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The New York State
Office of Temporary and Disability Assistance (OTDA) is the state agency
charged with helping New York’s most vulnerable citizens achieve and maintain
economic security through a range of work supports and services. OTDA’s
mission is multi-faceted: Assist those who are working but still struggling to
meet basic needs; help work-capable individuals find and maintain employment;
and assist those individuals with special needs for whom engaging in work is
not a realistic priority. In order to fulfill this complex mission, OTDA
oversees a range of programs that together weave a web of services and benefits
to help families who often face more than one barrier to economic
independence. These programs include employment and training services, food
stamps, child support, home energy assistance, immigration services, public
assistance, and SSI state supplementation. Additionally, OTDA includes the Division
of Disability Determinations (DDD), the entity which
serves as the Disability Determination Service in New York, and as such
is responsible for making federal disability determinations for claims filed
with the Social Security Administration (SSA).
Since OTDA’s
oversight includes Federal disability determinations, the state’s public
assistance programs and SSI state supplementation, our perspective encompasses
both our successful relationship with the Social Security Administration with
regard to disability determinations and the troubling impact the SSA backlog has
on New Yorkers generally, and on public assistance clients awaiting an appeal in
particular.
DDD makes
medical determinations on disability claims filed with the Social Security
Administration (SSA) for Supplemental Security Income (SSI) and/or Social Security Disability
Insurance (SSDI). The office collects all relevant medical evidence, and if
needed, arranges for the claimant to have an examination to gather further
information. A decision regarding medical eligibility is then made by DDD based
on all of the evidence. These two
programs represent the major economic support systems for the disabled. Additionally, individuals receiving federal
disability benefits also become eligible for essential health insurance through
Medicare and Medicaid.
New York’s DDD has long had a strong partnership with the SSA.
We value this relationship greatly, as it is beneficial for our State, for the
Federal government, and most importantly for disability claimants. In
addition, the DDD has a solid
performance record, meeting and often exceeding performance standards. Indeed,
in addition to its standard responsibilities, DDD often takes on extra tasks
such as working with SSA on pilot projects or helping other locations with
reviewing their disability applications. For example, DDD is currently working
to assist SSA with addressing the backlog through the Informal
Remand Initiative. Under this initiative, the SSA sends certain cases to DDD
to review in an effort to reduce the workload of the hearing officers.
Despite this initiative and other efforts
by the SSA, the backlog in appeals cases persists, and the impact on New York is enormous, both at the individual and state government levels. Nearly 38,000
New Yorkers are waiting for an appeal. These individuals wait 21 months on
average, a delay that in many cases results in a tragic loss of savings, home
or even life for some of the chronically ill or critically disabled individuals
seeking federal benefits. Of this total, more than 17,000 individuals awaiting
an appeal are on public assistance. This state-funded assistance is intended
to be a short-term stopgap. However, because of the long waiting period
resulting from the backlog, the state is providing months, sometimes more than
a year of assistance for individuals who, but for the backlog, are truly the
responsibility of the federal government. More importantly, since the public
assistance grant is typically less than the disability payment, the long delay
means that disabled individuals are not getting the level of financial support
to which they are entitled and need from the federal government.
Moreover, the
long wait places the state in a troubling position with regard to the federal
rules governing the Temporary Assistance for Needy Families (TANF) program. In
cases where it has been determined by the TANF program that a public assistance
client meets the federal requirements for a disability and the appropriate
application has been filed to receive SSI, New York exempts the individual from
TANF work requirements, and provides him or her with public assistance for the duration
of the disability determination. However, while the state exempts these
individuals from TANF work requirements, federal TANF rules do not. Therefore,
while the state is providing income support to these individuals who are not able to engage in full-time work due to their disability, we are at risk of
penalties for not meeting the required TANF work participation rate. This
policy is extremely problematic for states attempting to balance the
conflicting demands of these two federal programs, and New York has been
vigorously advocating for a common sense solution through changes in TANF regulation.
However, not only is this problem not resolved, it has been exacerbated by the
long waits for federal assistance resulting from the enormous backlog.
By reducing
the backlog in appeals and, therefore, reducing the waiting period, individuals
whose appeals are accepted would begin timely receipt of appropriate federal
assistance, therefore freeing up scarce state public assistance dollars for
other pressing needs. And for all who are waiting, reducing the waiting period
would minimize the potential for loss, both financial and personal, and help
these people on a path to economic stability.
Through the
strong relationship between the DDD and SSA, OTDA recognizes that SSA is making
a valiant effort to address the backlog despite a difficult combination of
circumstances: years of insufficient funding, expansion of responsibilities,
and an overstretched staff. This problem is due in part to an inadequate
number of Administrative Law Judges (ALJ) and support staff at the SSA to
conduct hearings and make determinations. However, despite repeated requests
for increased funding to address this issue, the SSA has not received adequate
funding to address this staffing shortage. While Congress provided an increase
in the FFY 2008 omnibus appropriations with language directing that the funds
be used for this purpose, given the size of the backlog and the extensive wait
times, more funding will certainly be needed. We urge Congress to provide the
SSA with sufficient funding to address this backlog and prevent it from
happening again in the future.
Given the increase in funding for
FFY 2008, OTDA commends SSA for hiring 135 new ALJs this year. However, we
join Senators Charles Schumer (D-NY) and Hillary Clinton (D-NY) in asking that
the geographical allocation of the new ALJs be revisited. We understand from the
testimony at the House Ways and Means Committee hearing on the disability
backlog that the allocation was intended to help offices carrying a significant
backlog caseload, yet only 10 of the 135 new ALJs were assigned in New York,
and to only four of the State’s nine hearing offices. Furthermore, no new
ALJs were assigned to the Buffalo office, even though that office currently has
one of the longest wait times in the country. The explanation that the
allocation was made in this manner due to the lack of office space for additional
staff is troubling. Thousands of individuals should not be made to wait for
disability assistance to which they are entitled because SSA cannot find office
space. OTDA urges SSA to reconsider the allocation plan, and stands ready to
offer assistance in finding adequate office space if necessary.
In addition to
increased funding and a reallocation of new ALJs, OTDA recommends that Congress
consider changing the criteria currently used to determine eligibility at the
time of the initial application. ALJs are allowed significantly more discretion
in allowing cases at appeal, and DDD can often tell when a case that is being
rejected based on the standard of evidence for the initial application will be
approved upon appeal. If the DDD were allowed similar discretion to the ALJs, then
the process would be expedited without impacting the integrity of the decision
process, thereby reducing the number of cases going to appeal, and reducing the
backlog.
For the
millions of individuals dealing with disabilities, SSI and SSDI are the
lifeline that helps them maintain economic stability and security. With
sufficient funding and other changes, the SSA will be able to eliminate the
backlog and provide this critical support to many vulnerable people eligible
for and entitled to federal disability assistance.
We hope
hearings like this one will catalyze changes for the SSA. We thank you for the
opportunity to comment on this important issue.
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