becomes totally out of the
question. Plus there is always the stress of having to deal with the SS
Continuing Disability Review Process every few years, where the threat
of having your benefits suddenly cut off constantly hangs over your
head.Many are under the mistaken notion that once the SSDI benefit
checks come, if one is finally approved for disability benefits, that
everything will be OK. Often the devastation caused while waiting for
SSDI claims to be processed leaves, permanent scars on one's health and
financial wellbeing as it did for me. Even though I won my case, I
continually deal with enormous stress and face the continued looming
threat of bankruptcy and homelessness, due to the cost of my healthcare
and basic living expenses, and I do not qualify for any public
assistance programs. After almost dying, and continuing to battle
several incurable diseases, I had to wipe out all my life savings/
pension money, and will never be able to recover from the financial,
physical and emotional devastation that was caused, due to the enormous
wait for my SSDI claim to be processed. Due to the 24 month waiting
period for Medicare, (I didn't become eligible for it until June 2004)
I had to spend over half of my SSDI check each month on health
insurance premiums and prescriptions, not including the additional co-
pay fees on top of it. All the SSDI retro pay is gone now as well--used
to pay off debts incurred while waiting for 1\1/2\ years to get my
benefits, and even though I am now receiving my monthly SSDI checks
benefits, they are no where near enough to live on for the rest of my
life.
It is hard enough to deal with all the illnesses that I have, but
then to have my entire life destroyed with the stroke of pen by a
neglectful government employee, to whom I was just an SS number, is
more than I can bear. So now, not only will I never recover from my
illnesses, but now I also will never recover from the permanent
financial devastation this has had on my life. I don't know how I am
going to survive without some miracle like winning the lottery. My
``American Dream'' will never be realized. I have now been forced to
live the ``American Nightmare'' for the rest of my days, because I
happened to get sick, and file a claim for Social Security Disability
benefits, a Federal insurance policy that I paid into for over 30
years. I am now doomed to spend what's left of my days here on earth,
living in poverty, in addition to all my medical concerns. I will never
be able to own a home, or get another car. My current vehicle which is
on death's door, is the ONLY method of transportation I have for
survival. When things break down now, I cannot fix them and have to do
without. I struggle every day to pay for food, medicines, healthcare,
gas etc. having to decide which things I can do without till the next
check comes, since I live strictly on the inadequate, monthly SSDI
check I receive, always teetering on the brink of disaster. This
totally unbearable, continuing source of stress and frustration, is
killing me. I did not ask for this fate and would trade places with a
healthy person in a minute. I tell you this not for pity or sympathy,
but so you can get an accurate picture of what is really happening to
the most vulnerable citizens of this nation, whom you were elected to
serve and protect.
Social Security Disability Claimants Face Death And Destruction When
Applying For Benefits
I must report with great sadness and disgust, that all these
hearings have not brought about much progress, if any at all, and
things continue to worsen by the day.In our country you're required to
have auto insurance in order to drive a car, you pay for health
insurance, life insurance etc. If you filed a claim against any of
these policies, after making your payments, and the company tried to
deny you coverage when you had a legitimate claim, you would be doing
whatever it took, even suing, to make them honor your policy. Yet the
government is denying Americans their right to legitimate SSDI benefits
everyday and this is an outrage!
I continually hear you talk about hearing waiting times 200 days vs
600 days, like it was nothing but a number. Everyday that a disabled
American must wait for their benefits, is a day that their life hangs
on by a thread, or worse yet, they do not survive. The stress from that
alone is enough to kill anyone. Since it has been proven over the years
that the average American has about two weeks worth of savings,
anything over a 14 day waiting period in any phase of the SSDI process
is totally unacceptable. Cutting hearing wait times down to even 30
days, is nothing to tout as some great accomplishment on your part, as
it still puts claimants lives in jeopardy. If any other private
company/organization operated with as poor customer service, and
processing times that the SSA currently does, subjecting people to
hours, days, weeks, months, and worse yet years, to get their issues
resolved, all employees would be fired, and they would be shut down
within weeks. Nobody would even attempt to give them their business,
yet Americans are held hostage to the SSA since they are required to
pay for their services out of their wages, and rightfully expect to get
what they have paid for. This is outrageous when something this
serious, and a matter of life and death, could be handled in such a
poor manner. Common sense would also lead you to the conclusion, that
there is a strong correlation between the crisis that disabled
Americans face while trying to get their benefits, and the housing, and
economic meltdown this country is in the midst of. I challenge anyone
of you to try and live for more than two weeks, not relying on your
assets (since many SSDI applicants lose all their assets while waiting
for a decision on their claims), with absolutely no income, and see how
well you survive. Also keep in mind that you are not disabled on top of
it, which adds its own challenges to the problem. Based on my own
experience, and the experiences of thousands of others which have been
shared with me, and current conditions, I firmly believe that the SSDI/
SSI program is structured to be very complicated, confusing, and with
as many obstacles as possible, in order to discourage and suck the life
out of claimants, hoping that they ``give up or die'' trying to get
their disability benefits! The following statistics back up my
statement:

Some Staggering Statistics During 2006 and 2007, at least
16,000 people fighting for Social Security Disability benefits
died while awaiting a decision (CBS News Report--Disabled And
Waiting--1/14/08). This is more than 4 times the number of
Americans killed in the Iraq war since it began.
During 2007, two-thirds of all applicants that were denied--
nearly a million people--simply gave up after being turned down
the first time (CBS News Report--Failing The Disabled--1/15/08)
PLEASE NOTE--I personally was the source behind these CBS News
reports and was featured in the broadcast of ``Disabled And
Waiting.'' Two-thirds of those who appeal an initial rejection
eventually win their cases (New York Times 12/10/07) In 2007
there were 2,190,196 applications, in 2008 there were 2,320,396
applications (a yearly increase of 130,200 new claims) and as
of March 2009 there have already been 677,553 new applications
(an increase of 113,784 claims for the January--March 2008
period) for Social Security Disability Insurance/SSDI benefits.
There are currently over 1 million people waiting for their
claims to be processed, over 154,000 of them are veterans, and
many have been waiting for years! Nationally as of March 2009,
about 61% of disability cases were denied at the initial stage
of the disability claims process and it took from 100.5-106
days for claimants to receive the initial decision on their
claim. If a claimant appeals the initial denial asking for
reconsideration, in all but 10 test states where the
reconsideration phase has been removed, 85.4% of cases were
denied and the waiting time for this phase was an average of
83.7 days. As of March 2009 there were 761,772 cases waiting
for hearings with an average wait time of 501 days. As of March
2009--266,951 hearings (35%) have already been pending over a
year, and there are only 1042.67 Administrative law judges
(ALJ's), to hear all those cases, with an average of 685.70
cases pending per judge nationwide. If a claimant appeals an
ALJ hearing decision to the Federal Appeals Council, the
average time from request for AC/Appeals Council Review to
Appeal Council's Decision is 8 months. NOTE: It is not unusual
to find cases pending for up to 24 months for various reasons.
Cases pending longer than 24 months are then considered for
expedited processing. In 2006--71% of the 88,907 cases that
were sent to the Appeals Council were denied. In 2007--637,686
disabled Americans were forced by law to endure the mandatory
24 month waiting period for eligibility to receive much needed
Medicare benefits. Source: Social Security Administration
Reports
An Office of the Inspector General Audit Report ``Disability
Claims Overall Processing Times'' (A-01-08-18011) released in
December 2008, found that in 2006, the average overall
processing times for disability claims from the date of
application to the date of denial or date of benefit payment
(including any back payments), that had to complete all phases
of the disability claims process (Initial, Reconsideration, ALJ
Hearing, Appeals Council and Federal Court) in order to be
resolved, took a total of 1,720 days to complete. In 2008 due
to the severe backlogs at the SSA especially at the ALJ Hearing
level, this overall processing time greatly increased and
unless the SSA gets the proper funding and staff it needs to
resolve the problems it is encountering, this trend will
continue. Federal Disability programs have been designated as
``High Risk'' by the GAO every year since 2003 and continue to
be on the GAO High Risk list in 2009. NOTE: GAO's High Risk
list serves to identify and help resolve serious weaknesses in
areas that involve substantial resources and provide critical
services to the public. Source: GAO-09-271--High Risk Series--
January 2009 According to Health Affairs, The Policy Journal of
the Health Sphere, 2 February 2, 2005: Disability causes nearly
50% of all mortgage foreclosures, compared to 2% caused by
death. ``The escalating pace of foreclosures and rising fears
among some homeowners about keeping up with their mortgages are
creating a range of emotional problems, mental health
specialists say. Those include anxiety disorders, depression,
and addictive behaviors such as alcoholism and gambling. And,
in a few cases suicide.
``Historically, research shows, rates of depression and
suicide tend to climb during times of economic tumult.''
``Studies show a strong connection between financial distress
and emotional stress, including anxiety, depression, insomnia
and migraines.'' Excerpts from Foreclosures Take Toll On Mental
Health--Crisis Hotlines, Therapists See A Surge In Anxiety Over
Housing--USA Today--Stephanie Armour--5/15/08 AARP/USA Today:
Health Care To Get The Hollywood Treatment--5/28/08--``More
middle-class people file for bankruptcy because of healthcare
related expenses than for any other reason.'' Market Watch:
Illness And Injury As Contributors To Bankruptcy--February 2,
2005--found that: Over half of all personal U.S. bankruptcies,
affecting over 2 million people annually, were attributable to
illness or medical bills. 15% of all homeowners who had taken
out a second or third mortgage cited medical expenses as a
reason. Dateline NBC--Debt: The Next Big American crisis?--
Chris Hanson--3/27/09--Medical bills are a leading cause of
debt in America. According to an insurance survey, conducted by
the International Communications Research of Media, PA from Jan
10-14th 2007, on behalf of the National Association of
Insurance Commissioners, researchers found 56% of U.S. workers
would not be able pay their bills or meet expenses if they
become disabled and unable to work. 71% of the 44% who had
insurance, stated it was employer provided, so if they lose or
change jobs they would no longer have disability coverage. In
April 2006, Parade Magazine in an article called ``Is The
American Dream Still Possible?''--published the results of
their survey of more than 2200 Americans who earned between
$30,000 and $99,000 per year, most stating that they were in
reasonably good health. 66% say they tend to live from paycheck
to paycheck and nearly 83% say that there is not much money
left to save after they have paid their bills. Approximately 54
million Americans, an estimated 20% of the total population,
have at least one disability, making them the largest minority
group in the nation, and the only group any of us can become a
member of at any time. As our baby boomer population ages and
more veterans return from war, this number will double in the
next 20 years. It is a diverse group, crossing lines of age,
ethnicity, gender, race, sexual orientation and socioeconomic
status.
People with disabilities are nearly twice as likely as people
without disabilities to have an annual household income of
$15,000 or less. Notwithstanding the strides made in disability
rights in the past 25 years, the majority of people with
disabilities are poor, under-employed and under-educated due
largely to unequal opportunities.

