[House Hearing, 106 Congress]
[From the U.S. Government Publishing Office]
SOCIAL SECURITY NOTICES
=======================================================================
HEARING
before the
SUBCOMMITTEE ON SOCIAL SECURITY
of the
COMMITTEE ON WAYS AND MEANS
HOUSE OF REPRESENTATIVES
ONE HUNDRED SIXTH CONGRESS
SECOND SESSION
__________
SEPTEMBER 26, 2000
__________
Serial 106-65
__________
Printed for the use of the Committee on Ways and Means
U.S. GOVERNMENT PRINTING OFFICE
67-603 CC WASHINGTON : 2000
COMMITTEE ON WAYS AND MEANS
BILL ARCHER, Texas, Chairman
PHILIP M. CRANE, Illinois CHARLES B. RANGEL, New York
BILL THOMAS, California FORTNEY PETE STARK, California
E. CLAY SHAW, Jr., Florida ROBERT T. MATSUI, California
NANCY L. JOHNSON, Connecticut WILLIAM J. COYNE, Pennsylvania
AMO HOUGHTON, New York SANDER M. LEVIN, Michigan
WALLY HERGER, California BENJAMIN L. CARDIN, Maryland
JIM McCRERY, Louisiana JIM McDERMOTT, Washington
DAVE CAMP, Michigan GERALD D. KLECZKA, Wisconsin
JIM RAMSTAD, Minnesota JOHN LEWIS, Georgia
JIM NUSSLE, Iowa RICHARD E. NEAL, Massachusetts
SAM JOHNSON, Texas MICHAEL R. McNULTY, New York
JENNIFER DUNN, Washington WILLIAM J. JEFFERSON, Louisiana
MAC COLLINS, Georgia JOHN S. TANNER, Tennessee
ROB PORTMAN, Ohio XAVIER BECERRA, California
PHILIP S. ENGLISH, Pennsylvania KAREN L. THURMAN, Florida
WES WATKINS, Oklahoma LLOYD DOGGETT, Texas
J.D. HAYWORTH, Arizona
JERRY WELLER, Illinois
KENNY HULSHOF, Missouri
SCOTT McINNIS, Colorado
RON LEWIS, Kentucky
MARK FOLEY, Florida
A.L. Singleton, Chief of Staff
Janice Mays, Minority Chief Counsel
______
Subcommittee on Social Security
E. CLAY SHAW, Jr., Florida, Chairman
SAM JOHNSON, Texas ROBERT T. MATSUI, California
MAC COLLINS, Georgia SANDER M. LEVIN, Michigan
ROB PORTMAN, Ohio JOHN S. TANNER, Tennessee
J.D. HAYWORTH, Arizona LLOYD DOGGETT, Texas
JERRY WELLER, Illinois BENJAMIN L. CARDIN, Maryland
KENNY HULSHOF, Missouri
JIM McCRERY, Louisiana
Pursuant to clause 2(e)(4) of Rule XI of the Rules of the House, public
hearing records of the Committee on Ways and Means are also published
in electronic form. The printed hearing record remains the official
version. Because electronic submissions are used to prepare both
printed and electronic versions of the hearing record, the process of
converting between various electronic formats may introduce
unintentional errors or omissions. Such occurrences are inherent in the
current publication process and should diminish as the process is
further refined.
C O N T E N T S
__________
Page
Advisory of September 19, 2000, announcing the hearing........... 2
WITNESSES
Social Security Administration, Hon. William A. Halter, Deputy
Commissioner................................................... 6
U.S. General Accounting Office, Barbara D. Bovbjerg, Associate
Director, Education, Workforce, and Income Security Issues;
Health, Education, and Human Services Division, accompanied by
Kay Brown, Assistant Director.................................. 13
SUBMISSIONS FOR THE RECORD
Bilingual Services Working Group: Disability Law Center, Inc.,
Boston, MA, Linda L. Landry; National Senior Citizens Law
Center, Los Angeles, CA, Gerald McIntyre; Northwest Justice
Project, Seattle, WA, Gillian Dutton; Greater Upstate Law
Project, Rochester, NY, Edwin Soto-Lopez; and Cedar, New York,
NY, Christopher Bowes; joint letter............................ 50
Center for Disability Advocacy Rights, Inc., New York, NY,
Christopher James Bowes, letter and attachment................. 52
Matsui, Hon. Robert T., a Representative in Congress from the
State of California, statement................................. 4
National Alliance for the Mentally Ill, Arlington, VA, Gerald R.
Tarutis, statement............................................. 54
Robert, Charles, Robert, Lerner & Robert, New York, NY, statement
and attachments................................................ 56
Tyler, Johnson M., South Brooklyn Legal Services, Brooklyn, NY,
letter and attachments......................................... 62
Vollmer, Peter, Vollmer & Tanck, Uniondale, NY, letter........... 66
SOCIAL SECURITY NOTICES
----------
SEPTEMBER 26, 2000
House of Representatives,
Committee on Ways and Means,
Subcommittee on Social Security,
Washington, DC.
The Subcommittee met, pursuant to notice, at 10:07 a.m., in
room B-318, Rayburn House Office Building, Hon. E. Clay Shaw,
Jr. (Chairman of the Subcommittee) presiding.
[The advisory announcing the hearing follows:]
ADVISORY
FROM THE COMMITTEE ON WAYS AND MEANS
SUBCOMMITTEE ON SOCIAL SECURITY
CONTACT: (202) 225-9263
FOR IMMEDIATE RELEASE
September 19, 2000
No. SS-23
Shaw Announces Hearing on Social Security Notices
Congressman E. Clay Shaw, Jr., (R-FL), Chairman, Subcommittee on
Social Security of the Committee on Ways and Means, today announced
that the Subcommittee will hold a hearing on Social Security notices.
The hearing will take place on Tuesday, September 26, 2000, in room B-
318 Rayburn House Office Building, beginning at 10:00 a.m.
Oral testimony at this hearing will be heard from invited witnesses
only. Witnesses will include representatives from the U.S. General
Accounting Office (GAO) and the Social Security Administration (SSA).
However, any individual or organization not scheduled for an oral
appearance may submit a written statement for consideration by the
Committee and for inclusion in the printed record of the hearing.
BACKGROUND:
Social Security programs (Old-Age, Survivors, and Disability
Insurance and Supplemental Security Income) provide monthly cash
benefits to about 50 million beneficiaries. SSA mails millions of
letters each year to applicants and recipients about its decisions to
award, change, or deny benefits. In many cases these letters contain
vital information needed by recipients and their families to make
important medical, financial, and personal decisions.
Yet, in 1994, GAO found that SSA's letters were often difficult to
understand, lacked essential details, presented information in an
illogical order, and required complex analysis to understand how
benefit adjustments had been made. Chairman Shaw has asked GAO to
assess SSA's progress in improving its letters. These findings will be
presented at the hearing.
In announcing the hearing, Chairman Shaw stated: ``One of SSA's
goals is to deliver customer-responsive world-class service. Such
service must ensure that these life-changing notices are accurate and
easy to understand. We need to know if agency notices provide
intelligible information for today's customers and if not, how this can
be corrected before workloads at the agency substantially increase with
the upcoming retirement wave of the baby boomers. Providing quality
notices should be one of the agency's top priorities.
FOCUS OF THE HEARING:
The hearing will focus on the quality of SSA's notices and the
status of SSA's actions to address notice improvement.
DETAILS FOR SUBMISSION OF WRITTEN COMMENTS:
Any person or organization wishing to submit a written statement
for the printed record of the hearing should submit six (6) single-
spaced copies of their statement, along with an IBM compatible 3.5-inch
diskette in WordPerfect or MS Word format, with their name, address,
and hearing date noted on alabel, by the close of business, Tuesday,
October 10, 2000, to A.L. Singleton, Chief of Staff, Committee on Ways
and Means, U.S. House of Representatives, 1102 Longworth House Office
Building, Washington, D.C. 20515. If those filing written statements
wish to have their statements distributed to thepress and interested
public at the hearing, they may deliver 200 additional copies for this
purpose to the Subcommittee on Social Security office, room B-316
Rayburn House Office Building, by close of business the day before the
hearing.
FORMATTING REQUIREMENTS:
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witness, any written statement or exhibit submitted for the printed
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but will be maintained in the Committee files for review and use by the
Committee.
1. All statements and any accompanying exhibits for printing must
be submitted on an IBM compatible 3.5-inch diskette in WordPerfect or
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pages including attachments. Witnesses are advised that the Committee
will rely on electronic submissions for printing the official hearing
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2. Copies of whole documents submitted as exhibit material will not
be accepted for printing. Instead, exhibit material should be
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3. A witness appearing at a public hearing, or submitting a
statement for the record of a public hearing, or submitting written
comments in response to a published request for comments by the
Committee, must include on his statement or submission a list of all
clients, persons, or organizations onwhose behalf the witness appears.
4. A supplemental sheet must accompany each statement listing the
name, company, address, telephone and fax numbers where the witness or
the designated representative may be reached. This supplemental sheet
will not be included in the printed record.
The above restrictions and limitations apply only to material being
submitted for printing. Statements and exhibits or supplementary
material submitted solely for distribution to the Members, the press,
and the public during the course of a public hearing may be submitted
in other forms.
Note: All Committee advisories and news releases are available on
the World Wide Web at ``http://waysandmeans.house.gov''.
The Committee seeks to make its facilities accessible to persons
with disabilities. If you are in need of special accommodations, please
call 202-225-1721 or 202-226-3411 TTD/TTY in advance of the event (four
business days notice is requested). Questions with regard to special
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materials in alternative formats) may be directed to the Committee as
noted above.
Chairman Shaw. Good morning.
Each year the Social Security Administration mails out
millions of letters to Social Security and SSI beneficiaries.
The purpose of these letters is to notify people about changes
in their eligibility status or inthe amount of monthly benefits
that they receive.
These letters represent the official communication between
the Social Security Administration and the public. Millions of
elderly Americans, especially those with low income, rely on
Social Security as their only source of incomes. Any changes in
benefits or eligibility has an extremely important impact on
these people's lives. The amount of their Social Security or
SSI check may be the difference between paying the monthly
bills or not paying the monthly bills.
Social Security rules are complicated enough. If someone
does not understand what a letter says, they may not understand
that their monthly income will change, or in some cases, even
be discontinued. And they may not understand what steps they
can take to address the situation if a mistake was indeed made.
As a result, it is vital that SSA's letters to the public are
as clear and easy to understand as possible.
Yet, SSA letters are not clear. They are confusing,
sometimes illogical, contradictory, and oftentimes frightening,
especially when a senior on a fixed income is told that they
owe $4,435 in 30 days. A recent court case ruled that certain
letters are even constitutionally defective because they
violate the principles of due process.
For many years GAO has criticized these letters and has
recommended that improvements be made, and for many years SSA
has agreed that a real problem does in fact exist, and they
have vowed to make improvements.
Last year I asked the General Accounting Office to report
on the progress SSA has made in improving their letters to the
public. I am extremely disappointed to learn that the answer is
little to none. GAO will testify today that improving these
notices has not been a priority for SSA. The agency has taken
very little action to fix the problem, and the letters remain
as confusing today as they were several years ago when the
problem was identified.
For an agency that prides itself on delivering world-class
customer service--and it does--it is beyond me how a problem of
this magnitude fails to be addressed. SSA has recognized this
problem and has pledged to fix it. Yet time and time again,
plans to address the problems have been rescheduled, delayed or
simply put off.
In a few years millions of baby-boomers will reach their
peak disability years and then their peak retirement years. As
a result SSA's workload will increase substantially. Indeed,
SSA has testified before the Subcommittee about the daunting
challenges ahead as the agency prepares for the
increasedworkload. It seems to me that SSA's ability to
effectively communicate with the public is paramount in
providing quality customer service, and this is a problem that
needs to be fixed before the baby boomers become SSA customers.
I look forward to hearing from our witnesses today and to
learn what SSA plans to do to address these problems, and I
would now yield to Mr. Cardin for such time as you may want to
consume.
Mr. Cardin. Thank you, Mr. Chairman, and let me express Mr.
Matsui's sorrow for not being able to be present today, and I
would ask that his statement be made part of our record.
Chairman Shaw. Without objection.
[The statement of Hon. Robert T. Matsui follows:]
Statement of Hon. Robert T. Matsui, a Representative in Congress from
the State of California
The Social Security program serves millions of people. This
year, over 150 million people will work in Social-Security-
covered employment, and the Social Security and SSI programs
will pay benefits to 50 million. Most of the time, we don't
stop to think about all the information that the Social
SecurityAdministration (SSA) provides. SSA communicates to the
American people through its toll-free telephone number, its
branch offices, and its website.
One of the most important ways that SSA provides
information is through written notices. This year alone, SSA
expects to send out approximately 390 million notices to
claimants, beneficiaries, workers, employers, and government
agencies. Over the past several years, SSA has worked to
improve the clarity and readability of the vast majority of its
notices. The Commissioner of Social Security, Ken Apfel,
testified before the Subcommittee earlier this year about the
agency's initiatives.
At today's hearing, our witnesses will talk more
specifically about a small subset of the agency's notices. The
General Accounting Office (GAO) is here to tell us about their
latest study, in which GAO examined four types of notices the
SSA issues. These notices tell people whether they have
beenawarded or denied benefits, or that their benefit payments
will be adjusted because of a change in their personal
circumstances.
The people who receive these notices rely on the
information contained in them to make vitally important
financial and legal decisions. Whether it is the mother
receiving a notice about SSI benefits for her disabled child,
or the elderly widow whose benefits are changing after the
death of her husband,people count on these notices to be clear
and thorough.
Today, GAO will report that these four types of notices
need significant improvement. The notices are often hard to
follow, and the recipient may have difficulty figuring out what
action SSA is taking. The notices may not explain why SSA is
taking a particular action. And the notices may be missing
critical facts that the recipient needs in order to make an
informed decision about what to do next.
I recognize that SSA faces a monumental task in revising
these four types of notices. Making the changes that GAO
recommends will involve reprogramming dozens of software
programs and hundreds of lines of computer code. Since these
notices convey decisions about programs with very complex rules
such as SSI it will always be a challenge to present this
information in an easily understandable manner. Finally,
because a relatively small percentage of people receive these
types of notices, the large amount of resources required to
improve them may not make this project very attractive.
However, these notices are sent to some of the most
vulnerable members of our society the young, the sick, and the
old. These people look to Social Security in times of need. To
leave them, or the people who care for them, bewildered over a
change in benefits or feeling as though they simply have
norecourse in responding to a decision is simply unacceptable.
I am very proud of our nation's Social Security program,
and I know SSA is committed to providing its clients with the
best possible service. Although these changes may be difficult,
I know that the agency can and will make them in a timely
manner. I look forward to hearing from Ms. Bovbjerg about
GAO'srecommendations for improving SSA's notices and from Mr.
Halter about the steps the agency is taking to implement them.
Mr. Cardin. We join you on this side of the aisle in
welcoming this hearing. We very much welcome the deputy
commissioner and the testimony from GAO as to the notices being
sent out by the Social Security Administration. We think this
is an extremely important subject. 150 million will work
inSocial Security covered employment this year, and Social
Security and SSI combined will pay benefits to about 50 million
people in 2000.
I don't think we quite understand the enormity of the task
that faces SSA in communicating with the American public about
these programs. Indeed, for 2000, SSA expects to send out
approximately 390 million customized notices to claimants,
beneficiaries, workers, employers and government agencies,
390million customized notices. That is quite a task.
As you point out, we have had hearings before this
Subcommittee, and we know that Commissioner Apfel has made
great strides in improving the annual Social Security statement
that is now sent to every American worker over the age of 25.
These annual statements now comprise approximately one-third
ofthe automated notices SSA issues. About 133 million such
statements will be issued for 2000.
We join the Chair in recognizing that improvements need to
be made, and we must continue to conduct oversight and make
sure that we improve the notices that are being sent to the
beneficiaries particularly, because they rely on that
information. It is extremely important they get accurate
informationand timely information.
But, Mr. Chair, if I might, on a personal note, make a plug
for the bill that you have been working on, and that I hope to
work with you on, and that is to remove the SSA's
administrative budget from the discretionary spending caps,
because I do think part of the problem is that we need to take
a look at what is the right amount of administrative support
for the agency, not just in personnel, but in systematic
improvements. And competing today in Labor-HHS-Education on the
discretionary caps makes little sense, and I would hope that
legislation would help us in providing the necessary tools and
holding SSAaccountable to perform the way that our constituents
expect them to perform.
So I look forward to the witnesses today and I look forward
to working with you in making sure that we get the best
possible service to the people of his nation under the Social
Security Administration.
Chairman Shaw. Thank you, Ben. The budgetary problems that
you mention, perhaps we can work together to develop an
argument during this hearing with regard to that.
We have here just two panels, each comprised of one person.
From the Social Security Administration we have the Honorable
William A. Halter, who is the Deputy Commissioner of Social
Security.
Then we have, from the U.S. General Accounting Office,
Barbara Bovbjerg, who is the Associate Director of Education,
Workforce and Income Security Issues, Health, Education and
Human Services Division.
If neither of the witnesses has any objection, I think it
would be to our advantage to be able to handle this as one
panel so that we can go from question to question and people
have an opportunity, particularly you, Mr. Halter, to reply to
any problems that Ms. Bovbjerg may point out to us.
So, Ms. Bovbjerg, if you would please, if you have no
objection to sitting here at the table together, I think it
would be very helpful to us and to this hearing.
I thank you. Mr. Halter.
STATEMENT OF HON. WILLIAM A. HALTER, DEPUTY COMMISSIONER,
SOCIAL SECURITY ADMINISTRATION
Mr. Halter. Thank you, Mr. Chairman, Congressman Cardin,
Congressman Levin.
It is my pleasure to be here today to discuss the GAO's
report and our continuing efforts to ensure that the notices
the Social Security Administration sends to the public are
clear and informative. Improving the notices targeted by the
GAO requires diverting resources from other priorities. We have
committed those resources. Furthermore, we will put in place
mechanisms necessary to measure our performance for improving
the notices.
Mr. Chairman, as you know and as Congressman Cardin alluded
to, Social Security processes large workloads each and every
day. Fifty million beneficiaries receive the right payment on
time each month. On average, each work day, about 100,000
people visit one of our 1,300 field offices, and over 240,000
people call our 800 telephone number.
Our goal at the Social Security Administration is to
provide the best in business service, which includes making
written notices easy to read, accurately communicating all
necessary information and clearly indicating any actions or
information that we expect from the recipient of the notice.
The most formidable challenge in improving our notices
results from the complexity of our programs and the sheer
volume of the notices we must produce. As Congressman Cardin
noted, each year we send out about 390 million forms and
notices to the public. This number has grown dramatically in
thepast year, primarily because we are now sending Social
Security statements to 133 million people annually. About 95
percent of the notices are produced from automated systems.
These systems use more than 10,000 different paragraphs of text
to compose letters to respond to the multitude of combinations
of circumstances that apply to different beneficiaries. The
notices cited by GAO, the Social Security Benefit Adjustment
Notices and SSI Notices, are especially complex. An average
benefit adjustment notice will contain eight pages, 40
paragraphs and 225 fill-in-the-blank spots. A complicated
notice can contain up to 15 pages, 100 paragraphs and 800 fill-
ins. In SSI notices, each paragraph can have from 2 to 122
fill-in choices. Each of these fill-ins also has multiple
variations.
All of Social Security's notices must meet certain legal
requirements, especially if they involve a customer's rights
and responsibilities. It is sometime very difficult to
construct notice language that accomplishes this while making
the notice simple. Producing millions of personalized notices
where many different fact situations are present is one of our
greatest challenges.
I would like to review with you today our progress so far
in improving our notices and our plans for further
improvements, including those steps recommended by GAO. In
1993, Mr. Chairman, 30 percent of our notices needed to be
improved. Over the years we have improved our notices so that
only 8 percent remain to be addressed.
Improvements made in the last few years include making 56
million more notices a year available in Spanish, improving the
language in debt collection or billing notices that we sent to
approximately 3 million a year, improving the language of 3\1/
2\ million health insurance notices, and revising all of our
hearing-level notices.
In its review GAO focused on four types of notices that go
to 14.2 million people each year and convey important
information about their eligibility for benefits or changes in
their benefit amount. Importantly, in two months, that is to
say, November 2000, we will have in place corrections for
nearly 7million of these 14.2 million notices. In addition,
because of the retirement earnings test elimination legislation
that was passed this past year, the 14.2 million figure will
decrease by another 1.4 million in the next year as certain
notices will no longer need to be sent.
The Social Security Administration has committed the
resources and has a project plan that describes the steps
necessary to fix the remaining 6 million notices from the GAO
report. To complete the notice improvement project our plan
will allow us to make steady progress on improving these, our
mostchallenging notices.
Now, as I noted, we have already made progress in
addressing the problems identified for two of the four notice
types identified in the GAO report. For example, the remaining
problems with the Social Security Award Notice will be resolved
within the next two months. The remaining problems with the
Social Security Benefit Adjustment Notice will be corrected by
July of 2002.
We recognize that we still need to improve notices that
explain the effects of the retirement test on benefits.
However, thanks to the elimination of the retirement test at
full retirement age earlier this year, about two-thirds fewer
beneficiaries are subject to that retirement test. The number
of complicated retirement notices, currently around 3\1/2\
million, will drop by approximately 40 percent.
We face our most difficult task in improving SSI Awards and
Benefit Adjustment Notices. Because the SSI program is complex,
explanations of the effect of income, resources and living
arrangement changes will always, by their nature, be difficult
to present in an easy, understandable manner. There is
virtually no limit on how many variations can apply to a single
beneficiary, meaning that the SSI notices must be able to
handle an almost unlimited array of possibilities with a large
number of variables. In addition, improvements to these notices
will require an investment of information technology resources
to change the SSI computational and notices systems.
Although, as noted in the GAO report, there are no quick
fixes for making improvements in this area, we are committed to
making the improvements needed as quickly as possible, and we
have started work on these changes. For example, in February of
this year we drafted and tested a prototype worksheet to be
added to the SSI Award and Benefit Adjustment letters, showing
how SSI benefits are computed. This worksheet shows how SSI
benefits are computed in relatively uncomplicated cases. That
is 90 percent of the cases in which SSI recipients have no
income or only unearned income such as SocialSecurity benefits.
This worksheet will be added to the SSI letters for this
population as part of the major notice system changes that will
be implemented by July of 2002.
We agree with GAO's recommendation to develop performance
measures for notice clarity and beneficiary understanding of
the most complex notices. In this coming fiscal year we will
conduct a customer satisfaction survey to secure reliable
baseline data on customer satisfaction with the notices that we
have targeted for improvement. Using the feedback obtained from
this survey, we will pursue the development of performance
measures that address GAO's concerns.
Regardless of how much improvement is made in our most
problematic notices, there are complex issues in which many of
our customers will need to discuss the information received.
Therefore, in addition to improving the majority of our
notices, we have provided our public contact personnel with
additional tools for responding to concerns or questions about
notices. For example, as a result of the Online Notice
Retrieval System, which was implemented nationally in November
of 1998, public contact personnel in our field offices and
teleservice centers now have direct online access to the
specific notice information and language contained in the vast
majority of notices received by the public. The next release of
this system planned for later this year will provide online
access to virtually all remaining notices and will further
enhance our ability to communicate effectively with our
customers.
In addition to making internal improvements to our process,
we are firmly committed to involving the public in the
evaluation of products and services that affect them. This year
alone we have conducted over 24 focus group tests to get the
public's reaction to this worksheet that we plan to add to our
SSInotices. In our annual customer satisfaction survey we ask
respondents to rate the clarity of information we mail to them.
Our most recent survey results indicate that 86 percent are
satisfied or very satisfied with their mail from the Social
Security Administration. Importantly, Mr. Chairman, this is
animprovement over prior years, where the results were 65
percent satisfaction rating in FY 1993.
In conclusion, Mr. Chairman, we agree with the
recommendations of the GAO report. We have already improved the
language and format of about 92 percent of our notices. In
fact, GAO acknowledged in its report that in spite of
increasing workloads and efforts to address agency priorities
such as maintaining program integrity, the Social Security
Administration has made major notice enhancements. And we have
recently committed resources to improving the remaining
problematic notices.
Mr. Chairman, I would be happy to answer any questions you
may have.
[The prepared statement follows:]
Statement of Hon. William A. Halter, Deputy Commissioner, Social
Security Administration
Mr. Chairman and Members of the Subcommittee:
I am pleased to be here today to discuss the General
Accounting Office (GAO) report and our continuing efforts to
ensure that the notices the Social Security Administration
(SSA) sends to the public are clear and informative. Effective
communication between the Social Security Administration and
theAmerican public is very important. We appreciate the
opportunity to discuss the progress that we have made in
improving our notices and our plans for future improvements.
While improving the notices targeted in the GAO report within
the timeframes we have set will require diverting resources
from otherpriorities, we have committed those resources.
Furthermore, we will put in place mechanisms necessary to
measure our performance for improving the notices, as
recommended by GAO.
Our goal at the Social Security Administration is to
provide the best in business service which includes making
written notices easy to read, accurately communicating all
necessary information, and clearly indicating any actions or
information that we expect from the recipient of the notice.
Not surprisingly, our customers tell us that a key aspect of
the service we provide is the clarity of our notices. In
numerous customer satisfaction surveys, notice recipients have
stated that it is important for them to readily understand what
we are writing to them about. Clear notices not only help the
customer but also lead to a much more efficient delivery of
services for the Social Security Administration.
Mr. Chairman, let me give you some examples of the
magnitude of the Social Security's service responsibilities. We
are committed to providing the right benefit payment to the
right person on time, and we do so over 600 million times a
year. This represents 50 million monthly payments to Old-Age,
Survivors and Disability Insurance (OASDI) and Supplemental
Security Income (SSI) recipients. On average, each workday
about 100,000 people visit one of our 1,300 field offices and
over 240,000 people call our 800 telephone number. Each workday
we process an average of 20,000 initial claims for retirement,
survivors, disability or SSI benefits, and hold 2,400 hearings
before Administrative Law Judges (ALJs). Each year, we make
certain that over 250 million earnings items are correctly
credited to workers' accounts to ensure that future benefit
payments are accurate. We take these responsibilitiesvery
seriously, because millions of Americans rely on us as they
have for the past 65 years.
The most formidable challenge in improving our notices
results from the complexity of our programs and the sheer
volume of notices we must produce. Each year, we send about 390
million forms and notices to the public. This number has grown
dramatically in the past year, primarily because we are
nowsending Social Security Statements to 133 million people
annually. Our notices are produced from 15 separate computer
software systems and from countless manual processes. About 95
percent of the notices are produced from automated systems.
