[House Hearing, 109 Congress]
[From the U.S. Government Publishing Office]
SOCIAL SECURITY SERVICE DELIVERY CHALLENGES
=======================================================================
HEARING
before the
SUBCOMMITTEE ON SOCIAL SECURITY
of the
COMMITTEE ON WAYS AND MEANS
U.S. HOUSE OF REPRESENTATIVES
ONE HUNDRED NINTH CONGRESS
SECOND SESSION
__________
MAY 11, 2006
__________
Serial No. 109-64
__________
Printed for the use of the Committee on Ways and Means
U.S. GOVERNMENT PRINTING OFFICE
30-446 WASHINGTON : 2006
------------------------------------------------------------------
For sale by Superintendent of Documents, U.S. Government Printing
Office Internet: bookstore.gpo.gov Phone: toll free (866) 512-1800;
DC area (202) 512-1800 Fax: (202) 512-2250. Mail: Stop SSOP,
Washington, DC 20402-0001
COMMITTEE ON WAYS AND MEANS
BILL THOMAS, California, Chairman
E. CLAY SHAW, JR., Florida CHARLES B. RANGEL, New York
NANCY L. JOHNSON, Connecticut FORTNEY PETE STARK, California
WALLY HERGER, California SANDER M. LEVIN, Michigan
JIM MCCRERY, Louisiana BENJAMIN L. CARDIN, Maryland
DAVE CAMP, Michigan JIM MCDERMOTT, Washington
JIM RAMSTAD, Minnesota JOHN LEWIS, Georgia
JIM NUSSLE, Iowa RICHARD E. NEAL, Massachusetts
SAM JOHNSON, Texas MICHAEL R. MCNULTY, New York
PHIL ENGLISH, Pennsylvania WILLIAM J. JEFFERSON, Louisiana
J.D. HAYWORTH, Arizona JOHN S. TANNER, Tennessee
JERRY WELLER, Illinois XAVIER BECERRA, California
KENNY C. HULSHOF, Missouri LLOYD DOGGETT, Texas
RON LEWIS, Kentucky EARL POMEROY, North Dakota
MARK FOLEY, Florida STEPHANIE TUBBS JONES, Ohio
KEVIN BRADY, Texas MIKE THOMPSON, California
THOMAS M. REYNOLDS, New York JOHN B. LARSON, Connecticut
PAUL RYAN, Wisconsin RAHM EMANUEL, Illinois
ERIC CANTOR, Virginia
JOHN LINDER, Georgia
BOB BEAUPREZ, Colorado
MELISSA A. HART, Pennsylvania
CHRIS CHOCOLA, Indiana
DEVIN NUNES, California
Allison H. Giles, Chief of Staff
Janice Mays, Minority Chief Counsel
______
SUBCOMMITTEE ON SOCIAL SECURITY
JIM MCCRERY, Louisiana, Chairman
E. CLAY SHAW JR., Florida SANDER M. LEVIN, Michigan
SAM JOHNSON, Texas EARL POMEROY, North Dakota
J.D. HAYWORTH, Arizona XAVIER BECERRA, California
KENNY C. HULSHOF, Missouri STEPHANIE TUBBS JONES, Ohio
RON LEWIS, Kentucky RICHARD E. NEAL, Massachusetts
KEVIN BRADY, Texas
PAUL RYAN, Wisconsin
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 May 4, 2006 announcing the hearing................... 2
WITNESS
The Honorable Jo Anne B. Barnhart, Commissioner, Social Security
Administration................................................. 5
SUBMISSIONS FOR THE RECORD
American Federation of Government Employees, Social Security
General Committee, and National Council of Social Security
Administration Field Operations Locals, Witold Skwierczynski,
statement...................................................... 28
Consortium for Citizens with Disabilities Social Security Task
Force, statement............................................... 37
Michael Steinberg and Associates, Michael A. Steinberg, Tampa,
FL, statement.................................................. 42
National Association of Disability Examiners, Shari Bratt,
Lincoln, NE, statement......................................... 43
National Council of Social Security Management Associations Inc.,
Richard E. Warsinskey, statement............................... 48
National Council on Disability, statement........................ 52
Social Security Advisory Board, Hal Daub, statement.............. 58
Social Security Disability Coalition, Rochester, NY, statement... 61
SOCIAL SECURITY SERVICE DELIVERY CHALLENGES
----------
THURSDAY, MAY 11, 2006
U.S. House of Representatives,
Committee on Ways and Means,
Subcommittee on Social Security,
Washington, DC.
The Subcommittee met, pursuant to notice, at 10:01 a.m., in
room B-318, Rayburn House Office Building, Hon. Jim McCrery
(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
May 04, 2006
No. SS-15
McCrery Announces Hearing on
Social Security Service Delivery Challenges
Congressman Jim McCrery, (R-LA), Chairman, Subcommittee on Social
Security of the Committee on Ways and Means, today announced that the
Subcommittee will hold a hearing on service delivery challenges facing
the Social Security Administration (SSA). The hearing will take place
on Thursday, May 11, 2006, in room B-318 Rayburn House Office Building,
beginning at 10:00 a.m.
In view of the limited time available to hear witnesses, oral
testimony at this hearing will be from invited witnesses only. However,
any individual or organization not scheduled for an oral appearance may
submit a written statement for consideration by the Subcommittee and
for inclusion in the printed record of the hearing.
BACKGROUND:
The SSA's work affects the lives of most Americans. Based on the
President's budget request, in fiscal year (FY) 2007, the SSA will
provide more than 54 million people with monthly cash benefits totaling
approximately $614 billion. In addition to paying benefits, the
agency's employees will process more than 6.7 million claims for
benefits, make decisions on more than 575,000 hearings and process
nearly 245,000 Medicare Part D low income subsidy applications. They
will also process 265 million earnings reports for crediting to
workers' earnings records, issue 18 million new and replacement Social
Security cards, and handle 59 million transactions through their 800-
number. The SSA will also serve 42 million visitors to field offices,
issue 142 million Social Security Statements, and conduct 1.6 million
continuing disability reviews and more than one million non-disability
Supplemental Security Income (SSI) redeterminations.
In addition to processing their core workloads, the SSA has an
impressive record of recent accomplishments towards improving service
to the public. For example, the agency improved its productivity by
nearly 13 percent since 2001 and completed the initial rollout of its
electronic disability folder system. The agency also sent 19 million
applications to individuals potentially eligible for extra help with
prescription drug costs, implemented a free service for employers to
verify Social Security numbers (SSNs) of employees, and issued more
than 73,000 immediate payments to displaced evacuees in the aftermath
of the Gulf Coast hurricanes.
Despite these accomplishments, the agency faces a number of service
delivery challenges, including the following: increased workloads
resulting from the leading edge of the baby boom that will reach early
retirement age in 2008, workloads associated with taking income subsidy
applications under the Medicare Modernization Act (P.L. 108-173), and
processing additional documentation for those applying for SSNs and
cards as required under the Intelligence Reform and Terrorism
Prevention Act (P.L. 108-458).
Also, due to current budget constraints, the agency has not made
progress in reducing its pending initial disability determination and
hearing workloads, and has limited the processing of workloads aimed at
ensuring program integrity and facilitating return to work. Finally,
according to an SSA study, 22 percent of agency employees became
eligible for retirement in 2005, and 56 percent of employees will be
eligible to retire in 2014.
For FY 2007, the President's budget requests $9.6 billion for the
administrative expenses of the SSA, which equals less than 2 percent of
total estimated outlays. The request would be an increase of 4.2
percent from last year. According to the SSA, the President's budget
provides adequate resources for the agency to make progress in
addressing objectives under Commissioner Barnhart's four strategic
goals--Service, Stewardship, Solvency, and Staff. These objectives
include reducing overall disability processing time through process and
automation improvements, strengthening opportunities for the public to
conduct business with the SSA electronically, reducing erroneous
payments and collecting related debt, while continuing productivity
improvements.