The source for these statistics: Disability Stats And Facts--
Disability Funders.org http://www.disabilityfunders.org/disability-
stats-and-facts Disabled Americans Unite For Reform Of Social Security
Disability Insurance Program The Social Security Disability Coalition,
of which I am President/Co-Founder, is made up of Social Security
Disability claimants and recipients from all over the nation, and our
membership increases by the day. It was born out of the frustration of
my own experience, and the notion that others may be dealing with that
same frustration. I was proven to be totally correct beyond my wildest
imagination. Our group is a very accurate reflection and microcosm of
what is happening to millions of Social Security Disability applicants
all over this nation. We fill a void that is greatly lacking in the
SSDI/SSI claims process. While we never represent claimants in their
individual cases, we are still able to provide them with much needed
support and resources to guide them through the nebulous maze that is
put in front of them when applying for SSDI/SSI benefits. In spite of
the fact that the current system is not conducive to case worker,
client interaction other than the initial claims intake, we continue to
encourage claimants to communicate as much as possible with the SSA in
order to speed up the claims process, making it easier on both the SSA
caseworkers and the claimants themselves. As a result we are seeing
claimants getting their cases approved on their own without the need
for paid attorneys, and when additional assistance is needed we connect
them with FREE resources to represent them should their cases advance
to the hearing phase. We also provide them with information on how to
access available assistance to help them cope with every aspect of
their lives, that may be affected by the enormous wait time that it
currently takes to process an SSDI/SSI claim. This includes how get
Medicaid and other State/Federal programs, free/low cost healthcare,
medicine, food, housing, financial assistance and too many other things
to mention here. We educate them in the policies and regulations which
govern the SSDI/SSI process and connects them to the answers for the
many questions they have about how to access their disability benefits
in a timely manner, relying heavily on the SSA website to provide this
help. If we as disabled Americans, who are not able to work because we
are so sick ourselves, can come together, using absolutely no money and
with very little time or effort can accomplish these things, how is it
that the SSA which is funded by our taxpayer dollars fails so miserably
at this task?
Social Security Disability Coalition--offering FREE information and
support with a focus on SSDI reform http://groups.google.com/group/
socialsecuritydisabilitycoalition Please visit the Social Security
Disability Coalition (ARCHIVE) website, or the Social Security
Disability Reform petition website: >Archive Of Old Social Security
Disability Coalition MSN Group Website http://
ssdcoalitionarchive.multiply.com Sign the Social Security Disability
Reform Petition--read the horror stories from all over the nation:
http://www.petitiononline.com/SSDC/petition.html At these two sites you
will see thousands of stories and over 8000 signatures and comments on
our petition, from disabled Americans whose lives have been harmed by
the Social Security Disability program. You cannot leave without seeing
the excruciating pain and suffering that these people have been put
through, just because they happened to become disabled, and went to
their government to file a claim for disability insurance that they
worked so very hard to pay for. There are three main reasons for the
disability hearing backlogs:

Lack of communication and educating the public
States of denial
State and private disability companies forcing claimants
to file disability claims with SSA or risk losing private coverage