These systems use more than 10,000 different paragraphs of text
to compose letters to respond to the multitude of combinations
of circumstances that apply to different beneficiaries.
All of Social Security's notices must meet certain legal
requirements, especially if they involve a customer's rights
and responsibilities. It is sometimes very difficult to
construct notice language that accomplishes this, while the
notice simple. Many of these notices require customized text
where the result of a Social Security Administration action
must be explained by computer insertion of relevant paragraphs.
These insertions must also be organized in a logical manner.
Producing millions of personalized notices where many different
fact situations are present is one of our most challenging
duties.
I would like to review with you today the process we are
using to improve our notices, including our actions taken so
far, and our plans for further improvements including those
recommended by GAO.
We have improved the clarity of the vast majority of our
notices, provided additional capabilities for staff responding
to notice inquiries, and we have modernized and streamlined the
way we produce notices. We have improved letters to retirement,
survivors and disability beneficiaries, SSI overpaymentletters,
notices announcing cost-of-living adjustments, notices to
employers and employees and the Social Security Statement.
Since 1985 the agency has been seeking to improve its most
problematic notices and high visibility form letters. We
focused our initial efforts on notices that affected the
greatest number of customers and that were less complex notices
to generate. This allowed us to improve 92 percent of the
notices we issue each year. In 1993, the agency convened a
steering committee composed of representatives of all parts of
Social Security to guide these efforts. As a result of this
initiative, the agency has made many major enhancements in the
quality of our notices and improved the service to notice
recipients. We have modernized and streamlined the notice
production environment.
Improvements made in the last few years include:
Improving the language of 3.5 million health
insurance notices,
Eliminating the use of confusing multi-use form
letters that were sent to 9 million people each year,
Improving the language in debt-collection or
billing notices that we send to approximately 3 million people
a year,
Improving letters that we send to approximately 4
million people each year to confirm appointments,
Revising all of our hearing level notices, which
amount to .5 million that we send annually,
Making 56 million more notices a year available in
Spanish, and
Consolidating duplicate notice language databases.
In 1993, 30 percent of our notices needed to be improved;
over the years, we have improved our notices so that only 8
percent remain to be addressed. We have already begun to
improve the remaining 8 percent, which were cited in the GAO
report.
The most challenging notices to improve are:
The Social Security benefit adjustment notices,
including overpayments and underpayments, and
SSI award notices and notices of action to be
taken by the Social Security Administration regarding the
recipient's SSI eligibility or benefit amount.
In its review GAO focused on 4 types of notices that
together total 14.2 million pieces of correspondence each year
which convey important information about eligibility for
benefits or changes in benefit amount. In two months, we will
have in place corrections for nearly 7 million of these
notices. In addition, because of the Retirement Earnings test
legislation, the 14.2 million figure will decrease by another
1.4 million in the next year, as certain notices will no longer
be sent. The Social Security Administration has committed the
resources and has a project plan necessary to fix the remaining
6 million notices. To complete the notice improvement project,
our plan will allow us to make steady progress on improving
these most challenging notices over the next four years.
With regard to the notices that were the focus of the GAO
report, we are pleased to report that we have already made
progress in addressing the problems identified in the report
regarding the Social Security Award Notice and the Social
Security Benefit Adjustment Notice. The remaining problems
withthe Award Notice will be resolved within the next two
months. With regard to remaining problems with the Social
Security Benefit Adjustment Notice, we have a team working to
complete all improvements in these notices by July 2002. The
complexity with the current Social Security Benefit Adjustment
Notices occurs because the notices are generated from 46
separate software programs and are composed by selecting from
146 different paragraphs. An average Benefit Adjustment Notice
will contain 8 pages, 40 paragraphs, and 225 fill-ins. A
complicated notice can contain up to 15 pages, 100 paragraphs,
and 800fill-ins.
Notices that explain the effects of the retirement test on
benefits will be improved as part of the effort that will be
completed in July 2002. However, thanks to the elimination of
the retirement test at full retirement age earlier this year,
about two-thirds fewer beneficiaries are subject to the
retirement test. The number of complicated retirement test
notices and subsequent notices dealing with the resulting
overpayments and underpayments, currently approximately 3.5
million, will drop by approximately 40 percent.
We face our most difficult task and greatest challenge in
improving SSI Awards and Benefit Adjustments Notices. Because
the SSI program is complex, explanations of the effect of
income, resources, and living arrangement changes will always,
by their nature, be difficult to present in an easy,
understandable manner. In addition, improvements to these
notices will require an investment of information technology
resources to change the SSI computational and notices systems.
As an example of the complexity of the task we face, the
SSI notices computer program selects from approximately 700
paragraphs, which are tailored to the characteristics of an
individual's case. Each paragraph can have from 2 to 122 fill-
in choices. Each of these fill-ins also has multiple
variations. The Social Security Administration produces an
average of 1.4 million SSI notices each month, not including
the 7.5 million cost-of-living adjustment (COLA) notices
generated each November. A SSI recipient can have different
income, resources, and living arrangements from month to month,
coupled with overpayments and/or underpayments. Notices reflect
past or present changes and the consequences of those changes.
There is virtually no limit on how many variations can apply to
a single beneficiary, meaning that the SSI notices must be able
to handle an almost unlimited array of possibilities with a
large number of variables.
Although, as noted in the GAO report, there are no quick
fixes for making improvements in this area, we are committed to
making the improvements needed as quickly as possible. The
Social Security Administration has started work on these
changes. In February 2000, we drafted and tested a prototype
worksheet to be added to SSI award and benefit adjustment
letters showing how SSI benefits are computed. The worksheet
that we tested was intended to show how SSI benefits are
computed in relatively uncomplicated cases--that is, the 90
percent of cases in which SSI recipients have no income or only
unearned income, such as Social Security benefits. This
worksheet will be added to the SSI letters for this population
as part of the major notice systems changes that will be
implemented by July 2002.
In July 2000 we tested the worksheet with SSI recipients
who have a combination of earned and unearned income because we
wanted to make sure that our worksheet would take care of more
complicated eligibility situations. Through incremental
improvements to these types of notices, by September 2004 we
plan to incorporate the more complex earned and unearned
situations, such as a child receiving benefits based on
parents' income, into the worksheet.
We have dedicated the resources necessary to fix almost all
of the Social Security notices cited by GAO by July 2002 and
almost all of the SSI notices by September 2004. This will
include the addition of a worksheet detailing the computation
for SSI notice recipients. Furthermore, we will put in place
the mechanisms necessary to measure our performance for
improving the notices as recommended by GAO.
As we implement these improvements, we will not lose sight
of the needs of the public for notices that are complete,
clear, and accurate, and we will continue to consult with the
public as to how well we are meeting their needs. Improvement
to our notices continues to be a central element to our overall
plan to provide high-level service to the public.
Regardless of how much improvement is made in our most
problematic notices, there are complex issues and/or unique
situations in which many of our customers will need or want to
discuss the information received. Therefore, in addition to
improving the majority of our notices, we have provided our
public contact personnel with additional capabilities to use
when responding to concerns or questions about notices. As a
result of the Online Notice Retrieval System (ONRS),
implemented nationally in November 1998, public contact
personnel in our field offices and teleservice centers now have
direct online access to the specific notice information and
language contained in the vast majority of notices received by
the public. The next release of Online Notice Retrieval System,
planned for later this year, will provide online access to
virtually all remaining notices by our public contact personnel
and will further enhance our ability to communicate effectively
with our customers. The Social Security Administration's field
offices and 800 number service provide additional assistance to
people with questions about their notices.
In addition to making internal improvements to our process,
we are firmly committed to involving the public in the
evaluation of products and services that affect them. In FY
2001 we will conduct a customer satisfaction survey to secure
reliable baseline data on customer satisfaction with notices
targeted for improvement.
As early as 1987, the Social Security Administration tested
notice language by obtaining public feedback, and we continue
to rely on similar methods of involving the public in notice
improvement activities. In 1997, we conducted a series of focus
groups to test reactions to new notice formats to see if these
new formats might help with notice comprehension. This year
alone, we have conducted over 24 focus group tests to get the
public's reaction to a computational worksheet that we plan to
add to SSI notices and another 6 focus group tests to get
public reaction to a work-related notice. Public input improves
the final product by focusing our improvements on public needs
and expectations.
Two prime examples of the Social Security Administration's
use of public input to improve our notices are the Cost of
Living Adjustment (COLA) notice and the Social Security
Statement. The Social Security Administration used comments
from in-depth interviews and focus group sessions with
disability and retirement beneficiaries to improve the COLA
notice by revising the language and improving its appearance
through format and overall style changes. The readability of
the notice also was improved by enlarging the type size and
changing the order of the information. The Social Security
Statement reflects our customers' requests to have the earnings
and benefit information presented in an easy to read and
understandable format. We simplified the explanations, reduced
the number of pages from 6 to 4, enlarged the type size,
increased the amount of white space on the form, and reordered
the information to make it flow better.
The GAO report recommended that the ``Commissioner of
Social Security direct SSA officials to develop performance
measures to hold the agency accountable for making the needed
comprehensive changes to its Social Security benefit adjustment
letters and SSI award and benefit adjustment letters. These
measures should include indicators that clearly articulate the
timetables and basis against which progress to complete
improvements can be tracked and, as further progress is made,
the effectiveness of the improvements.''
Regarding this recommendation on performance measures, we
looked to our annual customer satisfaction survey as the basis
for a performance measure. In our annual customer satisfaction
survey, we ask respondents to rate the clarity of information
we mail to them. Our most recent survey results indicate that
86 percent are satisfied or very satisfied with their mail from
the Social Security Administration. This is an improvement over
prior years when the results were 65 percent in FY 93.
Many of these respondents received very simple notices, and
we are not able to break out results for recipients of our more
complex notices. Therefore, to develop performance measures for
notice clarity and beneficiary understanding of the most
complex notices, we need to secure benchmark information about
how well our beneficiaries understand the current version of
these notices. We will conduct a customer satisfaction survey
for these complex notices in fiscal year 2001 to obtain this
information. Using the feedback obtained from the benchmark
survey, we will pursue the development of performance measures
that address GAO's concerns. As revised notice language is
developed, we will conduct follow up customer surveys targeted
to measure the level of customer understanding of the revised
notices and the degree to which the desired performance has
been achieved.
Mr. Chairman, the Social Security Administration has been
known for some time as a Government-wide leader in management,
planning, and service to the American public. Customer service
has always been the hallmark of the Social Security
Administration. The University of Michigan gave the Social
Security Administration an 82 for customer satisfaction in the
1999 American Customer Satisfaction Index Survey--That is 8
points higher than the comparable private sector index. The
1999 Government Performance Project conducted jointly by
Syracuse University's Maxwell School of Citizenship and
Government Executive Magazine ranked the Social Security
Administration at the top of 15 Federal Government agencies in
one of the most comprehensive studies of management performance
ever conducted. We have also won a prestigious award from CIO
Magazine--a ``2000 CIO-100 Honoree.'' CIO Magazine presents
this award annually to the top 100 organizations that exemplify
the ``best of the best'' in various business practices. This
year, the 100 honorees are organizations that excel in customer
service and customer relationship management.
We understand how vital our customers are, and we are
excited about this special recognition. But, in spite of these
accolades, we, like all other public institutions, face
significant demands, changes and challenges. We recognize the
problems with some of our notices and appreciate the importance
of correcting those problems. We will maintain our focus on our
customers and clearly explain our decisions so that they can
understand why and how we made them and what to do if they
disagree.
We agree with the recommendation in the GAO report. We have
already improved the language and format of about ninety-two
percent of all our notices that the public receives. In fact,
GAO acknowledged in its report that, in spite of increasing
workloads and efforts to address Agency priorities, such as
maintaining program integrity, the Social Security
Administration has made major notice enhancements. We have
committed resources to improve the problematic notices.
As we implement these improvements, we will not lose sight
of the needs of the public for notices that are complete,
clear, and accurate, and we will continue to consult with the
public as to how well we are meeting their needs. Improvement
to our notices continues to be a central element to our overall
plan to provide high-level service to the public.
Chairman Shaw. Thank you very much.
There is a general vote on the floor. We should be gone
only about 15 minutes, so we will stand in recess until we
return. Thank you. [Recess.]
Chairman Shaw. Ms. Bovbjerg.
STATEMENT OF BARBARA D. BOVBJERG, ASSOCIATE DIRECTOR,
EDUCATION, WORKFORCE, AND INCOME SECURITY ISSUES; HEALTH,
EDUCATION, AND HUMAN SERVICES DIVISION, U.S. GENERAL ACCOUNTING
OFFICE, ACCOMPANIED BY KAY BROWN, ASSISTANT DIRECTOR
Ms. Bovbjerg. Thank you, Mr. Chairman. Before I start, I
want to introduce my colleague, Kay Brown, Assistant Director
in our office, who is a customer service expert.
Chairman Shaw. Okay, thank you.
Ms. Bovbjerg. I am pleased to be here to discuss the
letters that Social Security sends to the public. Each year SSA
sends millions of letters to applicants for and recipients of
Social Security and Supplemental Security Income benefits.
These letters tell people if they are eligible to receive
benefits or if their benefits are changing. Because they
provide such important information, the letters must be written
in a way that can be clearly understood.
We have long been critical of SSA's letters and have
reported on this topic twice in the past. We have now completed
our most recent assessment of SSA's progress in improving
letters, and my testimony today summarizes these findings. We
are also issuing a report to you today that provides a more
detailed description of our work. I would like to focus my
remarks today on two areas: the problems that make some letters
hard to understand, and the status of SSA's actions to fix
them.
First the letters' problems. We looked at four types of
automated high-volume letters, two each for Social Security and
for SSI. In each program we focused on benefit award letters
and benefit adjustment letters because of their potential
significance to the people receiving them. We used writing
consultants to help us assess the clarity of communication and
identify the types of deficiencies.
What we found was problematic. The majority of letters in
each of the four categories we reviewed did not clearly
communicate on at least one of four dimensions. The letters
either failed to explain SSA's decision itself, the basis for
the decision, the financial effects of the decision on the
individual's benefits, or the recourse available to the
individual. Our report details the frequency and specifics of
the letters' shortcomings and reproduces several actual letters
as examples. While time doesn't permit me to discuss all of
these in detail, I have brought one letter that by itself
illustrates several of the problems we have seen.
Chairman Shaw. Is the letter in the testimony?
Ms. Bovbjerg. You have one in your package in color, Mr.
Chairman, but there is also a more elaborate one in the
testimony itself.
You can see on the board, excerpts from an actual SSI Award
Letter. Such letters are sent to applicants who have been
awarded benefits for previous months but not for future months.
We have color-coded it by the type of information provided. Let
me run through these problems quickly.
As you can see in the yellow areas, which describe SSA's
decision, the letter first tells the recipient she is eligible
for benefits, then subsequently states that she is ineligible,
which might seem confusing to the average person.
The first blue area down by letter ``C'' explains that she
is ineligible for disability benefits because, first, she is
disabled, and second, she lives in Massachusetts. Neither seems
to support the ineligibility decision. It is only later in the
letter, in the blue area by letter ``D'', that she can see that
in fact it is her income that makes her ineligible.
The pink area suggests that she is now going to receive 8
months of benefits and a check for more than $3,000, but the
letter later states that only one month of benefits will be
provided. At this point the recipient may have no idea what
amount of money to expect.
And then finally, the green area at the bottom incorrectly
states that if she thinks she might be eligible in the future,
she must reapply before benefits can resume. This is misleading
because, under SSI rules, monthly benefits can resume without
reapplying if the individual becomes eligible again within a
year.
I am not sure what the recipient of this letter would
think, even after reading it carefully. Letters like these
upset and confuse people and waste everyone's time as the
recipients seek and SSA staff have to provide additional
explanation. SSA sends over 100,000 award letters like this
oneevery year.
Let me now turn to SSA's plans for fixing these letters.
SSA has indeed specifically targeted these problematic letters
for improvement, yet little has been done, despite the
longstanding nature of the problems. Since we began examining
letters in 1994, the agency has completed only one minor
improvement to one of the four types of letters we reviewed,
and has announced plans to add clarifying language to other
letters sometime this fall.
This small amount of progress stems from the relatively low
priority SSA has placed on fixing these letters. Many of the
needed fixes, particularly for SSI letters, are complex. They
require changes to SSA's computer systems, and systems staff
has simply not been made available to do this work. Even if SSA
adheres to its current plans, comprehensive improvements will
take years to achieve. If SSA is to make these improvements
within a reasonable period of time, it needs to place a higher
priority on its letters.
In addition, we are recommending that the agency develop
performance measures to hold itself accountable for achieving
these improvements. These measures should help foster greater
urgency to complete this project, and will help SSA and others
both monitor its progress and assess the effectiveness of
changes made.
Failure to give more attention to this problem will allow
poor communications to continue and will detract from the
quality of SSA's customer service.
Mr. Chairman, that concludes my statement. I would be happy
to answer any questions you have.
[The prepared statement follows:]
Statement of Barbara D. Bovbjerg, Associate Director, Education,
Workforce, and Income Security Issues; Health, Education, and Human
Services Division, U.S. General Accounting Office
Mr. Chairman and Members of the Subcommittee:
We are pleased to be here today to discuss the letters the
Social Security Administration (SSA) sends to the public. Each
year SSA mails millions of letters to applicants and recipients
of the Old Age and Survivors Insurance and Disability Insurance
programs, commonly referred to as Social Security, and the
Supplemental Security Income (SSI) program. These letters tell
the public whether they are eligible to receive monthly cash
benefits or whether their benefit amounts are changing. Because
the letters contain important information affecting people's
everyday lives, they need to be clearly written and easy to
understand. Recognizing this, SSA has pledged to the public
that its letters will clearly explain the agency's decisions so
that the public can understand how and why SSA made the
decisions and what to do if it disagrees.
We have long been critical of SSA's letters. In 1994, we
testified before this Subcommittee that many SSA letters,
particularly those dealing with Social Security overpayments,
were difficult to understand.\1\ We found letters that left out
information necessary to understand SSA's decisions, presented
information in an illogical order, or failed to clearly explain
how SSA had adjusted benefits. More recently, you asked us to
assess SSA's progress in improving its letters. We have just
completed that assessment and are issuing our report on this
subject to you today.\2\ My testimony, which summarizes the key
findings of our report, focuses on (1) the problems that make
SSA's letters difficult to understand and (2) the status of
SSA's actions to fix them.
---------------------------------------------------------------------------
\1\ Social Security Administration: Many Letters Difficult to
Understand (GAO/T-HEHS-94-126, Mar. 22, 1994)
\2\ Social Security Administration: Longstanding Problems in SSA's
Letters to the Public Need to Be Fixed (GAO/HEHS-00-179, September 26,
2000).
---------------------------------------------------------------------------
We focused our review on four categories of automated,
high-volume letters to the public: (1) letters awarding Social
Security benefits, (2) letters adjusting Social Security
benefits, (3) letters awarding SSI benefits, and (4) letters
adjusting SSI benefits.\3\ SSA mails about 14.2 million of
these letters each year.\4\ We focused on these letters because
they reach a large number of people and convey important
information on their eligibility for benefits or changes in the
amount of their benefits issues that can significantly affect
their lives. We used writing consultants to help us develop the
criteria to assess whether the letters communicated clearly and
to verify our assessment of the types of problems that occur in
them. We also interviewed SSA officials responsible for
improving the agency's letters and reviewed documents on past
and current evaluations of the letters and its initiatives to
improve them.
---------------------------------------------------------------------------
\3\ SSA characterizes its letters as automated or manual. SSA
considers a letter automated if its personnel input transaction data,
such as a death or earnings report, and SSA's systems generate the
letter without any other human intervention. If SSA personnel were
involved in selecting paragraphs or providing individualized data, then
SSA considers the letter to have been manually prepared.
\4\ SSA estimates that it mails about 250 million letters and forms
annually to the public, including claimants, workers, employers, and
government agencies, on a wide variety of issues.
---------------------------------------------------------------------------
In summary, our work showed that the majority of letters in
each of the four categories we reviewed did not clearly
communicate at least one of the following key points: (1) SSA's
decision (that is, the action SSA was taking on a claim that
prompted the agency to send the letter), (2) the basis for
SSA's decision, (3) the financial effect of SSA's decision on
payments to the individual, or (4) the recourse the individual
could take in response to SSA's decision. The lack of clarity
was caused by one or more problems, such as illogically
sequenced information, incomplete or missing explanations,
contradictory information, and confusing numerical information.
An unclear explanation of the basis for SSA's decision that is,
not clearly explaining the program rules or facts on which
SSA's decision was based was the most widespread problem among
the four categories of letters. We also found one particular
group of SSI award letters in which none of the four key points
was clear.
SSA acknowledges that these letters contain the problems we
identified and agreed the problems have existed for years;
however, for many of the problems, the agency has not taken any
corrective action and, overall, the agency has not placed a
high priority on improving its letters. Many of the problems we
identified are not amenable to quick fixes but, rather, will
require a comprehensive revision of the language in the letters
and rewriting the agency's software applications that generate
them. Competing demands for computer systems resources have led
SSA to repeatedly reschedule improvements to the Social
Security benefit adjustment letters, and a pending nationwide
court case has led SSA to delay improvements to the SSI award
and benefit adjustment letters. SSA recently announced plans to
improve its Social Security benefit adjustment letters and has
begun a major initiative to improve its SSI award and benefit
adjustment letters. But it will be years before the
improvements are completed for most of these letters, even if
there are no more delays and SSA adheres to its current plans.
Background
The Social Security program and the SSI program provide
monthly cash benefits to individuals who meet the programs'
eligibility requirements. In fiscal year 1999, 44.5 million
persons received a total of $382.8 billion in Social Security
benefits, and 6.6 million persons received $28.1 billion in SSI
benefits. The rules affecting eligibility and benefit amounts
in these programs can be complex. Once individuals are
determined to be eligible for Social Security or SSI benefits,
changes in their circumstances, such as changes in the amount
of their income, disability or marital status, can affect their
continuing eligibility for benefits or the amount of their
benefits.\5\ When SSA learns of these changes either through
its own review processes or from individuals reporting changes
in their circumstances to the agency SSA adjusts individuals'
eligibility status or benefit amounts accordingly.
---------------------------------------------------------------------------
\5\ Our review did not include letters sent to individuals whose
benefits were terminated because they had been determined to be no
longer disabled.
---------------------------------------------------------------------------
The process for improving SSA's letters is complex as well.
The responsibility for improving letters is shared among
various SSA offices, including the office responsible for
customer service, which helps identify problems, and the
program offices, which are responsible for further analyzing
the problems and drafting revised language. The Office of
Systems, however, plays a key role because implementing changes
often requires systems programmers to rewrite one of the
multiple software applications that SSA uses to generate
letters. Each software application has its own programmed logic
to generate letters and its own language database. Depending on
the particulars of a transaction, each application is
programmed to select appropriate paragraphs from among the
numerous paragraphs in its language database, many of which
were written for use in multiple situations. Once the
paragraphs are selected, the software is programmed to complete
paragraphs by filling in case-specific information from SSA's
master records and to sequence paragraphs to assemble letters.
These master records contain account data for every
beneficiary.
Problems in SSA's Letters Limit Their Understandability
Many of SSA's letters in our review do not meet the
agency's own communication standard, and do not meet generally
accepted principles of good communication. Social Security
award letters, Social Security benefit adjustment letters, SSI
award letters, and SSI benefit adjustment letters do not
clearly communicate one or more of the following key points:
SSA's decision (that is, the action SSA is taking on a claim
that necessitated the letter), the basis for its decision (that
is, the program rules and facts on which SSA based its
decision), the financial effect of its decision on payments to
the individual, and the recourse the individual has in response
to SSA's decision. The unclear communication was caused by many
of the same problems we identified in SSA's letters in 1994,
such as illogically sequenced information, incomplete or
missing explanations, contradictory information, and confusing
numerical information.
Table 1 presents what we consider to be the most
significant problems, because of either their frequency or
their potential to adversely affect the individuals receiving
the letters.
Table 1--The Most Significant Problems in Four Categories of SSA Letters and Their Estimated Frequency
----------------------------------------------------------------------------------------------------------------
Social Security letter SSI letter
Key point -----------------------------------------------------------------------------------------------
Award Benefit adjustment Award Benefit adjustment
----------------------------------------------------------------------------------------------------------------
Decision 80% of cover letters
do not include all
decisions that affect
payments
----------------------------------------------------------------------------------------------------------------
Basis for 100% illogically 100% do not explain 86% do not clearly
decision sequence explanations relationship between explain relationship
of SSA's decisions program rules and between program rules
benefit amounts and changes in benefit
amounts
----------------------------------------------------------------------------------------------------------------
Financial effect 86% lack clear 55% lack clear
explanations of statement of timing or
adjustments amount of change in
benefits or
otherproblems
----------------------------------------------------------------------------------------------------------------
Recourse 95% do not state how 24% do not fully state
to appeal options for repaying
overpayments or how to
appeal
----------------------------------------------------------------------------------------------------------------
----------------------------------------------------------------------------------------------------------------
Note: We used two different approaches to quantify the
frequency of problems in these letters. For the letters
awarding Social Security and SSI benefits, we identified
specific problems and obtained information from SSA about the
number or percentage of letters that included these problems.
For the letters adjusting the amount of Social Security and SSI
benefits, we reviewed a statistical sample of 1 day's
production of letters.
As the table indicates, we found a variety of problems in
the four categories of letters.
SSA's decision was difficult to understand in
Social Security benefit adjustment letters because important
information was not explained in the cover letters but, rather,
was buried in the attachments or not explained at all. For
example, a cover letter informed a claimant that she had been
overpaid about $600 but it requested that she repay about
$2,200. The explanation for the different amounts SSA's
decision to also recover a prior overpayment was buried in the
attachment.
Another letter mentioned three different
overpayment amounts without explaining the differences.
The basis for SSA's decisions were often difficult
to understand because the program rules or facts on which the
decisions were based were explained in complex language that
was difficult to follow, were presented in illogical order
scattered throughout letters, or were not fully explained. For
example, no SSI award letter explained the relationship between
program rules and the amount of the SSI benefit. An SSI award
letter informed a claimant that she was awarded benefits for
July 1999 through November 1999 but that she would receive a
benefit for October and November lower than for the earlier
months. The letter did not explain why her benefit was reduced.
The financial effect of SSA's decision on payments
to claimants was difficult to understand in most Social
Security and SSI benefit adjustment letters because of
conflicting information about when adjustments would occur or
whether benefits were increasing or decreasing and because of
unexplained numerical information used to support SSA's
computation of benefit adjustments. For example, a worksheet
attached to a Social Security benefit adjustment letter
included computations showing that, on the basis of the
claimant's earnings, SSA should have withheld about $2,700 in
benefits. But on the very next line, the worksheet states that
SSA should have withheld about $2,000 in benefits. The letter
did not explain the $2,000 figure or the difference in the two
amounts.