In announcing the hearing, Chairman McCrery stated, ``Despite
growing workloads and a number of service delivery challenges,
including assisting the victims of the Gulf Coast hurricanes, the
employees of the Social Security Administration press on, doing
everything they can to effectively serve our Nation's seniors,
individuals with disabilities, and their families. The costs of
providing these services are paid for by the hard-earned wages of
American workers, and these workers expect and deserve responsive
service. This hearing will highlight the degree to which that service
is achieved, and at what cost.''
FOCUS OF THE HEARING:
The Subcommittee will examine the current service delivery
challenges facing the SSA and how the President's budget request will
help address those challenges.
DETAILS FOR SUBMISSION OF WRITTEN COMMENTS:
Please Note: Any person(s) and/or organization(s) wishing to submit
for the hearing record must follow the appropriate link on the hearing
page of the Committee website and complete the informational forms.
From the Committee homepage, http://waysandmeans.house.gov, select
``109th Congress'' from the menu entitled, ``Hearing Archives'' (http:/
/waysandmeans.house.gov/Hearings.asp?congress=17). Select the hearing
for which you would like to submit, and click on the link entitled,
``Click here to provide a submission for the record.'' Once you have
followed the online instructions, completing all informational forms
and clicking ``submit'' on the final page, an email will be sent to the
address which you supply confirming your interest in providing a
submission for the record. You MUST REPLY to the email and ATTACH your
submission as a Word or WordPerfect document, in compliance with the
formatting requirements listed below, by close of business Thursday,
May 25, 2006. Finally, please note that due to the change in House mail
policy, the U.S. Capitol Police will refuse sealed-package deliveries
to all House Office Buildings. For questions, or if you encounter
technical problems, please call (202) 225-1721.
FORMATTING REQUIREMENTS:
The Committee relies on electronic submissions for printing the
official hearing record. As always, submissions will be included in the
record according to the discretion of the Committee. The Committee will
not alter the content of your submission, but we reserve the right to
format it according to our guidelines. Any submission provided to the
Committee by a witness, any supplementary materials submitted for the
printed record, and any written comments in response to a request for
written comments must conform to the guidelines listed below. Any
submission or supplementary item not in compliance with these
guidelines will not be printed, but will be maintained in the Committee
files for review and use by the Committee.
1. All submissions and supplementary materials must be provided in
Word or WordPerfect format and MUST NOT exceed a total of 10 pages,
including attachments. Witnesses and submitters are advised that the
Committee relies on electronic submissions for printing the official
hearing record.
2. Copies of whole documents submitted as exhibit material will not
be accepted for printing. Instead, exhibit material should be
referenced and quoted or paraphrased. All exhibit material not meeting
these specifications will be maintained in the Committee files for
review and use by the Committee.
3. All submissions must include a list of all clients, persons,
and/or organizations on whose behalf the witness appears. A
supplemental sheet must accompany each submission listing the name,
company, address, telephone and fax numbers of each witness.
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
accommodation needs in general (including availability of Committee
materials in alternative formats) may be directed to the Committee as
noted above.
Chairman MCCRERY. Good morning, everyone. Today, we welcome
once again to our Subcommittee the Commissioner of Social
Security Jo Anne Barnhart, to review the service delivery
challenges facing the Social Security Administration (SSA).
Some of these challenges, as we know, are predictable, such as
the increased workloads resulting from the aging of our
generation, the baby boomers, which I am not in, who will begin
retiring in 2008. In fact, the expected retirements by the
agency's own baby boomer employees, which will pose another
problem.
Some new challenges, such as Medicare Part D increases the
workload the Agency is responsible for administering. Some
challenges are not expected, such as last year's Gulf Coast
hurricanes, where caring and compassionate Agency employees
provided needed help, including issuing nearly 74,000 immediate
benefit payments to those who could not return to their homes.
No matter what the challenge, as we will hear today, the
hard-working employees of the SSA have done their best to
respond.
Fortunately, the President's commitment to the Agency is
clear, as reflected in his budget request. For Fiscal Year (FY)
2007, the President requested $9.6 billion for the Agency to
deliver its essential services. This reflects an increase of
3.1 percent from last year, among the highest increase for all
Federal agencies, excluding the Departments of Defense and
Homeland Security.
One reason for this increase is the agency's impressive
strides in productivity. Earlier this year the President's
Office of Management and Budget (OMB) cited the SSA as a well-
managed Agency that uses technological and program design
changes to improve productivity annually.
In the past few years the Commissioner has fulfilled a
promise not to accept the status quo. Among her leadership
achievements, the transition from a paper to an electronic
disability folder has been accelerated, and an improved
disability determination process is now moving to
implementation. For employers, the Agency now provides an
important free service to verify the name and Social Security
numbers (SSNs) of employees and new hires.
Social Security affects the lives of nearly all Americans.
Wage earners and their families, beneficiaries, and employers
all have a stake in the success of the SSA, and their hard-
earned wages directly support the costs of running this
essential Agency.
Today, we will learn how the SSA will meet the challenge to
give all Americans the service we expect and deserve. Mr.
Levin.
Mr. LEVIN. Thank you very much, Commissioner Barnhart. Over
the past year the American people have reminded us how
deeply they value Social Security's guaranteed benefits for
retirees, disabled workers and families. I am pleased to be
here to discuss the challenges Social Security faces in
delivering all these kinds of benefits quickly and accurately.
To briefly state the obvious, there is a direct connection
between resources and the SSA's ability to do its work.
Unfortunately, Congress and the President both have
consistently short-changed SSA's administrative budget in
recent years. This year, for example, the President's budget
request is not enough. Inadequate funding means not enough
workers to do the work, and that means longer waiting times for
disabled workers to get benefits.
In recent years, as we know, Social Security has also had
to take on substantial new work. For example, the start of
enrollment for the new Medicare drug insurance program confused
and sometimes overwhelmed seniors, who deluged SSA with phone
calls, forcing the Agency to use much of their overtime budget
to answer the phones.
May 15, 2006 is the deadline for regular enrollment in the
drug program and also the lock-in date for those who have not
enrolled. As seniors who are locked into plans begin to enter
coverage that was not perhaps fully explained, it is likely
that SSA may again meet the increased costs.
I look forward to hearing from you, Commissioner, about the
impact of past and future budget decisions and the
administration's ability to deal with the challenges we face.
Because Social Security's effectiveness is so critical, I hope
also that we can continue to explore these issues, and in the
future we may also be able to discuss them with Social Security
employees and customers who deal with these challenges on a
daily basis. Thank you.
Chairman MCCRERY. Thank you, Mr. Levin. Ms. Barnhart, you
can proceed with your oral testimony. Your written testimony
will be included in the record in its entirety.
STATEMENT OF JO ANNE B. BARNHART, COMMISSIONER OF SOCIAL
SECURITY
Ms. BARNHART. In the interest of time, I am going to hit
the highlights, Mr. Chairman. I really want to thank you and
the Subcommittee for inviting me here to discuss the service
delivery challenges facing the SSA. I always look forward to
appearing before this Subcommittee.
Much has changed in the world and at SSA since my term
began more than 4 years ago, but the core mission of the Agency
remains the same, and that is giving the American people the
high-quality service that they expect and deserve.
In recent years, although at SSA we have enjoyed strong
support from this Subcommittee, as was pointed out in Mr.
Levin's opening comments, the Congress has appropriated less
for SSA than called for in the President's budget requests. As
Commissioner of Social Security, I believe my primary
responsibility is to ensure that benefits are paid as timely as
possible, and this means that workloads such as processing
retirement and disability claims have priority over other
workloads, including stewardship activities such as continuing
disability reviews and Continuing Disability Reviews (CDR)
and Supplemental Security Income (SSI) nonmedical
redeterminations.
