| Statement of Marty Ford, Co-Chair, Consortium for Citizens with Disabilities Social Security Task Force Testimony Before the Full Committee of the House Committee on Ways and Means April 23, 2008
Chairman Rangel, Ranking Member McCrery, and Members of the
House Ways and Means Committee, thank you for inviting me to testify at today's
hearing on Clearing the Disability Backlog – Giving the Social Security
Administration the Resources It Needs to Provide the Benefits Workers Have
Earned.
I am a member of the public policy team for The Arc and UCP
Disability Policy Collaboration, which is a joint effort of The Arc of the United States and United Cerebral Palsy. I serve as Chair of the Consortium for Citizens
with Disabilities (CCD), and also serve as a Co-Chair of the 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.
The focus of this hearing is extremely important to people
with disabilities. Title II and SSI cash benefits, along with the related
Medicaid and Medicare 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).
I. THE IMPACT ON PEOPLE WITH DISABILITIES OF
INSUFFICIENT FUNDING
FOR SSA’S ADMINISTRATIVE BUDGET
As the backlog in decisions on disability claims continues
to grow, people with severe disabilities have been bearing the brunt of insufficient
funding for SSA’s administrative budget. 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.[1]
Numerous recent media reports across the country have documented the suffering
experienced by these individuals. Access to other key services, such as replacing
a lost check or promptly recording earnings, also has diminished. Despite
dramatically increased workloads, staffing levels throughout the agency are at
the lowest level since 1972.
Backlog in Appeals of Disability Claims: The Human Toll
The National Organization of Social Security Claimants’
Representatives (NOSSCR), a member of the CCD Social Security Task Force,
recently conducted a quick survey of their members for an update on how the
backlogs are affecting claimants. The following short descriptions of
individual’s circumstances are a sampling of what is happening across the
country to claimants who are forced to wait interminably for decisions on their
appeals. Your own constituent services staff are likely well aware of similar
situations from your Congressional district.
· Mr. R is 38 years
old and lives in Brooklyn, New York. He has major depressive disorder,
anorexia nervosa with severe weight loss, somatoform disorder, and generalized
fatigue. He applied for SSI benefits in September 2003 and requested a hearing
in March 2004. The ODAR hearing office failed to send a Notice of Hearing
for the hearing, scheduled in December 2006. As a result, Mr. R did not
appear and his hearing request was dismissed. He obtained representation
in June 2007 after the dismissal. His attorney immediately contacted the ALJ
and submitted all documents establishing that Mr. R was never informed of the
hearing. She also sent all medical evidence she had obtained. The
attorney asked the ALJ to reopen the case and to schedule an expedited
hearing. The hearing was finally held in November 2007 and the ALJ issued
a favorable decision in late November 2007. There still was a delay in
receipt of benefits as Mr. R did not receive his first SSI past due installment
payment until March 2008 and his first SSI monthly payment until April 2008.
While waiting for the hearing decision and benefits
payments, Mr. R lost his welfare benefits and Medicaid, so he could not receive
treatment. His anorexia nervosa was so extreme as to cause severe tooth
decay requiring dentures. He received an eviction notice for his apartment but
his attorney worked with the landlord to stave off eviction based on the fact
that a new hearing was being scheduled. Because his welfare case
was closed, Mr. R had no money. He had to go to food pantries for any
donation and his neighbors helped him from time to time. He even had to
borrow money to ride the subway to his hearing.
· Ms. K applied for
disability benefits in August 2004. She lived in Key West, FL. Her husband shot her 5 times in the liver and abdomen and then killed himself.
Her disabilities stemmed from these injuries and from chronic obstructive
pulmonary disease (COPD). Her claim was denied and she requested a
hearing in April 2006. Nearly two years later, her hearing was held in March
2008 and the ALJ stated that benefits would be awarded. Unfortunately,
Ms. K died in late March 2008 of long-term complications from her wounds and
COPD, before the written decision was received. Because she did not have money
to live independently, she was forced to live with her mother. The
mother, who has dementia, is a chain-smoker. During the last part of her
life, Ms. K had frequent hospitalizations. She would then return to her
mother’s house and her condition would worsen. Her attorney last saw Ms.
K about a week before her death. Ms. K told her attorney that she believed she
would die if she could not get into a smoke-free living situation. Since
Ms. K died in part from COPD, her attorney believes that her compromised living
situation, due to the lack of income, shortened her life.
· Mrs. G, a 58 year
old woman from Georgia, worked her entire life, the last 15 years at a
convenience store. Over time, she developed degenerative joint disease and
cardiovascular problems. In 2004, she deteriorated to the point that she
stopped working. She had a house where she had lived for many years but fell behind
on the payments. Her attorney had to intercede on her behalf several times to
stop foreclosure. Her car, which she fully owned, sat idle because she could
not pay the tag fees and could not afford gas. Three years after she applied,
she had a hearing. While the ALJ stated at the hearing that a favorable ruling
would be forthcoming, it still took more than six months after the
hearing before she received her favorable decision. Even then she had
trouble getting her monthly benefits started. Several months passed and still
she did not receive past due benefits. As she still owed back mortgage
payments, the mortgage company started foreclosure proceedings again. She
reported to her attorney that the anxiety over her claim was making her
cardiovascular problems worsen. She never received her past due benefits. She
died still waiting. Her attorney notes that Mrs. G is his fourth client who has
died in the last three years while waiting for a favorable decision and payment
of benefits.
· Mr. M lived in the
Chicago, IL, area. He had various medical problems, but the most significant
one was the need for kidney dialysis, which became apparent after the
application was filed. The need for dialysis meant that his impairment met one
of the listings of impairments, at least as of the date that the dialysis
began. His request for hearing was filed in January 2007. Mr. M’s medical
condition worsened. In addition, he did not have a permanent residence and
stayed with his sister for part of the time that his claim was pending.
However, he informed his attorney that his sister was moving, that he could no
longer stay with her, and that he had no alternative place to live.
In July 2007, his attorney began a series of contacts with
the ODAR hearing office in an effort to have the case considered for an “on the
record” decision or to schedule a hearing on an expedited basis given Mr. M’s
medical condition and lack of a permanent residence. Between July 2007 and
February 2008, his attorney sent five letters, left multiple voice mail
messages, and spoke with the hearing office director about Mr. M’s case.
Finally, in February 2008, the hearing office called to schedule the case in
April 2008, sixteen months after the appeal was filed. Unfortunately, Mr. M
died in March 2008. As a result, he never received the benefits to which he
was entitled. He died destitute. And because this was an SSI claim, no one,
including his sister who helped him, will be eligible to receive the
retroactive benefits.
· Mr. O, from Richmond, Missouri, died in the lobby of the ODAR hearing office while waiting to be called
for his hearing on April 2, 2008. He was 49 years old and is survived by his
wife and 4 children. He filed his SSI application for disability in November
2005, alleging inability to work due to uncontrolled diabetes with neuropathy,
and shoulder and arm pain. He had worked for 14 years as a truck driver. His
claim was denied in March 2006 and he promptly filed a request for hearing in
April 2006. While waiting for hearing, he had numerous problems with child
support authorities and his home was foreclosed upon. His representative filed
a dire need request in July 2007 to expedite the hearing, but he did not
receive a hearing date until February 2008, when the hearing was scheduled for
April 2, 2008, the day he died.
· Mr. N lived in the
Charlotte, North Carolina area. He was 57 years old and died in August 2007.
As an adult, he obtained a degree in theology. From 1986 to 1997, he worked
doing maintenance on power generating stations. He developed heart disease and
emphysema and, from 1998 to 2004, he did less strenuous work. In June 2005, he
filed a claim for Title II disability benefits. His claim was denied and he
requested a hearing in April 2006. During the wait, he developed a spot on his
lung, but could not afford a CT scan for an accurate diagnosis. In May 2007,
he received a foreclosure notice, lost his house, and had to move in with his
daughter. He died in August 2007 of ischemic heart disease. In February 2008,
months after his death, his claim was approved on informal remand to the DDS.
· Mrs. M, a 33 year
old former waitress and substitute school teacher, lives in Muskogee, Oklahoma. She has degenerative joint disease of the lumbar spine, neck and hands; hearing
loss; left wrist injury; migraines; tingling/numbness in the left knee and left
foot; right hip problems; dizziness and nausea. She filed her application for
benefits in August 2005 and a request for hearing in May 2006. Mrs. M is
married with three children, including one son who is disabled. After a nearby
plant explosion damaged their home in 2004, the family was forced to move into
an apartment. Evicted in 2007, they have had no permanent residence since then
and have been forced to live in a variety of temporary settings, including a
shelter for women and children (Mrs. M’s husband slept in the car). After the
2007 eviction, Mrs. M’s attorney sent letters to the ODAR hearing office
requesting an expedited hearing because of the family’s homelessness. Mrs. M
received a fully favorable decision on March 26, 2008, nearly two years after
she filed her request for a hearing. Her disabled child also received a
favorable decision on March 25, 2008. On April 7, 2008, an SSA district office
worker informed the attorney that both Mrs. M and her disabled child were in
pay status.