The recourse available to claimants in response to
SSA's decisions on their claims was difficult to understand in
Social Security award and benefit adjustment letters because of
incomplete information. For example, the cover letters for some
of the benefit adjustment letters instructed individuals to
immediately repay the full Social Security overpayment without
informing them of other repayment options discussed in the
letters' attachments. The Social Security award letters failed
to inform claimants that if they choose to appeal SSA's
decision, they have to do so in writing.
Our report discusses these problems in detail, with
examples of actual letters.
Now to illustrate problems in SSA's letters, I would like
to discuss one particular type of SSI award letter ones sent to
applicants who have been awarded benefits for previous but not
future months. I have chosen an example of this type of letter
not because it is representative of all SSA award andbenefit
adjustment letters which, given the huge number and types of
letters SSA issues, no one example could be but because it
illustrates in one letter problems in clearly communicating all
four key points. Also, although SSA has long been aware of
problems in its SSI award letters, the agency did not know
about the particular problems in this type of letter until we
brought them to its attention.
Figure 1 shows key excerpts from a typical letter, sent on
October 13, 1999, to a disabled adult who was awarded benefits
for previous months but not future months.\6\ This example
illustrates the numerous contradictions, illogically sequenced
explanations, and incorrect statements common to these letters.
In 1998 and 1999, more than 100,000 individuals, or about 13 to
15 percent of all SSI awardees, received benefits only for
previous months and thus would have gotten a similar letter.
---------------------------------------------------------------------------
\6\ This situation occurs when individuals' circumstances change
while they are waiting for SSA's eligibility decision on their
application for benefits. Their circumstances make them eligible to
receive benefits for 1 or more months after they applied for SSI, but a
change in their circumstances makes them ineligible for SSI benefits in
the current month. A common scenario involves disabled individuals who
meet the SSI program's income limit only until they receive Social
Security Disability Insurance benefits. Their SSI payments stop once
these benefits cause them to exceed the SSI program's income limit.
---------------------------------------------------------------------------
Figure 1: Confusing Statements From an Actual SSA Letter
[GRAPHIC] [TIFF OMITTED] T7603.001
Note: Bold typeface added by GAO.
SSA's decision is unclear because the letter shown in
figure 1 goes back and forth about whether the applicant is
eligible or ineligible for SSI. For example, the first sentence
in the letter (``A'') informs the applicant that she is
eligible for SSI benefits, as does the first sentence on the
second page of the letter (``E''). She is also told on a
subsequent page that her benefits will continue if she is still
disabled in the future (``H''). But elsewhere in the letter,
she is told that she is not eligible for SSI (``F'' and ``G'')
and that she will not be receiving any more payments (``C,''
``D,'' and ``E'').
The basis for SSA's decision is unclear as well, because
the letter illogically tells the applicant that she cannot
receive any more payments because she is disabled and living in
Massachusetts (``E''). Also, this illogical reason for
nonpayment is listed before the actual reason for nonpayment
namely, her income (``F'').
The financial effect of SSA's decision is unclear, because
the letter makes contradictory statements about the months for
which benefits are payable. First, the letter informs the
applicant that she will receive $3,367.36 in benefits for March
through October 1999 (``B'' and ``D''), but later it
incorrectly states that SSA can pay benefits only for 1 month
March 1999 (``E'').\7\
---------------------------------------------------------------------------
\7\ This incorrect statement occurs in these letters only when
individuals receive more than 1 month's past due benefits--a common
scenario, according to SSA.
---------------------------------------------------------------------------
Finally, the recourse available to the claimant is unclear,
because the letter incorrectly informs her that she must file a
new application before she can receive any more benefits
(``I''). The letter does not explain that under SSI program
rules, monthly benefits can resume without the need to file a
newapplication if she becomes eligible again within 12 months.
Needed Improvements are Still Years Away
SSA has been aware for several years of the more serious
problems we found with three of the four categories of letters
we reviewed those adjusting Social Security benefits, those
adjusting SSI benefits, and those awarding SSI benefits. The
agency considers sending clear letters an important element
ofcustomer service, and it specifically targeted these letters
for improvement, yet it has taken only limited actions to
improve them. Its efforts have focused primarily on the changes
that are the easiest to complete. The more serious problems we
found require more comprehensive revision of language
andrewriting of software applications. Planned changes have
been repeatedly rescheduled because SSA did not have the
computer systems resources available to implement them because
of other priorities. SSA has recently announced plans to make
the needed improvements to these three categories of letters.
However, SSA has not established meaningful performance
measures to monitor its progress in improving the letters.
SSA Has Made Little Progress in Improving These Letters
Since at least the early 1990s, SSA has known about
problems with the Social Security benefit adjustment letters,
the SSI award letters, and the SSI benefit adjustment letters
that we identified as being the most problematic. The agency
agrees that these letters are among the least understandable
and most sensitive of the agency's high-volume mailings.
Annually, SSA sends out about 3.5 million Social Security
benefit adjustment letters, 0.6 million SSI award letters, and
3.3 million SSI benefit adjustment letters.\8\ In various
strategic and performance plans, SSA has identified sending
customers clear letters as an element of good service.
Beginning with its fiscal year 2000 performance plan, SSA
specifically targets improving these three letters as a
strategy that would increase customers' overall satisfaction
with the agency. Improving its letters is listed as one of the
agency's key initiatives.
---------------------------------------------------------------------------
\8\ Because of recently enacted legislation, Public Law 106-182,
that eliminated earnings-related reductions in benefits for
beneficiaries who have reached full retirement age, the volume of
Social Security benefit adjustment letters sent to individuals will
decrease in the future, but SSA has not determined exactly by how much.
---------------------------------------------------------------------------
Despite acknowledging numerous problems with the three
categories of letters, SSA has completed only one minor
improvement to one letter the Social Security benefit
adjustment letter. As noted in table 1, we found that 86
percent of these letters lacked a clear explanation of
adjustments to benefits. In July 1999, SSA added a worksheet to
this letter to show how the agency computed the amount it
underpaid or overpaid individuals on the basis of their
earnings. However, SSA officials view the worksheet as an
interim improvement because SSA did not rewrite the master
record. The master record holds data on each individual and
would have to be expanded to hold additional data so that it
could provide the appropriate information to support the
worksheet. We drew our sample of Social Security benefit
adjustment letters after SSA began including worksheets with
these letters. We found the worksheets helpful to some extent
in explaining how individuals' earnings contributed to SSA's
decision that it had underpaid or overpaid them. However, the
worksheets sometimes did not adequately explain some of the
adjustments SSA made when computing underpayments or
overpayments, in part because doing so would require rewriting
the master records.
In addition to the completed change described above, SSA
recently began to address two of the problems we identified
during the course of our present work. First, the agency has
taken steps to include language that had been omitted from
Social Security award letters informing individuals of the form
to use to appeal the agency's decisions. After we brought this
problem to SSA's attention, SSA officials told us that the
responsible program office has developed revised language that
the Office of Systems plans to implement in November 2000. SSA
has also initiated action to correct the error in SSI award
letters sent to individuals eligible for benefits in previous
months but not current benefits, shown at ``I'' in figure 1.
SSA officials told us that when the agency releases its next
set of SSI systems changes in October 2000,they plan to add
language to the letters to correct this problem.
Office of Systems officials told us that from a systems
standpoint, these types of problems are the easiest to correct
because they involve a straight substitution of language one
paragraph replaces another paragraph that had been used for the
same situation. This type of revision is relatively
straightforward because the software logic for selecting the
paragraph for insertion into a letter does not have to be
revised. SSA could therefore act relatively quickly to correct
these two problems.
It Will Take Years for SSA to Make Comprehensive Improvements
to Letters
SSA has made less progress in correcting problems that are
more difficult to fix. As shown in table 2, the other problems
we found would require significant work to revise the language
of the letters and to rewrite the master records and software
applications.
Table 2:--The Comprehensive Improvements Needed for Selected SSA Letters
----------------------------------------------------------------------------------------------------------------
Letter Improvement
----------------------------------------------------------------------------------------------------------------
Social Security benefit adjustment Revise language, rewrite program's master record, and rewrite
softwareapplication so that Cover letter discloses all decisions
discussed in attachment
Work-related earnings rules are co-located and logically
sequenced
Letter
individual, and
Letter
----------------------------------------------------------------------------------------------------------------
SSI award Revise language, rewrite program's master record, and rewrite
softwareapplication so that
Letter
Letter
benefit amount
----------------------------------------------------------------------------------------------------------------
SSI benefit adjustment Revise language, rewrite program's master record, and rewrite
softwareapplication so that
Letter
particularly how and when adjustments will be made for past months'
overpayments or underpayments
----------------------------------------------------------------------------------------------------------------
----------------------------------------------------------------------------------------------------------------
Office of Systems officials told us that the actions the
agency would need to take to make the comprehensive changes
that the three letters need are the most complicated from a
systems perspective because they involve extensive work to
revise or develop new paragraph language, to rewrite the
software application including the selection and sequencing
criteria for using the language and to rewrite the programs'
master records to hold additional data that may be necessary to
support proposed language changes.
SSA's ability to make these comprehensive improvements to
the three letters depends on the agency's allocating
significant systems resources. When allocating systems
resources, SSA appropriately gives highest priority to projects
that help the agency maintain operations essential to its
mission or that it needs to undertake in order to implement
legislative changes to the Social Security and SSI programs.
Resources not committed to these efforts are available for SSA
to use for discretionary projects, and senior officials
collectively determine which discretionary projects the
agency's systems staff will work on, based on each project's
ranking and expected contribution to SSA's strategic
objectives. However, the relative priority SSA gives projects
can change. For example, SSA may decide to shift priorities and
discontinue, delay, or deemphasize a specific project to
undertake others in cases in which SSA does not have systems
staff available.
Social Security Benefit Adjustment Letters
SSA has long had plans to make comprehensive improvements
to one of the categories of letters the Social Security benefit
adjustment letter. According to SSA documents, by 1996, SSA had
developed and tested in focus groups comprehensive language
changes for this letter. However, SSA's documents showed that
since developing the language, the agency has repeatedly
rescheduled the systems work required to implement the new
language. Officials from SSA's Office of Systems told us that
their computer systems staff did not work on projects at the
scheduled times because the agency had had to divert computer
programmers to other more pressing projects, such as those
required to implement significant program changes resulting
from legislation and to ensure that SSA's computer systems were
year 2000 compliant.\9\ They told us that the agency, with the
emergence of workloads arising from legislative changes, had to
shift priorities away from working on improvements to letters.
---------------------------------------------------------------------------
\9\ For example, the Personal Responsibility and Work Opportunity
Reconciliation Act of 1996 (Public Law No. 104-193) made major changes
to the SSI program. Among other things, it revised the criteria under
which children and noncitizens are eligible for benefits and added
restrictions governing the payment and use of certain large retroactive
benefit amounts.
---------------------------------------------------------------------------
In July 2000, an SSA official told us that the responsible
program office had recently requested that SSA senior officials
designate the project to improve Social Security benefit
adjustment letters as Customer Targeted Work. This is a
relatively new category for the use of discretionary resources
andwould give the project a higher priority than it has had
before.\10\ Although SSA is in the early planning stage of this
effort, the Office of Systems has established a plan for
completing the more comprehensive improvements by July 2002.
However, because SSA's decision is recent, we did not evaluate
the revised approach.
---------------------------------------------------------------------------
\10\ Key initiatives requiring systems work and Customer Targeted
Work must provide a significant return on investment or help meet
agency strategic goals. However, to be given the higher priority of
Customer Targeted Work, a sponsoring component is required to
substantiate the need for extra attention and prioritization.
---------------------------------------------------------------------------
SSI Letters
SSA has not made comprehensive improvements to either type
of SSI letter and has only recently begun developing action
plans for improving them. SSA officials told us that they
postponed plans to improve SSI award and benefit adjustment
letters pending the outcome of the recently decided court
case,a class action law suit that an SSI recipient initiated.
In that case, the court upheld the plaintiffs' claim that SSA's
letters denied recipients due process because the letters did
not adequately explain the basis for SSA's decisions. The court
ordered SSA to revise its automated SSI financial eligibility
letters including its SSI award and benefit adjustment letters
to more clearly communicate essential information to their
readers.\11\ SSA established a workgroup to review its SSI
letters and to determine the changes that were needed to
improve them. In December 1999, the SSA Commissioner signed a
decision paper in which he approved the workgroup's
recommendations to make comprehensive changes to SSI letters.
---------------------------------------------------------------------------
\11\ Ford et al. v. Apfel, No. CV-94-2736 (E.D.N.Y., Jan. 13,
2000).
---------------------------------------------------------------------------
Improving SSI letters will take time. The workgroup
recommended that SSA implement the recommendations in phases,
concentrating first on better explaining how benefit amounts
are determined. SSA has begun work on some of these changes. In
February 2000, SSA drafted and tested with some SSI recipients
a prototype worksheet to be added to SSI award and benefit
adjustment letters that shows how SSI benefits are computed in
the least complex cases that is, the 90 percent of cases in
which SSI recipients have no income or only unearned income,
such as Social Security benefits. SSA plans to add the
worksheet to the SSI letters by July 2002. SSA officials
estimated that it could take 10 years to implement the full
range of planned improvements.
SSA Does Not Have a Means to Measure Progress in Improving
Letters
Despite acknowledging problems with its letters, SSA
currently has no performance measures for monitoring its
progress toward improving them. In the past, SSA surveyed
customers about their overall satisfaction with the agency's
letters and monitored the percentage of customers rating the
clarity of SSA's notices as excellent, very good, or good. The
agency, however, found that the information it collected, which
was a measure of general satisfaction with the letters, was not
useful in identifying ways to improve letters, so SSA
discontinued these surveys. Instead, SSA now relies on a
relatively newprogram to help it target a few specific types of
letters each year and develop action plans for improving them.
This program the Market Measurement Program uses a variety of
initiatives, such as special studies and focus groups, to
gather information on the full range of services SSA provides
to help the agency improve customer service overall. According
to SSA's fiscal year 2001 performance plan, the agency plans to
establish a new indicator to monitor improvements to its
letters at a later point.
Conclusion
Although SSA has been aware for many years of some of the
more serious problems with its letters, it has not corrected
them. The agency's recently announced plans to improve the
Social Security benefit adjustment letter and its SSI award and
benefit adjustment letters will require significant
computersystems resources and will take years to complete. If
SSA is to improve its letters within a reasonable period of
time, it needs to allocate the necessary systems resources for
these improvements. To do this, the agency will need to better
anticipate and plan for the varied demands on its computer
systems'resources and place a higher priority on improving its
letters.
The agency will also need to develop appropriate
performance measures with which to hold itself accountable to
the public for achieving these improvements. These measures
should help SSA monitor its progress in adhering to the
proposed timetables to help the agency stay on track. In
addition, because past changes to letters have not always
significantly improved clarity, SSA should develop other
measures to assess whether changes to the letters have achieved
the intended results.
Because failure to implement the needed improvements will
mean continued poor service to the public in this area, we
recommend that SSA develop performance measures to hold itself
accountable for making the needed comprehensive changes to its
letters. These measures should include indicators to allow SSA
to track its progress in making improvements and to assess the
improvements' effectiveness. In commenting on our report, SSA
agreed with our recommendation and expressed its commitment to
making the needed improvements in these letters as quickly as
possible. SSA also outlined its plan for developing performance
measures for assessing beneficiaries' understanding of its
problematic letters.
Mr. Chairman, this concludes my prepared statement. I would
be pleased to respond to any questions you or other Members of
the Subcommittee may have.
* * * * *
For further contacts regarding this testimony, please call Barbara
D. Bovbjerg at (202) 512-7215. Others who made key contributions to
this testimony include Kay Brown, Jacquelyn Stewart, Ellen Habenicht,
Valerie Melvin, James Wright, Michael Alexander, Jay Smale, Ann
McDermott, and Patrickdi Battista.
Related GAO Products
Social Security Administration: Longstanding Problems in
SSA's Letters to the Public Need to Be Fixed (GAO/HEHS-00-179,
September 26, 2000). [Attached report is being retained in the
Committee files.]
Social Security Administration: Many Letters Difficult to
Understand (GAO/HEHS-94-126, Mar. 22, 1994)
Chairman Shaw. Mr. Halter, you listened to the testimony
from the General Accounting Office. What is the problem of
correcting these letters? I mean, it just doesn't make any
sense that all of these statements would be----
And I assume, Ms. Bovbjerg, these were all in the same
letter?
Ms. Bovbjerg. All of this in one letter, yes.
Chairman Shaw. Do you have an explanation for any of that?
Is this is the first time you have seen it? It is not fair to
ask you the question.
Mr. Halter. Well, actually, it is the first time I have
seen it in a readable fashion, here, arriving at the hearing
today. But let me try to address your more general point, Mr.
Chairman, which is, how did we get here?
The fact is that for the last eight years we have been
working on improving some extraordinarily complicated notices.
Thirty percent of our notices needed improvement in FY 1993,
and customer satisfaction with those notices was at about a 65
percent rate. Over the least 7 years, the Social Security
Administration has corrected problems with 22 percent out of
that 30 percent, leaving 8 percent of our notices still to be
addressed. The GAO, very appropriately, focused on letters
which in our universe of notices are the most complicated and
the ones that are most prone to being very complicated for the
reader to understand. This particular letter, with respect to
SSI, is probably the category that is the most difficult to
understand.
The complications arise from two different levels. The
first is the SSI program itself is extraordinarily complicated,
and as I noted in my testimony, the range of individual
circumstances that could apply to any individual beneficiary is
virtually infinite when you take all of the different variables
and how many different possibilities for each variable there
are. When you put together a notice in an automated fashion to
deal with that, you have one that is, by its nature, going to
be complex.
Now, I will say that we have focused on this over time. We
are focused on it now and have applied the resources that will
be necessary to fix this. However, when you have a program with
so many variables in it and you are trying to send something
out dealing with a complicated program, it is going to be
complicated to deal with.
Chairman Shaw. I understand that. But let me ask maybe a
simpler question. What is this letter trying to tell somebody?
Mr. Halter. Well, in this case, it is trying to tell the
individual recipient what SSI benefit they are entitled to and
how much that benefit is, when the payment is going to start,
and when, in this case, it is going to stop.
Chairman Shaw. Why don't you just do that?
Mr. Halter. Well, we do that, as you know, Mr. Chairman,
millions of times a year, and when you put together an
automated
Chairman Shaw. It worries me that we are getting so
automated that somebody just sits at a computer, picks out
paragraphs and tries to put them together that does not really
communicate.
Mr. Halter. Well, in fact, the way this works is they don't
pick out those paragraphs personally. They type in the data
that is necessary, and then the system produces a response.
Now, to correct that, Mr. Chairman, what we have to do is
go in and put together revisions to that program, and that is,
in fact, what we have under way now.
Chairman Shaw. You know, each of us in Congress, we get
asked the same question over and over again, and we all put
together--I imagine every member of Congress does that--you put
together paragraphs explaining your position, and those
paragraphs are selected in order to answer questions thatcome
into the office. Why don't you all just do it that way?
Mr. Halter. Well, what I will do for you, Mr. Chairman, is
give you for the record the list of variables that can change
each of these letters, and you will see that we are talking
about literally hundreds of data items. I understand the
letters that you are talking about, Mr. Chairman, because
Iworked on Capitol Hill and I helped put together those
letters, and I understand what you are talking about. They are
very straightforward and they provide your position on a
particular issue, but your position on a particular issue
probably does not have 10,000 different variants. You probably
have apretty straightforward position on the issue that someone
is writing you about.
[The following was subsequently received:]
SSI Notice Variables
This is a highly complex process because notices reflect
past or present changes and reflect the results of those
changes. There is virtually no limit on how these items can be
mixed and matched, meaning that the SSI notices must be able to
handle an almost unlimited array of possibilities with a large
number of variables. For example, a case can have different
income, resources, and living arrangements from month to month,
coupled with resulting newly identified overpayments and/or
underpayments. Variables that affect SSI notices are as
follows:
I. Computational Variants--31
Quarterly Accounting applies prior to 4/1982
Retrospective Monthly Accounting applies effective
4/1982
New computation rules for Spouse-to-Spouse deeming
effective 4/1982
New computation rules for Parent-to-Child deeming
effective 4/1982 with three formula
Different rules for needs-based assistance prior
to 8/1988
Computation rules for Impairment-Related Work
Expense prior to 12/90
Different rules for treating needs-based
assistance depending on which person it is
To compute any month, may need eligibility,
payment, windfall eligibility, windfall payment computation
Two eligibility, payment, windfall eligibility,
windfall payment computations needed for individuals with
ineligible spouses
Computation for COLA-Coordination of Title II,
Value-of-the One-third Reduction, and In-Kind-Support
Special computations when one member of a couple
is eligible and the other is not
Rules when one member of a couple is in one
eligibility category and the other in a different category
Special rules when a claimant is in multiple
eligibility categories (aged, blind, disabled)
Optional Supplementation default processes that
apply when one member of a couple is dead or when an ineligible
spouse has left a household
Exception computation of State supplementation for
Essential Persons
Different computation rules for in-kind support
based on SSI type of claim
Payment rounding rules
Special computation rules under Section
1611(e)(1)(e)
Special computation rules under Section
1611(e)(1)(g)
Optional supplementation considerations in
1611(e)(1)(g) default periods
State supplementation rules when 1619(a) applies
Application of the Livermore Court decision
Special rules for Maine's disregards (and when a
couple)
Rules that apply when a State has terminated
Federal supplementation
Computation of Vermont's State Countable Income
Computation rules for Presumptive Disability
Rules for application of Blind Countable Income
Computation of payment amount based on windfall
offset
Mandatory computations and specifically
adjustments for payment computation
Computation rules under trial work periods
2/3 rule for Child Support
II. Income Types, Disregards and Exclusions
Income Types (Partial)
State or Local Assistance Based on Need
Refugee Cash Assistance
AFDC
General Assistance From Bureau Of Indian Affairs
Disaster Relief
Veterans Benefits Based on Need (Paid Directly or
Indirectly as a Dependent)
Veterans Payments Not Based on Need (Paid Directly
or Indirectly as a Dependent)
Social Security
Black Lung
Railroad Board Benefits
Office of Personnel Management
Pension
Unemployment Compensation
Workers' Compensation
Interest
Dividends
Royalties/Honoraria (Unearned)
Rental/Lease Income Not From a Trade or Business
Alimony
Child Support
Other Bureau of Indian Affairs Income
Sick Pay (Earned)
Sick Pay (Unearned)
Wages
Self-employment Income
Other Income Based on Need
Other Income or Support Not Previously Mentioned
Income Disregards
$65 per month plus \1/2\ remainder earned income
disregard
$20 per month general income disregard
Income Exclusions
Student Child Earned Income Exclusion
Blind Work Expense
Income excluded under approved plan for self
support
Net loss from self-employment
Income Related Work Expenses
Resource Types
Vehicles
Life Insurance
Household Goods and Personal Effects (Cash)
Financial Institution Accounts
Stocks and Bonds
Promissory Notes/Loans/Property Agreements
Real Property/Business Property or Equipment
Resource Exclusions
Principal place of residence
Auto used for medical/other approved needs
Set aside for burial expenses
Excluded under a Plan for Achieving Self Support
Federal/State Living Arrangements
A Federal Living Arrangement (FLA) of A is used
primarily when a person is considered to be living in his /her
own household or when no other FLA code applies.
An FLA of B is used when an individual lives in
the household of another and receives food and shelter from
inside the household.
An FLA-C is used for a child under age 18 or under
or a ``protected'' student/child under age who lives in the
same household as an ineligible parent and who is not subject
to the value of the one-third reduction.
An FLA-D applies to an individual who lives in a
public or private medical institution throughout a month and
Medicaid is paying more than 50 percent of the cost of the
individual's care or, effective
12/96, a child under 18 subject to the $30 payment
limit while in a medical care facility in which
private insurance (or a combination of private
insurance and Medicaid) pays over half the cost of care.
The following States have at least 1 State living
arrangement: California , Delaware, District of Columbia ,
Hawaii, Iowa, Maine (prior to 4/96), Massachusetts, Michigan,
Montana, Nevada, New
Jersey, New York, Pennsylvania, Rhode Island,
Utah, Vermont, Washington, Wisconsin (prior to 1/96).
III. Payment Status Codes (Partial list)
Non-pay Codes: Many of these are initial claim
denial codes--both medical and non-medical denials, such as an
aged claim denied for failure to prove age or claimant is not a
citizen or lawfully admitted to the US.
Suspense codes: These indicate a recipient was
eligible to receive payment, but has since become ineligible,
often temporarily, because of some reason (e.g. whereabouts
unknown.) Once resolved, SSI payments can usually resume.
Termination codes: These codes indicate the record
has been terminated (e.g. death).
Eligible but not payable
E01 Eligible but nothing is payable
E02 Eligible for benefits but not due a payment (applies to
first month of eligibility only)
Benefits not payable
N01 Claimant has excess income or Section 1619(b)
eligible--no payment due.
N02 Claimant is a resident of public institution.
N03 Claimant is absent from the U.S.
N04 Claimant's nonexcludable resources exceed title XVI
limitations.
N05 FO is unable to determine eligibility for some month(s)
of a period of nonpayment OR failure to provide information for
children overseas.
N06 Claimant failed to file for other benefits.
N07 Cessation of recipient's disability.
N08 Cessation of recipient's blindness.
N09 Claimant refuses to accept vocational rehabilitation.
N10 Claimant failed to comply with treatment (DAA).
(Obsolete)
N11 Sanction Suspense month (DAA). (Obsolete)
N12 Claimant voluntarily withdrew from SSI program.
N13 Not a citizen of the U.S. or not an alien lawfully
admitted to the U.S.
N14 Aged claim denied for age.
N15 Blind claim denied, applicant not blind.
N16 Disabled claim denied, applicant not blind.
N17 Failure to pursue.
N18 Failure to cooperate.
N19 Claimant has voluntarily terminated participation in
SSI program.
N20 Claimant failed to furnish a required report or
required evidence.
N22 Claimant is an inmate of a penal institution.
N23 Claimant is not a resident of the U.S.
N24 Claimant has been convicted of a felony of fraudulently
misrepresenting residence in order to receive benefits/services
(SSI, Medicaid, AFDC, foodstamps) simultaneously in two or more
States.
N25 Claimant is fleeing to avoid prosecution for, or
custody or confinement after conviction for, a crime which is a
felony (or in New Jersey, a high misdemeanor) under the laws of
the place from which he/she flees, or is violating a condition
of probation or parole imposed under Federal or State law.
N27 Termination due to SGA--1619(a) or 1619(b) no longer
involved.