At SSA our responsibilities are great, and I believe our
mission is critical. In FY 2007 our employees will process over
6.7 million claims for benefits, almost 245,000 Medicare Part D
low-income subsidy applications; will make decisions on over
575,000 hearings; issue 18 million new and replacement Social
Security cards; process 265 million earnings items for workers'
earnings records; handle approximately 59 million transactions
through our 800 number; serve 42 million visitors to our field
offices; process millions of actions to keep beneficiary
records current and accurate; and conduct 1.6 million CDRs and
over 1 million nondisability SSI redeterminations. Mr.
Chairman, we will do all this for less than 2 percent of the
total Social Security annual budget.
As I have said often, and as you noted in your opening
statement, I did not accept this position to manage the status
quo. Nowhere was the need for change more apparent than in the
disability program, and therefore, from the outset of my
tenure, I made disability claimants a priority, especially the
successful development and implementation of the electronic
disability process, (eDib).
I am really proud that the medical information that we have
captured electronically since we began eDib in 2004 in the
State of Mississippi already is the world's largest repository
of electronic medical records, with over 34 million records,
and that is growing as we sit here this morning.
The implementation of electronic disability is important
for improving service and efficiency, but also was important
because it was a necessary prerequisite to the successful
implementation of process changes that I believe will
significantly improve the disability determination process. To
that end, as this Committee well knows, we developed the
regulations after a long and comprehensive outreach process to
all groups involved in every step of the disability
determination process. In response to the Notice of Proposed
Rule Making (NPRM), we received close to 900 comments, it was
actually 883, and those comments offered insight on the process
from every perspective and vantage point throughout the system.
In drafting the final rule, we were aware that, although
there was broad agreement on the fact that we needed change in
the disability program, numerous groups including this
Committee perceived our proposed rules as favoring
administrative efficiency over fairness, and that view was, as
I say, underscore here in the hearing that I appeared at last
fall. I want to assure you that was not our intent, and I
believe the final rule contains a significant number of changes
which we think underscores our commitment to serve the public
who depend on us.
At SSA we are committed to technology and innovation, but
we also believe that our devoted employees are the heart of our
success. Our most critical asset in continuing to maintain a
high level of services is the excellence of our work force, and
we currently have almost 65,000 full-time and part-time
permanent employees. We expect just over 40 percent of our work
force is going to be retiring by 2014.
Over the past 5 fiscal years alone, we have hired
approximately 18,350 permanent employees, and we focused on
equal opportunities for all, including minorities and women.
Currently, almost 37 percent of our claims representatives have
been in the position for less than 3 years, and at the other
end of the scale, 555 employees are reaching 40 years of
service this year, and we expect 745 employees to reach that
40-year milestone next year.
In the interest of time, I am not going to go into detail
about new responsibilities and workloads that the Chairman
referenced under the Medicare Modernization Act (P.L. 108-173).
I know this Subcommittee has been following our activity very
closely. I would like to say that I am proud of our Agency's
performance in meeting the responsibilities that we have for
the new prescription drug program and specifically the low-
income subsidy. I assure you also that we are on target to meet
our responsibilities for changes in the part B premium
structure for high-income beneficiaries.
Also, among the challenges facing us is one arising from
new verification requirements. These changes are in response to
requirements in the Intelligence Reform and Terrorism
Prevention Act (P.L. 108-458)and they have led to increased
traffic in field offices because some individuals have made
second or multiple trips in order to present the documents they
need to do business with us to receive a Social Security card.
Finally, as you know well, Congress is in the process of
considering changes in immigration policies that could require
additional verification processes or make other changes to the
way that we do business. I would hope that consideration of
such proposals takes into account the time and the resources
that Social Security would need to ensure that workers would
not have to wait lengthy periods after being hired because of
delays in the verification process.
In closing, Mr. Chairman, I want to thank you, Mr. Levin,
and the other Members of the Subcommittee for your unflagging
support for this Agency in order to meet the challenges that I
have described and continue to provide the kind of service I
know your constituents expect and deserve.
At this time I will be happy to try and answer any
questions that you or other Members may have.
[The prepared statement of Ms. Barnhart follows:]
Statement of The Honorable Jo Anne B. Barnhart, Commissioner, Social
Security Administration
Mr. Chairman and members of the Subcommittee, I am pleased to be
here today to discuss the Social Security Administration's service
delivery challenges. I appreciate the Subcommittee's interest in and
support of SSA in the past, and I look forward to continuing to work
with you. I want to thank you for holding this hearing and giving me
the opportunity to tell you of our accomplishments, our plans for the
future, and our budgetary needs.
The President's FY 2007 administrative budget request for $9.496
billion for SSA would provide the resources to allow SSA to maintain
service and fulfill new responsibilities, some of which I will outline
today. In recent years, although we at SSA have enjoyed strong support
from this subcommittee, the Congress has appropriated less for SSA than
called for in the President's budget requests. Consequently, I have
been faced this year, as last year, with the dilemma of determining
where among our workloads I should cut back resources from the
originally planned levels. As Commissioner of Social Security, I
believe my primary responsibility is to ensure that benefits are paid
as timely as possible.
This means that workloads such as processing retirement and
disability claims have priority over other workloads including
stewardship activities such as continuing disability reviews and SSI
non-medical re-determinations.
Mr. Chairman, we at SSA have been tasked with new and non-
traditional workloads through new legislation which I will discuss
later in my testimony. Managing these new workloads, such as our duties
under the Intelligence Reform and Terrorism Prevention Act and the
Medicare Modernization Act, in a way that does not erode our ability to
carry out our core mission, is a challenge, especially in a world of
tighter resource constraints.
In FY 2007, we will process over 6.7 million claims for benefits;
process almost 245,000 Medicare Part D low income subsidy applications;
make decisions on over 575,000 hearings; issue 18 million new and
replacement Social Security cards; process 265 million earnings items
for workers' earnings records; handle approximately 59 million
transactions through SSA's 800-number; serve 42 million visitors to our
field offices; process millions of actions to keep beneficiary and
recipient records current and accurate; and conduct 1.6 million
continuing disability reviews (CDR) and over 1 million non-disability
Supplemental Security Income (SSI) re-determinations.
First, I will discuss where we are in terms of delivering our
traditional services.
Service
As I have said many times, I did not accept the position of
Commissioner of Social Security to manage the status quo, and as you
know, I have made improving service to our disability claimants a
priority.
We have taken significant steps toward that end--especially the
successful development and implementation of the electronic disability
process, or eDib.
As you know, Disability Determination Services (DDS) are the state
agencies that make initial determinations for Social Security and SSI
disability claims. Already, the electronic claims folder is being used
in all 50 DDSs, and 92 percent of DDS staff adjudicate cases in an
electronic environment. I am proud that the medical information we
capture electronically is already the world's largest repository of
electronic medical records, with over 36.5 million records.
I want to assure you that we are monitoring the implementation of
eDib carefully. We have developed a certification process, called the
Independence Day Assessment (IDA) certification, to determine when each
State is ready to use eDib exclusively as the official Agency record.
We assess the electronic business process and evaluate the system
performance. IDA is an important quality assurance initiative that
accurately measures eDib rollout progress while allowing for the unique
characteristics of each State's disability determination
infrastructure, population, and demographics. The electronic claims
folder is the official Agency record for new disability claims in 37
States and the remainder will be IDA certified by the end of calendar
2006.
Let me share with you a real-life story that makes obvious the
necessity of eDib. In the aftermath of Hurricane Katrina--while issuing
more than 73,000 immediate benefits payments for displaced persons and
setting up response units at the Houston Astrodome and other evacuation
centers--SSA provided further relief. Of the 5,000 cases in the New
Orleans Disability Determination Services, 1,500 had already been
stored electronically through eDib. These records were immediately
transferred to other offices to be processed. Ultimately, we gained
access to the building, packed the remaining 3500 folders in 400 boxes
and carted those down six flights of stairs by flashlight. But thanks
to eDib, there was no delay in processing those 1,500 cases.