A full set of these stories, submitted from 29 states, is
located at the end of this testimony. Without a doubt, people with severe
disabilities are bearing extraordinary and unnecessary hardship as a result of
the persistent under-funding of SSA’s administrative expenses.
Inadequate Funding of SSA’s Limitation on Administrative
Expenses
The primary reason for the continued and growing disability
claims backlogs is that SSA has not received adequate funds for its management
costs. Although Commissioner Astrue has made reduction and elimination of the
disability claims backlog one of his top priorities, without adequate
appropriations, the situation will deteriorate even more.
Recent Congressional efforts to provide SSA with adequate
funding for its administrative budget are encouraging. The Fiscal Year 2008
appropriation for SSA’s Limitation on Administrative Expenses (LAE) was $9,746,953,000.
This amount was $148 million above the President’s request and was the first
time in years that the agency has received at least the President’s request.
While the FY 2008 appropriation allows the agency to hire
some new staff and to reduce processing times, it will not be adequate to fully
restore the agency’s ability to carry out its mandated services. Between FY
2000 and 2007, Congress appropriated less than both the Commissioner of Social
Security and the President requested, resulting in a total administrative
budget shortfall of 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.
Processing Times Have Reached Intolerable Levels
The average processing time for cases at the hearing level
has increased dramatically since 2000, when the average time was 274 days.[2]
In the current fiscal year, SSA estimates that the average processing time for
disability claims at the hearing level will be 535 days,[3]
nearly twice as long as in 2000. It is important to keep in mind that this is
an “average” and that many claimants will wait longer. 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.[4]
The current processing times in some hearing offices are
striking, and much longer than the 535 days targeted by SSA in FY 2008. SSA
statistics from March 2008 for its 144 hearing offices[5]
indicate that the average processing time at 47 hearing offices is above the projected
average processing time. There is wide fluctuation, with some offices over 700
days and even over 800 days.
Impact on Post-Entitlement Work
While the impact of inadequate funding on the backlog in
disability decisions is unacceptable, there are also other important functions
which SSA cannot perform in a timely manner. SSA has many mandated responsibilities,
which include: paying benefits; issuing Social Security cards; processing
earnings for credits to worker’s records; responding to questions from the
public on the 800-number and in the field offices; issuing Social Security
statements; processing continuing disability reviews (CDRs) and SSI eligibility
redeterminations; and administering components of the Medicare program,
including subsidy applications, calculating and withholding premiums, making
eligibility determinations, and taking applications for replacement Medicare
cards.
One aspect of post-entitlement work that has slipped in the
past is the processing of earnings reports filed by people with disabilities.
Typically, the individual calls SSA and reports work and earnings or brings the
information into an SSA field office. However, due to budget constraints, SSA often
fails to input the information into its computer system and does not make the
needed adjustments in benefits. Months or years later – after a computer match
with earnings records – SSA sends an overpayment notice to the beneficiary,
demanding re-payment of sometimes tens of thousands of dollars. All too often,
however, SSA will indicate that it has no record of the beneficiary’s earnings reports.
Many individuals with disabilities are wary of attempting to return to work
out of fear that this may give rise to the overpayment scenario and result in a
loss of economic stability and health care coverage upon which they rely.
Advocates report seeing problems of overpayments and
underpayments generated by the inability of SSA to open its mail.
Clients describe sending in pay-stubs and not seeing any change in
benefits for 6 months. One advocate indicated that his client
protested and requested waiver of an overpayment, insisting that she had
reported and sent in pay stubs as required. She requested that a
Claims Representative search the mail room and reported that a year's worth of
specially colored envelopes from her were found lying unopened in the district
office mail room.
Impact on Performing Continuing Disability Reviews (CDRs)
and SSI Redeterminations
The processing of CDRs and SSI redeterminations is necessary
to protect program integrity and avert improper payments. Failure to conduct
the full complement of CDRs would have adverse consequences for the federal
budget and the deficit. According to SSA, CDRs result in $10 of program savings
and SSI redeterminations result in $7 of program savings for each $1 spent in
administrative costs for the reviews.[6]
However, the number of reviews actually conducted is directly related to
whether SSA receives the necessary funds. SSA’s Budget Justification refers
specifically to CDRs based on medical factors.[7]
It is important when SSA conducts work CDRs that it assess whether reported
earnings have been properly recorded and ensure that they properly assess
whether work constitutes substantial gainful activity (SGA).
The Number of Pending Cases Continues to Increase
In its 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.[8]
The number of pending cases at the hearing level reached a low in FY 1999 at
311,958 cases. The numbers have increased dramatically since 1999, reaching 752,000
in FY 2008.[9]
SSA received funding in FY 2008 to hire approximately 150
new Administrative Law Judges to conduct hearings and some additional support
staff. We understand that SSA has already hired 135 ALJs. It will take some
time for the judges to be trained and to get up to speed in hearing and
deciding disability cases. However, productivity is not related solely to the
number of ALJs, but also to the number of support staff. While SSA senior
managers and ALJs recommend a staffing ratio of 5.25,[10]
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)
[11],
the number of pending cases older than 270 days was much lower.
Decreases in Staffing Result in Decreases in Services
Beyond the crisis in cases pending for hearings, SSA
estimates that in FY 2009 it will have a staffing deficit of essentially 8,100
full-time staff.[12]
The FY 2008 shortfall is 3,300 workyears, and the FY 2009 shortfall is projected
to be 4,800 workyears. We understand from Social Security officials that these
figures must be added together to see the cumulative shortfall of 8,100
staff. This shortfall explains the concerns mentioned above regarding the
agency’s ability to carry out its mandated services.
Impact of New Workloads
We were pleased that in the recent Economic Stimulus Act of
2008,[13]
Congress recognized the added work that SSA will incur as a result of the
legislation and appropriated an additional $31 million to the agency for FY
2008. However, over the past decade, Congress has passed legislation that
added to SSA’s workload, but did not necessarily provide additional funds to
implement these provisions. Recent examples include:
▪ Conducting pre-effectuation reviews on
increasing numbers of initial SSI disability allowances. SSA must review these
cases for accuracy prior to issuing the decision.
▪ Changing how SSI retroactive benefits
are to be paid. SSA must issue these benefits in installments if the amount is
equal to or more than three months of benefits. The first two installments can
be no more than three months of benefits each, unless the beneficiary shows a
hardship due to certain debts. Under prior law, the provision was triggered
only if the past due benefits equaled 12 months or more. SSA must address
these hardship requests and handle the increased number of installment
payments.
▪ SSA’s Medicare workloads. SSA has
workloads related to the Medicare Part D prescription drug program, including
determining eligibility for low-income subsidies; processing subsidy changing
events for current beneficiaries; conducting eligibility redeterminations;
performing premium withholding; and making annual income-related premium
adjustment determinations for the Medicare Part B program.
Mandatory employment verification would overwhelm SSA
We are very concerned about the potential impact of legislation
under consideration to mandate the use of the electronic employment eligibility
verification system (EEVS) to all employers. Since 1996, employers have had
the option of verifying names and Social Security Numbers of new hires against
SSA’s database through EEVS, an e-verification pilot program operated jointly
by SSA and the Department of Homeland Security (DHS). Currently 53,000
employers use it to verify the legal status of job applicants. Most are
participating voluntarily, but some are required to use the EEVS by law or due
to prior immigration violations. Studies have found that the current
system, used by less than 1% of all employers, is hampered by inaccuracies in
the DHS and SSA records. If made mandatory, the errors in EEVS would require
millions of U.S. citizens and legal immigrants to interact with SSA to prove
that they are eligible to work. At a hearing of the Social Security
Subcommittee on June 7, 2007, the SSA witness indicated that SSA would need at
least 2,000 to 3,000 additional staff to handle the new workload.
Given the current shortage in administrative resources for
SSA discussed above (8,100 workyears short in FY 2009), we cannot support
increased mandatory responsibilities of this magnitude. Past experience with new
workloads for SSA make us wary of the capacity to fully fund the administrative
responsibilities on a sustained basis. Such a mandate could have further
devastating effects on the disability determination system which is already so
overwhelmed.
CCD Recommendations Regarding SSA Limitation on
Administrative Expenses Funding
The President’s request for the SSA FY 2009 LAE does not go
far enough to put the agency on a clear path to provide its mandated services
at a level expected by the American public. SSA must be given enough funding
to make disability decisions in a timely manner and to carry out other critical
workloads. Due to the serious consequences of persistent and cumulative under-funding
of SSA’s administrative expenses, we strongly recommend that SSA receive $11
billion for its FY 2009 LAE. This amount will allow the agency to make
significant strides in reducing the disability claims backlog, improving other
services to the public, and conducting adequate numbers of CDRs and SSI redeterminations.