N30-N51 Medical Denials. (various)
P01 Potentially Eligible--SGA involved. (Obsolete)
Benefits payable, but suspended
S05 Prerequisite payment month development pending to
determine eligibility for special 1619(a) payments to a
disabled individual. S06 Claimant's whereabouts unknown.
S07 Check(s) returned for miscellaneous reasons.
S08 Representative payee development pending.
S09 Temporary institutionalization (TI) systems default.
S10 Claimant has refused to receive payments through direct
deposit.
S20 Potential Rollback case or disability decision made
prior to July, 1973.
S21 The recipient is presumptively disabled and has
received 6 months' payments.
Benefit eligibility terminated
T01 Death of claimant.
T20 Received duplicate payment based on two different
numbers.
T22 Received duplicate payment based on more than one SSR
established with the same number or different numbers.
T30 Manual termination (payment previously made).
T31 Systems termination (payment previously made).
T50 Manual termination (no payment made).
T51 Systems termination (no payment made).
IV. Payment Variants
Different rules prior to 4/1982
Goldberg v Kelly: temporary & permanent payment
protection
Different rules for collection of overpayments
Payment of windfall offset due amounts in Current
Computation Month
Collection of emergency advance payments/immediate
payments
Underpayments to survivors
Dedicated accounts & installments underpayments
Chairman Shaw. I would like to think so.
Mr. Halter. But this program, and the law, the law that we
are talking about here with respect to SSI, is complicated in
its very nature, and we would agree with you, Mr. Chairman,
that we need to work on these notices. That is what we are
doing.
Chairman Shaw. Now, I want to--we are getting to the nut of
what I really want to talk about, and I want you and Ms.
Bovbjerg both to address the law. Is the law the problem?
Anyone who has gone to get a loan for a home within the last
few years, I don't care if you are an attorney, an accountant,
or a realtor or who you are, by the time you sign all those
papers, you have no idea what is going on, that you just get to
be where you are signing because we require so many
disclosures, and we over-disclose to thepoint that I think the
borrower is just totally confused and just wants to just get
out of the closing office, so that they can go on with their
life. Is the law the problem here? Is the law so complex that
we should really go back and take a look at it?
Mr. Halter. Mr. Chairman, I would argue to you that the law
is a part of the problem, absolutely.
I would not wish to come before you and absolve our
administration from all culpability in creating complicated
notices. We are going to work on this.
I would say to you that the fact is that we have limited
resources as an organization, as you very well know, and we
have focused our resources particularly in the systems area on
matters that have been higher priority.
Chairman Shaw. Don't you have people in-house that can redo
the system as far as that is concerned, without spending a
whole bunch of money? Now, if money is the problem, then we
have to address that. But I don't see where putting together
the right kind of program, computer program to respond, should
be all that complicated that we can't do that.
Mr. Halter. I would argue, Mr. Chairman, that it is more
complicated than even I initially realized when I first sat
down to prepare for this hearing, that in fact, doing the types
of systems changes that we are talking about are going to
require a great deal of time and effort.
To your question, your very direct question about is it a
resource issue or just putting people up against it, I would
argue to you that it is both and that they are related, that
the budgets that we have been provided, at least that I have
looked at in the last six years, if additional resources had
been available to Social Security, we would have been
addressing this long before this point. The fact is----
Chairman Shaw. Have you come to us and asked for additional
funds in order to do this with specific requests?
Mr. Halter. Mr. Chairman, we have asked for, in the
President's budget----
Chairman Shaw. I think I have been very forthcoming in this
Committee in working with the Social Security Administration.
Mr. Halter. Absolutely, yes, sir. I absolutely agree with
that. But let me just point out that over the last six years,
the President's budget request, relative to what has been
appropriated, we are talking about a billion dollar difference
in our administrative budget over that six-year period. And I
would argue to you, just very straightforwardly, that if those
monies had been put in place, that this problem would have been
addressed much earlier. We have limited systems resources. The
Congress, just this past year,passed the retirement earnings
test elimination, and we, as you know, took resources, diverted
them to implementing that legislation, as we should. Every time
we come up with a new priority to implement, we have to divert
resources away from the work that we had scheduled.
Chairman Shaw. The return of the money on the earnings
penalty, this Committee reacted to that in getting more money
because we understood that was necessary, and we knew that was
very important.
Ms. Bovbjerg, could you comment on some of the things that
Mr. Halter has just talked about as to what is your thought
with regard to what has to be done? I can tell you everybody in
here under 40 knows more about computers than I do. So, speak
in terms that I can understand, please.
Ms. Bovbjerg. That should be easy for me because I am not a
systems expert either.
I want to start off by saying that we do recognize and
acknowledge the progress that the Social Security
Administration has made with other notices. Indeed, they say 92
percent of 300,000 letters have been fixed; a lot of that is
the Social Security statement, and we like to think that our
recommendations had some bearing on the improvements in that
statement that took place in the past year.
What we are saying about these notices is that just because
it is a small percentage left to fix, and they are hard to fix,
doesn't mean they shouldn't be fixed and shouldn't be taken
more seriously. There are 14 million of these going out a year,
and these notices really affect people very directly.
Thesenotices can be reducing peoples' benefits, and if they
can't understand the letter, it is difficult for them to
understand what is going to happen to their income. It is a
whole different level of stress for people than receiving the
Social Security statement, for example. So we think these
letters are very important to focus on.
We are concerned because SSA has recognized problems with
these particular letters, and has been talking about doing
something with them for years now, and there has been no
timetable for doing this.
The letters keep being pushed back further down the
priority list. Our concern is that there are complicated fixes
that have to be made. We don't disagree at all that this is a
complex program, and it is difficult to explain some of the
decisions that are made in the SSI program, but we believe it
is really important to start making these fixes.
I also want to say that it is my understanding that it is
not entirely a systems problem; program staff need to figure
out what the problem is, write the language--the actual
language in the paragraph that would address it--figure out how
the paragraphs might need to be reordered, and then test it,
you know,road test it, to see if these actually do address the
problem of improving peoples' understanding. And then after all
this is done it goes to systems. So it is really an issue that
goes beyond just the systems staff.
Chairman Shaw. And would that require more administrative
funding?
Ms. Bovbjerg. I am not in a position to say that. It is not
clear that there aren't efficiencies or shifting that could be
done within SSA to achieve this.
Chairman Shaw. Making those assessments though, coming up
with those opinions, would be within the framework of what you
all do though, wouldn't it?
Ms. Bovbjerg. It would be, but we would have to know what
exactly needed to be done and what the timetable was for doing
that. I know that in talking about SSI letters as part of the
court case, SSA said that it would take ten years to fix these
letters, and I understand from Mr. Halter's statement today,
that they are now saying it will take four years. We don't know
exactly how long it would take and what resources it would take
to do that.
Chairman Shaw. Why would it take four years?
Mr. Halter. Mr. Chairman, for SSI, what we are doing is
trying to address most of the letters as quickly as we can with
this worksheet that I described in my testimony, which we plan
to have out by July of 2002. The issue as to why it would take
that long is one that I would be happy to share with you by
providing a schedule of the project which lays it out month by
month. But as you go through this process of crafting the
language, developing the software, testing the software,
validating it, installing it, it takestime. We also have very
few people with the capabilities and the background and the
expertise to do this.
This is not going to be done by your standard journeyman
claims representative. This takes somebody with real systems
expertise within the program.
[The following was subsequently received:]
The time frame to complete the fixes to SSA's notices.
The accompanying schedules describe the steps necessary to
achieve our goals for the Social Security Adjustment notices
and Phase I for the SSI award/adjustment notices. Phase I
focuses on approximately 90 percent of the SSI notices by
supplying a detailed worksheet that describes the computations
that were used to compute the final benefit amount. Phase II
for SSI notice improvements is scheduled for completion in
August, 2003 and Phase III is scheduled for completion in
September, 2004. We expect to have our notice changes fully
implemented by September 2004.
Project Plan for Improving SSI Notices--Phase 1
Finalize Language--02/00-11/30/00
Policy, Office of Systems Requirements (OSR), and Office of
Systems Design and Development (OSDD) are all participating in
the finalization of the language. We have used focus groups for
input in designing the computation worksheet.
Translate Notices into Spanish--Complete by 12/30/00
Develop Requirements--12/01/00--05/01/01
OSR will provide a ``template'' of the new computations
worksheet as soon as possible to allow OSDD to begin discussing
design options. Thus, requirements development and program
development times will overlap.
Design New Process--Complete by 07/01
OSDD will begin design based upon the requirements.
Development--Complete by 11/01/01
The development for this project requires extensive
specialized experience because the SSI program is extremely
complex. SSI processes the whole master record going back in
time a number of years. This includes multiple actions, thereby
causing complex explanations in the notices. Since this is a
new computations and notices process, much of the required data
needs to be defined, records formatted and other programs in
the SSI integrated system need to make modifications to define
and/or process the new record. Extensive knowledge of the
existing SSI data elements and program logic flow is mandatory.
The new format, language and selection logic will need to be
developed and entered into the program and language data
facility.
Testing--Complete by 12/28/01
This testing is done in OSDD to ensure test scenarios
process as expected. In addition, the testing ensures the
programs run to job completion and builds the job control
language (JCL) that allows the programs to be validated and
moved to the production environment.
Validation--Complete by 05/31/02
The validation will be an iterative process. Since SSI can
process multiple actions that may be very complex, different
paragraph combinations will occur based on the types of
actions. Also, there are any number of different types of
transactions processed in SSI. Each of these must be validated
to ensure consistency and accuracy.
Mainframe Integration Testing--06/03/02--07/12/02
The software must be fully tested in the production arena
to ensure there are no adverse affects on the scheduling of
production runs.
Release Notice Language Procedures--Complete by 07/02
Implementation--Complete by 07/02
Project Plan for Improving Automated Benefit Adjustment Notices
Finalize Language--07/17/00--10/17/00
Policy, Office of Systems Requirements (OSR), and Office of
Systems Design and Development (OSDD) are all participating in
the finalization of the language. We are using ``Policy Net''
to help speed up the process by getting ``outside'' input from
other areas of SSA.
Develop Requirements--09/15/00--03/01/01
We've overlapped our requirements with the previous life
cycle to allow us to get to development quicker. OSR will
provide a ``template'' of the new benefit adjustment (AJS3)
notices as soon as possible to allow OSDD to begin the design.
Translate Notices into Spanish--Complete by 11/00
Design New Process--11/15/00--12/26/00
Again, we've overlapped the design phase with the
requirements phase to allow us to get to development quicker.
OSDD will begin the design based on the ``template'' from OSR.
This will allow us to set up a ``shell'' of our notice program.
Development--12/28/00--10/05/01
The development for this project requires extensive
specialized experience because the AJS3 program is extremely
complex. Unlike the other object programs under Title 2, AJS3
processes the entire master record going back in time up to 5
years. This includes multiple actions, thereby causing complex
explanations in the notices. Since virtually all of the
existing notice language is being changed, we need to remove
the old and then install the new generation criteria, paragraph
identifiers, and fill-ins. Extensive knowledge of the existing
AJS3 data elements and program logic flow is mandatory. While
in the development phase, we expect to encounter additional
needs for updated language or better sequencing of paragraphs,
so this will be an iterative process.
Testing--10/08/01--12/28/01
This testing is done in OSDD to ensure test scenarios
process as expected. In addition, the testing ensures the
programs run to job completion, build job control language
(JCL) that allows the programs to be validated and eventually
moved to the production environment, and provide for a review
of the output.
Validation--12/31/01--05/31/02
The validation will be an iterative process. Since AJS3 can
process multiple actions that may be very complex, different
paragraph combinations will occur based on the types of
actions. Also, there are 16 different types of transactions
processed in AJS3. Each of these must be validated to ensure
consistency.
Mainframe Integration Testing--06/03/02--07/12/02
The software must be fully tested in the production arena
to ensure there are no adverse affects on the scheduling of
production runs.
Implementation--07/15/02--07/15/02
Project Plan for Improving SSI Notices--Phase II and Phase III
Benefit Computation Worksheet--Unearned Income Not Previously
Considered
Focus Group Testing--04/03
Upon review of the focus group results from 03/02, language
will be revised and tested again at this time.
Phase 2 Scheduled Completion--08/03
This phase will provide computational worksheets for
recipients with earned income or a combination of earned and
unearned income. Notice language describing living arrangement
classifications will also be in this release. Additional
modifications for language and/or restructuring will be
included as defined and agreed to by the workgroup.
Phase 3 Scheduled Completion--09/04
This phase provides computational worksheets for recipients
with more complicated income situations (e.g. parent to child
deeming). Additional modifications for language and/or
restructuring will be included as defined and agreed to by the
workgroup.
And the reason that this has been deferred in the past is
because other priority projects like the ones I mentioned came
in, and we had to move the very people that would be doing this
work off of that work and onto some of the other priorities.
Chairman Shaw. Did they get the benefit from this letter?
How did it end up?
Mr. Halter. Oh, absolutely. I mean I have no indication
from anyone at GAO that anybody is not getting the benefit they
are actually entitled to.
Chairman Shaw. Then why did you ask them if they think they
qualify, to contact us if they have been qualified?
Mr. Halter. I am sorry, Mr. Chairman. Say that again?
Chairman Shaw. I am reading the line at ``F'', and I am
comparing it with the line at ``B'' that says ``We're sending
you a check'' on line ``B'' for $3,367. Then you go down to
line ``F'' and it says, ``If at any time in the future you
think you are qualified for the payment, please contact us.''
Then at line ``E'' it says, ``Since you are not eligible for
SSI.'' What are we sending them?
Mr. Halter. This is what we are saying to folks, as I
understand it, and again, I have just seen this letter today,
but my understanding is that these folks were eligible over a
certain period of time. They qualified for a benefit. We were
sending them a check for that amount. They are now currently
not eligible for a benefit, and paragraph ``E'' is telling them
that if in the future they think that they become eligible
again, that they should contact us and file a new application.
You can ask GAO though, since they have had the benefit of
actually picking this letter out, as to whether that is in fact
what happened.
Chairman Shaw. I will.
Ms. Bovbjerg. I have no idea whether this person was paid.
That wasnot something we reviewed. We assume that she was.
There are 100,000 of these kinds of letters. And we asked our
consultants--this is not just GAO's opinion as to whether the
letters can be understood we asked our writing consultants what
they thought about these. They said that one of the single most
important things in clear writing is to have the most important
information right up front all in one place and not to have it
scattered throughout a lengthy letter, because people don't
always read the whole thing. And I think that that is a
particularly important issue for this letter. It is hard--it
will be hard for a recipient to know that what is being said
is: ``You were eligible in the past, here is your check, but
you are not eligible right now, and that if you are eligible in
the future, there is recourse.''
Chairman Shaw. Then are you required, Mr. Halter, by law,
to put that paragraph ``F'' in there telling them that they can
reapply?
Mr. Halter. We certainly--whether we were required to do so
by law or not, Mr. Chairman, we would want to do it. I will
check and see whether or not in fact we are required to do it,
but we would want to whether it is a requirement or not.
[The following was subsequently received:]
There is no requirement in the law for the paragraph Mr.
Shaw refers to which states, ``If at any time in the future you
think you qualify for payment, please contact us immediately
about filing a new application. The earliest month for which we
can pay you is the month after you file a new application.''
SSA includes this paragraph as a part of SSI notices for
customer service purposes.
A corrected version of the paragraph will be implemented
effective October 2, 2000.
Chairman Shaw. Well, wouldn't you assume that the person
applied now. I guess they know they are better, they don't need
the assistance any more. But if they get in trouble again,
wouldn't they know to come back? Is that something we have to
tell them? What I am trying to do, I mean, brevity is really so
important in dealing--particularly in SSI. You are dealing with
low-income people, of probably a low level of education, easily
confused.
Mr. Halter. Right.
Chairman Shaw. Your people also deal with the elderly, and
you know, I think every member of Congress has had people
coming into their office almost in tears, and say, ``What is
happening?''
Mr. Halter. Right. Mr. Chairman, to answer your question on
that, as to whether or not that is required by law, we will
check on that, but in terms of whether we should do it, I would
argue that we should err on the side of actually telling folks
that if their circumstances change, they should in fact come
back and reapply. That would be the predisposition I think I
would have, rather than leaving it vague or unknown to them.
Ms. Bovbjerg. Mr. Chairman, could I jump in for a minute?
Chairman Shaw. Yes, please.
Ms. Bovbjerg. It is my understanding that that particular
language is being changed this fall because it is actually
incorrect. It tells people they have to reapply, and what it
should say is that you don't have to reapply within the first
year, but after 12 months you would have to submit a whole new
application, so that I believe----
Chairman Shaw. So what we should be telling them is that
they have a special circumstance, there is a special
circumstance here, that they would have to jump back in.
Mr. Portman?
Mr. Portman. Thank you, Mr. Chairman, and I am sorry I
couldn't have been here for all the testimony. I did, Mr.
Halter, get the benefit of hearing your testimony earlier at
the beginning of the hearing, and got a chance to look over the
testimony as well from GAO.
I have two questions. The first is what SSA knows about in
terms of the impact of this problem on your bottom line. With
the IRS, we spent a lot of time looking at the impact of both
the poorly written and many of the misleading notices, as well
as incorrect notices, and we found a tremendous downstream
cost. I know there is a case pending in the courts which has
indicated that for every 1 percent problem in terms of a letter
misstating something, there is roughly a $100,000 cost. They
came up with that.
My question to you is: what are the downstream costs? What
are the costs of these poorly written and sometimes in accurate
notices to SSA? We talked earlier about your need for more
funding, and you in essence said, ``If Congress would give us
more money, we would solve these.'' I think we have heard some
other testimony in that regard about priorities and planning
and timetables, and maybe shifting some focus. But my question
to you is what are the cost savings? Have we looked into that?
Do you have any information?
Mr. Halter. It is a good question, Congressman. In fact, we
know that if our notices are not as clear as they could be,
that that does generate telephone calls to us----
Mr. Portman. I would guess your 800 number is probably tied
up sometimes when it doesn't need to be, but also people
probably--in my district, they walk into the SSA office with
these notices in their hands sometimes.
Mr. Halter. That is absolutely correct. Now, we do know,
Congressman, about the frequency of calls to our 800 number,
because we do surveys on that, and of course we know broad
topics as to percentages as to who is calling and why. A fairly
low number of phone calls to our 800 number is about notices.
In addition to focusing on streamlining the notices
themselves, we have also focused some energy and resources on
making sure that our personnel have a system available so that
they can pull up the notice in question when somebody calls in,
so that they can in fact pull up a copy of that notice and then
help the person understand it. This is, of course, not the best
outcome. It is not the one that we are shooting for. What we
are shooting for is to solve these problems right there on the
front end.
Mr. Portman. Prevention is always the best policy.
Mr. Halter. Absolutely.
Mr. Portman. My only point is, in terms of making this
higher priority, because we do have testimony indicating that--
at least from GAO--that this has not been as high a priority as
it should have been, despite having been aware of this problem
for several years, that it would be helpful to have some data
to know what the impact is, not just on our constituents,
because we do hear about it and we get the case work, but also
on the system. And if you are talking about money, here is a
way to save money. It sometimes requires a little more
planning. You said you put some time into preparing for this
hearing and now you realize the problem is more complex than
you thought they were.
I guess that is a good reason, Mr. Chairman, to have had
the hearing, and I am glad we had it.
I would ask you whether the four-year period is realistic
now that you have spent more time on this, or is it ten years,
or is it six years, as we have heard from GAO? And what can we
expect in terms of a timetable and what specifically are you
asking for from Congress? You indicated earlier, again, that,
gee, if we just had more money, this wouldn't be a problem,
which again, seems to be counter to the GAO testimony.
Mr. Halter. Actually, Congressman, I didn't say that
precisely. What I did say was that if resources had been
forthcoming in the past, this issue would have been dealt with.
But let me go back to----
Mr. Portman. That sounds like my paraphrasing is pretty
much what you just repeated.
Mr. Halter. What I said was if we had the resources
forthcoming in the past----
Mr. Portman. No. I'm saying what you said is, ``Gee, if we
had just had more money, this wouldn't be a problem.''
Mr. Halter. We would have corrected this earlier.
Mr. Portman. And I would challenge that, based on what I
have heard. It is about setting priorities. You know, you have
got a huge budget, and you have a lot of decisions to make----
Mr. Halter. Absolutely.
Mr. Portman. And you have got to focus on certain things
and less so than others, and that is why I asked the earlier
question about how to get a higher focus. But is the four-year
time period one that you are comfortable with now that you have
spent more time on this?
Mr. Halter. Actually, let me walk through this because I
would like to give you even more detail than that in terms of
the timetable.
Of the 14.2 million notices that GAO has come in and talked
about, problems with 7 million of them will be resolved within
two months.
Mr. Portman. Almost half.
Mr. Halter. Yes. Problems with 1.4 million of them should
go away as a result of the passage already of the elimination
of the retirement earnings test. In other words, we shouldn't
have a problem with those notices. So now we are down to more
than half that we are dealing with.
In terms of the SSI notice with respect to the benefit
award and also the benefit adjustment, the major issue, and the
one that accounts for the bulk of the confusion, should be
resolved by July of 2002 with the implementation of a worksheet
that lays out for an individual how their SSI benefit is
calculated or how an adjustment is made. For about 90 percent
of those notices we should have a good workable solution by
July 2002.
For the remaining 10 percent of the SSI notices--and now we
are getting into very low numbers of notices here--it is going
to take until 2004. And the reason is that those are even more
complex than some of the others that we can solve more quickly.
So our expectation is that by September of 2004 the vast
majority, in fact, I would argue that in effect, all of the
problems that GAO has outlined here will be resolved. And, as I
said, within two months, more than half will be resolved. By
July of 2002 the vast majority of these will be handled.
Mr. Portman. Thank you, Mr. Halter. My time is up, but I am
glad you have some focus on it. I appreciate it.
Mr. Halter. Thank you very much.
Chairman Shaw. Mr. Hulshof.
Mr. Hulshof. Thank you, Mr. Chairman.
Mr. Halter, you think that whoever generated this letter
actually read it before it went out?
Mr. Halter. I could check, Congressman, but the likelihood
is probably not.
Mr. Hulshof. And I am not trying to get anybody--the
individual who generated this letter into hot water, but I was
interested in the dialog, colloquy you had with the Chairman,
and if you compared your constituent service with what we do
with constituent service, you know, it is certainly tempting to
plug in the figures, do the spell check and send it out and get
to the next letter, and yet, that is not really being
responsive.
I am also--let me follow up on something my friend from
Ohio pointed out about funding. You know, this Subcommittee, I
think Social Security Administration would agree, this
Subcommittee has been extremely sensitive to trying to work
with SSA, specifically going to bat for you--I am thinking of
Ticket to Work, where we withheld or authorized the withholding
of certain attorneys' fees so that SSA could have the money to
make sure that these changes that were implemented--so I think
the chairman has shown a great willingness to work with SSA.
And so I am concerned with the comments that we have not been
responsive. It is my understanding that SSA puts out a
strategic plan each year which outlines your agency's goals and
priorities for the coming years. So my question is: how many
times has the strategic plan included initiatives aimed at
improving notices?
Mr. Halter. Very frequently, Congressman. I don't think you
were here for the opening testimony. But the fact is we do 390
million notices a year. Improving all of those notices, or
making sure that in the beginning they are well written and
then improving them over time has certainly been a priority and
a key initiative for the organization.
In 1993 the identification of problems indicated that 30
percent of our notices needed simplification or needed work.
Over the last 7 years, that number has been whittled down to 8
percent, and as I mentioned in talking about what remains to be
done, if you give us credit for what happens two months from
now, knocking out 7 million out of these 14 million, that
percentage will be reduced even further.
We understand and have understood for a long time that
providing clear and compelling notices are something that we
should be doing, and we have devoted resources to it. So I
appreciate the question, and I would point out to you that in
our strategic plan, we have identified notices that we worked
on.
Mr. Hulshof. In light of that then, when has SSA approached
Congress with a credible plan or specifically designated cost
estimate so that we could plug that number in to help you fix
the problem?
Mr. Halter. When we present a budget to the Congress, we
don't present line items for these particular initiatives. And
the fact is, that over the last six years, the budget that
Social Security has received has been 1 billion dollars in
aggregate less than what the President requested for Social
Security's administrative budget. When you balance all of those
priorities----
Chairman Shaw. I think the lady behind you has two fingers
up, so I think it's two billion.
Mr. Halter. No, it is actually one billion dollars over 6
years. Over eight years it might be even higher.
Mr. Hulshof. Let me, Ms. Bovbjerg, very quickly, this is a
very compelling--and I know we are taking just this one single
letter, but I think it does probably speak to the issue as you
have walked us through it, so thank you for that example. Do
you have any data at GAO to indicate if there has been really
any adverse impact on beneficiaries as a result of confusing
letters like this or not?
Ms. Bovbjerg. There really isn't much information
available. It is anecdotal. We know people write to their
congressmen. We know that the 800 number does get calls on
this. But it is my understanding that the categories that the
800 number calls are put into are too broad to really narrow it
down to these notices. So we don't have much data.
Mr. Hulshof. Okay. Thank you. Thank you, Mr. Chairman.
Chairman Shaw. Mr. Cardin?
Mr. Cardin. Thank you, Mr. Chairman, and let me again thank
our two witnesses.
One thing is clear, and that is, whether it is one billion
or two billion, that SSA has received less administrative
support than the administration believed was necessary, and I
would suggest that probably less than what Congress thought was
necessary. But during those years we were fighting
discretionary budget caps that required all agencies to receive
less than was needed in order to meet our goals of a balanced
Federal budget. Many of us thought it did not make too much
sense to include the Social Security Trust Fund on budget for
the purposes of calculating the deficit. And many of us think
it doesn't make a lot of sense for your administrative budget
to compete with the other appropriations within Labor-HHS-
Education, and you shouldn't be subject to discretionary budget
caps. Now, it still means you will be subject to appropriation.
There will still be oversight to make sure that it is an
appropriate expenditure of public funds for every dollar you
spend. But I was listening to you try to justify switching of
priorities.
And I would suggest, Mr. Chairman, that in many respects,
that because you turn a spotlight on one problem, you might
shift some resources, and that is just going to mean next year
we are going to have to have a hearing on a different subject
because of the resources being diverted from maybe
determinations or redeterminations or other areas that we are
going to start hearing from our constituents, and indeed we do.
So I really do want to put a plug in for the bill that you
have been working on, Mr. Chairman, and that is to remove the
administrative budget of SSA from the discretionary budget
caps. I don't think it makes any sense to do that--to subject
it to it. I think that legislation should be enacted, and I
hope that we can work together to get that done, and I think it
would help. It is not the answer, but certainly again provides
the necessary resources and tools, and then we can hold the
agency accountable on a more straightforward way.
