There are over eighteen million Americans currently receiving Social Security disability benefits. There are over three million new applications pending with the Social Security Administration (SSA). Of those three million applications, 700,000 are waiting for a hearing before an Administrative Law Judge (ALJ). The average waiting time for an individual to receive a decision on their disability application after requesting a hearing is three hundred and fifty (350) days. This is a drastic improvement from just a few years ago when the average wait time was five hundred and fourteen (514) days (McCoy 2011). Nevertheless, this drastic improvement is still not acceptable for those waiting on a decision.
When filing for disability benefits, an individual is asking to be considered unable to work due to injury or illness. If one is unable to work and is not receiving benefits, they do not have a year to wait. Few people have the means to provide for themselves, let alone a family, with no income for a year. According to the SSA, "the long wait for a hearing leads to homelessness and loss of family and friends" (http://www.socialsecurity.gov/asp/StrategicGoal1.pdf).
The backlog at SSA hearing offices has resulted from the recession, lack of jobs and resources and the policies and procedures of the hearing offices themselves. Due to recent congressional inquiry regarding the backlog, the SSA designed and implemented the Hearing Backlog Reduction Plan in 2007 (http://www.ssa.gov/hearingsbacklog.pdf). This plan outlines steps the agency intends to follow to reduce the backlog in hearing offices. According to the plan, the Agency intends to establish individual annual expectation of ALJs, increase number of ALJs and support staff in hearing office, increase number of hearing offices, pre-screen hearing requests to approve some claims prior to hearing, improve workload management practices and increase the use video hearings. These initiatives have managed to decrease the wait time significantly, however, with an increase in the number of current filings, the agency will need to go beyond these measures to bring the wait time down to an acceptable level.
There are many other ways the agency could reduce the backlog permanently. Although they have established expectations of ALJS of 500-700 hearing decisions each year, this expectation is extremely low. This requires an ALJ to make only two decisions a work day to meet their goal. The average hearing docket consists of eight to twelve claims. ALJs should be required to hold hearings five days a week, or every day the hearing office is open. Most hearings last no more than fifteen minutes, leaving at least half the day for an ALJ to review evidence and make decisions. At this rate, they should be able to make as many decisions as hearings held a day, or eight to twelve instead of two.
Not all claims that are heard are final after the hearing. Many are left open for the submission of additional evidence or to give the agency time to secure an independent evaluation by a physician. The majority of the cases left open are due to the claimant's attorney or representative requesting additional time to submit evidence. By the time a hearing is held, a claim has been pending at some level of Agency for well over a year, usually two years or more. All evidence should have been obtained and submitted by the time of the hearing. Hearings are scheduled months in advance and do not come as a surprise to the representatives or claimants who should be more diligent in submitting evidence in a timely manner.
In order to best serve the public, it may be necessary for the SSA to impose stricter rules regarding postponements of hearings. As previously noted, hearings are scheduled months in advance. Claimants and representatives will wait until the scheduled hearing to either not show up or show up and request a postponement. Claimants may decide, after having a pending application for years, that they want to be represented and request a postponement to obtain an attorney. Representatives will request postponements if they have not adequately reviewed a file or obtained evidence. One of the largest problems that causes delays in hearing wait times and tie up staff is the changing of addresses of claimants. Many claimants will fail to notify the hearing office of a change of address and they never receive their hearing notice. This can cause months long delays in receiving a hearing decision.
While the SSA deserves recognition for the improvements they have made on the backlog in recent years, there is still much left to be done.
McCoy, Kevin. (June 2011). Backlog grows for Social Security appeals. USA Today. Retrieved September 14, 2012 from http://www.usatoday.com/news/washington/2011-06-19-social-security-appeals-backlog_n.htm
Social Security Administration. Eliminate Our Hearings Backlog and Prevent Its Recurrence. Retrieved September 18, 2012 from http://www.socialsecurity.gov/asp/StrategicGoal1.pdf
Social Security Administration. (September 2007). Plan to Reduce the Hearingsd Backlog and Improve Public Service at the Social Security Administration. Retrieved September 15, 2012 from http://www.ssa.gov/hearingsbacklog.pdf
Leigh,
ReplyDeleteAfter receiving flack from politicians and the media, the administration has been putting excessive pressure on judges to hear more and more cases in hopes of clearing out the backlogs quicker.
But according to reports from investigators, by trying to push cases through so quickly, many claims are being approved without citing adequate medical evidence or without explaining medical basis for many of the decisions. One report concluded that the judges did not take the time to review all the evidence in some cases due to pressure from Social Security. The Social Security Administration claims that without congressional support, the disability trust fund is likely to run out by the year 2016, leaving thousands without full benefits.
Many people including Illinois residents, currently claiming disability benefits are not only concerned that the administration may not have enough money to sustain itself but that the administration may have set itself up for a backlog of fraud investigations as well. This leads many to wonder if their benefits may be rescinded even though they may have a legitimate medical disability.
Carolyn,
ReplyDeleteWhen a claimant receives an unfavorable decision from an ALJ, they can appeal to the Appeals Council (AC). If the AC finds the decision provided inadequate medical basis for the decision, they will remand it back to the hearing office for another hearing and decision. When the agency implemented individual annual expectations of ALJs according to the Hearing Backlog Reduction Plan of 2007, the percentage of cases remanded by the AC declined, although the number of appeals has slightly increased every year, just as the number of new claims has.
The reports I believe you are referring to are based on the Senate Permanent Subcommittee on Investigations study where 300 cases were reviewed in 3 counties. It was decided that 25% of the decisions provided inadequate medical basis for the decision rendered. The 300 decisions they reviewed were made at four different levels of SSA, ALJs in hearing offices were only one of those four levels. A total of only sixty ALJ decisions were reviewed for the report. There was not any evidence that the decisions themselves were incorrect. Nor was there evidence that ALJs were not properly or completely reviewing evidence. The problem lied in the way the decisions were written and how they did, or did not, properly address the medical evidence in the file. ALJs do not actually write decisions themselves. Some ALJs told the Subcommittee that they felt their workload was too demanding, other complained about how complex the program's rules have become and how difficult it is to apply them.
Contrary to the belief that the agency is putting pressure on ALJs to hear more cases to reduce the backlog, the Agency hired 144 new ALJs in 2011 to lighten the load of each ALJ. They have continued to hire new ALJs in 2012. The Agency caps how many claims an ALJ can adjudicate in a month to 100. In the end, the Senate Permanent Subcommittee on Investigations report suggested many measures to increase the quality of the decisions on disability claims, reducing the workload of ALJs was not one of them.