At a minimum, SSA should receive the President’s request of $10.327 billion
plus $240 million for integrity work.
In addition, CCD also urges Congress to separate SSA’s LAE
budget authority from the Section 302(a) and (b) allocations for discretionary
spending. The size of SSA’s LAE is driven by the number of administrative
functions it conducts to serve beneficiaries and applicants. Congress should
remove SSA’s administrative functions from the discretionary budget that
supports other important programs. The LAE would still be subject to the
annual appropriations process and Congressional oversight.
II. RECOMMENDATIONS FOR IMPROVING THE DISABILITY CLAIMS
PROCESS
Money alone will not solve SSA’s crisis in meeting its
responsibilities. Commissioner Astrue has 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. Many of these
recommendations have already been initiated by SSA.[14]
We believe that these recommendations and agency initiatives, which overall are
not controversial and which we support, can go a long way towards reducing and
eventually eliminating the disability claims backlog. Finally, we have raised
concerns about SSA proposals to revise the appeals process for claimants who
have received initial denials of their disability claims.
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 bottom line evaluation
must be how the process affects 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 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. As seen earlier in this testimony, 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.
We believe that the critical measure for assessing
initiatives for achieving administrative efficiencies must be the potential
impact on claimants and beneficiaries. 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.
1. Improve Development of Evidence Earlier in the
Process
CCD supports full development of the record at the beginning
of the claim 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.
Developing the record so that relevant evidence from all
sources can be considered is fundamental to full and fair adjudication of
claims. The adjudicator needs to review a wide variety of evidence in a
typical case, including: medical records of treatment; opinions from medical
sources and other treating sources, such as social workers and therapists;
records of prescribed medications; statements from former employers; and
vocational assessments. The adjudicator needs these types of information to
make the necessary findings and determinations under the SSA disability
criteria.
Claimants should be encouraged to submit evidence as early
as possible. However, the fact that early submission of evidence does not
occur more frequently is usually due to many reasons beyond the claimant’s
control, including:
·
State agency disability examiners who fail to request and obtain
necessary and relevant evidence, including the failure to request specific
information tailored to the SSA disability criteria;
·
The failure of SSA and state agency disability examiners to
explain to claimants or providers what evidence is important, necessary, and
relevant for adjudication of the claim;
·
Cost or access restrictions, including confusion over Health
Insurance Portability and Accountability Act (HIPAA) requirements, which prevent
claimants from obtaining records;
·
Medical providers who delay or refuse to submit evidence;
·
Inadequate reimbursement rates for providers; and
·
Evidence which is submitted but then misplaced.
Claimants’ representatives are often able to ensure that the
claim is properly developed. Based on the experiences and practical techniques
of representatives, we have a number of recommendations[15]
that we believe will improve the development process:
· 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
application paperwork 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, state
disability determination service (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[16];
the evaluation of mental impairments, pain, and other subjective symptoms; the
evaluation of childhood disability; and the use of the Social Security Rulings.
· Improve
use of the existing methods of expediting disability determinations. SSA
already has in place a number of methods which can expedite a favorable
disability decision if the appropriate criteria are met, including Quick
Disability Determinations, Presumptive Disability in SSI cases, and terminal
illness (“TERI”) cases.
· 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.
2. Expand
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. The initiative to process
disability claims electronically has the prospect of significantly reducing
delays by eliminating lost files, reducing the time that files spend in
transit, and preventing misfiled evidence. Some of the technological improvements
that we believe can help reduce the backlog include the following:
· The
electronic disability folder: “eDIB.” The electronic folder should reduce
delays caused by the moving and handing-off of folders, allowing for immediate
access by different components of SSA or the DDS.
· Electronic
Records Express (ERE). ERE is an initiative to increase the use of
electronic options for submitting records related to disability claims that
have electronic folders. Registered claimant representatives are able to
submit evidence electronically through the SSA secure website or to a dedicated
fax number using a unique barcode assigned to the claim.
· 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.
· Use of
video hearings. Video hearings allow ALJs to conduct hearings without
being at the same geographical site as the claimant and representative and has
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.[17]
3. New Screening Initiatives
We support SSA’s efforts to accelerate decisions and develop
new mechanisms for expedited eligibility throughout the application and review
process. Ideally, adjudicators should use SSA screening criteria as early as
possible in the process and 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.[18]
The QDD process has the potential of providing a prompt disability decision to
those claimants who are the most severely disabled. Since the QDD process’s
August 2006 implementation in Region I states, the vast majority of QDD cases
have been decided favorably in less than 20 days.
· 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.[19]
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….” Like the QDD process, SSA is
looking at the use of computer software to screen cases by searching claims for
key words in the electronic folder.
4. Other Hearing Level Improvements
· The Senior
Attorney Program. In the 1990s, senior staff attorneys were given the
authority to issue fully favorable decisions in cases that could be decided
without a hearing (i.e. “on the record”). While the Senior Attorney Program
existed, it helped to reduce the backlog by issuing approximately 200,000
decisions. We are pleased that Commissioner Astrue has decided to reinstate
the program for at least the next two years[20]
and has proceeded with implementation.[21]
We believe that this initiative will help to reduce the backlog of cases at the
hearing level.
· Increasing
the time for providing notice of hearings. Current regulations in most of
the country provide only a 20-day advance notice for ALJ hearings. This time
period is not adequate for requesting, receiving, and submitting the most
recent and up-to-date medical evidence prior to the hearing. SSA has proposed
to expand the 75-day hearing notice requirement nationwide.[22]
We strongly support this proposed change. This increased time period will mean
that many more cases would be fully developed prior to the hearing and lead to
more on-the-record decisions, avoiding the need for a hearing.
CCD Response to the NPRM: Amendments to the Administrative Law Judge,
Appeals Council, and Decision Review Board Appeals Levels
On October 29, 2007, SSA published a Notice of Proposed
Rulemaking (NPRM), which would make major changes to the appeals process.[23]
We had very serious concerns about the proposed rule’s impact on claimants and
beneficiaries and submitted extensive comments on behalf of over 30 national
organizations.[24]
Our overarching concern was that many aspects of the proposed process would elevate
speed of adjudication above accuracy of decision-making. This is problematic
and not appropriate for a non-adversarial process.
On balance, we urged the Commissioner not to implement this
NPRM unless significant changes were made to protect the rights and interests
of people with disabilities. Our measure is whether the process will be fair.
While there are some positive proposed changes, e.g., a 75-day hearing notice
(the current rule provides only a 20-day notice); de novo review by the
ALJ; and retaining a claimant’s right to administrative review of an
unfavorable ALJ decision, we noted that the package of proposals, as a whole, would
result in more decisions that are not based on full and complete records. Claimants
would be denied not because they are not disabled, but because they would not
have had an opportunity to present their case. It is appropriate to deny
benefits to an individual who is found not eligible, if that individual has
received full and fair due process. It is not appropriate to deny benefits to
an eligible individual simply because he or she has been caught in procedural
tangles and barriers. We believe that the flexible nature of the current
non-adversarial, truth-seeking process must be preserved.
As you know, on January 29, 2008, after the close of the public
comment period, Commissioner Astrue informed Representative McNulty, Chairman
of the Social Security Subcommittee, that in light of the concerns expressed by
the public and Members of Congress, he was suspending the rulemaking process
for the provisions that were controversial.
Following that announcement, Commissioner Astrue met with
members of NOSSCR and CCD to discuss those areas of the proposed rule
considered controversial. We felt the meeting was productive and believe that
Commissioner Astrue and his staff are working in good faith to address the
serious concerns raised by advocates. We look forward to another meeting or
follow-up on those issues which SSA officials agreed to reconsider.
Claimant Stories Provided by Representatives in April
2008
ALABAMA
· Ms. S was a court
reporter for 26 years in Mobile, Alabama. She stopped working in March 2002 due
to severe carpal tunnel syndrome, chronic obstructive pulmonary disease (COPD),
and psychiatric impairments. The claimant filed a claim on her own in 2002 and
lost at the ALJ level a few years later and never appealed. She then sought
representation and her attorney helped her file a new claim. Two hearings were
held and there were two Appeals Council remands. By this time, Ms. S had undergone
several carpal tunnel release surgeries without any real relief, became
dependent on a continuous positive airway pressure (CPAP) machine to facilitate
her breathing, and her dementia became increasingly progressive to the point
that she was completely dependent on her adult son and her sister. Following a
request to the ALJ for an “on the record” decision, after the second Appeals
Council remand, the ALJ issued a favorable decision on March 28, 2008.
ALASKA
·
Ms. B of Sitka, Alaska, applied for Title II and SSI benefits in March 1998.