The second point I would like to underscore is the point
that you made a little bit earlier. And that is that a lot of
the responsibility rests with Congress. If we pass laws that
are difficult to interpret or difficult to understand--for good
reason--we have done that in the tax code and we have done it
in Social Security code--we need to take a look at that, and we
need your recommendations as to where we can simplify policy to
make it easier. I don't think we did the earnings test to
simplify your job. We did it because we thought it was right.
But it did simplify your job.
Mr. Halter. Absolutely.
Mr. Cardin. And we should look for ways in which we can
help you, and improve the policy as we go along, and I would
encourage you to be very bold in recommending those changes to
us.
The one question I want to ask that has not been raised
yet, and that is the language barrier, as to how you deal, or
what information you found in your study, that part of the
problem is the difficulty of our constituents to understand the
communication because of the language in which it is
communicated. I know you have made a real effort for Spanish,
but there are many other languages that my constituents feel
comfortable with, and I am just interested as to whether this
is a significant problem, and what you are doing to deal with
it.
Mr. Halter. I appreciate the question, Congressman Cardin.
In fact, we are very proud of what we have done in the way of
making sure that American citizens calling in, but not speaking
the English language, have the possibility of talking with a
Social Security employee in the language that they prefer.
In fact, this past year, just as one example, over a third
of our new hires are bilingual, which is an incredible
percentage when you compare it to the rest of the workforces
that are out there.
We have also, as you noted, done a number of notices in
Spanish. We have also offered translation services in over 16
different languages, and I would be happy to provide that list
of languages for the record that our staff have capability of
interacting with a constituent on.
Mr. Cardin. That would be helpful.
Mr. Halter. We will be happy to do that. But it is
definitely a diverse workforce, but it is something that we
will have to continue to devote efforts to.
[The following was subsequently received:]
Notices are routinely issued in English and Spanish. Also,
local offices create come-in notices in additional languages
that are heavily used in a particular neighborhood, such as
Chinese for San Franciscoand New York's Chinatown offices.
Public Information materials have been created in languages
beyond English and Spanish. Materials have been developed in
Korean, Chinese, Polish, Russian, Haitian Creole, Arabic,
Armenian, Cambodian, Lao, Portuguese, Punjab, Spanish,
Vietnamese, Farsi, Greek, Italian, Hmong, and Tagalog. These
publications are available from field offices, through FAX on
Demand, and through the Internet. Local offices may translate
materials into languages heavily represented in their service
areas.
SSA will provide interpreters and conduct interviews in the
customer's preferred language for all languages. Our policy is
to use bilingual employees whenever possible within an office
for interpretations and translations, and within a region for
translations. Beyond these boundaries, our policy is to provide
interpreter and translation services through outside
contractors.
SSA has over 6,000 bilingual public contact employees. The
top 10 languages spoken by bilingual public contact employees
are:
Spanish
French (including French Creole or Haitian)
Tagalog or other Philippine Dialects
Chinese (various dailects)
Vietnamese
German
Italian
Russian or Ukraine
Hmong, Cambodian or Lao
Portuguese
If bilingual employees are not available SSA has the
ability to obtain translation and/or interpreterservices in 97
languages.
Mr. Cardin. I am wondering whether part of the problem is
the constituents or the beneficiaries' difficulty in
understanding the language. I mean, is that part of the problem
we have here?
Ms. Bovbjerg. That was not the problem that we looked at in
this particular evaluation. We looked at English. And asked
writing consultants, who are accustomed to looking at all the
basics of effective communication to evaluate these notices.
I think that it was in the back of our minds that the
people who are getting these notices may not be very well
educated. SSI is a welfare program. Beneficiaries may not have
a very good command of English. We did not review whether a
translation worked, but instead were concerned that even in
English not all of notices are very effectively communicated.
Mr. Cardin. And, of course, the primary responsibility is
to make sure that it is understandable in English, but then I
would just urge that--we have to make sure that people who are
entitled to these notices can comprehend and understand what is
involved here. So you have to take it to the next level.
Ms. Bovbjerg. Yes, I agree.
Mr. Cardin. Thank you, Mr. Chairman.
Chairman Shaw. Mr. Collins?
Mr. Collins. Thank you, Mr. Chairman. Bill, good to see you
again.
Mr. Halter. Nice to see you, Congressman.
Mr. Collins. This is a computer generated letter; is that
right? And somebody has to put this language in that computer
for it to generate the letter.
Mr. Halter. Yes, sir. What happens, Congressman, is we
fashion paragraphs that are then mixed and matched by the
computer, depending upon the individual circumstances of that
particular beneficiary. And there is a software program that
determines the order in which those paragraphs are put in.
Mr. Collins. Maybe we should send on to the computer. You
know, how many pages is this letter? Three?
Ms. Bovbjerg. Eight.
Mr. Collins. How many?
Ms. Bovbjerg. Eight.
Mr. Collins. Eight pages.
Mr. Halter. Congressman, we don't actually have the letter,
and this is the first time I have seen this, so I can't tell
you about the actual letter.
Mr. Collins. Well, you talk about a lot of other letters
that need to be revamped. Have you seen those?
Mr. Halter. I have definitely seen samples, yes, sir, but
as you know, we send out 390 million forms, notices, letters a
year, so I only reviewed a sample.
Mr. Collins. They're not 390 million different messages
though. How many letters does that actually come down to be a
minimum of?
Mr. Halter. Well, with respect to SSI, I think what has
been indicated here is we are talking in the range of about
4\1/2\ to 5 million.
Mr. Collins. Well, you have got a letter for this, a letter
for this, a letter for that. Are there 20 letters? Are they
different letters? Are there five different letters, ten
different letters?
Mr. Halter. Actually, a much larger number than that,
Congressman, when you put it all together.
The key thing is that for this particular category of
letters that GAO is presenting to us here today, let us assume
that it is around 5 million that are different letters in this
category, that there are literally thousandsof different
permutations and combinations of that one letter, depending
upon the individual circumstances of the beneficiary. There are
literally hundreds of different variables that can affect the
way the letter is put together in the automated system, and
that is the complexity that we are trying to deal with.
And as the Chairman mentioned, and as Congressman Cardin
mentioned, a lot of that is driven by the complexity of the
program, and we have no choice administering the program and
putting together the benefits for that individual person. It
depends upon the circumstances and the variations are
variations that are written into the law.
Mr. Collins. Well, whoever put this software together
should have known, had better sense or more common sense than
to put an eight-page letter in that thing to be kicked out. You
know, if I received this letter, and it tells me right up front
that I am--this notifies me I am eligible for Social Security
income--it says payments--I think it ought to be subsidy,
because that is what it is, it is a subsidy. And then I look
down here and I see some numbers of how much a month. Then I
see another paragraph that follows it that says I am going to
receive a check for $3,367. I would quit reading there and go
to the mailbox. And I would stand by that mailbox, and when
that $3,367 ran out, I might pick the letter up and read
further in it, or I would pick up the phone and call the office
and find out why I am not getting any more money.
You know, this just doesn't make good common sense, Bill. I
mean, I don't know who put this together, but you need to go
pull those folks into your office this afternoon when you get
back over there, and say, ``Look, this is dumb.'' And, Bill, I
am going to tell you one other thing, one other thing.
Mr. Halter. Okay. Let me just respond to that real quick,
because I want you to know, Congressman, I have already pulled
them into my office, and we have had a conversation about it
and----
Mr. Collins. It shouldn't take three, four years to rewrite
something like this. You know, scrap this software thing and
start writing some common sense letters.
And I am going to tell you something else, I don't think
you need any more money. I think you could better use the money
you already have. This is a waste of folks' money, writing
letters like this. This is just not good common sense.
Mr. Halter. Well, let me respond to that, because you know
we have a great working relationship, and I just want to talk a
little bit about what would happen if we decided not to use an
automated system, but in fact went back and, as you say, put
some good common sense to it, and then generated individual
letters. You would be talking about an incredible use of
people's time to put together 5 million individually put
together letters.
Mr. Collins. I didn't say that.
Mr. Halter. Well, but that is the implication.
Mr. Collins. I didn't say that, Bill. I mean, we all get
thousands of letters a year too, and we have letters that
answer specific issues. And if we had to wait four or five
years to write a letter to answer, you know, tell our computer,
``Spit this letter out, wait four years'', because it is going
to take us that long to come up with an answer, we wouldn't be
here after two years to come up with an answer.
Mr. Halter. Well, I appreciate that.
Mr. Collins. It is just that you need to review these
letters. Somebody needs to review them, and I think it ought to
go right on up to the top and come up with some good common
sense approach to tell somebody why they are eligible, why they
are not eligible, because they are not going to read this. They
are not going to read eight pages. I wouldn't read it. I can
tell, I would see the first two or three paragraphs, and I
would go stand by the mailbox and wait for my money, and I
would enjoy it when I got it. But this is just not good
business.
Mr. Halter. You know I take to heart your personal
recommendations, and I want you to know that your first
recommendation has already happened, that the meeting that you
wished to happen, happened long ago, and in fact, the proposals
that are being put forward here to you today, do reflect
anincrease in the speed with which we as an organization are
dealing with this, and so that meeting that you described has
already happened.
Now if you are recommending to me that we go back and have
another meeting, I am happy to do that too. But the fact is--
and I would also, Congressman, be happy to spend some time with
you directly and talk through some of the complications of
this, because this is not an easy thing, and I think you and I
could come to a pretty good joint understanding of what is
going on with this particular set of issues.
This is not something--I just have to say--this is not
something that we look at as a non-problem. We recognize that
this is a problem, and we are working on it.
Mr. Collins. Well, Bill, you recognized that in 1990. You
didn't, but somebody did.
Mr. Halter. Well, I appreciate you pointing that out.
Mr. Collins. That is ten years.
Mr. Halter. I understand, and as you know, I have been
there ten months, but the fact is----
Mr. Collins. I think you have addressed everything that I
have known you to address in a very fashionable and appropriate
manner, but this one you need to address too. And I think if
you do, you concentrate on this, you will come up with a
solution that makes a whole lot more sense than this stuff.
Mr. Halter. Well, that is our goal, Congressman, and I hope
by the end of it, that you will look back and say that that is
exactly what we accomplished.
Mr. Collins. Well, draft your letter and send me a copy of
it, and I will tell you how it sounds. [Laughter.]
Mr. Halter. I tell you what, I will send you ten.
Mr. Collins. Ten different ones.
Mr. Halter. Ten different ones.
Mr. Collins. You can send 20 if you want to.
Mr. Halter. Okay.
Mr. Collins. Don't make them eight pages long though.
Mr. Halter. Well, now, this is something I have got to
respond to
Mr. Collins. Because I will send them back to you unread.
Mr. Halter. Now, with respect to this program we are under
court order to have particular information in these letters and
that lengthens these letters. I mean, we are under a court
order that tells us particular language that has to be in
there. And part of what we are working on, in terms of
thetimetable--and we have expedited it from what GAO initially
believed--is in fact a response to a court case, and a court
agreement, and so we are complicated in our response by that as
well.
Mr. Cardin. Mr. Chairman, could I ask unanimous consent
that the entire letter be put in our record?
Chairman Shaw. Without objection, I think that is a good
idea.
[The information was subsequently received:]
Social Security Administration
Supplemental Security Income Notice of Award
Date: October 13, 1999
Claim Number
*Application Filed--February 22, 1999
*Type of Payment--*Individual--Disabled
This is to notify you that you are eligible to receive Supplemental
Security Income payments under the provisions of Title XVI of the
Social Security Act. The rest of this letter will tell you more about
our decision.
How Much We'll Pay
------------------------------------------------------------------------
*Monthly Amount
*Beginning* *Through* Payable*
------------------------------------------------------------------------
February 22, 1999 February 28, 1999 $.00.
------------------------------------------------------------------------
March 01, 1999 October 31, 1999 $420.92.
This includes $87.58
from the State of
Massachusetts.
------------------------------------------------------------------------
November 01, 1999 Continuing $.00.
------------------------------------------------------------------------
------------------------------------------------------------------------
Information About Your Payments
We are sending you a check for $3,367.36. This is money due
you for March 1999 through October 1999. No further payments
will be sent to you.
You should receive the check no later than October 16,
1999.
Your SSI Is Based On These Facts
You met all the rules to be eligible for SSI
beginning February 22, 1999. However, we cannot pay SSI until
the month after you first meet the rules. In addition, we
cannot pay you any SSI for months after that because of the
reason or reasons given below.
You were disabled in February 1999 on.
You were living in the State of Massachusetts for
February 1999 on.
The amount of money we pay you from the State of
Massachusetts depends on the State's rules.
You are living in someone else's home for March
1999 on.
You have monthly income which must be considered
in figuring your payment as follows:
Your Social Security benefits--before deductions for
Medicare if any--of $812 for November l999.
The food and shelter you got in someone else's home or
apartment. We value that food and shelter at $166.66 for
February 1999 through November 1999.
We must count the full amount of any benefit
listed above as income even though all or part of a benefit
shown is being withheld to recover an overpayment.
Because of your income, you are not eligible to
receive Supplemental Security Income payments for November 1999
on.
Information About Your Back Payments
We are sending you a Supplemental Security Income check for
$3,367.36 in October 1999. We will not count the part of this
money which was due for back payments as your resource for 6
months. If the money is not spent before May 0l, 2000, we will
count any money left over as part of your resources. Butthings
bought--with this money may count as resources the month after
they are bought. Your Social Security office can tell you which
things count as resources. You cannot get SSI if the resources
we count have a value of more than $2000.00.
Information About Medicaid
Since you are not eligible now for SSI you are also not
eligible now for Medicaid based on SSI. However, if you need
help with medical bills, you may still be eligible for medical
assistance. Also, you may be eligible for Medicaid for the
months we paid you SSI.
Contact the nearest Massachusetts Division of Medical
Assistance office for information about your State's medical
assistance programs and your eligibility for Medicaid. When you
visit that agency; please take this letter with you. It will
help the people there answer your questions.
Things To Remember
Your 551 payments may change if your circumstances
change. Therefore, you are required to report any change in
your situation that may affect your SSI. For example, you
should tell us if:
you move
anyone else moves from or into your household
your marital status changes
income or resources for you or members of your
household change
your medical condition improves
you go to work
This will help us pay you correctly.
Please read the booklet ``When You Get SSI-What You Need To
Know'' carefully for additional information about this
requirement.
Because we believe that your health may improve,
we will review your case in about 3 years. We will send you a
letter before we start the review. Based on that review, your
SSI will continue if you are still disabled, but will end if
you are no longer disabled.
This decision refers only to your claim for
Supplemental Security Income payments.
If at any time in the future you think you qualify
for payment, please contact us immediately about filing a new
application. The earliest month for which we can pay you is the
month after you file a new application.
The application you filed for SSI was also a claim
for Social Security benefits. We looked into this, and decided
you can't get any Social Security benefits except the benefit
you are already getting. If you disagree with the decision, you
have the right to appeal. A case review, described later in
this letter, is the only kind of appeal you can have regarding
Social Security benefits.
Would you like to work? If so you should know
about special Supplemental Security Income (SSI) rules. These
rules can help you keep Medicaid and may help you keep getting
some SSI even though you are working. The enclosed fact sheet
tells you more about special SSI rules for people who work.
If You Disagree With The Decision
If you disagree with the decision, you have the right to
appeal. We will review your entire case, even the parts you
agree with. We also will consider any new facts you have and
then will make a new decision. The new decision could be more
favorable to you than the one you already have. But, keep
inmind that the new decision also could be the same as or less
favorable than the decision you already have.
You have 60 days to ask for an appeal.
The 60 days start the day after you receive this letter.
We assume you got this letter 5 days. after the date on it unless you
show us that you did not get it within the 5-day period.
You must have a good reason for waiting more than 60 days
to ask for an appeal.
To appeal, you must fill out a form called ``Request for
Reconsideration.'' The form number is SSA-561. To get this form,
contact one of our offices. We can help you fill out the form.
How To Appeal
There are two ways to appeal. You can pick the one you want. If you
meet with us in person, it nay help us decide your case.
Case Review. You have a right to review the facts in your
file. You can give us more facts to add to your file. Then we'll decide
your case again. You won't meet with the person who decides your case.
This is the only kind of appeal you can have to appeal a medical
decision.
Informal Conference. You'll meet with the person who
decides your case. You can tell that person why you think you're right.
You can give us more facts to help prove you're right. You can bring
other people to help explain your case.
If You Want Help With Your Appeal
You can have a friend, lawyer or someone else help yon. There are
groups that can help you find a lawyer or give you free legal services
if you qualify. There are also lawyers who do not charge unless you win
your appeal. Your local Social Security office has a list of groups
that can help you with your appeal.
If you get someone to help you, you should let us know. If you hire
someone, we must approve the fee before he or she can collect it.
If You Have Any Questions
If you have any questions you may call us toll-free at 1-800-772-
1213, or call your local Social Security office at 1-617-282-4159. We
can answer most questions over the phone. You can also write or visit
any Social Security office. The office that serves your area is located
at: Social Security, 2nd Floor, 540 Gallivan Blvd., Dorchester, MA
02124.
If you do call or visit an office, please have this letter with
you. It will help us answer your questions. Also, if you plan to visit
an office, you may call ahead to make an appointment. This will help us
serve youmore quickly when you arrive at the office.
We are sending you a pamphlet which contains important information
you should know. The pamphlet is called ``When You Get SSI-What You
Need to Know.'' We are also enclosing additional information about
rules that can help you if you are working or if you decide to work.
Kenneth S. Apfel
Commissioner of Social Security
Enclosures: SSI Rules That Help You Work
SSI RULES THAT HELP YOU WORK
We want to tell you about some special Supplemental
Security Income (SSI) rules that can help you while you are
working or if you begin working. These rules can help you get
or keep Medicaid and may help you keep getting some SSI even
though you are working.
How Your SSI May Change If You Work
If you work full-lime or part-time and make $65 or less
each month, your SSI will usually not change. As the money you
earn from your job goes up, your SSI will go down. However, if
you have no other income (money or support), you can earn up to
$1,313.77 a month and still get at least $1 in SSI.
If You Stop Working or Start Earning Less
If you stop working or start earning less, please let us
know right away. We can increase your SSI check, or start your
SSI and Medicaid again if they have stopped. You may not even
have to file a new application.
Medicaid
If you get Medicaid, it will usually continue as long as
you get SSI. If your SSI stops because you begin earning too
much money, you can often keep getting Medicaid as long as the
following are true:
You continue to be disabled or blind under our rules;
and
You can't pay your medical bills without Medicaid.
We Don't Count Some of Your Earnings Used for Work Expenses
The earnings you use for some of your working expenses may
not count as income. For example, we sometimes don't count
earnings used to pay for transportation to and from work. Also
we don't count the cost of special equipment that helps you to
work.
A Plan Can Help
You may be able to keep more of your SSI if you develop a
special plan to support yourself. We call this a plan to
achieve self-support(PASS). This plan lets you set aside money
for a certain amount of time for a work goal. For example, you
may set aside money to start a business, go to school, or get
training for a job.
We don't count what you set aside when we figure your SSI.
This can help keep you on SSI or help you get more SSI. A PASS
may also help someone you know qualify for SSI.
If You Need Help Finding a Job
We can ask someone who offers vocational rehabilitation
services to help you find a job or give you training.
If You Want To Know More
If you want to know more about these rules, contact any
Social Security office and ask to speak to someone about work
incentives.
Mr. Collins. Well, you just brought another interesting
comment up, and it adds to the problem, because there is a lack
of a lot of common sense when it comes to the courts too. But I
think the answer, even to the courts, is to come up with
something that makes sense, simple, to the point, the old KISS
theory. But this is just so confusing, complex and ridiculous
that it is not even worth the effort and the time and the money
it costs to mail it out. Thank you, Bill.
Mr. Halter. Thank you very much, Congressman.
Chairman Shaw. How much of the courts' orders that you are
complying with have to do with due process, and how much has to
do with the wording of the legislation or interpretation of
legislation?
[The information was received and is answered on page 48.]
Mr. Halter. Mr. Chairman, I would have to get back to you
with an answer on that, a precise answer on that.
Chairman Shaw. I would like you to go beyond that issue if
you would. If you would just summarize to us the requirements
that you see the letter has to have pursuant to the statute and
pursuantto the court order. It may be that the court order has
gone too far, and that might be able to be corrected by
statute, and I think we ought to take a look at it, because,
again, I think, certain information has to be given. And I
understand that. But if you give too much information, it is
lost and Mr. Collins isn't going to read that eight-page
letter, and I think that needs to be--really needs to be
reviewed, particularly when you are dealing with the education
level that most of these people have that are receiving these
funds.
Mr. Halter. We will be delighted to do that, Mr. Chairman.
Chairman Shaw. Ms. Bovbjerg, I believe she is the one that
said that you all are going to have to make a correction in
paragraph ``F'' up there, and that a new application would not
be necessary in this particular instance. What is involved in
making that correction and why couldn't that correction be done
system wide?
Mr. Halter. My understanding, Mr. Chairman, with respect to
that particular item, is that it is going to be corrected in
the month of October, but I want to ask our folks to confirm
that. That in fact is going to happen in less than 30 days.
Chairman Shaw. Well, then the question is: why can't some
of this other stuff be addressed within the next 30 days? I
think we need to take a whole assessment of what is going on.
Mr. Halter. I would partition the answer, Mr. Chairman, in
that there are some things that if it is just a language
change, we can make those very expeditiously, but if
Chairman Shaw. I think what we have here is an excess of
language.
Mr. Halter. Well, let me--as I partition this, I think it
will become clear what I am talking about. If it is simply
changing the words in a particular paragraph that is in the
system, we can do that very quickly. If, on the other hand,
what you are talking about is changing the software that mixes
and matches those paragraphs--and that is really the root of
this problem--that takes much longer for us to do, and that is
the real complication. So with respect to paragraph ``F'' and
paragraphs like that, where it is simply the case that we need
to change the actual language in the text, we can do that very
straightforwardly. If, on the other hand, you are talking about
the sequencing between paragraphs A, B, C, D, E and F, that is
much more complicated, and that is what is driven by all the
variables that we have been talking about with respect to the
program.
Chairman Shaw. But you could certainly--am I correct on
this? And again, I am asking for information on it. I don't
understand how these programs work. But if you took that
paragraph ``F'' and put a period right after ``immediately'',
and just struck the rest of that paragraph, it seems to me that
that would work.
Mr. Halter. And, Mr. Chairman, I believe that the change
that will be forthcoming here in the next few days or the next
few weeks will in fact be something like that. But I would like
to confirm that and get back to you with that particular thing.
[The following was subsequently received:]
Change in language to an SSI paragraph
The language in the paragraph referred to by Mr. Shaw will
be corrected effective October 2, 2000. The replacement
language will be: ``If you think you may be eligible for SSI
again, please contact us. If you do not contact us before [fill
in appropriate month and year], you may have to file a new
application. If you have to file a new application, the
earliest month for which we can pay you is the month after you
file.''
The revised language clarifies when a new application is
needed.
Chairman Shaw. I don't think you have to put that last
sentence, ``The earliest month for which we can pay you is the
months after''--well, you won't have a new application--but I
don't know whether any further information is necessary. I
think that is really what you have to really look at, is how
much information are you required to give, because it looks to
me that this is just totally confusing.
Mr. Halter. Right.
Chairman Shaw. Ben, do you have anything else?
Mr. Cardin. No.
Chairman Shaw. Well, I want to thank you both. Now, you are
going to follow up and give me the information that we have
requested?
Mr. Halter. Yes, sir.
Chairman Shaw. Setting forth statutory requirements and the
requirements of the court. And if you could have your legal
counsel also to advise us as to whether this court required
information is under dueprocess or as to the statutory
interpretation. Then we will have to look at it and see if we
see a way that we can
Mr. Halter. Mr. Chairman, I would be delighted to do that,
and we will follow up with you on those.
[The following was subsequently received:]
What the law requires to be in Social Security Notices
We are required to by Section 205(b)(1) (title II) and
Section 1631(c)(1)(A) (title XVI) to ``make findings of fact,
and decisions as to the rights of any individual applying for a
payment under this title.'' We include all the information in
our notices to satisfy these sections. When the courts find our
notices legally insufficient, it is usually because they
determine we have not included enough information, or not
stated the information clearly, to explain our findings of fact
and an individual's appeal rights.
Listed below are other specific citations that discuss
notice requirements.
Specific Notice Requirements
Section 205(s) (title II) and section 1632(o) (title XVI)
require SSA notices be written in ``simple and clear
language,'' and include a local social security office address
and telephone number.
Section 205(j)(2)(E)(ii) (title II) and section
1631(a)(B)(xii) (title XVI) give notice requirements to explain
that a representative payee will receive benefits on behalf of
an individual. The notice must be clearly written in easily
understandable language, identify the person chosen, and
explain the right to appeal that a representative is needed,
appeal who the representative is, and review the evidence we
used to make our decision.
Section 205(b)(3)(B) (title II) and section
1631(c)(1)(B)(ii) (title XVI) require, in an adverse situation,
SSA include the effect on possible eligibility for payments of
choosing to reapply rather than appeal the decision.
Section 206(a)(2)(D) (title II) and section 1631(d)(2)(A)
(title XVI) require a notice about a fee agreement to include:
the past-due amount, past-due amount payable to the claimant,
amount of the maximum fee that can be charged, and explanation
of review procedures.
Section 206(c) (title II) and section 1631(d)(2)(B) (title
XVI) require the notice to tell the beneficiary he/she can have
an attorney help with an appeal and that qualifying individuals
can get legal services free of charge.
Section 1631(k) (title XVI) requires notification of blind
and/or disabled individuals about the potential eligibility
under section 1619 at the time of the award, when income is
$200 or more for a month, and periodically afterwards as long
as the individual's income is $200 or more for a month.
Section 1631(l) (title XVI) requires SSA to provide
individuals applying for or receiving benefits because of
blindness the following notice options: receive a supplementary
notice by telephone within 5 working days after SSA mails the
initial notice; receive the initial notice by certified mail;
or receive notification by some alternative way established by
SSA and agreeable to the individual. Title II notices also
follow this requirement.
Sections 205(b)(1) and 1631(c)(1)(A) of the Social Security
Act require the Commissioner of Social Security to ``make
findings of fact, and decisions as to the rights of any
individual applying for a payment under this title'' (either
title II or title XVI). If a decision involves a determination
of disability and is partially or wholly unfavorable to the
individual, the notice describing the determination must
contain a statement of the case, in understandable language,
setting forth a discussion of the evidence and stating the
determination and the reason or reasons upon which the
determination is based.
Court Cases That Specify Notice Requirements
*We have annotated the cases where due process was an
issue.