The implementation of eDib is important in and of itself to
improving service and efficiency, but it is also a vital precursor to
the successful implementation of process changes that I believe will
significantly improve the disability determination process. On March
31, 2006, we published in the Federal Register final rules to implement
our plan for Disability Service Improvement, which will improve our
ability to make the right decisions as early in the process as
possible.
The rules were developed after a long and comprehensive outreach to
all groups involved at every step of the disability determination
process. We listened to interested parties and groups in both the
government and private sector, and to the claimants and beneficiaries
who rely on us to provide the best possible service. I personally
participated in more than 100 meetings with almost 60 groups, and we
received hundreds of informal comments and suggestions. Throughout this
dialogue, the professionalism and serious manner in which concerned
groups and individual citizens provided their thoughts and ideas
constantly impressed upon me the need to improve the process.
It was only after laying this firm foundation that we drafted the
notice of proposed rulemaking (NPRM) that was published last summer on
July 27, 2005. In response to the NPRM, we received close to 900
comments. They offered insight on the process from every perspective
and vantage point.
In drafting the final rule we were aware that, although there was
broad agreement on the need for change, numerous groups perceived our
proposed rule as favoring administrative efficiency over fairness. That
view was underscored by this subcommittee. Let me assure you that was
not our intent. The final rule contains a significant number of changes
which we think underscores our commitment to serve the public who
depend on us.
We will begin implementation on August 1, 2006, in the Boston
region, one of our smallest regions, consisting of the states of Maine,
New Hampshire, Massachusetts, Vermont, Connecticut, and Rhode Island.
We will carefully monitor the implementation process in the Boston
region and quickly address any problems that may arise. We will wait at
least a year before implementing these regulations in a second region
so we can be sure that our improved disability determination process is
functioning in the manner that we expect, and to be certain that we
have resolved any unanticipated issues that arise during the first
phase of implementation. Once we are satisfied with our progress, we
will then move to roll out the process one region at a time.
In our disability program, as with all our core services, the
Agency continually strives to find cost-effective means for providing
excellent service. For example, we have developed a system to control
and process reports of return to work by disability beneficiaries. The
system is called e-Work.
This is important because, if earnings are not processed timely,
beneficiaries trying to return to work may ultimately face large
overpayments. And, avoiding overpayments is a key element of good
stewardship.
The e-Work system allows for improved coordination between Field
Offices, enabling earnings information to be recorded at the point-of-
contact, thereby reducing the occurrence of overpayments. Work CDRs are
used to develop and evaluate the worth of the beneficiary's earnings to
determine if disability benefits should continue or cease. The e-Work
system replaced a manual, labor-intensive process, allowing SSA
employees to process work CDR more efficiently, timely and accurately.
The system also provides a mechanism to collect reports of earnings for
SSI recipients and issue receipts of such reports to both DI work CDR
beneficiaries and SSI recipients. The application provides improved
management information and tighter controls on the work CDR process.
At SSA, we are committed to providing service to all Americans in a
way that meets their needs. Thus, in addition to our traditional field
office and telephone service, we have developed a suite of Internet and
automated telephone applications that are safe, accurate and efficient.
Last year, more than 23 million inquiries were answered through our
Internet Frequently Asked Questions (FAQs), rather than by our
employees. FAQs are easy to use and ensure consistent and accurate
information is provided to those who need it.
Electronic transactions initiated by the public, such as
applications for benefits and reports of status changes, grew from
about 600,000 in FY 2004 to over 1. 5 million in FY 2005, an increase
of approximately 175 percent. Internet service is less costly than our
traditional service methods, and we are also finding that, as Americans
become accustomed to electronic services in banking and other areas of
their lives, a growing number prefer on-line access to SSA services.
Finally, I assure you that SSA complies with all applicable privacy and
security protections ensuring the availability, integrity and
reliability of personal information subject to the electronic business
processes I describe today.
Stewardship
Our commitment to quality service extends to all of SSA's programs.
I've discussed today some of the steps we are taking to improve the
disability process so that eligible claimants receive the benefits they
are entitled to. But true public service also requires sound
stewardship of public resources. The people of America, who fund the
Social Security program through their FICA tax contributions and the
SSI program through part of their income tax payments, expect and
deserve well managed programs. And we take very seriously this
responsibility to ensure that those entitled to benefits--but only
those that are entitled--receive them.
But good stewardship involves more than money. It also means making
sure that earnings reported and recorded by employers are as accurate
and precise as possible, credited to the correct worker, and that those
with criminal intent are prevented from using Social Security numbers
(SSNs) and cards to advance their illicit operations.
Accurate earnings information is vitally important to our
administration of the Social Security program because a worker's
earnings record is the basis for determining eligibility for and
computing retirement, survivors, and disability benefits. If a worker's
earnings are not properly recorded, he or she may not qualify for
Social Security benefits or the benefit amount payable may be wrong.
SSA has assigned over 436 million SSNs since 1936. Earnings posted
to an individual's SSN are used to determine eligibility for and the
amount of Social Security benefits to which that worker and his or her
family may be entitled. Ultimately, the SSN is used to track earnings
and the payment of those benefits.
Over the years, we have worked to offer employers alternative
methods to verify SSNs. One of those methods is the Employee
Verification Service (EVS). EVS is a free, convenient way for employers
to verify employee SSNs. It provides employers with several options
depending on the number of SSNs to be verified. For up to five SSNs,
employers can call SSA's toll-free number for employers (1-800-772-
6270) weekdays from 7:00 a.m. to 7:00 p.m.
Eastern Standard Time. Employers may also use this number to get
answers to any questions they may have about EVS or to request
assistance. In FY 2005, SSA responded to nearly 1.5 million calls.
Employers also have the option to submit a paper listing to the
local Social Security office to verify up to 50 names and SSNs. In
addition, employers may use a simple registration process to verify
requests of more than 50 names and SSNs or for any number of requests
submitted on magnetic media. Currently, almost 17,000 employers are
registered for this verification service.
To further increase the ease and convenience of verifying employee
SSNs, we developed the Social Security Number Verification Service
(SSNVS), which is an internet option that permits employers to quickly
verify the accuracy of employees' names and SSNs by matching the
employee-provided information with SSA's records. This service was
expanded to all employers in June 2005.
I announced the nationwide rollout at the SSA--sponsored National
Payroll Reporting Forum in Baltimore, Maryland, and we have publicized
SSNVS in various ways. An article on SSNVS appeared in the SSA/IRS
Reporter that is sent to over 6.5 million employers. It was also
featured in the SSA wage reporting email newsletter, W2News. We have
also highlighted SSNVS in our many speaking engagements before the
employer community. There is a special section on SSA's website for
employers that highlights and explains the use of SSNVS.
Through SSNVS, we processed over 25.7 million verifications for
over 12,000 employers in 2005, and 8.9 million verifications from
16,000 employers in the first four months of 2006.
In addition, employers may participate in the Basic Pilot program,
an ongoing voluntary program in which SSA supports the Department of
Homeland Security (DHS) in assisting employers confirming employment
eligibility for newly hired employees. Participating employers register
with DHS to use the DHS' automated system to verify an employee's SSN
and work authorization status. The information the employer submits to
DHS is sent to SSA to verify that the Social Security number, name, and
date of birth submitted match information in SSA records. SSA will also
confirm US citizenship, thereby confirming work authorization; DHS
confirms current work authorization for non-citizens. DHS will notify
the employer of the employee's current work authorization status. In
December 2004 the Basic Pilot was expanded. Currently the Basic Pilot
is being used by 6,509 out of a total of approximately 6.6 million
employers nationwide.
In 2005, through the EVS, SSNVS, and Basic Pilot programs, we
estimate we provided a total of 67 million employer verifications, up
from 62 million in 2004.