After initial denial of both claims, she had a hearing in March 2000. The
unfavorable ALJ decision was issued more than one year later in April 2001. She
filed a hand-written appeal to the Appeals Council in May 2001. In her appeal,
she wrote that her condition was grave because she had severe headaches,
dizziness, lost balance, had blurry vision, and severe head pain and fatigue.
Five and one-half years later, the Appeals Council denied review in December
2006. Ms. B was unrepresented through that point. She obtained counsel to file
an appeal to federal court. Upon reviewing the administrative record, her
attorney immediately noticed that the record contained substantial records from
another person, including the other person’s name. These are the same medical
records upon which the ALJ denied her claim in 2001, including the finding that
Ms. B was not credible. The fact that these records belonged to another
individual was obvious.
In federal court, the incorrect
records were brought to the attention of the SSA Office of General Counsel
(OGC) and the court. In May 2007, Ms. B’s attorney and the SSA attorney agreed
to a remand, which the court approved. Since May 2007, there has been no
action by SSA to move this claim toward disposition. Ms. B’s attorney has filed
a request for an “on the record” decision but has received no response. Ms. B
is now receiving benefits but only since 2007 when she received a favorable ALJ
decision on a subsequent application. However, that decision only paid
benefits starting in September 2003.
ARKANSAS
· Ms. R lives in Fayetteville , Arkansas, and filed for Title II and SSI benefits in April 2001. Her claim
was denied and a hearing was held in December 2002. Her SSI claim was allowed
but the Title II claim was denied based on lack of insured status. On appeal
to the Appeals Council, proof was submitted that she had worked and was
insured, but the claim was denied again. Ms. R filed an appeal in federal
court, which was remanded in April 2004 because the administrative record was
lost. Nearly two years later, in January 2006, the Appeals Council finally
remanded the case to an ALJ, certifying that all efforts to locate the file had
been exhausted, to have an immediate hearing to reconstruct the file. Ms. R’s
attorney has continually contacted the hearing office regarding the remand
hearing based on the court’s order four years ago. There has still been no
hearing set on this matter. Being restricted to SSI has seriously affected her
financial situation and she is being denied the Title II disability payments,
for which she has worked.
· Mr. M filed a
claim for benefits some time in late 2005, which was denied. He lives in Pettigrew, Arkansas. A hearing was requested in October 2006 and held in January 2008. A
decision has not yet been received. Mr. M has had a series of strokes, which
affect his ability to comprehend and his condition continues to worsen. He
also has been forced to move from place to place, because his family cannot
afford to pay for his living expenses and they lost their home.
· Ms. C from Farmington, Arkansas, filed a claim for benefits in early 2006. After being denied, she
requested a hearing in August 2006. A hearing was held in September 2007, but
it was another six months before she received a favorable decision, which was
more than two years after she filed her claim. During this time, Ms. C. lost
her home, which she shared with an abusive and alcoholic man because she had no
money and no other place to live. She now moves around, including staying with
her parents.
· Ms. M filed a
claim for benefits in August 2005 while living in Florida. The claim was
denied and she requested a hearing in April 2006. Following that hearing
request, Ms. M moved to Fayetteville, Arkansas, and obtained representation.
Beginning in November 2006, her attorney requested that her file be transferred
from Florida to Arkansas. The transfer finally occurred ten months later in
September 2007. A hearing was held in March 2008. Ms. M continues to decline
in physical, emotional, and mental health. She had been living with a sister,
but was asked to leave. She moves from family member to family member, and has
no money for medical treatment or even basic necessities.
CONNECTICUT
· Mr. C, who worked
as a landscaper, has liver failure. While waiting two years for a hearing, he
became homeless. By the time his hearing was held, he was living in his car in
the middle of winter. He was hospitalized right after the hearing and the
hospital had no place where he could be discharged. He waited for two months
after the hearing for a favorable ALJ decision and another month after that to
start receiving benefits.
FLORIDA
· Ms. K applied for
disability benefits in August 2004. She lived in Key West, FL. Her husband shot her 5 times in the liver and abdomen and then killed himself.
Her disabilities stemmed from these injuries and from chronic obstructive
pulmonary disease (COPD). Her claim was denied and she requested a hearing
in April 2006. Nearly two years later, her hearing was held in March 2008 and
the ALJ stated that benefits would be awarded. Unfortunately, Ms. K died
in late March 2008 of long-term complications from her wounds and COPD, before
the written decision was received. Because she did not have money to live
independently, she was forced to live with her mother. The mother, who
has dementia, is a chain-smoker. During the last part of her life, Ms. K
had frequent hospitalizations. She would then return to her mother’s
house and her condition would worsen. Her attorney last saw Ms. K about a
week before her death. Ms. K told her attorney that she believed she would die
if she could not get into a smoke-free living situation. Since Ms. K died
in part from COPD, her attorney believes that her compromised living situation,
due to the lack of income, shortened her life.
· Mr. F filed a
claim for disability benefits in September 2004 and was denied twice before his
hearing in July 2006. He has well-documented uncontrolled seizure disorder and
used a wheelchair for the first six months of his disability. He is 56 years
old. While waiting for his hearing, he could not pay his utility bills and his
electricity and water were turned off. He lived without any utilities for over
six months. He and his wife lived in a trailer. For water, they would carry
empty milk containers to a communal water faucet in the trailer park to fill
them. They used this water to wash dishes, bathe and flush toilets for over six
months. At the hearing, the ALJ approved the claim but with an onset date of
only two months prior to the hearing, and Mr. F has appealed the onset date.
· Mr. B is a 48 year
old former mechanic who lives in Bradenton, Florida. He has diabetes mellitus,
failed back surgery syndrome, three disc herniations in his lower back and two
in his cervical spine, ambulates with a cane, and has developed depression and
anxiety. His application was filed in September 2004. He has not yet had a
hearing, which is scheduled for June 18, 2008. He is a workers’ compensation
recipient. However, in the interim, his benefits were significantly reduced.
He had to move in with eight other family members and depends on them for
financial support. The workers’ compensation carrier has denied several of his
medical bills on grounds that his conditions were pre-existing, so he has had
no medical care for some time.
· Ms. L was a 44
year old female with advanced, end-stage breast cancer. She lived in Bradenton, Florida. She filed an application for benefits in 2002, her request for a hearing
was filed in August 2005, but she died from her condition in April 2006. She
was living with her mother at the time.
· Mr. M is a 57 year
old former businessman. He has end-stage kidney failure, uncontrolled
hypertension, and anemia. He had numerous reports stating his condition was
terminal. He filed an application in 2004 and a request for a hearing in
August 2005. He was awarded benefits without a hearing in April 2006 by the
ALJ, after his attorney sent two letters requesting an “on the record”
decision. Until the ALJ decision, his phone, electricity, and other utilities
were cut off. His house went into foreclosure. He had no medical insurance
and his wife could not afford to support him.
· Mr. D was a 56
year old laborer with a 6th grade education. He had end-stage lung cancer. In
2007, he filed an application in West Virginia, then moved to Florida. He died
in February 2008. While waiting for a determination, he lost his home, car,
wife, and all sources of income. He died in a hospice with no family
knowledgeable about his whereabouts.
GEORGIA
· Mr. A is 23 years
old. He previously received SSI benefits due to a heart transplant. His
benefits were terminated. Now, Medicaid will no longer pay for his
anti-rejection medication. If he does not get this medication, he will die.
His hearing request was filed in February 2007 but no hearing has been
scheduled.
· Mrs. G, a 58 year
old woman, worked her entire life, the last 15 years at a convenience store.
Over time, she developed degenerative joint disease and cardiovascular
problems. In 2004, she deteriorated to the point that she stopped working. She
had a house where she had lived for many years but fell behind on the payments.
Her attorney had to intercede on her behalf several times to stop foreclosure.
Her car, which she fully owned, sat idle because she could not pay the tag fees
and could not afford gas. Three years after she applied, she had a hearing.
While the ALJ stated at the hearing that a favorable ruling would be
forthcoming, it still took more than six months after the hearing before
she received her favorable decision. Even then she had trouble getting her
monthly benefits started. Several months passed and still she did not receive past
due benefits. As she still owed back mortgage payments, the mortgage company
started foreclosure proceedings again. She reported to her attorney that the
anxiety over her claim was making her cardiovascular problems worsen. She never
received her past due benefits. She died still waiting. Her attorney notes that
Mrs. G is his fourth client who has died in the last three years while waiting
for a favorable decision and payment of benefits.
HAWAII
· An attorney in Honolulu reports that the ALJ who hears claims in the Honolulu ODAR hearing office has
been out on sick leave since November 2007. Since then, no hearings have been
held in the State of Hawaii. For reasons he does not know, the SSA Regional
Office in San Francisco, CA, did not make arrangements to have the hearing
docket handled by a visiting ALJ. He personally has about 50 clients waiting
for their cases to be scheduled. Like other claimants, these are individuals
with severe illnesses that prevent them from working and they have no income.