Lack Of Communication Between Claimants, Doctors And SSA, Lack Of
Education On What Is Needed For A Claimant To Prove A Disability Claim
Currently there is little to no communication between the SSDI claimant
and the SSA caseworkers handling their claims. More communication is
needed and review of records by the claimant should be available at any
time during all stages of the disability determination process. Before
a denial is issued at any stage, the applicant should be contacted as
to ALL the sources being used to make the judgment. It must be
accompanied by a detailed report as to why a denial might be imminent,
who made the determination and a phone number or address where they
could be contacted. Also many times medical records submitted are lost
or totally ignored. In case info is missing, or the SSA was given
inaccurate information, the applicant can provide the corrected or
missing information, before an actual determination at any level is
made. This would eliminate many cases from having to advance to the
hearing or appeals phase. Also many times doctors, hospitals etc often
do not respond to SSA requests for medical information in a timely
manner, or sometimes ignore these requests entirely. ALL doctors, and
medical professionals including those at the VA should be required by
Federal or State law, to fill out any medical forms and submit
documents requested by the SSA within strict timelines or they will not
be allowed to practice medicine in this country. Also as part of their
continuing education program in order to keep their licenses, doctors
should also be required to attend seminars provided free of charge by
the SSA, in proper procedures for writing medical reports and filling
out forms for Social Security Disability and SSI claimants. The major
criteria used by the SSA to decide a disability claim, is residual
functionality and the ``Blue Book Of Listings,'' yet this is not
usually information that the general public is privy to when filing a
disability claim. In fact it is a pretty well kept secret unless you
know enough to do some research. In other words since the process is so
nebulous from beginning to end, the deck is purposely stacked against a
claimant from the very start. When the average person files a claim
they seem to think that all they have to do is mention what is wrong
with them, get their doctors to back up their medical claims, say they
are disabled and cannot work, fill out a few forms and the checks will
start coming in the mail. While in a ideal world the process should be
that simple, nothing could be further from the truth. They do not
realize, and are never told, that they must not only list their
illnesses, but more importantly describe HOW their illnesses prevent
them from doing work and daily activities. They are not told to list
EVERYTHING that is wrong with them, and often only file a claim for one
condition, that in itself may not be disabling, when they have several
of them, that in combination, may in fact render them totally disabled.
Many file claims because they cannot perform the job they have been
doing for years, or cannot work as many hours that used to before they
get sick. They do not fully understand that they have to not be able to
work ANY job in the national economy, and that the SSA does not pay for
partial disability. The SSA needs to do a much better job of educating
the public at the onset of filing a disability claim to avoid
confusion.
States Of Denial--The REAL Reason Behind The Social Security Disability
Hearing Backlogs
Since Social Security Disability is a Federal program, where you
live should not affect your ability to obtain benefits. Sadly this is
not the case. While funding is a major problem that SSA faces, the
other primary reason for these hearing backlogs, continues to be
ignored during these proceedings, and that is the initial phase of the
disability qualification process which is handled by the individual
state DDS/Disability Determination Services offices. There, the most
crucial part of your disability claim, the medical portion, is reviewed
by a caseworker/adjudicator and medical doctor on their staff who never
sees you, and in most cases never even communicates with you at all.
Too much weight at the initial time of filing, is put on the SS
caseworker's opinion of a claim. There needs to be more oversight that
disability decisions be based with controlling weight given to the
claimant's own treating physicians opinions and medical records in
accordance with (DI 24515.004) SSR 96-2p: Policy Interpretation Ruling
Titles II And XVI: Giving Controlling Weight To Treating Source Medical
Opinions. Even though this policy ruling is in place, this is very
often not happening. Excerpts from GAO-09-511T--Further Actions Needed
to Address Disability Claims and Service Delivery Challenges--3/24/09--
which can be found at: http://www.gao.gov/new.items/d09511t.pdf
Although SSA is responsible for the program, the law calls for initial
determinations of disability to be made by state DDS agencies. The work
performed at DDS offices is federally financed and carried out under
SSA disability program regulations, policies, and guidelines. See
42.U.S.C. Sec. 421(a)(1). From September 1998 to January 2006, over 20
percent of disability examiners hired during that period left or were
terminated within their first year. DDS officials said the loss of
experienced staff affects DDS' ability to process disability claims
workloads because it generally takes newly hired examiners about 2
years to become proficient in their role. For example in March 2009:
Ohio had the lowest percentage of approvals at the initial level of
27.2% >Alaska and Wyoming had the lowest percentage of approvals at the
reconsideration level of 0%.
Puerto Rico had the highest percentage of approvals at the initial
level of 64.1% Puerto Rico had the highest percentage of approvals at
the reconsideration level of 40.3% >Source: Social Security
Administration--March 2009
That is a major fluctuation depending on what state you happen to
apply for benefits in. Something is extremely wrong with this picture
and proves the inconsistency of decision making by the state DDS
offices in handing Federal disability claims. What would be an
incentive for states to deny Federal claims? Since many Social Security
Disability claims are SSI or both SSI/SSDI combined claims and many
states offer to supplement SSI payments at a higher benefit amount,
therefore they want to keep as many off the rolls as possible so they
do not have to pay out this supplement. Also since there is a different
pay scale for government vs state employees who are often underpaid,
lack training, are overworked, and must meet quotas of cases processed,
the tendency is greater to rubber stamp denials to move claims off
their desk when a case needs too much development. Thus the explanation
for the fluctuation in denial/approval/backlog rates by state.
Unfortunately there is very little if any training or oversight on the
state DDS offices to make sure they are making the proper decisions on
disability claims. This is why so many claimants appeal to the hearing
level where a huge percentage of bad claims decisions are overturned
and cases are finally approved. Anyone who doesn't see that a ``Culture
Of Denial'' has become a pervasive part of an SSDI claimants encounter
with the SSA, is either totally out of touch with reality or is
reacting evasively to the subject. Excerpts from GAO Report GAO-04-
656--SSA Disability Decisions: More Effort Needed To Assess Consistency
of Disability Decisions--Washington--July 2004 which can be found at:
http://www.gao.gov/new.items/d04656.pdf
``Each year, about 2.5 million people file claims with SSA for
disability benefits . . . About one-third of disability claims denied
at the state level were appealed to the hearings level; of these, SSA's
ALJ's have allowed over one-half, with annual allowance rates
fluctuating between 58 percent and 72 percent since 1985. While it is
appropriate that some appealed claims, such as those in which a
claimant's impairment has worsened and prohibits work, be allowed
benefits, representatives from SSA, the Congress, and interest groups
have long been concerned that the high rate of claims allowed at the
hearing level may indicate that the decision makers at the two levels
are interpreting and applying SSA's criteria differently. If this is
the case, adjudicators at the two levels may be making inconsistent
decisions that result in similar cases receiving dissimilar
decisions.'' ``Inconsistency in decisions may create several problems .
. . If deserving claimants must appeal to the hearings level for
benefits, this situation increases the burden on claimants, who must
wait on average, almost a year for a hearing decision and frequently
incur extra costs to pay for legal representation . . . SSA has good
cause to focus on the consistency of decisions between adjudication
levels. Incorrect denials at the initial level that are appealed
increase both the time claimants must wait for decision and the cost of
deciding cases. Incorrect denials that are not appealed may leave needy
individuals without a financial or medical safety net . . . An appeal
adds significantly to costs associated with making a decision.
According to SSA's Performance and Accountability Report for fiscal
year 2001, the average cost per claim for an initial DDS disability
decision was about $583, while the average cost per claim of an ALJ
decision was estimated at $2,157 . . . An appeal also significantly
increases the time required to reach a decision. According to SSA's
Performance and Accountability Report for fiscal year 2003, the average
number of days that claimants waited for an initial decision was 97
days, while the number of days they waited for an appealed decision was
344 days . . . In addition, claimant lawsuits against three state DDS's
have alleged that DDS adjudicators were not following SSA's rulings or
other decision making guidance . . . However, according to DDS
stakeholder groups, SSA has not ensured that states have sufficient
resources to meet ruling requirements, which they believe may lead to
inconsistency in decisions among states. Furthermore, SSA's quality
assurance process does not help ensure compliance because reviewers of
DDS decisions are not required to identify and return to the DDS's
cases that are not fully documented in accordance with the rulings. SSA
procedures require only that the reviewers return cases that have a
deficiency that could result in an incorrect decision.''
Excerpts from: Statement For The Record Of The National Association
Of Disability Examiners--Georgina Huskey, President--Prepared For
Subcommittee on Social Security/Subcommittee on Income Security and
Family Support Of the Committee on Ways and Means Joint Hearing on
Eliminating the Social Security Disability Backlog--March 24, 2009
``Even at the DDS level, where few backlogs are publicly reported and
where the average processing time for an initial claim is nearly 100
days, the stark reality is that there are tremendous backlogs pending.
Just because disability claims have been assigned does not mean they
are being worked and disability examiners who carry caseloads two,
three and even four times the number deemed reasonable are, in essence,
housing a backlog of claims at their desk. Unfortunately, this backlog
of claims can lead to mistakes in case development and contribute to
mistakes in judgment, resulting in the potential for erroneous
decisions.''
``As experienced staff walk out the door, either due to retirement
or because of career changing decisions, SSA and the DDSs have
struggled in many parts of the country to attract the kind of new hires
that will keep the Agency at a level of competence required in its
service delivery. Prior to the recent economic downturn, DDSs were
reporting an annual attrition rate approaching 15% with more than 22%
of newly hired disability examiners leaving by the end of their first
year. The result has been an increasing lack of experienced personnel
to process increasingly more complex disability claims and forcing the
DDSs to utilize limited training funds to continually hire new staff,
rather than provide ongoing training for existing staff.'' All phases
of disability claims processing should be moved to and handled out of
the Social Security individual field offices, including the DDS phase
which is the medical determination phase currently handled by the
states, and all hearing phases of the disability process. All people
who process Social Security disability claims should be employees of
the Federal Government to ensure accuracy and uniform processing of
disability claims under Federal regulations and Social Security
policies which is currently not the case. If the states are to continue
to handle the DDS phase of the disability process, then all state
employees handling Social Security claims should be required to receive
a minimum of 3 months standardized training by the Social Security
Administration, in SSA policies and Federal regulations governing SSDI/
SSI claims processing. If more time and effort were put forth to
communicate with claimants, and to make the proper decision at the
onset, there would be no need for all these cases to be appealed to the
hearings level in the first place. That in itself would be a huge
factor in reducing the hearing backlogs, but this fact has been greatly
ignored. Until you properly devote the time and energy to look into and
reform this crucial part of the problem, the hearing backlogs will
continue to grow at an uncontrollable rate, no matter how much money
you give to the SSA. Social Security Disability Program Problems--
Contributing Burden Factor on Medicaid/Social Service Programs For
States There seems to be a relationship, between SSDI claims processing
issues/backlogs, and the need for claimants to also apply for state
funded Medicaid/Social Service programs. Many are forced to file for
Medicaid, food stamps and cash assistance, another horrendous process.
For example in New York State, about half the 38,000 people now waiting
on disability appeals, for an average of 21 months, are receiving cash
assistance from the state (New York Times 12/10/07). Those who file for
these programs while waiting to get SSDI benefits, in many states, have
to pay back the state out of their meager benefit checks once approved.
As a result they're often kept below the poverty level, almost never
able to better themselves since they can't work, and now are forced to
rely on both state and federally funded programs instead of just one of
them. This practice should be eliminated. Regulation Is Necessary To
Avoid Improper Social Security Disability Claim Filings Due To State
And Private Insurance Company Policies There is a growing number of
claims being filed by people who may not actually qualify for
