Statement of The Honorable Jo Anne B. Barnhart, Commissioner, Social Security Administration Testimony Before the Subcommittee on Social Security of the House Committee on Ways and Means June 15, 2006 Mr.
Chairman, Mr. Levin, and Members of the Subcommittee,
I am always delighted to
appear before you, but today I am especially pleased to be here. Today, I am
here to report that, after three years of incredible effort and cooperation,
our new disability determination process is a reality. For the first time in
50 years, we are making significant changes to the Social Security
Administration’s (SSA) disability determination process—changes that
substantially increase our ability to make accurate disability decisions in a
timely way. And that means better service to the American public.
I will outline the elements
in the new process in a few moments, but first I want to take this opportunity
to talk about how we got to this point. It has been a long journey, and the
members of this subcommittee have shared with me the journey toward this
achievement. And so have many others within and outside SSA. And I want to
thank you and everyone who participated from the bottom of my heart.
When I became Commissioner
in 2001, I said that I did not take this job to manage the status quo, and
nowhere was the need for change more clear than in the disability process. I’m
sure you know that there were people who told us that it would be impossible to
make major, comprehensive changes to the disability determination process. But
we have, and we have succeeded because groups involved at every step in the
disability process came together in a spirit of cooperation and
professionalism. We succeeded because of that spirit of cooperation,
openness, and constructive dialogue that I have seen in the conversations we’ve
had with people involved at every stage of the process.
As you know, when I announced my new
approach, I began a massive outreach effort to obtain and give thoughtful
consideration to all comments on the current disability system and on our
proposed improvements. I have acted upon my commitment to listen to you, to the
interested parties and groups in both the government and private sector, and to
the claimants and beneficiaries who rely on us to provide the best possible
service.
I personally participated in more than 100
meetings with more than 60 groups involved in the disability process – inside
and outside of SSA. My staff conducted even more meetings and we received more
than 1000 comments and recommendations over the Internet alone. I was very
impressed with the spirit of cooperation and professionalism that these groups
brought to our discussion.
When we published the
proposed rule, I did not expect agreement on every element of the approach
outlined in the NPRM. However, I hoped for—and got—a continuation of the same
spirit that we saw in the initial outreach period.
During the comment period,
SSA received almost 900 comments. At the hearing last September on the NPRM,
members of this Subcommittee urged me to consider carefully the issues that
were being raised in the comments. I want you to know that I personally read
many of these comments in full and worked with my senior staff to review and
discuss all of them.
We listened and made changes
in response. The disability determination process that we will begin
implementing in our Boston Region on August 1 is both different and better than
the original blueprint I first discussed with you on July 24, 2003, and the
process outlined in the Notice of Proposed Rulemaking we published in July 2005.
In drafting the final rule,
we were aware that many commenters perceived our proposed rule as favoring
administrative efficiency over fairness—especially in regard to timeframes for
submitting evidence before a hearing. When I testified before this
Subcommittee last fall, members of the Subcommittee articulated these same
concerns. Let me assure you that was not our intent. The new approach
spelled out in the final rule contains many changes which underscore my
commitment to an open, inclusive dialogue in the true meaning of the word
dialogue – which includes listening.
We addressed the concerns
about giving claimants sufficient time to submit evidence in three ways.
First, we will give claimants at least 75 days notice before a hearing instead
of the 45 days proposed in the NPRM. This will allow claimants and their
representatives enough time to gather all necessary evidence and prepare for
the hearing. Second, the final rule allows claimants to submit evidence up to
5 business days before their hearing instead of 20. This gives the claimant
more time to submit evidence and will ensure that all parties to the hearing
have enough time before the hearing to review the evidence and prepare for the
hearing. Third, we expanded the range of circumstances in which an ALJ will
accept evidence that does not meet the 5-day deadline.