After the attorney and his clients wrote to one of their Senators, SSA began to
schedule video hearings for the end of April 2008 in Honolulu, which the
attorney reports is the first action since the end of November 2007. However,
the other islands in Hawaii are not set up for video hearings.
ILLINOIS
· Mr. M lived in the
Chicago, IL, area. He had various medical problems, but the most significant
one was the need for kidney dialysis, which became apparent after the application
was filed. The need for dialysis meant that his impairment met one of the listings
of impairments, at least as of the date that the dialysis began. His request
for hearing was filed in January 2007. Mr. M’s medical condition worsened. In
addition, he did not have a permanent residence and stayed with his sister for
part of the time that his claim was pending. However, he informed his attorney
that his sister was moving, that he could no longer stay with her, and that he
had no alternative place to live.
In July 2007, his attorney began a series of contacts with
the ODAR hearing office in an effort to have the case considered for an “on the
record” decision or to schedule a hearing on an expedited basis given Mr. M’s
medical condition and lack of a permanent residence. Between July 2007 and
February 2008, his attorney sent five letters, left multiple voice mail
messages, and spoke with the hearing office director about Mr. M’s case.
Finally, in February 2008, the hearing office called to schedule the case in
April 2008, sixteen months after the appeal was filed. Unfortunately, Mr. M
died in March 2008. As a result, he never received the benefits to which he
was entitled. He died destitute. And because this was an SSI claim, no one,
including his sister who helped him, will be eligible to receive the
retroactive benefits.
· Mr. R, age 48, has
Lou Gehrig’s Disease and became disabled in January 2006. His claim was
denied and his hearing request has been pending since October 2007. He
spent five years caring for his ailing mother prior to her death and now needs
assistance with most activities of daily living. However, his wife cannot
afford to stop working and he cannot afford to hire an assistant. He may
not live long enough to have a hearing.
· Mr. J is 51 years
old. He previously received disability benefits for five years due to a
back injury. He returned to work as a truck driver but was re-injured on
the job. His employer did not have workers’ compensation insurance.
He has an inoperable spinal disorder. His application was filed in
October 2005 and his hearing request was filed more than two years ago in March
2006. His attorneys’ requests for an “on the record” decision and for
expedited reinstatement of benefits have been denied. Mr. J’s treating
physician strongly supports this disability claim. Mr. J and his wife
have lost every financial asset that they accumulated while they were working
and they now live with the wife’s elderly mother who lives on a fixed income.
Exacerbating his impairment, Mr. J was in a car accident in April 2008,
which injured his neck and head and knocked him unconscious.
·
Ms. K is a 52 year old woman, and a resident of Joliet, IL. She has major
depression with psychosis, diabetic neuropathy, chest pain, and arthritis. She
was 48 years old when she applied for Title II disability benefits in 2004.
She requested an ALJ hearing in February 2006 and still does not have a hearing
scheduled. Since she applied in 2004, she has suffered deteriorating health
and severe financial hardship, including a utility shutoff during one of the
coldest winters in recent memory. Her attorney has been told that because she
has a paper file, this has further delayed the scheduling of her hearing. Her
attorney requested an “on the record” decision without the need for a hearing
based on the strength of her case and her long wait, but this request was
denied.
· Mr. B from Freeport, IL, requested a hearing in November 2001 and a hearing was held in May 2002. No
decision was issued and the ALJ scheduled a supplemental hearing, which was
held nearly 18 months later in October 2003. An unfavorable decision was
issued, more than two years after a hearing was requested. He appealed to the
Appeals Council but the file was misplaced. After Congressional intervention,
the file was located and a decision remanding the case to the ALJ was issued in
August 2007, more than three years after the ALJ decision. It has been more
than 6 years since he first requested a hearing. Mr. B, who is impoverished,
is still waiting for a new date for his remand hearing.
INDIANA
· Mr. I, a 46 year
old resident of Indianapolis, Indiana, was a school bus driver. He developed
high blood pressure, diabetes and lost vision in one eye. He could no longer
work. He applied for benefits in February 2004. Without income, he had to
choose food over his medication. His diseases became uncontrolled and he was
found unconscious on his apartment floor. He was hospitalized and eventually died
in February 2007. A favorable decision was issued in August 2007, nearly six
months after his death.
IOWA
· Ms. H is a Henderson, IA, resident and is now 48 years old. She filed her application in March 2005
and requested a hearing in December 2005. Nearly two years later, the hearing
was held in November 2007, but she still has not received a decision five
months later. All evidence was submitted before the hearing and there was no
post-hearing development ordered by the ALJ. Ms. H has Hepatitis B and C and
has had Interferon treatments for almost a year. She also has severe
arthritis, gastroesophageal reflux disease, and
depression. Her physician has written that she needs to rest three hours out
of an eight hour work day and that pain would interfere frequently with her
attention and concentration.
KENTUCKY
· Ms. R, age 53, of Richmond, Kentucky, worked as an inspector for a rubber operation. She had cancer and then
disability due to a mastectomy, nerve damage, emphysema, hypertension, plus other
conditions, including depression. She applied for benefits in October 2006. Her
case was appealed to the ALJ level. However, before a hearing was scheduled,
Ms. R died in March 2008. Her family continues the case.
MARYLAND
· Ms. W is a 30 year
old former retail employee who lives in Westminster, Maryland. As a result of
an automobile accident, she has various cervical, thoracic and lumbar spinal conditions
which cause severe instability in her legs and affect her in all activities of
daily living, including working. She has not been able to work since the
accident and will be unable to work indefinitely. She filed her application
for benefits in early 2006, which was denied. She requested a hearing in August
2007. The hearing was held on February 13, 2008, and a favorable decision was
issued on March 27, 2008. While this story has had a positive end result, the
path to getting there was anything but positive. By the time of her February
2008 hearing, she was homeless and had been living out of her beat-up, old car
for months. She was unable to pay any bills, including rent, and she was
evicted. During this time, she was unable to communicate with her attorney.
She also could not obtain proper medical treatment, and her condition continued
to deteriorate. She has finally found shelter, but is still awaiting receipt
of her first benefits payment.
MASSACHUSETTS
· Ms. W lived in Worcester, MA, and was 45 years old when she died from end-stage liver disease. She died
in January 2008, while waiting for a hearing. She filed an application in 2005
but it was lost. She filed another application in late 2006 or early 2007,
which was denied, in part, because of failure to consider that her condition
was expected to result in death. She obtained representation and requested a
hearing in July 2007, but the appeal was not processed promptly pending receipt
of the 2005 file, which had been lost. Between September 2007 and January
2008, her attorney contacted the SSA district office and the ODAR hearing
office on eight different occasions, requesting that the processing be
expedited because Ms. W was in desperate need of funds and was feeling quite
ill. In December 2007, the district office said the file had been sent to the
hearing office, but the hearing office denied receiving the file. On January
14, 2008, the attorney finally received a letter from the hearing office acknowledging
receipt of the hearing request. Ms. W died on January 18, 2008.
· Mr. F is a 45 year
old sheet metal mechanic from Fitchburg, MA, who worked for the same company
for 25 years. He filed his application in May 2006 at the urging of his
doctor. Following surgery for a cervical fusion, he has had complications,
including decreased range of motion, severe and constant headaches, severe
chronic pain, arm and hand numbness, and hip and back pain. His hearing
request was filed in December 2006. While waiting more than two years for a
hearing, he also developed severe anxiety and chest pain. By the time of his
hearing in October 2007, he had lost his beloved home to foreclosure, lost both
his wife’s and his cars to repossession, lost his boat, lost his 401(k)
account, and nearly lost his 16 year old daughter to severe depression after
they lost their home and were forced to move into the unfinished basement of a
relative. Mr. F received a favorable ALJ decision in December 2007 after his
attorney requested an expedited hearing.
MICHIGAN
· An attorney in Saginaw, Michigan, reports that the current delay between filing a request for hearing and
the date of the hearing in his area ranges from 24 to 28 months. This
delay is on top of waiting anywhere from two months to four months to hear
whether the initial application has been approved. While some ALJs will
issue a decision on the record, it often takes one to two months to get the
written decision and another one to four months for the individual to actually
get paid. Many clients are experiencing a delay of three years or more
between the time of initial application and the time they finally get their
benefits. He has had numerous clients who have lost their homes, cars, and
other property while waiting. Many of his clients have had to go through
bankruptcy because of the delay. These financial stresses also contribute
to family stresses and several of his clients have gotten divorced and
attribute the divorce directly to financial stresses.