disability benefits under Social Security guidelines, but who are being
forced to file Social Security Disability/SSI claims by their private
disability and state disability carriers or risk not being eligible for
benefits under those programs. Recently there has been media coverage
on this issue which can be found here: Trial Against Unum Over Handling
of Disability Insurance Claims Opens Today--Market Watch--PRNewswire
via COMTEX--Boston--9/22/08 http://www.prnewswire.com/cgi-bin/
stories.pl?ACCT=109&STORY=/www/story/09-22-2008/0004890097&EDATE=
Insurers Faulted As Overloading Social Security--NY Times--Mary
Williams Walsh--4/1/08 http://www.nytimes.com/2008/04/01/business/
01disabled.html Grassley Works To Strengthen Social Security Disability
Program--3/27/09 http://grassley.senate.gov/news/
Article.cfm?customel_dataPageID_1502=19961 Exhibit A--Private Insurers
Policies And Practices http://grassley.senate.gov/private/upload/
EXHIBIT-A.pdf Exhibit D--Letter To Senator Charles Grassley From
Disability Claimant Who Was Required By Private Insurer To File Claim
For Social Security Disability Regardless Of Eligibility Or Risk Loss
Of Private Disability Insurance Benefits--1/21/09 http://
grassley.senate.gov/private/upload/Exhibit-D.pdf Exhibit E--Letter From
SSA Commissioner To FTC Chairman Regarding Private Disability Companies
Requiring Their Claimants To File For Social Security Disability
Benefits--11/26/08 http://grassley.senate.gov/private/upload/Exhibit-
E.pdf Congress and the SSA needs to look into this issue and this
practice needs to be stopped immediately as this too greatly adds to
the disability backlog problem. In this case the claimants should not
be penalized but the insurance companies should be.
Improper CE/IME Medical Exams Ordered By Social Security Result In
Higher Rate Of Denials, Hearings And Appeals
Too much weight at the initial time of filing, is put on the
independent medical examiner's opinion of a claim. CE/IME examiners are
paid a fee by Social Security for each person they see, so the more
claimants they process, the more money they make. Often times they are
caught saying they performed exams that they in fact never performed,
make mistakes, or make false, misleading statements about claimants.
Many times the DDS offices or ALJ's are sending claimants to doctors
that have very limited knowledge of their specific health conditions,
who are not specialists, or even the proper type of doctor, to be
examining a claimant for the type of medical conditions that they have.
These doctors have no real idea how a patient's medical problems affect
their lives after only a brief visit with them, and yet their opinion
is given greater authority than a claimant's own treating physician who
sees them in a much greater capacity? Something is way out of line with
that reasoning, yet it happens every day. Even though a claimant's
treating physicians are supposed to be given greater weight in decision
making, this is often not the case. Whenever SSA required medical exams
are necessary, they should only be performed by board certified
independent doctors who are specialists in the disabling condition that
a claimant has (example--Rheumatologists for autoimmune disorders,
Psychologists and Psychiatrists for mental disorders). Common sense
dictates that these poorly executed, and often unnecessary, medical
exams result in a waste of time, money and energy, for both the
claimants and the SSA, especially when the claimant ends up appealing a
denial based on these improper SSA ordered examinations.
Utilize Hearing On The Record/Pre-Hearing Review Option To Reduce
Backlogs
More emphasis and support staff need to be devoted to the pre-
hearing review process which could greatly reduce the current hearing
backlog. This would obviously and should require more communication
between hearing office staff and claimants or their representatives to
update case files. Once the files have been updated, many would be able
to be decided solely on the records in the file without having a full
hearing in front of an ALJ.
Changes/Proper Funding Necessary For SSA To Accomplish It's Goals And
Properly Serve Disabled Americans
I continually hear talk at these hearings about increasing the
funding for the SSA, and you asking witnesses for answers, on how much
the SSA will need to fix the current problems, and prevent new ones
from arising in the future. One thing is said at the hearings, but when
push comes to shove to vote for the SSA budget money, other programs or
projects become higher priority, even though properly funding the SSA
is literally a matter of life and death for millions of Americans.
Nothing is more important than the health and wellbeing of the American
people, and as elected officials it is crucial that you never lose
sight of that priority! Still I see that the SSA is under funded almost
every year, and there is a continued challenge to get the money that
the SSA requests. SSA should not have to compete each year for funding
with the Departments of Labor, HHS and Education which are highly
publicized and therefore, often more popular programs. All money that
is taken out of American's paychecks for Social Security should not be
allowed to be used for anything else other than to administer the
program and pay out benefits to the American people. As stated in the
previous testimony provided by Witlold Skierwczynski--President--
National Council Of Social Security Administration Field Operation
Locals to the House Ways And Means Committee on 4/23/08 it is
recommended that: Congress should enact off budget legislation
including SSA administrative expenses with benefits which are already
off budget. Congress should retain appropriations and oversight
authority albeit unencumbered by artificial budget caps and scoring
restrictions. Congress should enact legislation requiring the
Commissioner to submit the SSA appropriation request directly to
Congress. Congress should support the House Budget Committee
recommendation to increase the SSA administrative budget by $240
million over the President's budget request.
Oversight is Crucial!
In an editorial letter from SSA Commissioner Astrue dated 8/21/08
to the Atlanta Journal Constitution in regards to the severe hearing
backlogs it was stated that ``We have taken a big step toward resolving
that problem by bringing onboard 175 additional administrative law
judges and additional staff to support them..'' In reality: At of the
end of fiscal year 2007 the amount of ALJ's available to hear cases was
at 1006, and at the end of fiscal year 2008 the amount of ALJ's
available to hear cases dropped to 960.13. As of March 2009 there were
in fact only 1042.67 ALJ's currently available to hear cases. Source:
Social Security Administration Reports The 175 new ALJ's that the SSA
Commissioner has hired, may actually already be factored into the March
2009--1042.67 number--the report does not distinguish. So even with the
so called 175 new ALJ's we are still not much above the 2007 level.
Basically this is still inadequate amount of ALJ's, since it does not
account for the fact that more judges may continue to leave for various
reasons (retirement etc), and that the level of disability claims
continues to increase instead of decrease, based on past history. The
Commissioner has failed to publicly account for this fact, so he makes
it sound like there is going to be several additional ALJ's above and
beyond previous years, when he is in reality replacing judges who are
leaving and not actually increasing by any substantial amounts, the
number of the additional staff he truly needs. Also very often these
judges have not even been allocated to the areas that have the largest
hearing backlogs and there is no oversight on the SSA Commissioner to
make sure they go where they are needed most. So the likelihood of the
claims backlog being resolved with this so called ``fix'' is slim to
none. In other words ``this is like putting a band aid on a gushing
wound.'' More investigation of this problem by Congress, the Inspector
General and GAO needs to happen immediately!
Horrendous Customer Service
In a January 2007 Harris poll designed to evaluate the services
provided by 13 federal agencies, the public rated SSA at the bottom of
the public acceptance list and it was the only agency that received an
overall negative evaluation. SSA Field Offices have lost over 2,500
positions since September 2005 and nearly 1,400 positions since
September 2006. In 2007 SSA Field Offices saw about 43 million visitors
a week, and that number is expected to increase by over a million more
in 2008. Constituents visiting these local Field Offices continue to
experience lengthy waiting times and the inability to obtain assistance
via the telephone. Here is just a small sampling of some of the major
problems with the current Social Security Disability program and State
Disability (DDS) offices who process the initial phase/medical portion
of disability claims: Severe under staffing of SSA workers at all
levels of the program Claimants waiting for weeks or months to get
appointments, and hours to be seen by caseworkers at Social Security
field offices Extraordinary wait times between the different phases of
the disability claims process Very little or no communication between
caseworkers and claimants throughout the disability claims process
before decisions are made. Employees being rude/insensitive, not
returning calls, not willing to provide information to claimants or not
having the knowledge to do so Complaints of lost files and in some
states, case files being purposely thrown in the trash rather than
processed properly Security Breaches--Complaints of having other
claimants information improperly filed/mixed in where it doesn't belong
and other even worse breaches Fraud on the part of DDS/OHA offices,
ALJ's, IME's--purposely manipulating or ignoring information provided
to deny claims, or doctors stating that they gave medical exams to
claimants that they never did. Claimants being sent to doctors that are
not trained properly, or have the proper credentials in the medical
field for the illnesses which claimants are being sent to them for.
Complaints of lack of attention/ignoring--medical records provided and
claimants concerns by Field Officers, IME doctors and ALJ's. Employees
greatly lacking in knowledge of and in some cases purposely violating
Social Security and Federal Regulations (including Freedom of
Information Act and SSD Pre-Hearing review process). Claimants cannot
get through on the phone to the local SS office or 800 number (trying
for hours even days) Claimants getting conflicting/erroneous
information depending on whom they happen to talk to at Social
Security--causing confusion for claimants and in some cases major
problems including improper payments Proper weight not being given to
claimants treating physicians according to SSA Federal Regulations when
making medical disability determinations on claims. Complaints of ALJ's
``bribing'' claimants to give up part of their retro pay (agreeing to
manipulation of disability eligibility dates) or they will not approve
their claims Poor/little coordination of information between the
different departments and phases of the disability process Complaints
of backlogs at payment processing centers once claim is approved
Federal Quality Review process adding even more wait time to claims
processing, increasing backlogs, no ability to follow up on claim in
this phase NOTE: These complaints refer to all phases of the SSDI
claims process including local field offices, state Disability
Determinations offices, CE/IME physicians, Office of Hearings and
Appeals, the Social Security main office in MD (800 number).
Fraud/Program Integrity--The Stigma Encountered By Social Security
Disability Claimants
SSDI is not welfare, a hand out, reward, golden parachute or
jackpot by any means, and most people would be hard pressed to survive
on it. Yet, often claimants are treated like criminals--viewed as
frauds trying to scam the system, and that the SSA must ``weed out''
them out by making it as hard as possible to get benefits. Yes, I'm
well aware as I write this, that there's some who've abused the system
and that's a shame, because it casts a bad light on those who really
need this help. The percentage of claims that in fact, aren't
legitimate is very miniscule. In March 2009, the average monthly Social
Security Disability Insurance (SSDI) benefit was only $1061.86. Nobody
in their right mind would want to go through this process, and end up
living in poverty on top of their illnesses, if they could in fact
work. I have heard nothing in these hearings or this hearing today that
addresses the fraud on the part of the Federal Government used to deny
deserving claimants their benefits. I have heard nothing about the
rubber stamping of denials, the tossing out of claimant files, the
security breaches of highly sensitive data, the total disregard of
overwhelming evidence by claimants treating physicians, subjecting
claimants to unnecessary fraudulent CE/IME exams, and the cases of
ALJ's ``bribing'' claimants to give up years of back benefits or they
will not approve them. All these things are criminal at best. Most
Americans do not know their rights under the law, that they are allowed
to get copies of their SSA claim files. If more people exercised this
right, they would be horrified to know what was happening behind their
backs, and the true perpetrators of fraud would come to light. in a
major way. The SSA currently spends way more resources to evaluate
cases (Federal Quality Review Process) that are approved, more than any
that are denied unjustly.
Electronic/Internet VS In Person/Paper Filing Of Disability Claims
If a person files a claim online rather than filing in person, the
claimant is not allowed to submit crucial medical records and
documentation that is necessary to speed up and adequately process a
claim in a timely manner. We always encourage claimants to submit as
much information as possible at the onset of filing, so that SSA
workers do not have to spend extra time hunting down medical records
etc and can get their claims resolved faster. We believe it is
important to help SSA workers to help us in order to streamline the
process, and for the hearing backlog problem to be resolved. Online/
internet filing does not give claimants the opportunity to do this. In
closing, in spite of my own horrible experience, I have vowed to do
everything humanly possible to get total reform of the Social Security
Disability program so that nobody else will ever have to endure the
hell that I have had to. Since my time is quickly running out, I hope
you will join me soon in my quest to accomplish this final lifetime
goal, to make our country a better place for our most vulnerable
citizens. Thank you for your time and consideration.