Mullane v. Central Hanover Bank & Trust Co., 339 U.S. 306,
314 (1950). When government action threatens the deprivation of
an individual's property, due process requires that the
individual receive notice that is reasonably calculated, under
all circumstances, to apprise the individual of the action
taken and afford him or her an opportunity to present
objections. Due process.
Goldberg v. Kelly, 397 U.S. 254, 267-68 (1970). The Supreme
Court held that before welfare benefits can be terminated, due
process requires ``that a recipient have timely and adequate
notice detailing the reasons for a proposed termination, and an
effective opportunity to defend by confronting any adverse
witnesses and by presenting his own arguments and evidence
orally.'' Due process.
Cardinale v. Mathews, 399 F. Supp. 1163 (D.D.C. 1975). The
court applied the holding in Goldberg v. Kelly to reductions,
suspensions, and terminations of SSI benefits. As a result,
SSA's notices explaining intended reduction, suspension, or
termination of SSI benefits must explain that the individual
has the right to a review of SSA's determination and that the
individual may choose a case review, informal conference, or
formal conference. Due process.
Califano v. Yamasaki, 442 U.S. 682 (1979). The Supreme
Court held that title II beneficiaries who request waiver of
collection of an overpayment are entitled to the opportunity
for a prerecoupment oral hearing. Consequently, SSA must inform
individuals whose waiver request cannot be granted based on the
written request of their opportunity for an oral hearing. Based
on the language of section 204(b) of the Social Security Act.
Benson v. Schweiker, 652 F.2d 406 (5th Cir. 1981). The
court determined that the notice of the right to be represented
by counsel must include an explanation of the fee limitations
in sections 206 and 1631(d) of the Social Security Act, of the
possibility of representation by a private attorney on a
contingent fee basis, and of the possibility of free
representation if the claimant cannot afford a lawyer. See also
Holland v. Heckler, 764 F.2d 1560 (11th Cir. 1985). Based on
statutory language.
Wall v. Califano, (N.D. Cal. July 6, 1982). In a settlement
agreement, the Secretary agreed to simplify the language
describing the three ways to appeal SSI post-eligibility
reduction, suspension, and termination decisions. The
settlement agreement set forth specific readability and content
standards. Settlement agreement.
Muir v. Schweiker, (D. Or. February 24, 1983). In a class
action settlement agreement, the Secretary agreed to include on
the SSI notice of the decision to recover an overpayment a
statement advising recipients that ``appearing in person may
help the person deciding your case to make a decision.'' The
settlement agreement applied nationwide. Settlement agreement.
Ellender v. Schweiker, 575 F. Supp. 590, 600 (S.D.N.Y.
1983). To be constitutionally adequate, SSI overpayment notices
must explain to the beneficiaries the time periods during which
overpayment arose, the amount of overpayment in each time
period and in total, the amount of any prior repayments, the
reason for overpayment, that the recipient has a right to
appeal and/or reconsideration, and that under specified
conditions the recipient may have the right to a waiver of
repayment of the overpayment. Due process.
Buffington v. Schweiker, No. 734-73C2, (W.D. Wash. Feb. 7,
1983). The court established standards for notifying a title II
beneficiary about the scheduling of a personal conference on
the issue of waiver of the overpayment when an initial paper
review regarding waiver is adverse. The written notice must
contain: all the necessary information about date, time, place,
the procedure for reviewing the file prior to the hearing, the
procedure for seeking a change in the scheduled date or time or
place, and all other information deemed necessary by the
Commissioner to fully inform the claimant about the personal
conference. Due process.
Page v. Heckler, No. 82-1388 slip op. (M.D. Pa. July 2,
1984). In this State-wide Pennsylvania class action, the court
agreed to a proposal to have SSA follow the same waiver of
overpayment procedures under title XVI as were required in
Buffington for title II overpayments and waivers. The
Commissioner is required to send a notice of a personal
conference, which meets the standards announced by the
Buffington court to overpaid SSI recipients seeking waiver. Due
process.
Powell v. Heckler, 789 F.2d 176 (3d Cir. 1986). The court
held that the Appeals Council cannot review an entire case when
the claimant appeals only part of the decision unless the
Council gives the claimant notice of its intention to do so
within 60 days of the ALJ decision. Due process.
Gonzalez v. Sullivan, 914 F.2d 1197, 1203 (9th Cir. 1990).
The court held that SSA's initial notice of an adverse
determination violated Fifth Amendment due process because it
did not clearly explain the difference between appealing the
denial and filing a new application. The notice did not clearly
indicate that if no request for reconsideration is made, the
determination is final. Due process.
Ford v. Apfel, No. CV-94-2736 (E.D.N.Y. January 13, 2000).
After negotiations between the parties, the court required that
SSA revise its automated SSI financial eligibility notices
(e.g., denial, change in payment amount) to better explain the
financial calculations that affect eligibility and payment
amount. Among other things, the court required that SSA include
in the notices information regarding the individual's right to
review his or her claim and how the appropriate legal citations
can be obtained from SSA. Due process.
Greenawalt v. Apfel, No. 99-CV-2481 (E.D.N.Y. December 26,
1999). In a nationwide class action settlement agreement, the
Commissioner agreed to extend the practices and procedures
followed in Pennsylvania pursuant to Page in all SSI
overpayment cases where the recipient seeks waiver. Notices
must comply with the standards used in Buffington and Page.
Settlement agreement. Challenge was based on due process and
equal protection.
Chairman Shaw. And, Ms. Bovbjerg, can you do an assessment?
Are you all prepared to give us an assessment as to what
funding would be necessary in order to write new programs? You
said you are not a systems operator, and I am certainly not. Do
you have the expertise at the General Accounting Office to take
a look at what their plan is for doing this over four years and
see if you can see a way that it can short-circuited and
whether new funding would be required?
Ms. Bovbjerg. I believe someone at the General Accounting
Office has that expertise.
Chairman Shaw. Okay. Well, take a shot at it.
Ms. Bovbjerg. But you were correct it wouldn't be me doing
systems work.
Chairman Shaw. Take a shot at it, please. Thank you very
much. The hearing is adjourned.
[Whereupon, at 11:41 a.m., the hearing was adjourned.]
[Submissions for the record follows:]
Bilingual Services Working Group
October 6, 2000
The Honorable E. Clay Shaw, Jr.
Chairman, Social Security Subcommittee
Committee on Ways and Means
U.S. House of Representatives
1102 Longworth House Office Building
Washington, D.C. 20515
Dear Representative Shaw:
Thank you for the opportunity to submit written comment for the
hearing record on the very important issue of the quality and
effectiveness of Social Security notices. Although the Social Security
Administration (SSA) has put some effort into notice improvement, many
notices remain unintelligible to the public, who are being held
increasingly responsible through the various anti-fraud initiatives for
understanding and responding appropriately to the complex rules and
reporting responsibilities in the benefit programs administered by the
agency. As the agency moves forward with its programs to encourage
disability benefit recipients to work, it is critical for the agency's
notices to clearly explain the rules and recipient responsibilities in
the work incentive programs, as well as the effect of work on benefits.
Understanding the agency's notices is an especially difficult problem
for those with cognitive limitations, mental impairments, low
educational levels, and for those who do not speak English or have
limited English proficiency.
Because I write on behalf of the Bilingual Services Working Group,
I will confine the remainder of this statement to issues involving SSA
customers with limited English proficiency. The Bilingual Services
Working Group is a national group of Social Security and SSI advocates
who have been working for several years with SSA to increase access to
SSA's services for persons with limited English proficiency.
The pressing issue for persons with limitations in English is the
need to receive notices in a language they will understand. In order to
make that happen, SSA must develop the capability to identify the
language spoken by each of its customers. Currently, the only language,
other than English, in which the agency even attempts to provide
written notices in Spanish. However, even this limited attempt is not
well executed because SSA does not, at present, determine and capture
the language spoken by its customers, except for new claims.
As you know, the President recently issued an Executive Order on
``Improving Access to Services for Persons with Limited English
Proficiency.'' 65 Fed. Reg. 50119 (Aug.16, 2000). The Executive Order
requires each agency administering a Federally conducted program to
develop and implement a plan consistent with the compliance standards
established for the States by the Department of Justice Office of Civil
Rights. 65 Fed. Reg. 50123 (Aug.16, 2000). This order will go far to
ensure equal access to services. It will also enhance program
efficiency and integrity. Unfortunately, the Executive Order makes
clear that it cannot be enforced against Federal agencies.
If the OCR standards were applied to SSA, the agency would clearly
be required to identify the languages spoken by its customers and
provide written notices in many different languages. It is unlikely
that any other benefit agency in the nation serves as a great number of
recipients who are limited in English proficiency. The eligibility
rules for the Supplemental Security Income (SSI) program are
particularly complex, requiring frequent contact with and many notices
from the agency, and the percentage of aged SSI recipients who are
limited in English proficiency continues to grow each year. Yet, the
agency is woefully behind in providing notices in a language the
benefit recipient understands.
SSA needs to provide written notices in the languages spoken by its
customers and must place the highest priority on identifying the
languages spoken by all SSI recipients. Until SSA has the capability of
capturing the language spoken by its customers, it is unable to send
notices in a language the customer understands. It is also unable to
provide timely and effective service with interpreters when it does not
know the language the customers speaks. SSA must undertake the
necessary systems changes now to identify and capture language
preference to avoid an even larger workload later on and further delays
in providing these critical services.
SSA has made great strides over the past few years in the
development and implementation of its excellent policy with regard to
the provision of interpreters for conducting SSA business. It now needs
to make similar progress on the provision of written notices in the
customer's language. There are highly dedicated individuals within the
agency who participate in a work group for improving services to
individuals with limited English proficiency. Further progress will be
hampered, however, unless and until the agency has the ability to
capture the languages spoken its customers.
SSA undoubtedly sends out more notices to the public on issues of
vital importance than any other Federal or State agency. It should set
the example when it comes to providing notices in the languages of its
customers. I urge the Committee to determine what needs to be done to
enable the agency to meet the written notice standards set forth in the
exemplary OCR policy guidance. The Executive Order should not be
ignored simply because it is unenforceable against SSA. Its spirit
should be followed because it is good public policy for the reasons
stated above.
Respectfully submitted,
Linda L. Landry, Esq.
Disability Law Center, Boston, MA
Gerald McIntyre, Esq.
National Senior Citizens Law Center, Los Angeles, CA
Gillian Dutton
Northwest Justice Project, Seattle, WA
Edwin Soto-Lopez
Greater Upstate Law Project, Rochester, NY
Christopher Bowes, Esq.
Cedar, New York, NY
Center for Disability Advocacy Rights, Inc.
New York, NY 10003
October 9, 2000
The Honorable E. Clay Shaw, Jr.
Chairman of the Subcommittee on Social Security
Committee on Ways and Means
U.S. House of Representatives
1102 Longworth House Office Building
Washington, D.C. 20515
Dear Representative Shaw:
I am writing to submit these comments for inclusion with the
September 26, 2000 hearing record on the issue of the quality of the
Social Security Administration's (SSA) benefit notices and the status
of SSA's actions to address notice improvement. At the outset, let me
state how appreciative I am to the Committee for addressing these
problems and for holding this hearing to place pressure on SSA to
remedy the notice problems that remain essentially unchanged despite
over 8 years of promises to correct them.
My name is Christopher J. Bowes and I am the Executive Director of
CeDAR, the Center for Disability Advocacy Rights. CeDAR is a not for
profit poverty law office providing legal advice and representation to
poor persons with disabilities and older persons before the Social
Security Administration. Through our daily work, CeDAR's staff has a
wealth of experience dealing with the problems created by SSA's poorly
drafted Supplemental Security Income (SSI) and Social Security
Disability (SSD) benefit notices. CeDAR's attorneys are also co-counsel
for eight of the thirteen named plaintiffs and the plaintiff class in
Ford, et. al. v. Apfel, 87 F. Supp. 2d 163 (E.D.N.Y 1999), the
nationwide SSI class action that successfully challenged the adequacy
of SSI notices mentioned in the GAO's report.
I hope that the Committee will consider incorporating the entire
Ford decision with the record of this hearing as the findings contained
therein provide a careful analysis of the issues before the Committee,
including SSA's failure to make any significant headway with respect to
Notice improvement since September 1992 when the Office of the
Inspector General issued a report harshly critical of SSI financial
notices. Moreover, while I know that the Committee has heard testimony
severely critical of the quality of SSA's notices, I believe that the
Ford decision provides additional detail regarding the harm visited to
over 6.5 million SSI recipients.
Highlights of the Court's Decision in Ford
The Court found that SSA's SSI notices violated due process because
the notices fail to convey essential factual and legal information
necessary to inform the reader. The Court found that the risk of
erroneous deprivation was great given that SSI recipients already
subsist on the edge of poverty. Finally the Court held that SSA would
not be unduly burdened if required to correct the SSI notices.
The Notices Fail to Convey Underlying Factual and Legal
Assumptions
The Court noted that it was common knowledge that SSA's SSI notices
failed to contain the factual and legal premises with which a person
can make a decision as to the correctness of the notice. The Court
cited the Office of Inspector General's September 1992 report
recommending the addition of abenefit worksheets itemizing gross
payment and all applicable deductions. The Court also cited the 1994
General Accounting Office's (GAO) report finding that even GAO staff
with an accounting background and years of Social Security program
knowledge had difficulty determining or verifying specific
pointscontained in the SSI notices. Several of the named plaintiffs
testified to the fear caused by the SSI notices that they could not
understand, leaving them upset and humiliated.
The Likelihood of Erroneous Deprivation is Great
Next the Court considered the likelihood that a confusing SSI
notice would erroneously deprive an SSI recipient of desperately needed
cash assistance. Each recipient of a potentially erroneous SSI notice
is either elderly or suffering from severe mental and/or physical
disability. SSA's own witnesses testified that SSI claimants are often
intimidated simply by the fact they have received a government letter.
It is to this audience that the inadequate SSI notices are sent, and
the recipient is placed in the position of tryingto first ascertain
whether a negative determination has been made against them, and
secondly whether it is factually and legally proper. Although SSA
provides for a 60-day appeal period, the notice recipient must in fact
make a decision whether to appeal within 10 days in order to maintain
their benefits at the status quo. While SSA has an 800 telephone number
where a claimant can call toll free for information, that system
requires that the caller be on SSA's MSSICS computer system. As it
turns out, only twenty percent of all SSI recipients have their
information stored on MSSICS, making a call to the 800 number an
inadequate solution for the vast majority of SSI recipients. Moreover,
there is a dearth of trained poverty law attorneys available to assist
these individuals.\1\
\1\ I am aware that this Committee has recently heard testimony
regarding a possible amendment to the Act that would allow withholding
of past due SSI benefits for payment of attorneys fees. While this
proposed amendment is likely to encourage more private attorneys to
represent SSI claimants seeking disability benefits, the amendment will
not help SSI claimants who seek clarification of their SSI notices for
the simple reason that SSI financial notice cases typically do not
result in an award of past due benefits.
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Revising the Notices Will Not be Unduly Burdensome on SSA
Finally, the Court considered whether notice improvement would be
unduly burdensome for SSA. SSA provided testimony that notice
improvement would require substantial modification to its computer
systems. The Court considered the testimony of Charles Wood, Associate
Commissioner of the Office ofSystems and Design and Development, who
testified that it would take six months for three to four computer
programmers to test and debug the proposed changes and two years to
fully implement the changes sought by the plaintiffs. Other SSA experts
testified that SSA would have to buy additional computers to handle the
additional workload imposed by improved notices. On the other hand,
SSA's witnesses testified that improved notices would reduce SSA's
workload because clear notices result in fewer inquires to SSA by
recipients seeing notice clarification. Overall, the Court held that
notice improvement would not unduly burden the SSA.
The Glacial Pace of SSI Notice Improvement
We are obviously concerned regarding the slow pace of SSA's
proposed implementation, particularly given Associate Commissioner
Wood's testimony at trial that all the changes sought by the Ford
plaintiffs could be completed in two years. We are therefore surprised
to hear that it may take 10 years to fully implement all of the
changes. It has also come to our attention that SSA has no intention of
issuing any worksheets in so-called ``very complex'' cases
(representing three percent of all notices) because it would be too
difficult. SSA's timeline and the scope of implementation should be
revisited and scrutinized so that all SSI financial notices include
worksheets and that this is done as soon as possible, not at a pace
that is administratively convenient.
We are also vexed at the suggestion mentioned in the GAO report
that SSA held off on SSI notice improvement pending the outcome of the
Ford litigation. Because this is prominently stated twice in the GAO
report, it should be noted that this statement is not supported by
fact. Throughout the course of this litigation, the Court repeatedly
urged the parties to settle and assigned a magistrate judge to preside
over the proceedings. Plaintiffs would have been more than happy if SSA
had agreed to implement the worksheet and other changes suggested in
1992 by the OIG and in 1994 by the GAO. At trial, it was established
that SSA opposed the OIG and GAO suggestions regarding worksheets
because such changes were perceived by SSA to be too costly and
burdensome.
Lastly, I must bring to the Committee's attention problems with
SSA's intention to increasingly rely on the Internet as a means of
disseminating program information to SSI and SSD recipients. See
September 26, 2000 Testimony of Deputy Commissioner William Halter
regarding the Online Notice Retrieval System (ONRS). While this may
generally be a worthwhile endeavor, with respect to the SSI population,
the unstated assumption that SSI recipients are computer literate and
have ready access to computers is unfounded. To the contrary, the
technological ``digital divide'' is a tremendous obstacle to the
effective use of the ONRS. See Falling Through the Net, July 8, 1999
and revised in November 1999. The July 1999 report is available on the
Internet at http://www.ntia.doc.gov/ntiahome/fttn99/contents.html; see
also www.digitaldivide.gov. It is noted that ``[w]hile a significant
majority of Americans (58.9 percent) making over $75,000 frequent the
Internet from any location, many fewer persons (16.0 percent) at the
lower end of the payscale ($5,000$10,000) use the Internet.'' A quick
overview of this report will debunk any assumption that the poor are
computer literate and with ready access to the Internet.
Thank you again for considering these comments and for tackling
this difficult issue. Please feel free to contact me if you have any
questions regarding this letter or the status of the Ford case.
Respectfully submitted,
Christopher James Bowes
Executive Director
[An attachment is being retained in the Committee files.]
Statement of Gerald R. Tarutis, National Alliance for the Mentally Ill,
Arlington, VA
Chairman Shaw, Representative Matsui and members of the
Social Security Subcommittee, I am Gerald R. Tarutis of
Seattle, Washington. In addition to serving on the Board of the
National Alliance for the Mentally Ill (NAMI), I am also an
attorney in private practice. I am pleased to have the
opportunity to share NAMI's views regarding ongoing problems
with the Social Security Administration's letters to
beneficiaries with disabilities and their families.
In over 25 years of practicing law, I have represented many
clients with severe disabilities who have been claimants for
Social Security cash benefits. While some of my clients' cases
before Social Security were dealt with in a fair and
straightforward manner, many others found the experience of
endlessappeals, examinations and bureaucratic delays
frustrating and in many cases, humiliating. This is especially
true for adults with severe mental illnesses and other
disabilities that are not readily apparent to the staff of the
Social Security Administration (SSA) field offices.
Too many adults with severe mental illnesses, and their
families, find their dealings with the SSA on matters ranging
from appeals for denial of eligibility, to reporting wages, to
seeking a straight answer regarding an alleged overpayment to
be intimidating. Nowhere is this process more frustrating than
in trying to interpret and understand the letters that
claimants and beneficiaries receive from the agency. It would
be difficult for me to overstate the confusion and aggravation
that NAMI members feel when theyreceive important
correspondence from SSA regarding eligibility, benefit
adjustments and overpayments with conflicting and confusing
information.
For adults with serious brain disorders including
schizophrenia, manic-depression, major depression and severe
anxiety disorders both SSI and SSDI serve as a critical Federal
safety-net program that is essential to meeting the most basic
needs for food, clothing and shelter. In NAMI's view, it is
critically important that these most vulnerable Americans, and
their families, get clear information from SSA about
eligibility and benefits. The receipt of confusing or
conflicting information about eligibility and benefits canhave
disastrous consequences particularly for individuals who work
part-time under SSA's limited employment programs, i.e. 1619
for SSI beneficiaries and the trial work period (TWP) for SSDI
beneficiaries. As these programs expand under the Ticket to
Work and Work Incentives Improvement Act (P.L. 106-170), it
will be all the more important for beneficiaries to get clear
and precise information from SSA about where they stand.
In fact, TWWIIA itself points to the frustration that
individuals with disabilities have had over the years with
SSA's letters. As an aside, NAMI would like to again thank you
Chairman Shaw, and all the members of this Subcommittee on both
sides of the aisle, for your leadership in passing this
historic legislation to help adults with severe mental
illnesses and other disabilities go to work. As you know,
Congress included a provision in TWWIIA authorizing a new
``benefits counseling and assistance'' program to assist
beneficiaries in their decisions regarding employment. What is
most noteworthy about this initiative is that Congress insisted
that these benefits planning programs be independent of SSA
largely because of the low level of confidence among
beneficiaries and their families about the accuracy of the
information they receive from Social Security. While some of
this may be caused by past histories of overpayments (which too
often results from confusing or out of date information given
by SSA field office staff), it is surely also a result of
confusing and difficult to understand letters from SSA itself.
An examination of the General Accounting Office's (GAO)
recent report on SSA's longstanding problems with its letters
to the public illuminates why beneficiaries and their families
are so frustrated. GAO reviewed several categories of letters,
including those awarding and adjusting SSI benefits. In
analyzing these letters, NAMI understands that the GAO used a
team of writing consultants (including English teachers) to
assess whether the letters communicated clearly and to verify
the types of problems that regularly occur with these letters.
The GAO's findings are remarkable. The majority of the
letters in every category (including SSI eligibility and
adjustments) did not clearly communicate on at least one of the
following: 1) SSA's actual decision on the claimant's action,
2) the basis for SSA's decision, 3) the financial recourse of
SSA's decision on the beneficiary, or 4) the recourse available
to the beneficiary. Among the factors noted by GAO and their
consultants were illogically sequenced information, incomplete
or missing information, contradictory information and confusing
numerical information.
The GAO report notes that:
An unclear explanation of the basis for SSA's
decision was the most widespread problem cited by the GAO, i.e.
80 percent of sampled letters were described as unclear,
principally because the cover sheet failed to disclose all of
the decisions contained in the attachments.
100 percent of the sampled SSI award letters do
not explain the relationship between program rules and the
amount of the actual SSI benefit (86 percent of SSI benefit
adjustment letters failed to explain this as well).
More than half of the surveyed SSI benefit
adjustment letters lacked a clear statement of timing or the
amount of change in benefits.
Letters sent to SSI beneficiaries who are eligible
for a previous, but not a future, month's benefit, were unclear
in communicating all of the criteria.
A startling 95 percent of award letters for Social
Security benefits (including those to SSDI claimants) fail to
detail how to appeal the decision.
In its report, GAO noted that while SSA acknowledges many
of these problems, changes have been slow in coming. Both GAO
and SSA appear to acknowledge that comprehensive revision of
the language used in beneficiary letters is needed, as well as
an overhaul of the computer software used to generate these
letters. NAMI is hopeful that this process will be accelerated
as a result of a 1999 Federal court order for SSA to develop a
comprehensive plan to improve its SSI letters. Unfortunately,
GAO reports that SSA has ``not placed a priority on improving
its letters to the public, and it will be years before
improvements are completed to most of these letters, even if
there are no more delays and SSA adheres to its current
plans.''
Because so many people with the most severe and disabling
mental illnesses rely on SSI and SSDI for basic support to live
in the community, NAMI believes that SSA should take the steps
necessary to ensure that information regarding eligibility and
benefits is understandable. NAMI would concede that the
complicated nature of SSA's disability cash benefit programs
and their interaction with health care programs does not make
this task easy. However, the GAO report makes clear that
improving the content of letters to beneficiaries has not, this
far, been a high priority at SSA.
What needs to be done? NAMI recommends that Congress direct
the Commissioner to put in place acomprehensive plan to improve
SSI benefit award and adjustment letters. As the GAO
recommended in its report, such a system should include
performance measures that hold SSA accountable, with
specifictimetables and outcomes to assess progress.
Moreover, SSA should invest in training for field office
staff to help these officials better understand severe mental
illness and the unique challenges that they (and their
families) face in becoming eligible forSSI and SSDI. The
overriding experience of too many NAMI members is that the
stigma associated with severe mental illness, and the lack of
understanding among field office staff has served as a barrier
to getting quick, accurate and fair decision from the agency.
On August 21, SSA completed work on revised criteria for
``Evaluating Mental Disorders.'' These new criteria revise SSA
``adult neurological listings.'' SSA is now in the process of
training field office staff and State disability determination
offices on these criteria. NAMI believes that this provides a
unique opportunity for SSA to educate field office staff and
State determination agencies on how to more effectively serve
claimants and beneficiaries with severe mental illnesses.
Mr. Chairman, thank you for the opportunity to present
testimony on this important issue for NAMI's consumer and
family membership.
Statement of Charles Robert, Robert, Lerner & Robert, Rockville Centre,
NY
Thank you for the opportunity to present testimony to be
placed in the Record of the Hearing on Improving Social
Security Notices. Since the 1974 beginning of the Supplemental
Security Income (SSI) program implemented by President Nixon to
replace State welfare programs providing benefits to theaged,
blind, and disabled, I have represented SSI recipients
appealing incomprehensible SSI denial and reduction Notices.
Chairman Shaw's Opening Statement accurately highlights the
importance of the accurate and comprehensible Notices for SSI
recipients. ``The amount of their Social Security or SSI check
may be the difference between paying the monthly bills or
not.''
A. The clandestine SSA nonacquiescence policy as a root
cause of the incomprehensible SSI Notices.
In the past two decades of legal representation, almost all
of my SSI clients' appeals have included a challenge the SSA
nonacquiescence policy whereby the SSA has denied or reduced
SSI benefits because of a standard established by Executive
Branch counsel and not as established in a duly promulgated SSA
regulation. See Glasgold v. Califano, 558 F. Supp. 129 (E.D.
N.Y. 1982), aff'd sub. nom. Rothman v. Schweiker, 706 F. 2d 407
(2nd Cir. 1983), cert. den. sub. nom. Guigno v. Schweiker, 464
U.S. 984 (1983). Ruppert v. Bowen, 671 F.Supp. 151 (E.D.N.Y.
1987), aff'd in part, rev'd in part, Ruppert v. Bowen, 871 F.
2d 1172 (2d Cir. 1989), Gordon v. Shalala, 55 F. 3d 101 (2d
Cir. 1995), cert. den. 116 S. Ct. 1317 (1996).