· Mr. H is 61 years
old and lives in Holland, Michigan. He was unable to work and applied for
disability benefits in March 2005. He requested a hearing in September, 2005,
more than 30 months ago. His attorney requested an “on the record” decision in
the fall of 2007, after his case was transferred to another ODAR hearing office
because of overload in the Grand Rapids, Michigan ODAR office. The ALJ denied
the request and a hearing was held in November 2007. Two years and 8 months
after requesting the hearing and 3 months after the hearing, he received a
favorable decision from the ALJ in February 2008. As of April 10, 2008, he has
received no benefits. Mr. H needs his disability benefits so his children do
not need to continue to pay his bills.
· Ms. M, a 46 year
old woman living in Muskegon, Michigan, applied for disability benefits in
March 2004 because she could no longer work due to degenerative osteoarthritis
of the hips and spine, obesity, and psychological impairments. While waiting
for her hearing, she received a foreclosure notice on her house and was behind
on her utility bills. Her impairments worsened due to stress and uncertainty
about where she would live. Her representative filed a request for an
expedited hearing based on “dire need” in May 2006. After the hearing, the ALJ
issued a favorable decision in September 2006 but she never received any of her
benefits until December, 2006 – far too late to save her house.
MISSISSIPPI
· Mr. C, a 58 year
old former machinist who lives in Como, Mississippi, has severe neck, right
shoulder and arm pain after a 2 pound tumor was removed from his neck, and he
is illiterate. These conditions prevent him from working. He filed his
application for benefits in November 2004. He had a hearing January 9, 2008.
During his wait for a hearing, he lost his home to foreclosure and was unable
to afford required tests for his impairments.
· Ms. D, a 47 year
old former data entry clerk who lives in Doddsville, Mississippi, has
fibromyalgia, chronic obstructive pulmonary disease, and severe anxiety, which
prevents her from performing even simple work tasks. She filed her application
for benefits in March 2005. While waiting for a hearing, she has become
homeless and unable to stay in a shelter, due to having to work for board,
which she is unable to do. Because she has nowhere to cook, she only is able
to eat food that does not require cooking.
· Mr. L, a 45 year
old former equipment operator who lives in Louisville, Mississippi, lost 20% to
30% of his lung capacity in a workplace accident. He also has severe migraine
headaches, daily blackout spells, and severe post-traumatic stress disorder
(PTSD), all of which prevent him from working. He filed an application for
benefits in February 2006. While waiting for a hearing, he is 3 payments
behind on his home and risking foreclosure, has lost all of his vehicles, and
all utility bills are about 3 months behind.
· Mr. J is a 50 year
old former truck driver who lives in Leland, Mississippi. He has Type I
diabetes, a pinched nerve, and back problems. He applied for benefits in March
2006. While waiting for a hearing, he has been forced to live in his truck for
four months.
· Mrs. G is a 53
year old former machine operator who lives in Greenwood, Mississippi. She has
Type II diabetes, moderate degenerative disc disease, a herniated disc, and an
esophageal restriction. She applied for benefits in October 2006. She is
currently waiting for a hearing date. Her home is in the final stages of
foreclosure.
· Mrs. K is a 53
year old former secretary who lives in Kosciusko, Mississippi. She has
diabetes, protruding discs, spinal stenosis, arthritis, carpal tunnel syndrome,
and depression. She applied for benefits in March 2006, and is waiting for a
hearing date. She has just become homeless.
MISSOURI
· Mr. O, from Richmond, Missouri, died in the lobby of the ODAR hearing office while waiting to be called
for his hearing on April 2, 2008. He was 49 years old and is survived by his
wife and 4 children. He filed his SSI application for disability in November
2005, alleging inability to work due to uncontrolled diabetes with neuropathy,
and shoulder and arm pain. He had worked for 14 years as a truck driver. His
claim was denied in March 2006 and he promptly filed a request for hearing in
April 2006. While waiting for hearing, he had numerous problems with child
support authorities and his home was foreclosed upon. His representative filed
a dire need request in July 2007 to expedite the hearing, but he did not
receive a hearing date until February 2008, when the hearing was scheduled for
April 2, 2008, the day he died.
· Mrs. C is a 40
year old Marine Corps veteran who lives in Columbia, MO. She has been unable
to work as an over-the-road trucker since December 2004 because of migraines,
degenerative disc disease of the neck and lower back, and depression. Her
husband, a truck mechanic, supports the family of four, including a daughter in
college, on $1,900 monthly take-home pay. Mrs. C filed for benefits in April
2005 and requested a hearing, which took place in March 2007. Her claim was
denied in December 2007 and she appealed to the Appeals Council in February
2008. In March 2008, Mrs. C traveled from Missouri to Colorado and had
neurosurgery, following a diagnosis of Chiari Malformation. Her recovery is
uncertain.
· Mrs. Y is a 37
year old registered nurse, from Columbia, Missouri, who is married with three
small children. She had a very good work record until she became incapacitated
by pelvic and hip pain in December 2004, following the worsening of an injury
during delivery of one of her children. Her claim for Title II benefits was denied
in December 2006 and she requested a hearing. The family had already filed for
bankruptcy. While waiting for a hearing, her condition worsened. She needs a
rare surgery performed by only a few surgeons in the country and which requires
a six-month recovery period in a hospital bed and another six months using a
wheel chair. The family would need a different house that is accessible.
Despite the financial and medical information, SSA did not expedite the hearing
for 13 months. She finally received a favorable ALJ decision in February 2008.
· Mr. L, a 26 year
old former nurse’s assistant from St. Louis, Missouri, has grand mal seizures
that have been occurring more and more frequently, and that make it
dangerous for him to work. He had to stop working as a nurse’s assistant, as he
had some severe seizures at work, which caused injury to him and the fear of
injury to patients with whom he worked. He filed his application for
benefits in August 2006. Since he has been awaiting a hearing, he has become
homeless. He now lives with his girlfriend’s family, which is very difficult
for Mr. L and his girlfriend’s family, as they are forced to care for and
financially assist a young man who is not related to them, simply because they
do not want to see him homeless. Mr. L has no health insurance, and he
cannot afford the very expensive medications that are needed to help keep his
seizures under better control. It is a “Catch 22” for him since he cannot work
because he has seizures that are uncontrolled, yet he cannot control the
seizures until he has the money to pay for the medications. He has been
waiting almost two years to even be heard by an ALJ.
NEBRASKA
·
Ms. O is now 56 years old and lives in Omaha, Nebraska. By late 2004, symptoms
from her bipolar disorder, combined with a new diagnosis of cerebral
degeneration, worsened her coordination and cognitive skills, and precluded all
work. In January 2005, she lost her job as a cashier at a grocery store where
she had been employed for 15 years. She filed her claim in June 2005. She
filed a request for hearing January 2006. On October 26, 2006 she asked for an
“on the record” decision because she had been hospitalized for both her
physical and mental impairments and her treating sources found significant
limitations. The request was denied and she is still waiting for her hearing
to be scheduled, more than two years after her appeal was filed. She has
exhausted all of her savings and is dependent on county general assistance and
the county mental health clinic for all of her treatment.
·
Mr. B, a 46 year old former cook who lives in Seward, Nebraska, has Bipolar I
Disorder, unspecified organic brain syndrome, paranoid personality disorder and
borderline personality disorder, which prevent him from working. He filed his
application for Title II and SSI benefits in December, 2005. While waiting for
a hearing, which was requested in July 2006, he has lost his Medicaid benefits
and has been without medical treatment and prescriptions since July, 2007.
·
Ms. K, a 49 year old former dry cleaning clerk who lives in Omaha, Nebraska, has depression, post-traumatic stress disorder, adjustment disorder with anxiety,
chronic obstructive pulmonary disease and fibromyalgia, which prevent her from
working. She filed her application for Title II benefits in October 2005 and
requested a hearing in July 2006. Ms. K is in an abusive marital relationship,
but has been unable to move out and find an alternative residence because she
does not have the income and resources to leave her husband. Also, she is
dependent upon her husband’s health insurance so that she can receive treatment
and prescription medications for her disabling conditions.
NEVADA
· Ms. L is 45 years
old and lives in Las Vegas, Nevada. She worked as a clerk for an area resort.
She has back, hip, knee and breathing problems and suffers from pain including
headaches and abdominal pain. She also has depression and has not been able to
continue working. She applied for benefits in March 2005 and was denied in
August 2005. Her case was appealed to reconsideration and she received a
decision, again denying the claim, nearly three years later in April 2008. Her
case is now pending at the ALJ hearing level. She has received utility cut-off
notices and foreclosure notices. She recently has contacted her Congressional
representative to help expedite her case.
NEW JERSEY
·
Mrs. E, a 50 year old former cardiac nurse who lives in Eastampton, New Jersey,
has severe pain from impairments of her lower back, hips and shoulders
(post-surgeries bilaterally) as well as depression and anxiety attacks. These
conditions have made it impossible for her to work since 2003. She
applied for benefits in 2005. While waiting for a hearing, she has exhausted
all of her retirement savings and is now being threatened with foreclosure due
to past-due mortgage payments. Her hearing has finally been scheduled for
May 2008.