Sincerely,

Linda Fullerton--President/Co-Founder--Social Security Disability
Coalition

ssdcoalition@hotmail.com Please introduce/support--Fullerton--Edwards
Social Security Disability Reform Act: http://groups.google.com/group/
socialsecuritydisability
coalition/web/fullerton-edwards-social-security-disability-reform-act

Statement of National Association of Disability Representatives
The National Association of Disability Representatives is a
professional organization comprised of non-attorneys and attorneys who
assist people in applying for disability income assistance from the
Social Security Administration. Our members help individuals and their
families navigate an often complex and lengthy process to demonstrate
their eligibility for disability benefits. As advocates for claimants,
we want to commend Chairman Tanner, Chairman McDermott, Ranking Member
Johnson, Ranking Member Linder, and all of the Members of both
Subcommittees who have demonstrated a keen interest in pushing for
improvements in the SSA disability determination process, and
especially in the unconscionable delays that are part of the current
system.
NADR members are on the ``front lines'' helping persons with
disabilities complete applications, gather and submit evidence, and
attend Administrative Law hearings with applicants. We see first-hand
the serious toll that the long wait for decisions can take on people,
most of whom are already experiencing significant life changes,
traumas, and hardships. Last year, the average processing time for
cases at the hearing level nationwide was 535 days. This year, SSA
estimates that the average processing time will be 506 days. While this
indicates that things are moving in the right direction, an average
waiting time of almost one-and-a-half years is still much too long for
claimants to wait for benefits to which they are entitled.
Beyond this unconscionable hearing delay, claimants must again wait
for a decision, and if successful, must wait still longer for actual
payment of their claims. Those facing grave or terminal illnesses may
not live to see the fiduciary promise they paid for each week in their
paycheck from their Social Security taxes. Families who need care-
givers or other assistance to provide necessary relief and support in
helping their loved ones may be burdened for years, trying to balance
family needs without any help. This strains marriages, parent/child
relationships, and impoverishes people at a time when their need is
greatest.
As an illustration of the hardship real people have suffered as a
result of the hearing backlog, following are stories of claimants
represented by NADR members:

Stella, age 52, was in a motor vehicle accident and
suffered severe trauma to the left side, including her arm, leg and
foot. She had no real useful ability on that side, and also had COPD,
PTSD and severe depression. She applied for benefits in August 2006 and
was finally approved after a hearing on June 31, 2008, but not before
she was forced out of her home and robbed of all her possessions while
living on the street.
Marie, age 46, suffered from seizures and cirrhosis. She
filed for benefits in June of 2006. She was in a coma in the hospital
for almost a month before she died of liver failure on February 27,
2009. Her favorable on-the-record decision was dated March 4, 2009, too
late to help Marie.
David filed concurrent claims for Social Security
Disability Insurance Benefits and Supplemental Security Income
disability benefits on November 9, 2004, alleging onset of disability
on June 15, 2004. Medical records indicated David suffered from
diabetes mellitus, hypertension, hypotension, chronic anemia, arterial
calcification of his left lower extremity and chronic diarrhea. The
initial claim was denied on February 25, 2005. Upon reconsideration,
the claim again was denied on June 24, 2005. An ALJ hearing was
requested July 22, 2005. On March 13, 2008, nearly 3\1/2\ years after
David filed his initial claim, a fully favorable decision was issued.
Unfortunately, at that point David had been dead for almost a year and
a half.
Charlene, age 45, had previously been in SSDI payment
status. After trying unsuccessfully to return to work, she reapplied
and currently is waiting for a hearing that is not expected to be
scheduled for at least a year. After being denied initially and
awaiting Reconsideration (her second level of appeal), she had a
serious suicide attempt. No state transitional assistance is available
to her and she is losing her home due to nonpayment of rent. Recently
she was in a motor vehicle accident that caused severe brain injury.
Charlene's only option at this point is to enter a nursing home as she
can't afford to live at home with help.

Amazingly, these stories are happening to individuals who are
``insured'' for disability, having paid their Social Security taxes,
including those that fund SSA disability benefits. Most assume that
these benefits will only be needed at retirement. Yet, when accidents
or illness strike, people reasonably expect to receive the critical
support that disability payments can offer. And, they most certainly
expect to get it within a reasonable timeframe. Unfortunately, many
Americans are not finding their government reliable in this arena.
We applaud Congress' recent efforts to address the backlog. For FY
2008, Congress appropriated--for the first time in 15 years--$148
million more than the President's budget request for SSA administrative
expenses. The FY 2009 omnibus appropriations bill provided SSA with
more than $700 million over the FY 2008 level. And the American
Recovery and Reinvestment Act of 2009 provided SSA with an additional
$500 million to handle the increase in retirement and disability
applications due to the economic downturn, as well as funds to replace
its old and out-dated National Computer Center.
While these are important steps, sustained increases in funding
over several years are needed to get the backlog under control. The
President has requested $11.6 billion for SSA's administrative expenses
for FY 2010, a 10 percent increase over FY 2009. NADR strongly supports
the President's request. We believe this level of funding is necessary
in order for SSA to truly have an impact on the disability backlog,
while continuing to carry on other related administrative functions to
serve beneficiaries and applicants.
That said, it will take more than additional funding to address the
issues SSA faces as a result of the dwindling resources and increased
workload it has sustained over the past decade. As a member of the
Consortium for Citizens with Disabilities' Social Security Task Force,
NADR was a signatory on testimony presented to the Subcommittees by
Task Force Co-Chair Peggy Hathaway, and supports the recommendations
for improving the disability-claims process and eliminating the backlog
included in that testimony.
In particular, we want to bring to the Subcommittees' attention the
need to make permanent the fee demonstrations in the Social Security
Protection Act of 2004 (SSPA), P.L. 108-203. These programs were
designed to improve access to representation for claimants applying for
Social Security disability and Supplemental Security disability
benefits, and have proven effective over time. Section 303 of the Act
established a demonstration project to allow withholding and direct
payment of fees to eligible non-attorney representatives. Section 302
authorized the withholding and direct payment of fees in Supplemental
Security Income cases. Both programs are scheduled to sunset on March
1, 2010.
Fee Withholding for Qualified Non-Attorney Representatives
Section 303 of the SSPA established a demonstration program to
examine the effectiveness of non-attorney representatives who qualify
for fee withholding. To qualify for the program, non-attorney
representatives must possess a bachelor's degree (or equivalent
experience); prove they carry up-to-date malpractice insurance coverage
at all times; undergo a criminal background check; and pass an exam
developed by Administrative Law Judges that tests their knowledge of
the Social Security disability system. Participants also must complete
a minimum of 12 hours of qualifying continuing education courses
dealing specifically with Social Security disability matters during the
initial 18-month period and complete 24 hours of instruction in each
subsequent 2-year period. Pursuant to Title III of the Act, the
Government Accountability Office (GAO) released a report in October
2007 analyzing the performance of non-attorney representatives in
disability cases before the SSA (GAO-08-05).
As part of its study, GAO surveyed both claimants and
Administrative Law Judges on representatives' expertise, and examined
available SSA records to analyze representatives' caseloads. The study
results indicated that non-attorney representatives who met the
criteria for fee withholding demonstrated levels of knowledge and
success rates at least equal to that of practicing attorneys.
Key points in the GAO study include the following:

Non-attorneys eligible for fee withholding have the most
experience representing disability claimants and are most likely to
specialize in disability representation;
Most eligible non-attorneys had at least a college
degree; approximately one-quarter had prior experience as an SSA
employee, and another quarter had experience working as a paralegal or
in a legal setting;
Administrative law judges expressed equal satisfaction
with the performance of attorneys and eligible non-attorneys on key
elements of disability representation, including submission of all
relevant evidence, knowledge of applicable laws and regulations, and
case knowledge;
Judges expressed satisfaction with the implementation of
the demonstration project, and some went on to say that ``non-attorneys
tend to be better prepared and more familiar with the details of their
cases than attorneys'';
The judges surveyed did not view lack of legal experience
as an obstacle, as long as the non-attorney representative had a
demonstrated competence of the disability claims process: ``Many of
these judges expressed the view that experience in disability
representation rather than formal legal training is the key to
effective representation, or that it is not necessary to have a law
degree to effectively represent disability claimants.''

The positive responses GAO received from judges and claimants alike
about the effectiveness of eligible non-attorney representatives
demonstrate that lack of a law degree is not an obstacle to successful
representation of disability claimants--and should not be an obstacle
to fee withholding.
Disability representatives can only receive a fee when the claim
results in a favorable determination. The demonstration program to
provide fee withholding for non-attorney representatives has been
extremely effective in improving access to qualified representatives
for claimants. Just as important, many NADR members work with claimants
from the time of filing the initial application. This serves not only
to expedite valid claims, but also to provide counseling that can weed
out inappropriate cases before they enter the system. Once a claimant
does enter the system, qualified representatives who understand the
requisite objective documentary needs can assist the claims examiner
and adjudicators to gather this critical information in a timely
manner. All this leads to savings of time and resources.
The demonstration program to provide fee withholding for non-
attorney representatives has been extremely effective in improving
access to qualified representatives for claimants while saving
administrative costs, and most importantly, time.
Withholding and Direct Payment of Fees in SSI Cases
Section 302 of the SSPA amended Section 1631(d)(2) of the Act to
extend the Title II attorney fee withholding and direct payment
procedures to claims under Title XVI of the Act. This authority will
not apply to claims for benefits with respect to which the claimant and
the representative enter into an agreement for representation after
February 28, 2010. Because this provision has increased opportunities
for SSI claimants to obtain representation, NADR supports making this
provision permanent.
Increasing and Indexing the Fee Cap
Finally, NADR supports H.R. 1093, legislation introduced by Rep.
John Lewis (D-GA) to raise the current fee cap from $5,300 to
$6,264.50--which is what it would have been had it been adjusted for
inflation since the last increase in 2002. We also vigorously support
the bill's provision calling for ongoing annual COLA adjustments to the
cap. If enacted, these changes will help to assure that there is a
knowledgeable, experienced pool of representatives available to
represent claimants.
Conclusion
For all these reasons, NADR urges Congress to act this year to make
permanent both demonstration programs. They have demonstrated their
effectiveness in improving access to qualified representation for
claimants while saving the system tax dollars and time, and helping in
a small, but very meaningful, way to reduce the backlog. We also urge
swift congressional action to enact H.R. 1093, legislation to increase
and index the fee cap.
We appreciate the opportunity to present our views on ways to
reduce the social security backlog. Our goal is to help our clients get
the assistance they need in the most efficient way possible. We have a
long way to go in transforming SSA's disability program into a more
timely and responsive safety net, but your leadership and attention
gives many of us reason to hope for improvements. We look forward to
continuing to work with Congress and with SSA Commissioner Michael
Astrue to assure that SSA is able to provide people with disabilities
the benefits to which they are entitled in a timely fashion.

Statement of National Council on Disability
I am pleased to write to you on behalf of the National Council on
Disability (NCD), an independent federal agency, to submit for the
record the executive summary of our 2005 report entitled ``The Social
Security Administration's Efforts to Promote Employment for People with
Disabilities: New Solutions for Old Problems.'' We are making this
submission in order to be considered part of the testimony for the
March 24, 2009 joint hearing of the Subcommittee on Income Security and
Family Support and the Subcommittee on Social Security entitled
``Eliminating the Social Security Disability Backlog.''
NCD is composed of 15 members, appointed by the President with the
consent of the U.S. Senate. The purpose of NCD is to promote policies,
programs, practices, and procedures that guarantee equal opportunity
for all individuals with disabilities, and that empower individuals
with disabilities to achieve economic self-sufficiency, independent
living, and integration into all aspects of society. To accomplish
this, we gather stakeholder input, review federal programs and
legislation, and provide advice to the President, Congress and
governmental agencies. Much of this advice comes in the form of timely
reports and papers NCD releases throughout each year.
In light of the subject matter of Tuesday's hearing on the
disability application backlogs, we respectfully submit a summary of
our 2005 report on Social Security Administration programs to assist in
providing greater context to the topic at hand. The executive summary
of that report is attached. The Council believes that the severity of
the backlogs continues to negatively influence individuals who may
otherwise consider leaving the Social Security Disability Income (SSDI)
rolls in pursuit of employment. With the knowledge that they will once
again have to face lengthy wait periods to access financial assistance
should their attempts to work be unsuccessful, many likely believe that
the risks outweigh the benefits of making the attempt in the first
place. While a correlation between the two is difficult to prove, the
sad fact that less than 1% of the individuals living on SSDI ever
return to gainful employment is indicative of the value they place on
this program of support.
We applaud the Social Security Administration for the progress it
has made in addressing the backlog that has impacted thousands of
qualified individuals with disabilities each year who depend on the
system when their lives are disrupted due to disability. However, we
also recognize that there is much more to be done before the system
will operate as Congress intended.
If you have any questions about this submission or any matter
related to disability policy, please contact NCD Executive Director
Michael Collins by phone at (202) 272-2004, or email at
mcollins@ncd.gov. On behalf of NCD, thank you for your leadership in
focusing attention on this important topic. I also thank you for the
opportunity to submit this statement for the record.

Respectfully,

John R. Vaughn
Chairperson
The Social Security Administration's Efforts to Promote Employment for
People with Disabilities: New Solutions for Old Problems