Final Rule
The final rule was published
in the Federal Register on March 31. It explains the new
procedures for adjudicating initial claims for disability insurance and for
Supplemental Security Income based on disability or blindness. The preamble to
the final rule explains in detail the changes from the NPRM that were made as a
result of the comments the Agency received. We created a dedicated website, www.socialsecurity.gov/disability-new-approach,
to provide you with information about the new regulation and background related
to its development.
The new disability
determination process takes full advantage of Social Security’s new electronic
disability claims system, or eDib. Using eDib technology, the DSI changes will
shorten decision times and pay benefits to people who are clearly disabled much
earlier. eDib also allows us to access the electronic folder from any location
making possible many of the changes in the new process.
Changes to the NPRM
As I
mentioned at the beginning of my statement, in drafting the final rule, we were
aware that, although there was broad agreement on the need for change, numerous
groups perceived our proposed rule as favoring administrative efficiency over
fairness.
We made a number of changes
in the final rule in addition to the changes in the timeframes for submitting
evidence that I discussed a moment ago.
We added language to the
final rule to make it clear that a claimant, unable to make a timely request
within 60 days of receiving his or her initial notice, can request additional
time to request a review both before and after the 60-day period has ended.
The claimant will also be permitted to submit new evidence after requesting
review up until the date of the Federal Reviewing official, or FedRO decision
(I will discuss this provision in more detail later).
We heard many concerns with
the proposal that the Decision Review Board, or DRB, would consider only
statements that it requested from claimants. In response, in the final rule,
we allow claimants to submit statements to the DRB whenever the DRB notifies a
claimant that it will review his or her claim.
Without question,
elimination of the Appeals Council and its effect on the Federal courts was the
area in which the most concern has been raised. At present, all social security disability cases
appealed to the Federal courts must first be reviewed by the Appeals Council.
Despite this final administrative review, nearly 60% of all appealed cases are
remanded to the Agency either “voluntarily” through requests made by our
General Counsel or as a result of findings made by the courts. Accordingly, in
the NPRM we proposed gradually to phase out the Appeals Council and replace it
with a new DRB. While claimants would no longer have a right to request review
of an ALJ decision, the DRB would review an equal number of error-prone allowances
and denials.
Throughout the comment
period, concerns were expressed about this approach by organizations
representing disability claimants who expressed fears that clearly erroneous
denial decisions might escape review. The Judicial Conference and others also
expressed concern that the Federal courts might be inundated with meritorious
claims that would otherwise have been intercepted and resolved by the Appeals
Council. In both instances, these concerns centered on the question of whether
the Agency could develop an effective method for selecting the cases to be
reviewed by the DRB.
In response to these
concerns, we have decided that the DRB will initially review all of the
administrative law judge decisions– allowances and denials– issued in the Boston region. This 100 percent review will allow us carefully to design, test, and
validate a predictive model for selecting a subset of all ALJ decisions for DRB
review that include those most likely to be remanded by the U.S. District
Courts. During this same period, we will analyze the effects of the new
approach on the workload of the Federal courts within the region.
We also heard many concerns
about the changes we proposed regarding our reopening rules. Many argued that
our existing reopening rules already worked well for claims decided at the
earlier stages of the process. In response, we decided that our existing
reopening rules would continue to operate for all claims adjudicated prior to
the hearing level. We retained other changes to the reopening rules to allow
for the reopening of claims decided at the hearing level or beyond while at the
same time ensuring that we could efficiently close the record, with good cause
exceptions, after we have issued a final decision.
Overall, our expectation is
that the disability service changes will result in substantial improvements
that will enable claimants to receive more accurate, consistent, timely, and
understandable decisions. We also believe that this rule ensures an
adjudicatory process that is consistent with due process, will give claimants a
meaningful opportunity to be heard, and make accurate allowances as early in
the process as possible.