Employers report wages to SSA on Forms W-2 (Wage and Tax
Statement). SSA processes the Form W-2 data for tax purposes for the
Internal Revenue Service (IRS). Self-employed individuals report
information on self-employment income to IRS on Schedule SE. IRS then
sends this self-employment information to SSA. SSA uses the SSN to
record employees' earnings.
Last year, SSA processed over 235 million W-2s from 6.6 million
employers that are sent to the SSA either on electronic media or on
paper. Over 150 million wage earners work in jobs covered by Social
Security, which means that many workers were employed in more than one
job during a year. While some employers continue to send us their
reports on paper, we encourage electronic filing. We work with the
employer community to educate them on the advantages of this method and
expect its use to expand as technology improves. In fact, in FY 2005,
66 percent of W-2s were filed electronically, up from less than 10
percent in 1999. We believe the increase in electronic filing will
reduce errors over time.
As you know, SSA mails Social Security Statements to workers over
age 25 each year (approximately 144 million in 2005). The Statement is
a concise, easy-to-read personal record of the earnings on which the
worker has paid Social Security taxes during his or her working years
and a summary of the estimated benefits the individual and his/her
family may receive as a result of those earnings.
We encourage workers to review the Statement to ensure that the
information in SSA's records is correct and to contact SSA to make any
corrections necessary.
When a person files for benefits, an SSA employee reviews the
earnings record with the worker and assists the worker to establish any
earnings that are not shown or are not correctly posted. However, since
it may be difficult for the worker to accurately recall past earnings
or to obtain evidence of them, we strive to maintain accurate records
at the time the wages are reported.
Apart from enumeration initiatives, we also fulfill our fiscal
stewardship responsibility by conducting Continuing Disability Reviews
(CDRs), which ensure that those who receive disability benefits
continue to meet our definition of disability. CDRs are a cost-
effective program integrity workload, saving $10 in program benefits
for every $1 spent in administering them. As I noted earlier, we are
doing fewer CDRs than called for in the President's budget request for
FY 2006 because we have given priority to our claims processing
workloads including applications for disability benefits. An increase
in the number of CDRs conducted in FY 2007 will result in greater
program savings, but let me stress that we need our full request for
administrative resources for CDRs, whether provided in our
appropriation within the discretionary spending cap, or provided as an
adjustment to the cap.
Staffing
At SSA, we are committed to technology and innovation, but we also
believe that our devoted employees are the heart of its success. Our
most critical asset in continuing to maintain a high level of service
is the excellence of our workforce, and we currently have almost 65,000
full time and part time permanent employees.
We expect that just over 40 percent of our workforce will be
retiring by 2014. Our workloads are also expected to grow dramatically
as the baby boom generation approaches their peak disability and
retirement years. Consequently, the greatest human capital challenge
facing us is to develop strategies that ensure we will be able to
maintain a high performing workforce that is prepared to deliver
quality service.
To meet this challenge, we developed our first Human Capital Plan
(HCP) in 2004 as a tool to chart the Agency's course, and we issued an
updated Plan in 2005. It outlines our plans to successfully recruit,
hire, develop, and retain a diverse workforce to carry out the mission
of the Agency. SSA was well positioned to implement our HCP because we
had started in the 1990s to analyze and plan for the impact of future
retirements. This early Retirement Wave analysis resulted in our
original Future Workforce Transition Plan, which now serves as a
tracking mechanism for the HCP.
Because of our earliest Retirement Wave analysis addressing
potential future losses, we have successfully used several key
strategies to control the impact of possible retirements. We
implemented an aggressive, agency wide recruitment strategy, we
strategically use early-out in order to ``flatten'' the retirement
wave, and we renewed our national leadership development programs.
Our HCP aligns with and supports the Agency Strategic Plan goal of
strategically managing and aligning staff to support SSA's mission by
demonstrating how we will invest in and use human capital. It focuses
on the areas of Strategic Alignment, Workforce Planning, Workforce
Development and Knowledge Management, Performance Culture, Leadership,
and Accountability Measures.
It includes steps directly related to employee recruitment,
development and retention. Our human capital goals also focus on
developing a performance culture linked to Agency mission and goals,
and enabling us to identify and develop our future leaders. This plan
sets our course for continuing to achieve measurable human capital
results, which will not only continue to improve SSA's service to the
American public, but also provide accountability for all of our human
capital activities. We update our analysis and assess our progress
annually.
Approximately 23% of our employees are currently eligible for
regular retirement. In five years (2010), 40% will have become eligible
and that figure will continue to grow.
Overall, we estimate the wave will peak between FY 2008 and FY
2010, when the greatest number of employees will retire from our
workforce. Typically, we've found that our employees retire 3.7 years
after they are first eligible.
Our recruitment strategies continue to succeed. During FY 2005, we
hired 4,610 new employees. In this massive recruitment effort, we hired
2,200 new front line employees in support of the Medicare legislation.
We have experienced a steady improvement in retaining new hires.
Between 1998 and 2004, the two year retention rate for new hires has
increased from 84% for 1998 to 88% for those hired in 2004. Our one-
year retention rate for all employees for FY 2005 was 93.4%, as
compared to 91.6% in the Federal government overall.
Through our efforts, we have turned the retirement wave into an
opportunity. Over the past five fiscal years, we have hired
approximately 18,350 permanent employees, and we have focused on equal
opportunities for all, including minorities and women. Currently,
almost 37 percent of our claims representatives have been in position
for less than 3 years. At the other end of the scale 555 employees are
reaching 40 years of service this year and we expect 745 to reach that
milestone in 2007.
We attribute our success to several factors:
Support from the highest levels of the agency;
Strong linkage to the agency strategic plan;
Development of a long-term service vision;
A specific Human Capital Plan;
Analysis and study of potential future losses;
and National and regional leadership development
programs.
Through these strategic Human Capital approaches, we are confident
that we will continue to maintain a high performing workforce that is
prepared to deliver quality service to the public we serve.
At the beginning of my testimony, I said that I am concerned that
new and non-traditional workloads may affect our ability to perform our
core responsibilities. I will discuss those now.
New Enumeration Procedures
As I touched on earlier, we have taken a number of steps to further
strengthen the processes associated with issuing SSNs. You will recall
that SSA formed a high-level response team to develop recommendations
on enumeration policy and procedure in the aftermath of the terrorist
attacks of September 11, 2001. Implementation of many of the team's
recommendations has strengthened our capability of preventing those
with criminal intent from obtaining and using SSNs and SSN cards. Some
of these initiatives include:
Beginning June 1, 2002, we began verifying birth records
with the issuing agency for all United States born SSN applicants age
one or older. Under former rules, we only verified birth records for
applicants age 18 and older. As of December 17, 2005, we are verifying
all birth records.
Beginning in July 2002, we began verifying the
immigration status of all non-citizen applicants for SSNs with DHS
before assigning SSNs.
In addition, we have new responsibilities under the Intelligence
Reform and Terrorism Prevention Act of 2004 which became effective in
mid-December 2005. As a result, the processes we employ to issue Social
Security numbers and cards have changed. For instance, we now require
applicants to submit documents that include a name, identifying
information, and a photograph. For U.S. citizens, we must see a
driver's license, a state-issued picture ID, or a passport if one is
available. If these documents are not available and the applicant
cannot obtain one within 10 days, we will accept other documents, such
as an employee identification card, a school ID, a health insurance
card, or an adoption decree. For non-citizens, we must see current U.S.
immigration documents. This may require an applicant to return to the
field office if they come to an office without one.
Medicare Prescription Drug Program
As you know, the Medicare Modernization Act, or MMA, enacted in
December 2003, established the new Medicare prescription drug benefit.
The new Medicare prescription drug coverage was designed to help
beneficiaries meet their needs for prescription drugs. Under the new
coverage, all people with Medicare have the opportunity to voluntarily
enroll in prescription drug plans. MMA also provided an extra level of
assistance for people with Medicare who have limited incomes and
resources in helping to pay for the monthly premiums and cost-sharing
required by the new Medicare prescription drug coverage. This
assistance is the low income subsidy, or extra help, as it is
frequently called.