National Council on Disability
November 30, 2005

National Council on Disability
1331 F Street, NW, Suite 850
Washington, DC 20004

Read the full report at:
http://www.ncd.gov/newsroom/publications/2005/ssa-
promoteemployment.htm#exec
Executive Summary
Americans with disabilities remain underemployed, despite the fact
that many are willing and able to work. Although the Social Security
Administration (SSA) has instituted a number of incentives to reduce
the numerous obstacles to employment faced by its Supplemental Security
Income (SSI) and Social Security Disability Insurance (DI)
beneficiaries, such efforts have had little impact because few
beneficiaries are aware of these incentives and how they affect
benefits and access to healthcare.
Introduction to the Problem
Social Security beneficiaries with disabilities must spend months
or even years convincing SSA that they are unable to work as a
condition of eligibility. Yet, upon their receipt of benefits, SSA
begins to communicate to beneficiaries that work is an expectation for
them. Congress and SSA have developed a variety of work incentives and
special programs designed to encourage beneficiaries to attempt to
obtain and sustain employment. Yet SSA's efforts to eliminate work
disincentives have often added to the complexity of the entire program,
confusing beneficiaries and making them leery of any actions that might
unknowingly jeopardize their benefits.
Current SSA benefit amounts are quite small and merely allow
beneficiaries to live at a basic subsistence level. SSI resource limits
make it very difficult to accumulate the financial resources necessary
to move toward economic self-sufficiency. Tying eligibility for
Medicaid or Medicare to eligibility for SSA benefits forces individuals
with high-cost medical needs who could otherwise work to choose between
pursuing a career and retaining the medical insurance that sustains
their very lives.
The fear of losing benefits and medical insurance through an
unsuccessful employment attempt starts well before adulthood with SSI
beneficiaries. Many SSI recipients first apply for benefits as children
while enrolled in public schools. These individuals often remain on the
rolls well into adulthood, with very few transitioning from high school
into substantial employment after graduation (GAO, 1996b; GAO, 1998b).
Failure to focus on Social Security and other public benefits during
transition is not only a missed opportunity, but harm may be caused
when students and family members are not educated or prepared for the
effect of earnings on cash benefits and medical insurance (Miller and
O'Mara, 2003).
There is also the problem with poor educational attainment of DI
beneficiaries who enter the disability system later in life. Efforts to
help this population return to work are stymied by their lack of
education and marketable job skills--particularly in today's highly
competitive information economy. It is now more important than ever
that people of all ages have access to higher education and the
financial means with which to pay for training and education (Moore,
2003).
Response of Congress and the Social Security Administration to the
Problem
Well aware of the enormity and seeming intractability of this
problem, Congress and SSA have initiated multiple efforts to promote
employment and return to work among SSA beneficiaries. In recent years,
a number of work incentives for SSI and DI beneficiaries have been
implemented, allowing individuals to keep more of their earnings while
retaining their benefits. Work incentives are aimed at reducing the
risks and costs associated with the loss of benefit support and medical
services as a result of returning to work. Some of the most commonly
used incentives are Section 1619(a) and (b) provisions; impairment-
related work expenses (IRWE); trial work period (TWP); Plan for
Achieving Self-Support (PASS); extended period of eligibility (EPE);
and continued payment under a vocational rehabilitation program.
However, despite efforts by SSA and the Federal Government that
have led to more favorable conditions for returning to work, most SSI
and DI beneficiaries continue to stay on the disability rolls. The work
incentives offered by SSA remain largely underutilized; in March 2000,
of the total number of eligible working beneficiaries, only 0.3 percent
were using PASS, 2.8 percent were using IRWEs, 7.5 percent were
receiving Section 1619(a) cash benefits, and 20.4 percent were
receiving Section 1619(b) extended Medicare coverage (SSA, 2000). The
major reasons cited for the extreme underutilization of these work
incentives by beneficiaries were (1) few beneficiaries knew that the
work incentives existed, and (2) those who were aware of the incentives
thought they were complex, difficult to understand, and of limited use
when entering low-paying employment (GAO, 1999).
The Office of Program Development and Research (OPDR) and the
Office of Employment Support Programs (OESP) under the Deputy
Commissioner for Disability and Income Security Programs are primarily
responsible for the implementation of multiple components of the Ticket
to Work and Work Incentives Improvement Act of 1999 (TWWIIA). The
TWWIIA provides a number of new program opportunities and work
incentives for both SSI and DI beneficiaries, including the Ticket to
Work (TTW) and Self-Sufficiency Program; development of a work-
incentives support plan through the creation of national network of
Benefits Planning, Assistance, and Outreach (BPAO) programs; and new
work incentives, including expedited reinstatement (EXR) of benefits
and postponement of continuing disability reviews.
The National Council on Disability's Study of the Problem
It is not known whether the new TWWIIA programs will have any more
success than past attempts by SSA to impact the employment rate and
earnings of beneficiaries. What is clear is that there has not been, in
recent times, a comprehensive, research-based examination of the
practices that are most likely to support the employment of SSI and DI
beneficiaries. This study has been undertaken in response to the need
for such a comprehensive analysis. The study was designed to address
four research questions:

What are the evidence-based practices that promote the
return to work of working-age beneficiaries of DI and SSI programs?
What policy changes are needed, given recent trends in
program participation and employment?
Are there proven and documented practices that work
better for some populations of people with disabilities and not others?
Which factors ensure that documented and evidence-based
practices could be adapted/ adopted by SSA and other entities that seek
to ensure the employment of people with disabilities? Which factors
prevent adaptation/adoption?