Changes in SSA’s
Structure
To improve the management of
our initiative as we move forward, I made two major organizational changes at
SSA. I created a new Deputy Commissioner-level office named the Office of
Disability Adjudication and Review to manage the agency’s disability
adjudication process. The Office of Disability Adjudication and Review, or
ODAR, will manage the new FedRO level, the hearings and appeal functions
formerly managed by the Office of Hearings and Appeals, and the new Decision
Review Board. I believe it is important to have a single Deputy Commissioner
that I can rely on to manage effectively every level of our disability
adjudication appeals process, so that I can be sure that the entire
adjudicatory process is functioning efficiently and fairly for every single
claimant.
I also established a new
Office of Quality Performance to manage the Agency’s newly developed and still
evolving integrated quality system which I believe will improve our disability
determination process, as well as other program areas such as the Social
Security retirement program and the SSI age-based program. The new Office of
Quality Performance will manage a new quality system that includes both in-line and end-of-line quality review throughout
the new DSI process. The Office of
Quality Performance will be able quickly to identify problem areas, implement
corrective actions, and identify related training as we implement the new DSI
process.
Features of the New
System
So how does the new process
work? In summary:
- The State Disability
Determination Services (DDS) will continue to make the initial determination.
- Individuals who are clearly
disabled will have a process through which favorable determinations can be made
within 20 calendar days after the date the DDS receives the claim.
- A Medical and Vocational Expert
System (MVES) will enhance the quality and availability of the medical and
vocational expertise that our adjudicators at all levels need to make timely
and accurate decisions.
- A new position at the Federal
level – the Federal Reviewing Official, or FedRO – will be established to
review state agency determinations upon the request of the claimant. We intend
to have well-trained attorneys serve as FedROs and we expect that this level of
review will help ensure more accurate and consistent decision making earlier in
the process.
- The right of claimants to request
and be provided a de novo hearing conducted by an administrative law judge is
preserved.
- The record will be closed after
the administrative law judge issues a decision, with provisions for good cause
exceptions.
- A new body, the Decision Review
Board (DRB), will be created to identify and correct decisional errors and to
identify issues that may impede consistent adjudication at all levels of the
process.
- And the Appeals Council will be
gradually phased out as the new process is implemented throughout the nation.
Two key improvements are embedded
in the process. First are improvements in documenting the record at each step,
so that all relevant information is available to adjudicators, and the claimant
fully understands the basis for whatever decision is made. Second is a greatly
strengthened in-line and end-of-line quality review process. In addition,
quality feedback loops at every level will foster continuous improvement.
Implementation
The DSI process will be
rolled out in a careful and measured manner. This gradual implementation will
allow us to monitor the effects that the changes are having in each region, on
our entire disability process, and the Federal courts. The lessons that we
learn in the early stages of implementation will help us as we move into the
later stages of the roll-out.
Just as we did with the
implementation of our electronic system, implementation will be phased in and
if we find that additional improvements are needed during the roll-out, we can
and will make them. We will continue to listen to those with concerns, and we
will make changes when necessary.
Moreover as we roll out the
DSI process we intend to continue and expand our efforts to make sure that all
adjudicators make their determinations and decisions based on a record that is
as complete as possible. To do so, we plan to review and improve our
informational services to claimants and to medical providers so that they will
better understand what information adjudicators need to make determinations or
decisions.
We also are developing
requirements for training physicians and psychologists who perform our
consultative examinations to make certain that they understand our
determination process and the information adjudicators need to make accurate
decisions. As part of this effort to improve consultative examinations, we are
instituting a quality review to ensure that claimants are getting a good
evaluation of their conditions by the right set of eyes and to ensure these
examinations are yielding the information we need to make decisions. In
addition, we are developing templates that adjudicators will use when they
request examinations to ensure that the appropriate information is requested.
Decisional templates are
also in the works for adjudicators at the DDS and FedRO levels that will assist
them in writing decisions, and we have already started using a decisional
template at the administrative law judge level. The use of these templates
will help ensure that claims are properly developed, legally sufficient, and
consistent with our policies.
The templates are being or
have been created and tested with considerable input from adjudicators in the
field – the very people who will use them in the new process. They are a
critical factor in ensuring accuracy and consistency, and in enabling the
quality feedback loops.