SSA was given the responsibility by Congress to take extra help
applications and to make extra help eligibility determinations for
individuals who were not automatically eligible. Additionally, SSA was
charged by Congress with the collection of premiums for the
prescription drug program itself, in cases where beneficiaries tell the
prescription drug plans when they enroll that they want their premiums
withheld from monthly Social Security benefits. This withholding of
premiums is similar to the function SSA already performs for
beneficiaries in the withholding of other Medicare premiums.
We were given these responsibilities because of our network of
nearly 1,300 offices with 35,000 employees across the country, and
because of our existing role in administering some parts of the
Medicare program as well as our proven experience in serving the
public. Over the past 70 years, our agency has gained a reputation for
helping citizens in the communities where they live, and Congress
realized that our presence on the ground would be vital in the launch
of the Medicare extra--help program.
As of April 30, we had received applications from more than 4.9
million beneficiaries, of which almost 850,000 were unnecessary,
because either the applicants were automatically eligible or because
they had filed more than one application. We have made over 3.9 million
determinations on the eligibility for extra help, and have now found
more than 1.7 million of these individuals eligible. We have also
notified the individuals who filed unnecessary applications of their
current eligibility.
We will face new Medicare challenges at the beginning of FY 2007.
Section 811 of the MMA reduces the federal subsidy of Medicare Part B
premiums for those with higher incomes. Currently, Part B enrollees pay
about 25 percent of their Part B cost (the ``standard'' premium). The
remainder is financed by transfers from general revenues into the part
B Trust Fund.
Starting in January 2007, the federal Part B premium subsidy will
be reduced so that higher income beneficiaries pay higher Part B
premiums. There will be four levels of increases to these premiums.
This subsidy reduction will be phased in over three years. MMA requires
that we use IRS data to determine who is affected and the amount of the
additional premium they will have to pay.
In 2007, the threshold amount above which a higher premium must be
paid is $80,000 for those who file a single income tax return and
$160,000 for married couples who file a joint return. Threshold levels
will be indexed annually.
MMA requires use of modified adjusted gross income. This is
adjusted gross income plus tax-exempt interest income and other income.
We will do the first annual data exchange with IRS in October 2006 for
premiums paid effective 2007. Weekly exchanges for the newly entitled
will start prior to January 2007. Ongoing premium amount determinations
will be made annually, prior to the start of each calendar year, and
will be effective the entire year. It will also be made on an ongoing
basis as people enroll in Medicare Part B.
The IRS data we will receive is 2 to 3 years old. Because of the
time lag, the law permits Medicare beneficiaries to provide more recent
tax return data to determine the premium when they have a life-changing
event that significantly reduces their income or to provide corrected
or amended tax returns.
SSA published proposed regulations concerning these rules on
Friday, March 3 and the public comment period closed on May 2. We will
be evaluating the comments in the coming weeks to determine what
changes, if any, made by needed to the proposed regulations. We expect
to publish the final rule later this year.
Those regulations and the statute define those life changing events
as well as the procedures beneficiaries may use to provide corrected or
amended returns when determining premiums. Beneficiaries may appeal
SSA's calculation of the premium.
Affected Medicare beneficiaries will receive a notice from Social
Security later this year. And I need not tell you, Mr. Chairman, that
we can expect to see an up tick in calls and visits when those notices
go out.
In fact, I should note that all of the challenges I've talked
about--especially our new Medicare responsibilities and changes in
verification requirements--have combined to create substantial
increases in the number of field office visits and 800 number calls,
especially in January.
The volume of visits and calls has receded from the January peak
although they are still higher than historical levels. And I want to
take this opportunity to recognize the efforts of SSA employees to
handle the increased workloads we experienced during the fall and
winter.
Funding and Productivity
Our achievements over the last year are proof that resources
provided to SSA are used efficiently and effectively to administer
America's social security programs. In FY 2005, SSA made benefit
payments monthly to over 52 million people for an annual total of over
$552 billion. And we did all of this, and much more, with
administrative expenditures of less than 2 percent of the SSA budget.
In FY 2005, SSA productivity increased by 2.7 percent over the
previous year, part of an impressive cumulative increase of 12.6
percent since 2001. I am proud to note that we increased productivity
annually for fiscal years 2003, 2004, and 2005.In addition, from FY
2001 to FY 2005, SSA improved performance in several key service areas.
For example, SSA has reduced processing time for both initial
disability claims (from 106 days to 93 days) and appeals of hearing
decisions (from 447 days to 242 days). SSA has also processed more
work. In FY 2005, SSA processed over 450,000 more initial disability
claims, approximately 140,000 additional SSA and Medicare hearings, and
over 670,000 more retirement and survivors claims than in FY 2001.
Coupled with productivity increases, funding is the fuel that
drives our ability to meet the needs of the people who rely on our
services.SSA's service delivery budget provides a context for making
funding decisions and determining the effect a given level of funding
would have on the Agency's ability to provide service over a broad
range of workloads.
Conclusion
I am very proud of the exceptional dedication of the men and women
of Social Security and the State Disability Determination Services. Our
employees share a deep commitment to finding better ways to be even
more responsive to those who depend on our service and sound fiscal
stewardship. I am fortunate to work with such dedicated and
compassionate public servants. And I want to thank you, Mr. Chairman
and members of the Subcommittee, for your support for the Agency. In
order to meet the challenges I have described and continue to provide
the kind of service your constituents expect and deserve, we will need
your continued support.
I will be glad to answer any questions you may have.
Chairman MCCRERY. Thank you, Commissioner Barnhart. Let's
follow up on the thing you mentioned last about the Social
Security Number Verification Service (SSNVS). According to
information that I have, in 2006 your Agency is on track to
increase the SSNVS activity by about 38 to 40 percent. In your
statement just now you indicated while you are doing that,
there may be some delays in getting that verification to the
employers.
Ms. BARNHART. I appreciate the opportunity to clarify. With
SSNVS there is no delay, as the Chairman points out. We
absolutely are on target to increase the usage of that SSNVS,
which is a real-time system. Employers who choose to
participate get a pin and password; type in a name, address,
birth date, and SSN; and we will send back immediately whether
that information matches or doesn't match.
The issue in terms of delays relates specifically to the
Basic Pilot, which, as you know, is a system that we
participate in that is operated by the U.S. Department of
Homeland Security (DHS), and one of the immigration proposals
that is being considered is to make the Basic Pilot mandatory.
Right now it is a voluntary program, and I think about roughly
6,000 employers participate. If it is made mandatory, that
number goes up dramatically.
The reason that it creates delay is that when the system
checks to see if your name and SSN are in the system to verify
your citizenship status and birth date, if there is an issue
and it doesn't match, what we call fall-out work, which means
the ones that don't match come to the Social Security office,
and we have to do follow-up activities to resolve the fact it
doesn't match, to find out whether it really doesn't match, or
is a mistake, or someone got married. It is that kind of work
that could cause a delay if we don't have adequate resources,
because obviously we are operating at full capacity and then
some.
We are already on target to increase productivity this year
by about 2\1/2\ percent, so if we add new responsibilities, and
we don't have commensurate resources, then it means there could
be delays in terms of doing that follow-up work, which would
affect someone's ability to start a new job, for example.
Chairman MCCRERY. Could there be or is there some sort of
automatic checklist that the employee could receive
immediately. In other words, have you been recently divorced or
married; common reasons why the match might not work so it
would help you, they can check off those things and send it
right back to you and verify that?
Ms. BARNHART. Certainly, we could do those kind of things,
but the information comes in from the potential employers. They
are the ones that go to DHS. We could do that once it gets to
us, obviously, which requires contact with the individual. The
ideal thing would be if that kind of thing could happen at
contact with the employer, but then it is up to the employer to
actually make that happen.