A four-step approach was taken to implement the study. First, a
comprehensive literature synthesis was completed through a review of
published and unpublished literature. Second, detailed structured
interviews were conducted with key stakeholders, including SSA
beneficiaries, federal SSA officials, representatives of other federal
agencies, consumer and advocacy organizations, service organizations,
community service providers, and business representatives. Third, a
preliminary list of findings, evidence-based practices, and
recommendations based on the literature review and structured
interviews was used to develop seven topic papers. These papers were
used to facilitate discussion and obtain reaction from participants who
were invited to a consensus-building conference at the end of January
2005. Individuals with disabilities (including current and former SSI
and DI beneficiaries), advocacy organizations, service providers, and
policymakers who attended the conference had the opportunity to further
develop the recommendations that appear throughout the report.
Major Findings of the Study
Purpose and Mission of SSA's Disability Benefit Programs
Our nation's current disability benefit programs are based on a
policy principle that assumes that the presence of a significant
disability and lack of substantial earnings equates to a complete
inability to work. The current SSA eligibility determination process
thwarts return-to-work efforts, because applicants are required to
demonstrate a complete inability to engage in substantial gainful
activity (SGA) in order to qualify for benefits. The definition fails
to recognize that, for many consumers, disability is a dynamic
condition. The length of the application process in our current
programs actually contributes to the ineffectiveness of our return-to-
work efforts and our inability to intervene early in the disability
process.
For DI individuals, lack of a gradual reduction in benefits as
earnings increase and lack of attachment to the DI and Medicare
programs after an individual has maintained employment for an extended
period of time make return to work unfeasible. For SSI beneficiaries,
the program's stringent asset limitations thwart efforts toward asset
development and economic self-sufficiency. Inconsistencies in program
provisions lead to confusion and inequities for beneficiaries of both
programs.
Beneficiary Perspective and Self-Direction
To receive benefits, applicants must characterize their situation
as an inability to work long-term. They must demonstrate that they are
unable to work in any significant way. Once they are determined to be
eligible for disability benefits, beneficiaries face a host of complex
program rules and policies related to continuing eligibility for cash
benefits and access to healthcare. Many beneficiaries are confused or
uninformed about the impact of return to work on their life situation
and have shied away from opportunities to become self-sufficient
through work.
Beneficiaries report that their experience with SSA is often
unfavorable. Insufficient staffing has led to long lines and poor
services. Misinformation is frequent, and mistrust common. Local SSA
field office staff members are overburdened with accurate and timely
processing of post-entitlement earnings reporting, which often leads to
overpayments to beneficiaries. Beneficiaries do not trust SSA to make
appropriate and timely decisions. There is prevalent fear that work
attempts would result in either a determination that the disability had
ended or the need to repay benefits.
SSA has implemented many legislative changes, program
modifications, training initiatives, and automation efforts in the past
15 years to improve its customer service. Although efforts to
streamline processing and improve customer service should be lauded,
they have not significantly improved beneficiaries' ability to direct
and control their own careers.
Income Issues and Incentives
A multitude of rules regarding employment income, continued
eligibility for disability benefits, waiting periods, earnings
reporting, management of benefit payments, and management of assets
(among many others) come into play once an individual is determined to
be eligible for DI or SSI. SSA rules regarding employment and income
are such that many beneficiaries will actually be worse off financially
if they work full time. Disincentives to employment in the current
benefits programs include a sudden loss of cash benefits as a result of
earnings above the SGA level for DI beneficiaries. Despite a number of
programs that are designed to encourage asset building among SSI
beneficiaries, it remains very difficult for beneficiaries to save and
accumulate resources under SSI, which contributes to long-term
impoverishment and dependence on public benefits.
Over the past decade, SSA has devoted considerable resources to
promoting employment and return to work among SSI and DI beneficiaries.
The agency has aggressively implemented a number of new initiatives
authorized under the TWWIIA, such as the Ticket to Work and Self-
Sufficiency Program, the BPAO program, area work incentive
coordinators, and Protection and Advocacy for Beneficiaries of Social
Security. It has modified program rules to provide increased work
incentives to beneficiaries, such as the EXR and protection from
continuing disability review provisions of TWWIIA, indexing the SGA
threshold, and increasing the level of earnings allowed during the
Trial Work Period (TWP). The agency has also launched or is planning to
initiate a number of demonstrations that will test the efficacy of new
modifications to work incentives within the DI program and services
targeted toward youth with disabilities. Yet, while SSA has taken steps
to improve its return-to-work services through the provision of work
incentives, these efforts are hampered by the underlying program rules
that were designed for individuals assumed to be permanently retired
from the workforce and individuals who were viewed as unable or
unlikely to work in the future.
Coordination and Collaboration Among Systems
Expansion of the disability programs and the poor employment rates
of adults with disabilities have become major concerns for SSA and
disability policymakers across the country. Too often, the alarming
growth of the Social Security disability rolls has been represented and
perceived as SSA's problem to solve in isolation, when in fact it is a
larger societal problem with myriad complex causes. Receipt of Social
Security disability benefits is merely the last stop on a long journey
that many people with disabilities make from the point of disability
onset to the point at which disability is so severe that work is not
possible. All along this journey, individuals encounter the policies
and practices of the other systems involved in disability and
employment issues. When these systems fail to stem the progression of
disability or work at cross-purposes with one another to prevent
successful employment retention or return to work, it is the Social
Security disability system that bears the eventual brunt of this
failure. Any meaningful effort to slow down or reverse this relentless
march toward federal disability benefits will require significant and
sustained collaboration and coordination among SSA and the other
federal agencies with a stake in developing disability and employment
policy.
The complex obstacles to employment faced by SSA beneficiaries
require a comprehensive set of solutions. New approaches must be
identified that emphasize beneficiary control of career planning and
the ability to access self-selected services and supports. Public and
private healthcare providers must develop new collaborations and new
approaches to combining coverage from multiple sources to improve
program efficiencies. SSA must continue to work with the Rehabilitation
Services Administration (RSA) and the Department of Labor (DOL) to
improve implementation of the TTW program and identify new approaches
that will overcome the traditional inability of SSA beneficiaries to
benefit from services provided by the nation's employment and training
programs. Secondary and postsecondary educational institutions must
emphasize benefits counseling and financial management training as the
foundation for beneficiary self-direction and economic self-
sufficiency. Federal agencies and the business community must realize
that collaborative approaches to incorporating beneficiaries into the
workforce are needed as a way to reduce dependence on federal benefits
while simultaneously enhancing the productivity and competitiveness of
large and small business.
Recommendations
A total of 38 specific recommendations have been developed in the
areas of Beneficiary Perspective and Self-Direction, Income Issues and
Incentives, and Coordination and Collaboration Among Multiple Public
and Private Systems. The recommendations are presented and justified in
Chapters III, IV, and V of the report, and a complete list is provided
in Chapter VI. The key recommendations resulting from the study are
summarized below.
Beneficiary Perspective and Self-Direction
Customer Service--SSA should take immediate steps to improve the
services provided to beneficiaries by improving the accessibility of
SSA field offices and Web sites; redesigning field office personnel
roles, staffing patterns and work assignments; continuing efforts to
automate work reporting procedures; and enhancing outreach efforts to
beneficiaries.
Ticket to Work Program--Congress and SSA should address current
shortcomings in the TTW program by (1) expanding Ticket eligibility to
include beneficiaries whose conditions are expected to improve and who
have not had at least one continuing disability review (CDR), childhood
SSI beneficiaries who have attained age 18 but who have not had a
redetermination under the adult disability standard, and beneficiaries
who have not attained age 18; (2) modifying the TTW regulations to
ensure that Ticket assignment practices do not violate the voluntary
nature of the program and beneficiary rights to grant informed consent;
and (3) implementing a strong national marketing program to inform
beneficiaries about TTW and other SSA programs.
Facilitate Beneficiary Choice--Congress should authorize and direct
SSA, the Rehabilitation Services Administration (RSA), the Centers for
Medicare and Medicaid Services (CMS), the Department of Housing and
Urban Development (HUD), and the Department of Labor Employment and
Training Administration (DOLETA) to develop and implement an integrated
benefits planning and assistance program that coordinates resources and
oversight across several agencies that enables beneficiaries to access
benefit planning services within multiple federal systems. Congress
should also authorize and direct these agencies to consider changes to
the existing BPAO initiative to improve the accuracy and quality of
services provided to individual beneficiaries.
Reduce SSA Overpayments to Beneficiaries--Congress and SSA should
implement a series of procedural reforms to reduce overpayment to
beneficiaries by increasing the use of electronic quarterly earnings
data and automated improvements to expedite the processing of work
activity and earnings; piloting the creation of centralized work CDR
processing in cadres similar to PASS and Special Disability Workload
Cadres; and enhancing efforts to educate beneficiaries on reporting
requirements, the impact of wages on benefits, and available work
incentives.
Eliminate the Marriage Penalty--Congress and SSA should undertake a
complete review of the SSI program and make program modifications that
eliminate the financial disincentive to marriage inherent in the
present program, including amending the current Title XVI disability
legislation to modify the manner in which 1619(b) eligibility is
applied to eligible couples.
Income Issues and Incentives
Ease the SGA Cash Cliff for DI Beneficiaries--Congress should
modify the current Title II disability legislation to eliminate SGA as
a post-entitlement consideration for continued eligibility for Title II
disability benefits and provide for a gradual reduction in DI cash
benefits based on increases in earned income.
Reduce Restrictions on Assets for SSI Beneficiaries--Congress
should direct SSA to (1) develop and test program additions and
regulatory modifications that will enable SSI beneficiaries to
accumulate assets beyond existing limits through protected accounts and
other savings programs, and (2) change current program rules and work
with other federal agencies to modify and expand the value of
individual development account (IDA) programs to SSA beneficiaries.
Decrease the Complexity of the DI/SSI Program Rules Governing
Income and Resources--Congress should direct SSA to (1) simplify
regulatory earnings definitions and wage verification processes so that
they are consistent across the SSI and DI programs, and (2) direct SSA
to modify regulations related to the treatment of earnings in the DI
program by applying the same rules currently applied in the SSI
program.
Coordination and Collaboration Among Multiple Public and Private
Systems
Health Care Systems--Centers for Medicare and Medicaid Services
(CMS) and SSA should work together closely to (1) modify existing
program regulations in order to uncouple Medicare and Medicaid coverage
from DI/SSI cash payments; (2) identify and eliminate the many
employment disincentives currently built into the Medicaid waiver,
Medicaid buy-in, and Health Insurance Premium Payment (HIPP) programs;
(3) expand benefits counseling services to include the full range of
financial education and advisement services; and (4) work
collaboratively with public and private insurance providers and
business representatives to design public-private insurance
partnerships that will expand access to healthcare for individuals with
disabilities.
Vocational Rehabilitation (VR) System--SSA should modify TTW
program regulations to allow the SSA's traditional VR cost
reimbursement program to carry on as a parallel program to the
Employment Network (EN) outcome or outcome-milestone payment
mechanisms, and ensure that an EN is able to accept Ticket assignment
from a beneficiary, refer that individual to the VR agency for needed
services, and not be required to reimburse the VR agency for those
services.
Federal Employment and Training System--Congress, SSA, and the
Department of Labor should undertake an analysis of the impact of
allowing DOL One-Stop Career Centers to receive cost reimbursement
payments for successfully serving beneficiaries under the TTW program,
evaluate the impact of the Workforce Investment Act (WIA) performance
standards on beneficiary participation in WIA programs, and design and
test a set of waivers that will assist beneficiaries in accessing and
benefiting from WIA core and intensive services, as well as individual
training accounts.
Educational System--Congress should direct SSA to work with the
Department of Education (ED) to (1) ensure that benefits planning and
financial management services are available to the transition-aged
population; (2) expand the current student earned income exclusion
(SEIE) and the Plan for Achieving Self-Support (PASS) to encourage
involvement of SSA beneficiaries in postsecondary education and
training; and (3) implement a policy change that would disregard all
earned income and asset accumulation limits for beneficiaries who are
transitioning from secondary education to postsecondary education or
employment for at least one year after education or training is
completed.
Employers, Business Community, and Private Insurance Industry--
Congress should direct SSA and the Department of the Treasury to (1)
evaluate the possible effects of a disabled person tax credit as a
means of increasing the use of disability management programs in
business to prevent progression of injured and disabled workers onto
the public disability rolls, and (2) collaborate with Department of
Labor's Employment and Training Administration (DOLETA), the Small
Business Administration (SBA), and the Rehabilitation Services
Administration (RSA) to develop and implement an employer outreach
program targeted toward small and mid-size businesses.

Statement of Renee B. Jubrey
I am writing to you with great concern regarding the matter of the
Social Security Vocational Expert Rate Raise. As a Vocational Expert I
have provided testimony in court for the Office of Disability,
Adjudication and Review (ODAR) specific to individual documented
limitations, past relevant work and numbers of jobs in the local
economy as well as the nation. The judges I work for continue to use my
services as it helps them make an informed decision and fewer cases are
remanded. They have told me my participation in these hearings is
invaluable, assisting in clearing the much touted backlog and I could
be scheduled more than I am now.
Vocational Experts working for ODAR have not had a raise in our
rates since 1972 and therefore the current rate of pay is substantially
below what we are paid in the private sector. Although we continue to
work for this amount, it is only with the thought that a sense of fair
play and justice will prevail. The new rates were provided to us, and
some of us even had contracts mailed to us, only to be rescinded. We
had been told that the language of the contract needed to be altered
and they would be redistributed and ``up and running'' by 1/1/09. Since
then we have waited patiently for the continuing resolution to play
out, and now that we have seen the budget approved for Social Security
we remain hopeful. If the purpose of increasing the Social Security
budget in 2009 as well as 2010 is to reduce the backlog, then
Vocational Experts will play a crucial role in this endeavor.
The Social Security Commission funded a panel a few years back to
conduct a needs assessment related to current administration needs. The
panel report (found at) made clear the need for Vocational Experts as
well as Medical Experts to receive an increase in fees. I feel that we
Vocational Experts have been more than patient and beseech you to
address this on our behalf. I am a member of the International
Association of Rehabilitation Professionals (IARP) and we hope for your
support in this matter.

Sincerely,

Renee B. Jubrey, MS, CVE
RBJ Vocational Experts
674 Prospect Avenue
Hartford, CT 06105