In addition, we are working
with medical sources to encourage the submission of evidence electronically
whenever possible in order to expedite the decisional process. Special
arrangements are in place to obtain both medical and non-medical records from
large governmental agencies such as the Department of Veterans Affairs, the Military Personnel Records Center, and State Division of Vital Statistics. As a result,
Social Security is already the largest repository of electronic medical records
in the world. And, we have stringent policies and procedures in place to
properly safeguard personally identifiable and medical information from loss,
theft, or inadvertent disclosure.
We will begin implementation
in the Boston Region for claims filed on or after August 1, 2006. Boston is one of our smallest regions and is comprised of the six States of Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont. After full implementation
in these states, we expect to wait an entire year – to monitor the changes and
collect management information – before we consider rolling out in a second
region.
By taking this careful and
measured approach, we will be able to address any issues that may arise and
ensure that implementation in future regions will progress efficiently.
Under our implementation
plan, DSI will only apply to claims that are filed in a region where the DSI
process has been implemented. If a claim is filed in a region where we have
not yet implemented the new process, we will use current procedures to
adjudicate the claim.
If a claimant moves from one
State – where the new process is in place – to another State – that does not
have the new process – the adjudicators will apply the regulations that were
initially applicable to the claim. In other words, once a claim is under one
system, it will stay in that system. This also applies to the pending cases in
a region when roll-out begins. Those cases that are already in the system will
be worked under the “old” rules and new cases will be worked under the “new”
rules.
For example, the elimination
of an Appeals Council review will only apply in regions where we have rolled
out the new DSI process and to disability claims that have been processed from
the start under this rule.
Of
course, we will continue to monitor the effects on the disability determination
process and the Federal courts as we implement DSI in other regions of the
country. Obviously, if we find that there are issues, we will make changes as
necessary.
Rollout Begins August
1
As I said, we are rolling
out the process on August 1st, and you have my assurance that we are
doing all that we can to make sure that we implement in an orderly and timely
manner. In typical fashion, the hardworking men and women of SSA and the state
DDSs have pulled together and are getting the things done that must be done to
move forward.
So far, we have developed
major new computer systems to support the DSI initiative. We have performed
all of the personnel and hiring work necessary to make sure that we have the
new employees in their new positions, properly trained, in time to perform
their new DSI duties when implementation begins. We are working to ensure that
effective training is prepared and presented to every employee who will be
involved with the new disability determination process. Although we do not
have the same kind of personnel or hiring issues at the hearing level as we do
for other levels, we do have systems needs unique to the hearing level, and we
are currently working to ensure that the necessary computer systems are in
place by the time the first DSI claim reaches the hearing level.
Conclusion
As you know, shortly after I
became Commissioner, I met with President Bush to discuss SSA’s disability
programs. He asked me three questions:
- Why does it take so long to make
a disability decision?
- Why can’t people who are
obviously disabled get a decision immediately?
- Why would anyone risk going back
to work after going through such a long process to receive benefits?
I am proud to say that our
new disability process addresses all of these concerns.
As I look back over the long
road to the changes we will begin implementing in just a few weeks—and reflect
on the spirit of cooperation, professionalism and dedication to serving the
public that has been demonstrated by the men and women of SSA and the DDSs,
advocacy groups, and Congress—I am convinced that we can make this happen. I
am also convinced that the American public will benefit greatly.
As we roll out DSI, we plan
to continue the dialogue that has served the process so well. Because this is
not
just about getting it done; it’s about getting it done right.
In closing, I want to
express again my heartfelt thanks to everyone who has helped us on our journey
toward an effective DSI. As I said at the beginning of my testimony today,
this subcommittee has traveled with us throughout the journey. I want to thank
you again publicly for your advice, insight and support that have meant a great
deal to the agency and to me personally. And I know that we can count on your
continued support and advice as we make DSI a reality.
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