As a result of the HHS and SSA nonacquiescence policy, the
SSA Commissioner has not equally applied SSI standards in all
50 States as intended by the Congress. This is one of the root
causes of the incomprehensible SSI Notices.
The survival of this clandestine nonacquiescence policy
into 2000, has been in large part because of the continued use
of the indecipherable SSA Notices which do not explain the
standard applied or cite to the applicable law. Over the past
decades HHS General Counsel Juan del Real, SSA Chief Counsel
Donald Gonya, and SSA General Counsel Fried knew that if they
had explained the ``nonacquiescence'' policy in the SSI
Notices, then even the legally defenseless aged, blind, and
disabled SSI recipients would have intuitively known that
something was wrong when a different standard was used to
compute monthly SSI benefits for SSI recipients who lived in
different States in a Federal program established by the
Congress to apply a uniform Federal standard.
As explained in more detail in the Sections discussing
Solicitor General Waxman's courageous decision to withdraw the
Ford appeal, the accuracy of SSA General Counsel Fried's May
22, 1997 sworn Congressional testimony, the implementation of
the Jackson nonacquiescence policy, and SSA GeneralCounsel
Fried's decision not to acquiesce to Christensen v. Harris
County, SSA General Counsel Fried has known that when an
``acquiescence'' decision was made to limit the application of
Circuit Court decision to that Circuit's States, the SSA
computer was not reprogrammed. Thus, SSA General Counsel Fried
has always cynically known that there was no practical
difference between the pre-June 3, 1985 ``nonacquiescence''
policy of HHS General Counsel del Real and the post-June 3,
1985 ``acquiescence'' policy of SSA General Counsel Fried
because other than the named litigants in an ``acquiescence''
case, the SSA Notices sent to all other similarly situated SSI
recipients within that Circuit and in all other Circuits was
the ``incorrectly'' decided Executive Branch counsel's
interpretation of the SSA statute and implementing regulations
that the unappealed Circuit Court had rejected.
When the new President appoints the new SSA Commissioner,
that new SSA Commissioner's duty will be to comply with Judge
Sifton's Ford decision and construct ``Ford'' Notices that cure
the present due process violations. The new SSA Commissioner
will have to program the SSA computer to explain the standard
that Congress intended to be applied equally in all 50 States.
If the same legal standards are applied in all 50 States, then
the new SSA Commissioner will have de facto ended SSA General
Counsel Fried's clandestine nonacquiescence policy.
If the new SSA Commissioner's staff provides him/her with
accurate information, then the new SSA Commissioner will learn
that for decades incorrect standards had been used to deny and
reduce six million SSI recipients benefits based on the legal
opinions of HHS General Counsel del Real, SSA Chief Counsel
Gonya, and SSA General Counsel Fried. If the SSA staff provide
accurate information, then the new SSA Commissioner will also
learn that these Executive Branch counsel believed that they
had the extraordinary authority to be de facto Supreme Courts
and in effect ``overrule'' Circuit Court decisions by not
changing the standards used in all 50 States. The new SSA
Commissioner will also learn that in order to prevent any case
from percolating to the Supreme Court, that these Executive
Branch counsel had made the critical litigation decisions not
to appeal what they believed to have been the ``incorrectly.''
decided District and Circuit Court decisions. See 20 C.F.R.
Sec. 416.1485 Application of Circuit Court Law. Hence, the
critical timing of this Subcommittee's Hearing prior to the
appointment of the new President's new SSA Commissioner who
will have the immediate duty to construct new SSI ``Ford''
Notices to comply with Judge Sifton's now unappealed Ford v.
Apfel certified nationwide class decision. Therefore, the
Chairman should consider raising the SSI Notice issue at the
confirmation hearing of the new President's SSA Commissioner
and inquire of the new SSA Commissioner whether he/she will be
implementing SSA General Counsel Fried's nonacquiescence policy
whereby the SSI standards have not been equally applied to six
millions aged, blind, and disabled SSI recipients.
B. Solicitor General Waxman's courageous decision to
withdraw SSA General Counsel Fried's Ford appeal
On September 11, 2000, Solicitor General Waxman
courageously withdrew SSA General Counsel Fried's Second
Circuit appeal of Judge Sifton's Ford v. Apfel, 87 F. Supp. 2d
163), decision which certified a nationwide class of SSI
recipients whose due process rights were violated because the
SSI Notices did not explain the standards applied or cite to
the applicable law. Upon information and belief, the key reason
why Solicitor General Waxman withdrew the appeal was because
Solicitor General Waxman, the ``people's lawyer'', apprehended
the impossibility of defending SSA General Counsel Fried's
clandestine nonacquiescence policy when ``Ford'' Notices would
have to explain the same standards to be applied in all 50
States and cite to the same Federal regulations duly
promulgated pursuant to the SSACommissioner's compliance with
the Administrative Procedure Act (APA).
In Ford, Judge Sifton discussed the plight of SSI
recipients who did not the reasons why the benefits were denied
by citing to Gray Panthers v. Schweiker, 652 F. 2d 146, 168-169
(D.C. Cir. 1980):
Unless a persons is adequately informed of the reasons for
the denial of a legal interest, a hearing serves no purpose--
and resembles more a scene from Kafka than a constitutional
process. Without notice of the specific reasons. . .a claimant
is reduced to guessing what evidence can or should be submitted
in response and driven to responding to every possible
argument. . .at the risk of missing the critical one
altogether. . . .Id. at 181.
Judge Sifton's harsh conclusion was based in part on SSA
Commissioner Apfel's own SSA computer experts trial testimony
which revealed the problems with the SSA computer and the
limitations in the SSI Notices that were sent to six million
legally defenseless aged, blind, and disabled citizens. That
trial testimony revealed that when an ``acquiescence'' decision
was made by Executive Branch counsel, the SSA computer was not
reprogrammed with the new ``acquiescence'' standard. As a
result, the old ``nonacquiescence'' standard continued to be
applied in all cases except for the litigants in the
``acquiescence'' case. This was not an innocent mistake of an
overburdened Federal agency with an outdated computer, but the
cold calculating intentional decision of Executive Branch
counsel to clandestinely implement a nonacquiescence policy.
See City of New York v. Bowen, 106 S. Ct. 2023 (1986).
As discussed in more detail regarding the Jackson
nonacquiescence policy, upon information and belief, Solicitor
General Waxman apprehended that the ``Ford'' Notices will have
to be constructed with explanations of the same legal standards
applied and cite to the same regulation to be equally applied
in all 50 States. If SSA General Counsel Fried's clandestine
nonacquiescence policy continues unabated, then the ``Ford''
explanation of the SSA standard and the citation to the
applicable law will result in evenmore incomprehensible Notices
as the new SSA Commissioner will have to explain General
Counsel Fried's reasons why the same standards are not to be
applied in each Circuit.
Given that the Solicitor General represents the citizens of
the United States and not the client agency, the courageous
Solicitor General Waxman has had to confront the toxic legacy
of the continuation of the pre-June 3, 1985 nonacquiescence
policy of HHS General Counsel del Real that on July 25,
1985Members of Congress had been advised had ended on June 3,
1985. Since that July 25, 1985 sworn Congressional testimony
had not been accurate, Solicitor General Waxman knew that he
could no longer ratify the clandestine implementation of the
nonacquiescence policy of HHS General Counsel del Real, SSA
Chief Counsel Gonya, and SSA General Counsel Fried when the
``Ford'' Notices were constructed and sent to six million SSI
recipients in all 50 States.
Upon information and belief, Solicitor General Waxman
apprehended that contrary to the sworn July 25, 1985
Congressional testimony, the nonacquiescence policy did not end
on June 3, 1985 because the HHS-SSA computer had not been
reprogrammed when HHS General Counsel del Real, SSA Chief
Counsel Gonya, and SSA General Counsel Fried made their
subsequent ``acquiescence'' decisions. Upon information and
belief, Solicitor General Waxman apprehended that SSA General
Counsel Fried's May 22, 1997 sworn Congressional testimony was
not accurate because the same legal standards have not been
applied at all levels of SSA adjudication. Upon information and
belief, Solicitor General Waxman has determined that AG Reno's
DOJ should end its implementation of SSA General Counsel
Fried's Constitutionally suspect ``co-ordinate Branches of
Government'' theory that Executive Branch counsel has equal
authority to the Judiciary to interpret the intent of Congress.
Thus, Solicitor General Waxman's courageous litigation
decision to withdraw SSA General Counsel Fried's Ford appeal
was based on his realization that the new ``Ford'' Notices will
have to explain the samestandard in all 50 States and cite to
the same regulatory standards that the Congress intended were
to be equally applied by the SSA Commissioner in all 50 States.
Therefore, because the Ford appeal has been withdrawn, whomever
the new President appoints as the new Attorney General, the new
AG will have to instruct the client agency to cure the due
process violations as determined by Judge Sifton in his now
unappealed Ford decision.
C. SSA General Counsel Fried's sworn May 22, 1997
Congressional testimony that the nonacquiescence policy had
ended in the June, 1985 and that the same legal standards were
applied at all levels of SSA adjudication
On May 22, 1997, Social Security Administration General
Counsel Arthur Fried testified before the Committee on
Judiciary Subcommittee on Commercial and Administrative Law and
advised Members of Congress under oath that the Social Security
Administration does acquiesce to Circuit Court decisions
andthat the nonacquiescence policy had ended in June, 1985. SSA
General Counsel Fried also testified that the same legal
standards were applied at all levels of SSA adjudication. Copy
of the May 22, 1997 sworn Congressional testimony is attached
as Exhibit A.
SSA General Counsel Fried explained the SSA
``acquiescence'' policy:
When a U.S. Circuit Court of Appeals publishes a decision on a
claim for Social Security Benefits, or Supplemental Security
Income (SSI) payments, and that decision conflicts with our
national policy, we either issue an Acquiescence Ruling, change
our national policy, or, in rare cases, seek review by the
Supreme Court. We never ignore these decisions. This has been
our policy since 1985, and the publication of our current
policies in regulations in 1990 essentially ended criticism by
the courts in this area. Emphasis Added.
General Counsel Arthur Fried testified that the
nonacquiescence policy had ended in June, 1985. This was prior
to the July 25, 1985 sworn House Subcommittee testimony of
Acting SSA Commissioner Martha Mc Steen, Deputy Attorney
General Carolyn Kuhl, and SSA General Counsel Donald Gonya
testified that the pre-June 3, 1985 nonacquiescence policy of
HHS General Counsel del Real had ceased:
This is not the first hearing before the subcommittee on
administrative law concerning this issue. Back in 1985, SSA
testified about the change in our policy from nonacquiescence
to acquiescence. Prior to that point, when a circuit court
decision was inconsistent with our interpretation of the law
and regulations, SSA's practice had been to apply the decision
only to named litigants in that particular case. In June of
1985, however, reacting to criticism in both Congress and the
courts, we announced a new policy wherein we would apply
circuit court decisions at the hearings level, following an
Acquiescence Ruling, in adjudicating claims in the circuit. No
legislation was enacted at that time. Since then, we have gone
even farther--we acquiesce to circuit court decisions at all
levels of administrative adjudication.
SSA General Counsel Arthur Fried advised how national
policy is made in collaboration with the Department of Justice
when there are no regulations promulgated pursuant to the
Administrative Procedure Act by the application of a ``careful
scrutiny'' test by ``SSA officials'' and the Office of
GeneralCounsel:
Instead, the interpretation of a circuit court's decision and
its consistency with SSA policy is appropriately made with
careful scrutiny by SSA officials who have a broad
understanding of national policy and who work closely with
Department of Justice attorneys in this effort. If an ALJ or
other decisionmaker believes that a particular circuit court
decision conflicts with SSA policy, the decisionmakers can
provide input to the Office of the General Counsel through the
appropriate channels about either appealing the case or issuing
an Acquiescence Ruling.
SSA General Counsel Arthur Fried, apparently sincerely,
emphasized that it is the Social Security Commissioner who
makes all the rules in order to have uniformity throughout the
Social Security Administration:
Nonetheless, it remains the Commissioner's responsibility
to decide what Agency rules are. This is vital in order to
maintain decisional consistency not only within a particular
adjudicatory level, but cross levels as well--a key goal in our
process unification efforts to obtain similar results in
similar cases at all levels of SSA adjudication. There is no
other way to ensure that constitutional and statutory
requirements are properly and consistently applied and that the
Agency can be held accountable for any failure to do so.
Emphasis Added.
However, then SSA General Counsel Arthur Fried admits to
the implementation of the nonacquiescence policy that occurs
when a circuit court renders its decision that conflicts with
the national policy. He advises that the Social Security
Administration does not comply with the APA and amend the
policy by rulemaking, but rather, issues an Acquiescence Ruling
regarding that particular circuit:
As I stated before, whenever any circuit court decision
conflicts with our national policy, SSA's published regulations
require us to issue an Acquiescence Ruling if we are not
changing national policy unless it is one of the rare occasion
that we appeal. It is the Agency's responsibility to tell our
decisionmakers how to implement a conflicting holding when we
do not appeal, but we do not arbitrarily reject circuit court
decisions.
Needless to say, SSA General Counsel Fried did not inform
the Members of the House Subcommittee that he knew that the SSA
computer was not reprogrammed when an ``acquiescence'' decision
was made. SSA General Counsel Fried also did not inform the
Members of the House Subcommittee that regulations were not
applied equally in all 50 States notwithstanding his
representation that the same legal standards were applied at
all levels of SSA adjudication.
The ``smoking gun'' evidence of that fact SSA General
Counsel Fried's May 22, 1997 Congressional testimony was not
accurate is found in the sworn Ford trial testimony of SSA
Commissioner Apfel's SSA computer experts and in SSA General
Counsel Fried's implementation of the April 21, 1986
``Jackson'' regulation, 20 C.F.R. Sec. 416.1130 (b) , that is
only applied in the Seventh Circuit States of Indiana,
Illinois, and Wisconsin. The Chairman should consider reading
that Ford trial testimony and the Jackson regulation to
determine for himself whether the May 22, 1997 sworn
Congressional testimony of SSA General Counsel Fried was
accurate.
D. The Jackson intra-circuit and inter-circuit nonacquiescence
policy
Perhaps, the best evidence of how the SSA Notices have been
intentionally deceptive, is SSA General Counsel Fried's
implementation of the Jackson nonacquiescence policy. Given the
Ford nationwide class, SSA Commissioner Apfel will now have to
decide whether the ``Ford'' Notices willexplain the SSI income
standard that is to be applied when an SSI recipient, who
cannot afford to pay the rent with the SSI monthly payment that
is set below the poverty level, receives a private rent subsidy
to avoid eviction. The history of the Jackson regulation
reveals the importance of compliance with the APA in order for
SSI recipients and the public be advised of the standards
applied in a national program which Congress intended to have
the uniform standards applied by SSA in all 50 States.
On January 6, 1984, fourteen years prior to the Christensen
decision, Chief Judge Sharpe in Jackson v. Heckler, 581 F.
Supp. 871 (N.D. Ind. 1984), ordered Secretary Heckler to
promulgate an SSI in-kindincome regulation in order to comply
with the Seventh Circuit's unappealed 1982 Jackson remand
order:
As an initial matter, the court will consider the parties'
dispute over whether the Secretary must amend the relevant
regulation or simply modify internal operation procedures and
manuals. The plaintiff argues that the relief mandated by the
court of appeals will be effectively implemented only if SSI
claimants and their representatives or advocates have access to
the modifications throughout the regulations found in the
Federal Register and the Code of Federal Regulations.
Otherwise, persons using the normal research tools will find
nothing but the regulation which found inadequate by the court
of appeals and will have no indication that it has been
modified. While instructions and guidelines in internal
operating manual and policy statements may be effective means
of informing social security administration personnel it is not
an effective means of informing claimants and their
representatives. There is simply no basis for assuming internal
operational manual are generally available. Furthermore, the
Secretary has not advanced any compelling reason why the
regulation should not be amended. Therefore, this court will
require and amendment to the challenged regulation. Emphasis
Added.
On July 25, 1985, Acting Commission Martha Mc Steen, DOJ
Deputy Assistant Attorney General (DAAG) Carolyn Kuhl, and SSA
Chief Counsel Donald Gonya advised a House Subcommittee
considering legislation to end the HHS nonacquiescence policy
that the nonacquiescence policy of HHS General Counsel del Real
had ended on June 3, 1985 and that Jackson was not a
``nonacquiescence case.'' They announced the establishment of a
Policy and Review Committee (PRC), that would be reviewing all
court decisions:
. . .recommend to the Commissioner which issues and cases
should be relitigated in order to obtain a definitive ruling
from the appropriate Court of Appeals of the Supreme Court. For
those cases in which relitigation is not recommended, the
Committee will address what changes, if any, in SSA policies
and procedures need to be made. Acting Commissioner Mc Steen's
June 24, 1985 Implementation of Acquiescence Policy attached as
Exhibit B.
On October 10, 1985, Judge Sharpe issued a Jackson order
requiring publication of the amendment to the SSI in-kind
income regulation to comply with the Seventh Circuit's order in
Jackson v. Schweiker, 683F. 2d 1076 (7th Cir. 1982). However,
contrary to the July 25, 1985 Congressional testimony,
Secretary Heckler limited the proposed regulation to only the
State of Indiana.
On December 3, 1985, Judge Bua in the unappealed Beckless I
v. Heckler, 622 F. Supp. 715 (D.C. Ill. 1985), certified an
Illinois class of SSI recipients and applied the Jackson to
Illinois SSI recipients:
However, it is not clear from the Jackson decision whether the
Secretary is refusing completely to comply with the Seventh
Circuit's decision. The Secretary has not issued a policy of
non-acquiescence as was done in Lopez, and without further
evidence, it is unclear whether the Secretary has failed to
perform her duties as a public official. Id. at 719. Emphasis
Added.
On March 27, 1986, based on the unappealed Jackson v.
Schweiker Seventh Circuit decision, Secretary Bowen certified a
proposed amendment to the SSI regulation, 20 C.F.R.
Sec. 416.1130. However, without explanation, Secretary Bowen
limited the regulation's application to only SSI recipients who
resided in the Seventh Circuit States of Indiana, Illinois, and
Wisconsin. See 51 FR 13487 (April 21, 1986). This limitation
was also contrary to the July 25, 1985 sworn testimony of
Acting Commissioner McSteen, DAAG Kuhl, and SSA Chief Counsel
Gonya that the pre-June 3, 1985 nonacquiescence policy had
ended and that Jackson was not a nonacquiescence case.
Because the SSA computer was not reprogrammed within the
Seventh Circuit States, a decade later the Jackson intra-
circuit nonacquiescence policy was explained in the unappealed
Beckless II v. Chater, 909 F.Supp. 575 (N.D.Ill. 1995). Judge
Bucklo noted how SSA Chief Counsel Gonya's interpretation of
Jackson had eviscerated the Seventh Circuit Jackson holding:
The defendant essentially argues that the ``Exception''
applicable to the Seventh Circuit should be read out of section
416.1130(b). Opposition def. br. 10. By its words, the
exception does not confine a business arrangement to payment of
full rent charged by a landlord. Rather, a business arrangement
exists ``when the amount of monthly rent required to be paid
equals or exceeds the presumed maximum value. . . .'' Id. at n.
4, p. 580. Emphasis Added.
Notwithstanding his sworn May 22, 1997 Congressional
testimony, SSA General Counsel Fried continued to implement the
clandestine Jackson nonacquiescence policy. In the unappealed
Ragsdale v. Apfel, 999 F. Supp. 814 (E. D. Vir. 1998), Judge
Payne echoed Judge Bua's 1985 admonishment of Secretary Heckler
in Beckless I and Judge Bucklo's 1995 admonishment of Secretary
Shalala in Beckless II, and admonished SSA Commissioner Apfel
for not to applying the Jackson standard to Virginia SSI
recipients:
This litigation need never have occurred. And, that it did,
reflects poorly on the Agency which elected not to seek review
of the decisions issued by the Second or Seventh Circuits and
then put the Ragsdales to the needless task of establishing the
obvious: that the decisions of the Second and Seventh Circuit
were correct. Citizens residing in the Fourth Circuit should
not be required needlessly to incur costs and fees in order to
achieve the rights already enjoyed by those individuals
residing in the Second and Seventh Circuit. It may be that the
Agency's conduct is not sanctionable in this case, but it must
be hoped that the Agency will not, in the future, pursue the
course which it has followed here. Id. at 824. Emphasis Added.
However, notwithstanding SSA General Counsel Fried's sworn
May 22, 1997 Congressional testimony, based on the advice of
his counsel, SSA Commissioner Apfel has continued to defy Judge
Payne's' Ragsdale admonition. Fortunately, Solicitor General
Waxman decided not to defy Judge Payne's Ragsdale admonition.
Hence, the litigation stage is now set for the new SSA
Commissioner to construct ``Ford'' Notices to be sent to SSI
recipients, like the Ragsdales, who reside in all 50 States and
will now be provided the basic due process rights of
explanations of the standards applied to deny and reduce their
benefits with the new SSA Commissioner citing to the applicable
law.
E. SSA General Counsel Fried's decision not to acquiesce to the
Supreme Court's Christensen decision
On May 1, 2000, the Supreme Court decided Christensen v.
Harris County, 120 S. Ct. 1655 (2000). Justice Thomas clarified
the Chevron deference standard:
Here, however, we confront an interpretation contained in an
opinion letter, not one arrived at after, for example, a formal
adjudication or notice-and-comment rulemaking. Interpretations
such as those in opinion letters-like interpretations contained
in policy statements, agency manuals, and enforcement
guidelines, all of which lack the force of law--do not warrant
Chevron-style deference. Id. at 1662. Emphasis added.
However, quite incredibly, SSA General Counsel Fried has
determined not to acquiesce to Justice Thomas' Christensen
decision because he does not want to cite to the duly
promulgated regulations in the ``Ford'' Notices. Rather, SSA
General Counsel intends to continue to use the multi-volumed
POMS as the ``law'' to which the ``Ford'' Notices will cite.
Upon information and belief, SSA General Counsel Fried
recommended to SSA Commissioner Apfel that the ``Ford'' Notices
inform the SSI recipients to surf the internet and to ``call
up'' the cited POMS on the work-in-progress SSA home page to
learn the reason why their SSI benefits were denied or reduced.
SSA General Counsel Fried knows that if the SSA
Commissioner acquiesces to Christensen, then this will be the
de facto end to his clandestine implementation of the SSA
nonacquiescence policy because the ``applicable law'' will be
properly promulgated regulations and not the Executive Branch
counsel created POMS. Hence, the importance of the new
President's SSA Commissioner acquiescing to Christensen when
constructing the ``Ford'' Notices and programming the SSA
computer. The Chairman now has an extraordinary October, 2000
opportunity to assist six million legally defenseless SSI
recipients by inquiring of SSA General Counsel Fried the basis
of his decision not to acquiesce to Christensen and not to
include in the ``Ford'' Notices citations to the ``law'' which
is the duly promulgated regulations. It is most respectfully
submitted that if the Chairman asks SSA General Counsel Fried
whether the proposed ``Ford'' Notice will be citing to the
``Jackson'' regulation that will be provided to the millions of
SSI recipients in all 50 States who cannot afford to pay their
rent without a private rent subsidy, then SSA General Counsel
Fried will inform the Chairman that in his legal opinion, as
Executive Branch counsel, he has the Constitutional authority
not to heed the admonition of Judge Payne in his unappealed
Ragsdale decision.
The Chairman and the Committee are now witnesses to SSA
General Counsel Fried's extraordinary expansion of HHS General
Counsel del Real's and SSA Chief Counsel Gonya's
nonacquiescence policy which they applied to District and
Circuit Court decisions. That nonacquiescence policy has now
become SSA General Counsel Fried's Constitutionally defying
policy and practice not to acquiesce to a decision of the
United States Supreme Court. Hence, the importance of this
Committee warning the new SSA Commissioner of the expectation
that the SSA Commissioner will acquiesce to Justice Thomas'
Christensen holding and in the ``Ford'' Notices cite to
applicable duly promulgated regulations.
Summary
Please excuse the harshness of the comments which have
evolved over two decades of tortuous litigation challenging the
HHS-SSA nonacquiescence policy notwithstanding the sworn
Congressional testimony that the nonacquiescence policy had
ended in June, 1985. However, as Judge Sifton has determined,
after taking trial testimony from SSA Commissioner Apfel's own
expert witnesses, SSA Commissioner Apfel's present
administration of the SSI program as to SSI recipients is a
Kafkaesque procedure whereby SSA Commissioner Apfel does not
explain in simple English the standards that he has used to
deny and reduce benefits to legally defenseless aged, blind,
and disable SSI recipients.
The present incomprehensibility of the SSA Notices is not
because of the enabling statute or duly promulgated
regulations, but rather is a result of an expansion of
Executive Branch power based on the nonacquiescence policy and
SSA General Counsel Fried's ``co-ordinate Branches of the
Government'' Constitutional theory. Thus, the seemingly simple
issue of the production of readable SSI Notices masks a more
fundamental issue of the Executive Branch not only providing
inaccurate information in sworn Congressional testimony, but
now usurping the Constitutional authority of the Supreme Court.
Hence, theimportance of this Committee's bi-partisan Report
regarding Improving Social Security Notices becoming a
Constitutional challenge to the new Congress and the new SSA
Commissioner.
Thank you for considering these comments and considering
the suggestion that the Chairman inquire of SSA General Counsel
Fried whether he has recommended to SSA Commissioner Apfel that
the SSA Commissioner should acquiesce to Christensen when the
``Ford'' Notices are constructed by citing to the duly
promulgated regulations in order that six million aged, blind,
and disabled legally defenseless citizens will understand the
Notices that result in the reduction and denial of benefits
upon which their very lives depend. SSA General Counsel Fried's
answer to the Chairman's Christensen inquiry could be an
excellent bright line standard for the new President's new SSA
Commissioner to evaluate prior to the SSA Commissioner's
confirmation hearing.
[Attachments are being retained in the Committee files.]
South Brooklyn Legal Services
New York, NY 11201
October 6, 2000
Congressman E. Clay Shaw, Jr.
Chairman, Subcommittee on Social Security
Committee of Ways and Means
A.L. Singleton, Chief of Staff
Subcommittee on Social Security
Committee of Ways and Means
U.S. House of Representatives
1102 Long worth House Office Building
5Washington, D.C. 20515
Re: Social Security Notices
Dear Congressman E. Clay Shaw, Jr., and Mr. A.L. Singleton,
In response to your September 19, 2000 notice soliciting comments,
I write to complain about a notice used by Social Security's
administrative appellate board, the Appeals Council. I am a legal
services attorney who represents indigent persons seeking Supplemental
Security Income (``SSI'') and Social Security Disability (``SSD'')
benefits. These comments are submitted on behalf of these clients.