We would look at all kinds of things like that to cut down
on the fall-out work, believe me, and that is a good
suggestion.
Chairman MCCRERY. Are you conducting outreach activities to
the employer community to know about this service?
Ms. BARNHART. Absolutely. We have sponsored conferences
with payroll communities to let employers know. We have
positions in which employers support liaison officers who are
all over the country and go out and seek out contacts with
local businesses and employers or to inform them of it.
We also have a number of publications. We put things on the
Internet. We have a whole section on our Website that speaks
specifically to the services that we provide to employers and
highlights the SSNVS.
Yes, sir, we are doing everything we possibly can to reach
out to the employer community.
Chairman MCCRERY. Let's talk about the President's budget
for just a moment with respect to additional funding, emergency
funding. I am thinking particularly of hurricanes and the
additional expenses that the SSA incurred as a result of the
hurricanes.
The President in his budget requested some additional
funding, supplemental appropriations for inspector generals,
but not for, I think, the $38 million that the Senate has
included in their bill, general increases in your expenses
related to hurricane follow-up.
What is the status of that? Has the administration made any
comment on the Senate's $38 million? What is your position on
that?
Ms. BARNHART. Certainly, as I am sure you can appreciate
being from Louisiana, more than probably anyone in this room.
Many agencies spent additional unanticipated funds as a result
of Hurricane Katrina, and I have to say that I am very proud of
the job that Social Security did, and I appreciate your kind
comments because our people clearly went above and beyond the
call of duty as individuals because many of them were affected
themselves in terms of losing everything they own and still
going to the closest offices to provide service to other
people. It was really a remarkable occurrence.
However, the supplemental appropriation request that the
administration submitted did not include additional funds for
Social Security. We originally estimated our costs somewhere
around $73 million, Some we took care of under last year's
budget. It covered things like the 15 offices that were
damaged. Ten of those--I think it's eight that are almost
completely demolished. We've set up 10 temporary work sites to
deal with those.
We had relocation expenses for employees. We had 58 SSA
employees who volunteered with U.S. Federal Emergency
Management Agency (FEMA). It was a host of things that occurred
as a result of Hurricane Katrina, but, no, there was no funding
request included for Social Security in the administration's
supplemental.
Chairman MCCRERY. Again, thank you for so competently
responding to that disaster. I wish that I could say the same
for every Federal Agency that was involved. I know other panel
Members have questions, so I will stop now. I may come back and
ask you a few more inquiries. Mr. Levin.
Mr. LEVIN. Thank you, Mr. Chairman. I share your expression
of admiration for the effort of the administration and your
wish that that were achieved elsewhere.
Let me ask you some questions about levels of support that
come from both the budget of the administration and from here.
I know that you are in somewhat of a sensitive position. Years
ago I was in an Agency, and there was always the dilemma of how
do we talk about the President's budget--some of us who were
appointees of the President. There is a problem there, and I
respect that.
I do think it is important to get as clear an understanding
as possible of where the Agency is and also whether you really
have the resources that are necessary to carry out these
responsibilities. You mentioned these new responsibilities. As
we go through this, I think we are struck by the additional
jobs that you all have. You mentioned the level of support of
cost and how efficient SSA is, but I think we have to be
careful that we don't put so much pressure on you that that
level of efficiency is undermined.
Let's talk a bit about the budget request as much as you
can say, because I think it may also have some impact on what
the appropriators do. There is mention here the Congress had
appropriated less for SSA than called for in the President's
budget request. At the same time, as I understand it, the
President's budget request for 2007 was considerably less than
you requested, right?
Ms. BARNHART. I appreciate your comments. Thank you very
much for understanding the situation, this so-called budgetary
dilemma, as you describe it.
One of the reasons that I created this service delivery
budget plan is precisely because of that dilemma. I thought it
was really important for a program this significant that is
such a part of the fabric of American society for Congress, the
administration, the President, and the Office of Management and
Budget (OMB) to understand, what it took to get to where we
want it to be, and that is why I did a 5-year budget, which I
have upgraded every year. Had I gotten everything that I asked
for or laid out in that original service delivery budget plan,
had I received the funding levels that I show to be necessary
to achieve the goals of getting rid of all backlogs by 2008, we
would, in fact, have accomplished all those things. We would
not have backlogs anywhere. We would be in a very good position
not just because of the money, but also because of the
productivity increase that the Agency has managed. As the
Chairman mentioned in his opening comments, it is almost 13
percent. That is one way to look at it.
Another way to look at it is in the last several years
Congress gave us $720 million less than the President
requested, which equates to about 9,000 work-years. If we had
gotten those 9,000 work-years, we would have no backlogs in the
hearing offices. There would be 400,000 pending hearings. That
amount pending is considered pipeline work just so that there
is work going on in the process. We would still have backlogs
in our postentitlement work, maintaining accurate records and
so forth, posting, changing address, those types of things.
Does that give you the picture you were looking for, Mr. Levin,
to discuss it in those terms?
Mr. LEVIN. More or less. Mr. Chairman, we have a vote. How
many votes do we have? I think I will stop here and let my
colleagues, because we may be there for a while. We have so
much to do, I am not sure we want to delay your departure.
Maybe what we will do is I will submit further questions, and
you can communicate with us.
Ms. BARNHART. Be happy to, or happy to meet with your
staff.
Mr. LEVIN. Maybe we want to come back. It is not clear how
long we will be gone. I will finish.
Mr. POMEROY. Thank you, Mr. Chairman.
Madam Commissioner, I also wanted to say that I think you
are doing an extraordinary job. I don't know of an Agency that
is as strongly led as Social Security under your leadership. I
think very highly of the job you are doing, and I share your
view, the staff commitment is incredible. In North Dakota
offices, okay, who is the new-timer here; how long; 18 years.
It is just amazing to me.
It is clear to me that this is really a mission that these
people feel about providing this service. In that context I had
a visit with a couple of employees at a Medicare sign-up event
in North Dakota. They were concerned about the diminished
service levels that had occurred in the office. It was Minot,
North Dakota, but I don't single out Minot, and the replacement
ratio is something like four workers leaving before you can
hire one to fill has significantly reduced their staffing by
like 40 percent, and they just cannot provide the kind of
service that they used to provide.
For people who are so deeply committed to doing the best
they can, watching their performance be diminished is
difficult. I think there is a shared responsibility in terms of
underfunding. I don't think the administration has given you
the resources you require, and I think Congress further
whacking back the administration has really been remiss in
taking that action. We are diminishing the service levels in
the Social Security office in our districts when we don't fund
the President's request on Social Security. That is the least
we should do, not some kind of arbitrary mark, you start paring
from there.
Over the years you and I have talked about this
administrative law judge (ALJ) issue and the insufficient
number of ALJs on the disability system. How many do we have?
Ms. BARNHART. Where we are on that, Mr. Pomeroy, is we have
1,100 ALJs on duty. We are in the process of hiring 42 this
year. I originally planned to hire 100 this year, but because
of the fact we received $294 million less than the President
requested, we are hiring 42 ALJs. Our strength is coming back
up. In terms of ALJs, and I would be happy to provide for the
record----
Mr. POMEROY. Have they opened the list, refreshened the
pool of potential ALJ applicants?
Ms. BARNHART. I am pleased to report that the Office of
Personnel Management did publish an Notice of Proposed Rule
Making (NPRM) in December. They tell us the regulation will be
final in about 3 months, at which point they will have the test
available. Then they will administer the exam, and I think,
probably, by the end of this year we should have a new register
for ALJs. Obviously, I know you have been very interested and
very supportive in this whole effort, and that is going to be
very important, since we have been using a list over 10 years
old. I am sure there are many well-qualified people who have
lots of experience in that 10-year period that didn't make the
grade the first time.