·
Mr. N, now 59 years old, from Northvale, New Jersey, was originally denied by
an ALJ in February 2005. After appeals through the federal court level,
the case was remanded to the ALJ in November 2006. In January 2008, 14 months
after the court remand order and 35 months after the first ALJ denial, the ALJ
issued a fully favorable “on the record” decision. Mr. N has a severe mental
impairment and has expressed suicidal ideation throughout the process. At
the time the claim was approved in January 2008, foreclosure proceedings were
started by his mortgage company. Mr. N is married with 2 teenage sons.
·
Mr. H was living in a homeless shelter in Hackensack, New Jersey, at
the time of his February 2006 hearing. The ALJ, despite knowing of the
client’s homeless situation and receiving a letter from the client threatening
suicide, did not issue a decision until October 2006, more than 7 months after
the hearing date.
·
Mr. F is a resident of Florence, New Jersey. He originally filed his claim for
Title II and SSI benefits on December 1, 1997. He has mental retardation, a
separate learning disability, and a herniated lumbar disc. His claim has been
heard by an ALJ three separate times so far. After his last hearing, he was
found to be disabled at a date after his Title II insured status expired. He
has been eligible for SSI benefits of less than $600.00 per month and not the
Social Security benefits of at least $1,000.00 per month he had worked to earn.
The last ALJ decision was appealed to the federal district court, which
remanded the case on June 1, 2007. A fourth hearing is now scheduled for May 1,
2008.
NEW MEXICO
·
Mr. R lives in Rio Rancho, New Mexico, and applied for benefits in November
2005. His hearing was held in August 2007. Eight months later, he is
still waiting for a decision from the ALJ. In the meantime, he tried to
return to work in order to have money for living expenses. An
acquaintance gave him a job with accommodations for his disability. Even with
the accommodations, he was unable to complete even two months on the job, which
SSA considers to be an unsuccessful work attempt. Now Mr. R is certain
that he cannot work at any job. · Ms. A lives in Albuquerque, New Mexico, and applied for benefits in October 2005. Her hearing was held in
November 2007, more than two years later. She has had to give up her own
home and move in with her adult children. She calls her attorney every
month, and the attorney calls the hearing office to check on the status of the
case. Her case is still in post-hearing review with the ALJ, even though there
is no further development that needs to be completed.
NEW YORK
· Mr. R is 38 years
old and lives in Brooklyn, New York. He has major depressive disorder,
anorexia nervosa with severe weight loss, somatoform disorder, and generalized
fatigue. He applied for SSI benefits in September 2003 and requested a hearing
in March 2004. The ODAR hearing office failed to send a Notice of Hearing
for the hearing, scheduled in December 2006. As a result, Mr. R did not
appear and his hearing request was dismissed. He obtained representation
in June 2007 after the dismissal. His attorney immediately contacted the ALJ
and submitted all documents establishing that Mr. R was never informed of the
hearing. She also sent all medical evidence she had obtained. The
attorney asked the ALJ to reopen the case and to schedule an expedited hearing.
The hearing was finally held in November 2007 and the ALJ issued a favorable
decision in late November 2007. There still was a delay in receipt of
benefits as Mr. R did not receive his first SSI past due installment payment
until March 2008 and his first SSI monthly payment until April 2008.
While waiting for the hearing decision and benefits
payments, Mr. R lost his welfare benefits and Medicaid, so he could not receive
treatment. His anorexia nervosa was so extreme as to cause severe tooth
decay requiring dentures. He received an eviction notice for his apartment but
his attorney worked with the landlord to stave off eviction based on the fact
that a new hearing was being scheduled. Because his welfare case
was closed, Mr. R had no money. He had to go to food pantries for any
donation and his neighbors helped him from time to time. He even had to
borrow money to ride the subway to his hearing.
· Ms. T lives in Ronkonkoma, New York. She is 55 years old. She was a pharmacy technician for over
thirty years. She has been hospitalized three times in the past year for
chronic obstructive pulmonary disease (COPD). She has been unable to work
since December 2005. She filed for benefits in January 2007 and requested a
hearing in May 2007. Her husband’s income is not enough to meet their needs
and they have had to borrow money from family in order to meet living
expenses. This winter, they had no choice but to reduce their expenditure on
oil for the household. They tried to reduce the household temperature, but
this causes worsening of her lung symptoms. In addition, Ms. T is depressed
and constantly worries about what will happen when the next month’s bills
become due.
NORTH CAROLINA
·
Mr. N lived in the Charlotte, North Carolina area. He was 57 years old and
died in August 2007. As an adult, he obtained a degree in theology. From 1986
to 1997, he worked doing maintenance on power generating stations. He
developed heart disease and emphysema and, from 1998 to 2004, he did less
strenuous work. In June 2005, he filed a claim for Title II disability
benefits. His claim was denied and he requested a hearing in April 2006.
During the wait, he developed a spot on his lung, but could not afford a CT
scan for an accurate diagnosis. In May 2007, he received a foreclosure notice,
lost his house, and had to move in with his daughter. He died in August 2007
of ischemic heart disease. In February 2008, months after his death, his claim
was approved on informal remand to the DDS.
· Ms. G, from the Charlotte, North Carolina area, was 50 years old when she died. She had worked in the
garment trade, in management, and retail. She applied for Title II benefits
about January 2007 and requested a hearing in June 2007. She died April 4,
2008, probably from heart disease with complications of chronic pancreatitis
and hyperparathyroidism. Her attorney notes that the facts leave out that Ms.
G was a funny, vital woman, with two children age 18 and 21. She had left an
abusive and controlling husband, and was trying to make it on her own, with
absolutely no income.
· Mr. E died on
August 21, 2007, at age 52 from congestive heart failure, chronic atrial
fibrillation, pneumonia, obesity and peripheral artery disease. He lived in
the Charlotte, North Carolina area and worked for 15 years as a pipe insulator,
and usually held a second job. He applied for Title II benefits in March 2006,
which was denied, and requested a hearing in November 2006. Four months after
his death, on December 27, 2007, a favorable decision was issued without
hearing.
· Ms. R, a 52 year
old former cook and waitress who lives in Rocky Mount, North Carolina, has
Major Depressive Disorder, post-traumatic stress disorder, panic attacks,
carpal tunnel nerve damage in both hands, chronic obstructive pulmonary
disease, and migraine headaches. These conditions prevent her from working.
She filed her application for benefits in November 2006. While waiting for a
hearing she encountered numerous hardships, including: being on the verge of
committing suicide; having extreme debilitating joint pain and disk pain;
becoming homeless; and having frequent nausea due to migraine headaches. Her
claim was approved in March 2008 by the ALJ after her attorney submitted a
“dire need” request.
OKLAHOMA
· Mr. H, from Tulsa, Oklahoma, filed an application for disability benefits in March 2006, due to
Hepatitis B and liver and renal failure. Unfortunately, he died on September
13, 2007, without having been able to attend a hearing.
· Ms. B, from Tulsa, Oklahoma, filed an application in April 2006 and has not yet been scheduled for a
hearing. She has Multiple Sclerosis and a mental impairment. In July 2007,
her attorney wrote the hearing office requesting an “on the record” decision.
She is so desperate that she is willing to change her date of disability onset
to a later date. As of April 2008, no action has been taken on the request.
Since the request was made, Ms. B has been hospitalized on at least two
occasions for her psychiatric condition.
· Ms. K, from the Tulsa, Oklahoma area, has a rare kidney disease and is passing a kidney stone almost once a
week, which causes severe pain. She is diagnosed with Major Depressive
Disorder, Graves Disease, recurrent and severe pain disorder, and recurrent kidney
stones. Her treating physician has stated that she could not return to work.
After her application was denied in 2006, she requested a hearing. In the
summer of 2007, her attorney submitted additional evidence from her treating
doctor. No action has been taken. She is in dire financial straits.
· Mrs. M, a 33 year
old former waitress and substitute school teacher, lives in Muskogee, Oklahoma. She has degenerative joint disease of the lumbar spine, neck and hands; hearing
loss; left wrist injury; migraines; tingling/numbness in the left knee and left
foot; right hip problems; dizziness and nausea. She filed her application for
benefits in August 2005 and a request for hearing in May 2006. Mrs. M is
married with three children, including one son who is disabled. After a nearby
plant explosion damaged their home in 2004, the family was forced to move into
an apartment. Evicted in 2007, they have had no permanent residence since then
and have been forced to live in a variety of temporary settings, including a
shelter for women and children (Mrs. M’s husband slept in the car). After the
2007 eviction, Mrs. M’s attorney sent letters to the ODAR hearing office
requesting an expedited hearing because of the family’s homelessness. Mrs. M
received a fully favorable decision on March 26, 2008, nearly two years after
she filed her request for a hearing. Her disabled child also received a
favorable decision on March 25, 2008. On April 7, 2008, an SSA district office
worker informed the attorney that both Mrs. M and her disabled child were in
pay status.