Included as part of these clients are Mitzie Girvan and Rosa Calderon,
both of whom could not understand the Appeals Council's notice and
therefore missed their statutory deadlines with which to file their
appeals in Federal court.
The notice in question is used to deny a request for review of an
unfavorable Administrative Law Judge decision, and typically bears the
heading ``ACTION OF APPEALS COUNCIL ON REQUEST FOR REVIEW.'' (The text
of the notice is typed at pages 7-8 of these comments, while an
original copy is attached as exhibit A). The notice is impossible to
understand unless you have 15 and a half years of education (the
equivalent of three and one half years of college.) In fact, according
to a common yardstick used by courts and writers to assess the
readability of a document, a typical applicant for Supplemental
Security Income (``SSI'') or Social Security Disability (``SSD'')
benefits is better able to understand Lincoln's ``Gettysburg Address''
or the 1040 EZ tax instruction form than the contents of this notice.
The notice is sent annually to about 75,000 persons \1\ who have had
crucial Social Security and SSI benefits denied, terminated or reduced.
Congress requires that Social Security notices be written in ``simple
and clear language.'' 42 U.S.C. Sec. Sec. 405(s); 1383(o). While Social
Security is well aware that the notice is statutorily defective, See
e.g. Mosley v. Apfel, 98-CV-6652 (E.D.N.Y),\2\ it has not re-written
the notice. Accordingly, I ask that this sub-committee require Social
Security to change its Appeals Council notice.
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\1\ SSA Key Workload Indicators, Hearings--Appeals--Civil Actions,
Attorney Fees, for fiscal years 1997 and 1998 respectively reveal that
69,369 and 78,991 requests for review to the Appeals Council were
denied resulting in the issuance of the appended notice.
\2\ Mosley was a class action challenging the language in the
Appeals Council notice in question. It was dismissed as moot after the
defendant waived the 60 day time limit for the named plaintiff to seek
judicial review.
---------------------------------------------------------------------------
The Appeals Council notice at issue is not written in simple or
clear language as statutorily required. Rather it is laced with
legalese, long sentences, and difficult words. For example, when
describing a persons's right to file an appeal, the notice does not use
simple language such as ``if you want to file an appeal'' or ``if you
think this decision is wrong''. Rather, the notice states:
if you desire court review of the Administrative Judge's
Decision you may commence a civil action by filing a complaint
in the United States District Court for the judicial district
in which you reside within sixty (60) days from the date of the
receipt of this letter. . . .
(Emphasis supplied on difficult or poor word choice.)
Nor does the Appeals Council notice have any useful headings as in
the Commissioner's other notices, such as ``Your Right to Appeal'' or
``If You Disagree with the Decision.'' Nor does it give the address of
the Federal court where the appeal could be filed, or the address of a
local Social Security office (as required by 42 U.S.C.
Sec. Sec. 405(s); 1383(o)) where one could obtain instructions
regarding how and where to file an appeal in Federal court.
Further, an analysis of the word choice used in the appended
Appeals Council notice indicates that one needs 15.41 years of
education (the equivalent of three and a half years of college) to
understand itsmeaning.\3\ This means that the Appeals Council notice is
harder to understand than either Lincoln's ``Gettysburg Address'' or
the instructions to a 1040 EZ tax form.\4\
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\3\ To obtain a measure of the readability of the Appeals Council
notice, I typed the text of the notice into my computer and ran the
Grammatik program on my WordPerfect 7.0 program. The Grammatik's
analysis of the Appeals Council notice placed it at the 15.41 grade
level on the Flesch-Kincaid index for readability. Courts have used the
Flesch-Kincaid index to assess the readability of notices. Pereira v.
Shalala, 841 F. Supp. 323 (C.D. Cal. 1993).
\4\ The Grammatik's program on readability places Lincoln's
``Gettysburg Address'' at the 12.9 grade level and the 1040 EZ
instructions at the 10.5 grade level.
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Documents written for a general audience should be written at a six
to eighth grade level.\5\ Indeed, a typical SSA notice containing the
appeal rights of a person denied SSI at the initial level is written at
the nine and one half grade level.\6\ Clearly, Social Security knows
how to make a notice readable when it wants to.
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\5\ See definition of Flesch-Kincaid Grade Level, in ``help'' box
of Grammatik. Corel (WordPerfect) Corporation 1996. See also David v.
Heckler, 591 F. Supp. at 1037 (documents at 12-14th grade level ``defy
understanding by the general populace''); Pereira v. Shalala, 841 F.
Supp. at 327 (documents at 13-15th grade level ``likely to confuse and
deceive areasonable claimant'').
\6\ See September 12, 1995 notice (form SSA-L444) which scored 9.5
on the Flesch-Kincaid Grade Level. It is appended in full at the end of
these comments (pgs 8-9) and attached as exhibit B.
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The consequences of not using simple language and not providing the
address of the court house where the appeal could be filed, or a social
security office where additional information could be obtainedabout how
to file a Federal court appeal, are serious. First, if you do not file
your appeal, your case is finished and, generally, cannot be reopened.
Here, the appended Appeals Council notice does not state the
consequences of its decision or of not filing an appeal in Federal
court. Rather it vaguely states in rather difficult prose that ``your
request [for review of the Administrative Law Judge's decision] is
denied and the Administrative Law Judge's decision stands as the final
decision of the Commissioner of SocialSecurity in your case.''
Second, if you do not file your Federal court appeal on time, the
Commissioner will move to dismiss it (and generally will win, thereby
precluding any further appeal). This is true even if you filed the
appeal pro se, have a marginal education, and state you did not
understand the notice. Indeed, this happened to two of my clients, Ms.
Calderon and Ms. Girvan. Ms. Calderon, a woman with a seventh grade
education, missed her deadline to file her Federal court appeal by a
few weeks.\7\ The pro se clerk suggested that she explain why she was
late. With the aid of her daughter, she wrote that she ``was unable to
comprehend the notice given to me,'' and still Social Security sought
to dismiss her complaint as untimely. Similarly, Ms. Girvan, who reads
and writes only marginally well, filed her appeal 19 days late because
the Appeals Council notice ``didn't state where to go. I never know
[sic] where to go or who to ask.'' \8\ The Federal court judge
nevertheless dismissed Ms. Girvan's complaint.\9\
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\7\ Calderon v. Apfel, Eastern District of New York (CV-99-5157),
The Commissioner later waived its jurisdictional defense for reasons
other than it's defective notice.
\8\ Girvan v. Apfel, Eastern District of New York (CV-99-5649).
\9\ Her case is presently prending at the Court of Appeals, Second
Circuit, Girvan v. Apfel, 00-6242.
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Finally, the incomprehensibleness of the Appeals Council's notice
robs low income persons of crucial benefits that often are obtained by
appealing to Federal court.\10\ The Federal reporters are filled with
cases in which Social Security's decision denying benefits are
overturned. Indeed, a review of this office's docket for 1999 and 2000
indicates that of the 13 Federal court appeals we obtained from
litigants who appeared pro se before administrative law judges, three
were reversed for payment of benefits by Federal judges while eight
were remanded for de novo hearings.
---------------------------------------------------------------------------
\10\ The notice also deprives city and State welfare agencies of
``interim assistance'' payments that might be obtained if the applicant
appealed to Federal court and ultimately prevailed.
---------------------------------------------------------------------------
In conclusion, Social Security must change its Appeals Council
notice in order to comply with its statutory obligations that it be
written in ``simple and clear language.'' 42 U.S.C. Sec. Sec. 405(s);
1383(o). Its failure to do so results in tens of thousands of persons
failing to pursue crucial benefits to which they often are entitled.
Changing the language would not be hard. As a starter, I would change
the fifth paragraph from:
[i]f you desire a court review of the Administrative Law
Judge's decision, you may commence a civil action by filing a
complaint in the United States District Court for the judicial
district in which you reside within sixty (60) days from the
date of the receipt of this letter. . .
to
If you think this decision is wrong, you may file an appeal at
the Federal court house located at [insert address of Federal
court house]. You must go there and file the appeal soon. If
you do not go in the next 60 days your case will be over and
you will not be allowed to appeal any further. If you have
questions about this letter, you can ask for help at your local
social security office. Your local Social Security office is
located at [insert address and phone number].
Thank you for considering these comments. Please feel free to
contact me if further information is needed.
Sincerely,
Johnson M. Tyler, Esq.
SSI Unit Director
cc: Kenneth Apfel, Commissioner, Social Security Administration Arthur
Fried, Chief Counsel, Social Security Administration
Social Security Administration
Refer to: TAHB5
Office of Hearings and Appeals
SS# ###-##-###
Falls Church, VA 22041-3255
June 22, 1999
Action of Appeals Council on Request for Review
Ms. Mitzi Girvan
416 Rockaway Parkway,
Apt. 17B
Brooklyn, NY 11212
Dear Ms. Girvan,
The Appeals Council has considered the request for review of the
Administrative Law Judge's decision issued on September 22, 1997.
Social Security Administration regulations provide that the Appeals
Council will grant a request for review where: (1) there appears to be
an abuse of discretion by the Administrative Law Judge; (2) there is an
error of law; (3) the Administrative Law Judge's action, findings, or
conclusions are not supported by substantial evidence; or (4) there is
a broad policy or procedural issue which may affect the general public
interest. The regulations also provide that where new and material
evidence is submitted with the request for review, the entire record
will be evaluated and review will be granted where the Appeals Council
finds that the Administrative Law Judge's actions, findings, or
conclusion is contrary to the weight of the evidence currently of
record (20 CFR 416.1470).
The Appeals Council has concluded that there is no basis under the
above regulations for granting your request for review. Accordingly,
your request is denied and the Administrative Law Judge's decision
stands as the final decision of the Commissioner of Social Security in
your case. In reaching this conclusion, the Appeals Council has
considered the applicable statutes, regulations, and rulings in effect
as of the date of this action.
If you desire a court review of the Administrative Law Judge's
decision, you may commence a civil action by filing a complaint in the
United States District Court for the judicial district in which you
reside within sixty (60) days from the date of the receipt of this
letter. It will be presumed that this letter is received within five
(5) days after the date shown above unless a reasonable showing to the
contrary is made. The complaint should name the Commissioner of Social
Security as the defendant and should include the Social Security
number(s) shown at the top of this notice. The right to court review is
provided for in section 1631(c)(3) of the Social Security Act (42
U.S.C. 1383(c)(3)).
If you cannot file your complaint within 60 days, you may ask the
Appeals Council to extend the time in which you may begin a civil
action. However, the Council will only extend the time if you provide a
good reason for not meeting the deadline. Your reason(s) must be set
forth clearly in your request.
If a civil action is commenced, the Commissioner must be served by
sending a copy of the summons and complaint by registered or certified
mail to the General Counsel, Social Security Administration, Room 611,
Altmeyer Building, 6401 Security Boulevard, Baltimore, MD 21235. (See
rules 4(c) and (i) of the Federal Rules of Civil Procedure). In
addition, you must serve the United States Attorney for the district in
which you file your complaint and the Attorney General of the United
States, as provided in the FederalRules of Civil Procedure.
Sincerely yours,
Susan C. McNabb
Appeals Officer
Supplemental Security Income Notice
Department of Health and Human Services, Social Security
Administration.
Social Security Number:
John Doe
xxx-xx-xxxx
Brooklyn, NY 11231
Sept. 12 1995
We have determined that you cannot get supplemental security income
payments based on the claim that you filed. The attached page explains
why we decided that you are not disabled or blind. However, you may
appeal this determination if you still think you are disabled or blind.
The determination on your claim was made by an agency of the State.
It was not made by your own doctor or by other people or agencies
writing reports about you. However, any evidence they gave us was used
in making this determination. Doctors and other people in this State
agency who are trained in disability evaluation reviewed the evidence
and made the determination based on Social Security law and
regulations. The law is explained on the second page of this letter.
Your Right to Appeal
If you think we are wrong, you can ask that the determination be
looked at by a different person. This is called a reconsideration. IF
YOU WANT A RECONSIDERATION, YOU MUST ASK FOR IT WITHIN 60 DAYS FROM THE
DATE YOU RECEIVE THIS NOTICE. IF YOU WAIT MORE THAN 60 DAYS, YOU MUST
GIVE US A GOOD REASON FOR THE DELAY. Your request must be made in
writing through any Social Security office. Be sure to tell us your
name, Social Security number and why you think we are wrong. If you
cannot write to us, call a Social Security office or come in and
someone will help you. You can give us more facts to add to your file.
However, if you do not have the evidence yet, you should not wait for
it before asking for a reconsideration. You may send the evidence in
later. We will then decide your case again. You will not meet with the
person who will decide your case. Please read the enclosed leaflet for
a full explanation of your right to appeal.
There are groups that can help with your appeal. Some of these
groups may be able to give you the name of a lawyer who will help you
for free. Contact any Social Security office if you want the names of
these groups.
New Application
You have the right to file a new application any time, but filing a
new application is not the same as appealing this decision. If you
disagree with this decision and file a new application instead of
appealing you might lose some benefits, or not qualify for any
benefits. So, if you disagree with this decision you should file an
appeal within 60 days.
This determination refers only to your claim for supplemental
security income payments. You will be notified separately if you also
filed a claim for Social Security benefits.
If you have any questions, call, write, or visit, any Social
Security office. Most questions can be handled by telephone or mail. If
you visit a Social Security office, please take this notice with you.
Disability and Blindness Requirements
To get Supplemental Security Income payments:
You must be unable to work due to a medical condition which has
lasted or will last for at least 12 months in a row. The condition bust
be severe enough to keep you from working not only at your usual job,
but in any other substantial gainful work. We look at your age,
education, training and work experience when we decide whether you can
work. Children under age 18 must be found disabled based only on a
severe physical or mental condition.
Or
Your eyesight must be no better than 20/200 in the better eye with
the use of a correcting lens or your visual fields must be restricted
to 20 degrees or less.
Other Important Information
Definitions of disability are not the same in all government and
private disability programs. Government agencies must follow the laws
that apply to their own disability programs. A finding by a private
organization or other government agency that a person is disabled does
not necessarily mean that the person meets the disability requirements
of the Social Security Act.
[Additional attachments are being retained in the Committee files.]
Form SSA L444
Law Offices of Vollmer & Tanck
Uniondale, NY 11553
October 9, 2000
The Honorable E. Clay Shaw
Chairman, Subcommittee on Social Security
Committee on Ways and Means
U.S. House of Representatives
1102 Longworth House Office Building
5Washington, D.C. 20515
Dear Congressman Shaw:
Thank you for the opportunity to submit this written comment for
the hearing record on the topic of the quality and effectiveness of
Social Security notices. In your opening statement, you noted that
Social Security Administration (``SSA'') notices ``are confusing,
illogical [and] contradictory,'' and referred to ``a recent court case
[ruling] that certain [Social Security] letters are. . .
`constitutionally defective' because they violate the principles of due
process.'' I am one of the attorneys of record in that court case.
In Ford v Apfel, 87 F.Supp.2d 163 (E.D.N.Y. 1999), Robert Ford, a
disabled recipient of Supplemental Security Income (``SSI''),
challenged the constitutional adequacy of financial eligibility and
benefit notices sent by SSA to 6.5 million elderly, blind and/or
disabled SSI claimants nationwide. Mr. Ford did not challenge the
readability of the SSI notices (that is, the level of comprehension of
the language used), but rather the substantive content and accuracy of
those notices (that is, whether the notices and SSI benefit payment
amounts were based on complete information and were correctly
calculated).
I submit this letter to request that the text of the Ford decision
be included in its entirety in the record of this hearing. I also write
to provide your Subcommittee with historical information obtained
through discovery and at trial about SSA's non-compliance with SSI
notice improvement recommendations made in the 1992 and 1994 Reports of
the Office of the Inspector General of the United States Department of
Health and Human Services (``OIG'') and the United States General
Accounting Office (``GAO'').
During her testimony on September 26, 2000, Barbara D. Bovbjerg, an
Associate Director of the GAO, summarized the key findings of a newly
released GAO report which updated your Subcommittee on the extent to
which SSA adopted and/or implemented the notice improvements that OIG
and GAO recommended more than 8 years ago.
Regrettably, Ms. Bovbjerg testified that ``SSA has not made
comprehensive improvements to [SSI award notices or SSI benefit
adjustment notices] and has only recently begun developing action plans
for improving them.'' She reported that SSI award and benefit
adjustment notices still do not adequately explain the basis for the
decision, the relationship between program rules and benefit amounts,
or a decision's effect on the claimant's SSI payment precisely the same
deficiencies identified by IOG in 1992 and by GAO in 1994.
When GAO inquired why SSA had not undertaken comprehensive
corrective action over the last 8 years, Ms. Bovbjerg, citing Ford in a
footnote, reported to the Subcommittee that
. . .SSA officials told [GAO] that they postponed plans to
improve SSI award and benefit adjustment letters pending the
outcome of a recently decided court case [finding] that SSA's
letters denied [SSI] recipients due process because the letters
did not adequately explain the basis for SSA's decisions.
If this recitation of SSA's position is accurate, then SSA, having
failed to revise its SSI notices as pledged, now seeks to revise
history instead. Contrary to SSA's portrayal, the pendency of this
litigation did not postpone SSA's plans to improve its SSI notices
consonant with GAO and OIG recommendations because no such plans
existed. Nor did SSA formulate such plans when plaintiffs repeatedly
offered to settle the litigation if SSA stipulated to implement those
recommendations.
From October, 1995 through December, 1998, United States Magistrate
Steven M. Gold presided over multiple settlement conferences in a
concerted effort to avoid trial and expedite the notice modifications
that were eventually won by plaintiffs after trial. I personally
attended every settlement conference on behalf of plaintiffs.
Throughout these negotiations, plaintiffs offered to settle the case if
SSA agreed to implement the GAO and OIG recommendations.
Specifically, plaintiffs demanded that SSA include a budget
worksheet with SSI notices which summarized how the benefit amount was
calculated. Plaintiffs also sought limited textual revisions to the SSI
notices to enable SSI claimants to ascertain how their benefit amount
was determined, why their SSI applications were denied, what legal
authority supported the intended action, and how they could access and
review their case files for further information.
SSA made only two counterproposals. In March, 1997, SSA offered to
include generic notice language inviting SSI claimants to ``contact
[SSA]. . .if you have any questions about how [SSA] made these
decisions [or] to review [SSA] records with you.'' This fell far short
of the GAO and OIG recommendations and was rejected by plaintiffs.
In February, 1997, SSA agreed to include boilerplate notice
language which recited that the SSI claimant had the right to review
and obtain free copies of his/her SSA records, but rejected every other
notice modification because ``SSA is virtually unable to produce
routine notices with the amount and type of information which plaintiff
seeks.'' Again, this fell far short of GAO and OIG recommendations and
was rejected by plaintiffs.
SSA never engaged in serious settlement discussions to implement
the GAO and OIG recommendations. Had they done so, the matter could
have been resolved at any point in time from the 1994 filing of this
litigation through the entry of final judgment after trial in January,
2000.
By Judgment and Order dated January 13, 2000, the Honorable Chief
Judge Charles P. Sifton directed SSA to
. . .expeditiously prepare and implement a plan. . .that
modifies [SSA's] automated SSI financial eligibility notices so
as to provide information required in order to understand the
reasons for the award, modification, termination or denial of
SSI benefits in such detail as is necessary to permit a
reasonable person to understand the basis for the agency's
action. . .
The Court directed SSA to implement an array of notice
modifications so SSI claimants could obtain ``information and
explanation'' about their living arrangement category (a key factor in
computing the actual monthly SSI benefit payment), permissible resource
levels, the right to review case files and the legal authority for the
intended action. Reflecting the import of the OIG and GAO reports that
were introduced at trial, Chief Judge Sifton also ordered SSA to
include ``benefit computations in worksheetform.''
The Court retained jurisdiction for the purpose of enforcing
compliance, and directed SSA to submit an implementation plan with its
time line for the completion of the notice modifications within 120
days and to update the Court on progress every successive 120 days
until implementation was complete.
In her testimony, Ms. Bovbjerg stated that ``SSA plans to add the
[budget] worksheet to the SSI [notices] by July 2002,'' but ``SSA
officials estimated that it could take 10 years to implement the full
range of planned improvements.'' If SSA is permitted to proceed at its
present pace, it will take longer for SSA to implement SSI notice
improvements than it took NASA to land men on the moon.
The addition of another decade to SSA's timeline hardly constitutes
``expeditious'' implementation, and is especially troubling given SSA's
historical propensity to pledge one thing and do another.
In September, 1992, OIG recommended that SSA
. . .include a worksheet with all award and postentitlement
[SSI] notices. This worksheet should itemize the gross payment,
all deductions, the net payment amount, and the payment
date.\1\
\1\ See ``Office of Inspector General's Clarity of Supplemental
Security Income Notices, September 1992,'' page 11.
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In her written response to OIG's recommendations, Gwendolyn King,
then-Commissioner of SSA, assured OIG that SSA would ``take the
suggestions into consideration. . .when we revise our notices [and]
determine whether certain of the suggestions are technically
feasible.'' \2\
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\2\ See ``Office of the Inspector General's Examples of revised
Supplemental Security Income Notices, September, 1992,'' page A-4.
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Despite the former Commissioner's pledge to assess ``technical
feasibility,'' plaintiffs established at trial that the worksheet
recommendation was never brought to the attention of Charles Wood,
SSA's Associate Commissioner of the Office of Systems Design and
Development, George Schmittle, SSA's computer expert in charge of SSI
notices, or Lorna Leigh, defendant's computer specialist in charge of
SSI computational software. Ford, 87 F.Supp.2d at 171-172.
In 1994, Joseph F. Delfico, then-Director of the GAO, testified
before this very Subcommittee that
. . .GAO selected and read over 500 [notices] to get a sense of
how easy or difficult they were to understand. GAO staff with
an accounting background and years of Social Security program
knowledge had difficulty determining or verifying specific
points contained in the [notices].\3\
\3\ Social Security Administration: Many Letters Difficult to
Understand (GAO/T-HEHS-94-126, March 22, 1994).
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In its findings, GAO reported that
. . .the purpose of [the notices is] not being clearly stated,
no information [is provided] on dollar amounts used by SSA to
adjust payments,. . .and the reader must] perform complex
analyses to reconstruct adjustments to benefits.
At trial, Nancy Lloyd, SSA's program analyst in charge of
operational aspects of the SSI program, testified that SSA decided to
reject GAO's recommended inclusion of a budget worksheet with SSI
notices because ``it was found to be too costly and too burdensome on
[SSA].'' Donna Goon, a member of SSA's notice clearance and review
staff, testified that SSA considered GAO's conclusions, but took no
action to redress the problems identified by GAO. Instead, SSA made a
policy decision to suspend improvements to SSI notices while SSA
devoted its computer resources to other matters. Ford, 87F.Supp.2d at
171-172.
Although SSA now claims that implementation of the requisite notice
improvements will require another decade, Charles Wood, SSA's Associate
Commissioner of the Office of Systems Design and Development, and Lorna
Leigh, defendant's computer specialist in charge of SSI computational
software, both testified at trial the GAO's proposed budget worksheet
would could be ``designed and debugged'' within six months.
Commissioner Wood also testified that implementation of all forms of
plaintiffs' relief (notice textual changes and budget worksheet) would
take just two years under current staffing levels that assign just 13
computer programmers to format and produce all SSI notices. Ford, 87
F.Supp.2d at 163, 183. With the addition of additional staff, the
requisite notice improvements could doubtless be completed in less than
2 years.
Despite the urgings of the OIG, GAO and a Federal court, SSA
continues to balk at implementation of the requisite SSI notice
improvements. Consider, for example, SSA's response to the inclusion of
appropriate legal citation in the text of its SSI notices.
Among his fact findings, Chief Judge Charles P. Sifton noted in
Ford that SSI notices
. . .fail to identify the provision of Federal law, Federal
regulation or [SSA policy material] that has been applied to
make determinations to grant or deny, change or terminate
benefits. Without reference to such authorities (and most often
without other legal assistance), plaintiffs are deprived of any
meaningful way of correcting legal error by consulting such
legal texts as may be available in public libraries, regional
SSA offices or elsewhere. Ford, 87 F.Supp.2d at 180-181.
In its current implementation plan, SSA intends to ``provide
information regarding legal authorities via the Internet'' in lieu of
inclusion of specific citation within the body of the SSI notices
themselves. Instead, SSA intends to develop notice language ``referring
the SSI individual to the website.''
According to the National Telecommunications and Information
Administration of the United States Department of Commerce, there is a
growing ``digital divide'' that deprives low income households of
internet access.\4\ According to that agency, only 6.1 percent of
households with annual income equivalent to SSI income levels had
internet access.\5\ Our nation's SSI population surely fall on the
wrong end of this digital divide.
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\4\ See Falling Through the Net, a Report of the National
Telecommunications and Information Administration of the United States
Department of Commerce dated July 8, 1999, which is available via the
internet at http.ntia.doc.gov/ntiahome/fttn99/contents.html.
\5\ Id. at page 15, ChartI-21.
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In December, 1999, SSA provided SSI benefits to 6.5 million
claimants nationwide.\6\ One in three is over age 65, and one in six is
over age 75 \7\. One in every three suffer suffers from mental
retardation orsome other mental disorder.\8\ While disability can also
be a barrier to understanding written notices, Internet access also
requires not only reading and comprehension skills, but a set of
``computer literacy'' skills. Poverty, marginal education, blindness,
mental impairments and advanced age surely impede Internet access for
this vulnerable, low-income population. It is difficult to envision a
classification of persons less suited to rely on the Internet than SSI
claimants.
---------------------------------------------------------------------------
\6\ See 1999 SSI Annual Statistical Report of the Social Security
Administration, page 11.
\7\ Id. at page 11, 32.
\8\ Id. at page 36.
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Although the Court in Ford retained jurisdiction to oversee the
implementation of SSA's notice improvements, courts are generally
reluctant to micromanage the internal operations of a government
agency. That supervisory function is reserved to the executive and
legislative branches of government.
In your opening statement, you expressed extreme disappointment
that SSA had made little or no progress in improving its notices
despite the agency's repeated pledges to make improvements. You
correctly noted that SSA simply must accelerate corrective actions
``before millions of baby boomers reach their peak disability years.''
I urge the Subcommittee to use its influence to encourage SSA to
implement GAO's recommendations with all deliberate speed.
In a slightly different context, former President Ronald Reagan
once noted that it is important to ``trust, but verify.'' I
respectfully submit that it is time for your Subcommittee to schedule
annual hearings on this very important issue in order to verify that
SSA does its utmost to implement these long-overdue notice improvements
on behalf of our nation's most vulnerable constituency.
Respectfully submitted,
Peter Vollmer, Esq.
-