SOUTH CAROLINA
· Mr. A was living
in Augusta, South Carolina, when he was in a car accident. In his 30s, he had
been working as a computer professional, but the accident resulted in a severe
and chronic pain condition. He could not sit down, stand up or lay down for
more than 15 minutes at a time. He applied for SSDI benefits in January 2003.
His case was denied in September 2003. At reconsideration, his case was denied
again in August 2004. His mother was required to return to work from her
retirement to help him with medical costs. Mr. A died five months before his
December 2006 hearing from an accidental overdose of pain medication. He would
have been 41 years old this year. The ALJ denied the claim and his mother has
continued the case by filing an appeal to the Appeals Council. No decision on
the appeal has been received.
TENNESSEE
· Ms. B from Tiptinville, Tennessee, died in July 2006 just shy of her 52nd birthday due to chronic
obstructive pulmonary disease (COPD). Ms. B was a school cafeteria cook her
entire life and stopped working in September 2002 due to back and lung
impairments. She was on an oxygen machine, as well as a continuous positive
airway pressure (CPAP) machine. She filed her claim for benefits in 2002 and
was denied for the first time by an ALJ in February 2005 after waiting 5 months
for a decision from her first hearing in September 2004. The claim was appealed
to the Appeals Council and two years later was remanded back to the ALJ to
reconsider the treating doctor’s opinion. An ALJ allowed the claim with an “on
the record” decision in April 2008.
TEXAS
· Ms. T is 34 years
old and had a good work history. Four years ago, she developed
gastrointestinal problems and lupus. She has no health insurance or other
income to use for medical treatment, even though recent tests indicate she has
had heart damage. She is 5 feet, 6 inches tall, but over the last four years
her weight has been as low as 77 pounds, which should meet a listing of
impairments. She has been waiting for a hearing over 1000 days even though her
attorney has sent “dire need” letters and requested an “on the record”
decision. The ALJ has denied the requests. A hearing has finally been set for
later in April 2008.
· Mr. D is a veteran
and living in domiciliary care at an area VA Hospital. He was homeless
and had cancer three times in a period of just over two years. During the
second episode of cancer, he had a pulmonary embolism and was put on life support.
The VA could not find his family to see about ceasing the life support and the
veteran was in the nursing home for a period of time. Miraculously, Mr. D
survived and then had to have surgery for a brain tumor. He had to wait
over one year for his hearing. There were thousands of pages of medical
records in his file. At the hearing, he and his attorney learned that the
hearing office had not sent the medical records to the medical expert witness
for pre-hearing review. This delayed the decision. Mr. D eventually received a
favorable decision and his benefits.
· A woman in the Paris, Texas area had heart and kidney problems. She had a stent inserted so she could have
dialysis. She was waiting to start dialysis when her condition
deteriorated and she died. Three weeks later, she received a favorable
ALJ decision. Her attorney had requested an “on the record” decision before
the claimant died, but to no avail.
VIRGINIA
· Ms. H was a 47
year old receptionist living in a nursing home in Fairfax, Virginia, after
having been homeless on and off since 2003. She had an extensive medical
history which included cervical, dorsal and lumbar spinal strains, pinched
nerve, shoulder pain, uncontrolled diabetes mellitus, diabetic neuropathy,
nephritic proteinuria, hypertension, obesity and dyslipidemia. She also had severe
kidney disease including an acute episode of renal failure. In June 2007, she
was hospitalized with a myocardial infarction after which she had two strokes.
One in the cerebellum was complicated by hydrocephalus requiring neurosurgical
relief.
Ms. H first applied for SSI and Title II benefits in January
2004, having last worked in October 2003. She had an ALJ hearing in August 2005
and was denied again in October 2005. She was not represented at that
hearing. She reapplied on her own sometime in 2006 and obtained legal
assistance in July 2006. Another request for hearing was filed in March 2007.
Ms. H had a heart attack in June 2007 but her legal representative was not
informed until August 2007. The representative immediately requested a
favorable “on the record” decision. The ODAR hearing office did not respond
until January 2008. Ms. H received her Notice of Award on February 4, 2008.
She received her retroactive benefits on March 28, 2008. She died on April 3,
2008.
WASHINGTON
· Ms. S is a 38 year
old resident of Seattle, Washington, who is dealing with a combination of
autoimmune diseases, which have progressively worsened. She had to drop out of
medical school because of her medical condition. She cannot work and her
chronic disease continues to worsen. She applied for benefits in May 2003.
Her representative sent briefs to the ODAR hearing office in February 2004 and
July 2005. Her case was denied by the ALJ, remanded by the Appeals Council,
denied by the ALJ again, and eventually appealed to federal district court.
The court remanded the case for a new ALJ hearing. As of April 2008, her case
is still pending for a third ALJ hearing, yet unscheduled.
WISCONSIN
· Mr. W is 48 years
old and was a manager at a social services organization in the area of Oshkosh, Wisconsin. He experienced a worsening of mental illness (neurotic depression) and
stabbed himself. He survived but endured homelessness. He lived in a boarding
house for a time. He was getting food from shelters and the Red Cross. He filed
for benefits in March 2006 and was finally approved for benefits in February
2008.
CONCLUSION
As you can see from the circumstances of these claimants’
lives and deaths, delays in decision-making on eligibility for disability
programs can have devastating effects on people already struggling with
difficult situations. On behalf of people with disabilities, it is critical
that SSA be given substantial and adequate funding to make disability decisions
in a timely manner and to carry out its other mandated workloads. We
appreciate your continued oversight of the administration of the Social
Security programs and the manner in which those programs meet the needs of
people with disabilities.
Thank you for the opportunity to testify today. I would be
happy to answer questions.
ON BEHALF OF:
American Council of the Blind
American Foundation for the Blind
American Network of Community Options and Resources
Council of State Administrators of Vocational Rehabilitation
Easter Seals, Inc.
Epilepsy Foundation
Goodwill Industries International, Inc.
Inter-National Association of Business, Industry and
Rehabilitation
National Alliance on Mental Illness
National Association of Disability Representatives
National Disability Rights Network
National Multiple Sclerosis Society
National Organization of Social Security Claimants’
Representatives
NISH
Paralyzed Veterans of America
Research Institute for Independent Living
The Arc of the United States
Title II Community AIDS National Network
Tourette Syndrome Association
United Cerebral Palsy
United Spinal Association
[1]
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. § 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. § 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.
[2] Social Security Disability: Better Planning, Management, and Evaluation
Could Help Address Backlogs, GAO-08-40 (Dec. 2007)(“GAO Report”), p. 22.
[3] Social Security Administration: Fiscal Year 2009 Justification of Estimates
for Appropriations Committees (“SSA FY 09 Budget Justification”), p.
6.
[4]
GAO Report, p. 20.
[5]
“National Ranking Report by Average Processing Time” for the month ending March
28, 2008.
[6]
SSA FY 09 Budget Justification, p. 18.
[7]
SSA FY 09 Budget Justification, p. 92.
[8]
GAO Report, p. 20.
[9]
SSA FY 09 Budget Justification, p. 6.
[10]
GAO Report, p. 32.
[11] Id.
[12]
SSA FY 09 Budget Justification, page 92, Table 3.2 – Key Performance Targets,
under Selected Outcome Measures.
[13]
Pub. L. No. 110-185.
[14]
Commissioner Astrue announced a number of initiatives to eliminate the SSA
hearings backlog at a Senate Finance Committee hearing on May 23, 2007. The
18-page summary of his recommendations is available at www.senate.gov/~finance/sitepages/hearing052307.htm.
An update on the status of the recommendations/initiatives is the subject of
the Plan to Eliminate the Hearing Backlog and Prevent Its Recurrence: End
of Year Report, Fiscal Year 2007, SSA Office of Disability Adjudication and
Review (“ODAR Report”).
[15]
Our recommendations include those made by Linda Landry, Disability Law Center, Boston, MA, at the SSA “Compassionate Allowance Outreach Hearing for Rare Diseases”
held in Washington, DC, on December 4, 2007. Her testimony is available online
at: http://www.ssa.gov/compassionateallowances/LandryFinalCompassionateAllowances2.pdf.
[16]
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).
[17]
20 C.F.R. §§ 404.936 and 416.1436.
[18]
20 C.F.R. §§ 404.1619 and 416.1019.
[19]
72 Fed. Reg. 41649 (July 31, 2007).
[20]
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).
[21]
ODAR Report, p. 3.
[22]
72 Fed. Reg. 61218 (Oct. 29, 2007).
[23] Id.
[24]
See:
http://www.c-c-d.org/task_forces/social_sec/CCD_NPRM_comments_FINAL_12-27-07.pdf.
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