Mr. POMEROY. Thank you. In the interest of time I will
forego further questions.
Chairman MCCRERY. Thank you, Mr. Pomeroy.
Mrs. Tubbs Jones.
Ms. TUBBS JONES. Thank you, Mr. Chairman.
Madam Commissioner, it is always good to see you. I wanted
to let you know that in February I had the opportunity to speak
at the Beachwood office of the SSA with regard to Black History
Month, and I had a wonderful time. One of the most amazing
things for me is this office is 99.44 percent or near 100
percent women. The other exciting thing about the office was
the fact that----
Chairman MCCRERY. Maybe that is why it works so well.
Ms. TUBBS JONES. Yes.
Mr. BECERRA. That is on the record now.
Ms. TUBBS JONES. I have been trying to tell you all that
all along. It has been difficult to get it through.
The other thing that was so amazing was the length of
service. The women in that office had 20, 25 years of service,
and I was really pleased to see that as well.
Let me quickly just say that we appreciate the work you
have done to bring more ALJs in to handle the work. You can't
scream because you are part of the administration, we are all
going to scream for you. You deserve to have the money. You
must be doing such a great job that they are giving you all
these other responsibilities, and we are going to scream and
holler about them. The basic needs of workers in the United
States of America, on disability, on Social Security, come to
your office, and you ought to have the people to do the work.
That is why we are against the pay cuts.
Thank you very much. I yield my time. I mean tax cuts, not
pay cuts. Tax cuts.
Ms. BARNHART. I will share the comments about the Beachwood
office with them. It will mean a lot. Thank you very much.
Chairman MCCRERY. Mr. Becerra.
Mr. BECERRA. Commissioner, good to see you again. First, I
hope that you will help us lay the case that you need more
money. There is just no way that anyone can expect to continue
to achieve what you have done so tremendously well with the
amount of money you are getting. At some point you are going to
be overburdened to the point of collapse, and we should not
expect that you nor the troops under you at the administration
should be expected to continue to perform at this level and
not, at some point, just expire from overwork.
I hope that we will get message out within the Congress to
the appropriators and to the White House and OMB; you need to
have more money. You are doing great work, and you need to do
it with the right amount of resources because no one should
expect you to burn both ends of the candle.
Two issues, and it relates to the fact that your folks are
overworked. We keep hearing in Los Angeles--right now
California branch offices, I have been told, have been
operating without full access to the computers; computer
software used in entering information is slow and cumbersome,
we are being told; databases used in all California offices
have been down since this past Tuesday, or, I am sorry, last
Tuesday of last week. We are being told that currently, there
are folks in these offices averaging 50 new cases per week, per
week. The backlog on medical determinations is up, where
before, apparently, they were able--in these offices in Los
Angeles, able to complete the processing of some of these
medical determinations within a 90-day period.
My understanding is that you all are beginning to
investigate the quality of some of the casework being done in
Los Angeles. I think a lot of the folks are going to say that
we have had to sacrifice quality because we have such a massive
caseload that is growing on us. We can't handle it if we don't
have the resources. This is not to knock the Agency, this is to
say that I think this is just a symptom of not having the
resources you need to do the work with the good people that you
do have.
The other thing I wanted to raise in the short time I have
is that we are also hearing some concern from parents of
disabled children that the disabled adult-child program--there
is not enough information out there for families that face this
problem with children who became disabled before they turn 22
and, therefore, qualify for the disabled adult-child program,
and that this program is out there and available to families
that would qualify. I can submit some questions to you, but
maybe we can have some correspondence on that particular issue.
I know I have to yield back.
Ms. BARNHART. On that second point, let me say, certainly,
that is not an issue that I was aware of, that parents are
expressing those concerns. I really would like to have any
information you can provide because, obviously, we try to do
outreach to make sure everyone who is entitled and eligible for
assistance gets it.
If I could comment for just a moment on the California
situation and the system situation; I am pleased to be able to
tell you the system is back up and running full speed today.
The problem did not start last Tuesday. I will try to make this
quick. We were upgrading capacity because of the electronic
disability workload. California is one of our first large
States to move to an entirely electronic environment. We have
done upgrades in other locations, and they have gone without
incident.
On Tuesday or Wednesday--my understanding is Wednesday or
Thursday of last week the system started experiencing slowdown,
which we expected, which is why we were going to upgrade the
capacity. Friday was a planned down day to do that, to shut the
system down, increase the capacity of the server, and then be
back up by Monday.
Unfortunately, because of the overconfidence of our
contractor who had actually done a superb job up to that point,
took the old server down, and we did not have it as a back-up,
system. We had done fine with the upgrade 31 times. I wish the
32nd time hadn't been in California a week before I came before
this Subcommittee.
Anyway, I have been monitoring the situation personally
very closely, and as a result we got the new system up. The old
server has been rebuilt and is available as a back up in the
event that we need it, even though now we'll be able to process
faster with the new system. We monitor these things very
closely because the whole point is to be able to provide better
service, not worse service.
Anyway, as a result of the down time, if you include
Friday, which was a planned down time, we had lost about 5,500
cases that did not get worked. That is how many would have been
worked in terms of claims closed or opened, those kinds of
actions. We are making accommodations for our flexible
disability unit in San Francisco to help. We will get caught
up, you have my assurance.
I do want to say the workers were not sitting idle, because
there are many things they can do even when the system is down,
and in every single location we have what is called an
alternative business process, which means if we are down, we
still have an alternative process whereby work can still be
done. DDS staff can call to request medical evidence, pull up
the e-view screen and make notations on the case. There are
things that they can do even if they can't open or close the
case. I want you to know that we were absolutely on top of it.
It was very unfortunate, and we are going to make sure that we
have the old server available parallel system as we continue to
do future upgrades throughout the Nation.
Mr. BECERRA. Thank you.
Chairman MCCRERY. Thank you, Madam Commissioner. We will
submit some additional questions in writing, and we appreciate
very much your coming before us today and the job that you are
doing.
Thank you, panel members.
Ms. BARNHART. If I can say, finally, I really do appreciate
the opportunity to come before this Committee. Your interest
and knowledge of and support for these programs, I think, is
unparalleled, and it is really remarkable and wonderful for the
people of the Agency who work so hard. They are working their
hearts out every single day. They care a lot, and I care about
them, and I know you do too.
Ms. TUBBS JONES. Mr. Chairman.
Just think how lucky you are, Madam Commissioner. This is
the last day before the weekend, and there are lots of votes.
You get to get out of here.
Chairman MCCRERY. The hearing is adjourned.
[Whereupon, at 10:37 a.m., the Subcommittee was adjourned.]
[Questions submitted by Chairman McCrery to the Honorable
Jo Anne B. Barnhart and her responses follow:]
Question: The funding that was enacted for your Agency in Fiscal
Year (FY) 2006 was about $300 million below the President's budget
request. Please provide more details about how you make decisions in
terms of what workloads will or will not be processed, and how your
Agency's ability to serve the public has been affected. If the
President's budget for the SSA for FY 2007 is not enacted, would you
tell us how service delivery will be further affected?
Answer: As Commissioner of Social Security, I believe my primary
responsibility is to ensure that benefits are paid as timely as
possible. This means that workloads such as processing retirement and
disability claims have priority over other workloads, including
stewardship activities such as continuing disability reviews (CDRs) and
Supplemental Security Income (SSI) non-medical redeterminations. In
addition, understanding the priority that the President and Congress
place on the implementation of the Medicare prescription drug program,
I made a commitment to direct as much of our funding as was needed to
achieve successful implementation.
All of this means that this year we will not be able to process as
many CDRs and SSI redeterminations as was planned in the fiscal year
(FY) 2006 budget request. This was a difficult decision, because these
stewardship activities produce significant program savings compared to
their administrative cost.
The FY 2007 President's budget request for Social Security includes
$9.496 billion for our Limitation on Administrative Expenses. If
Congress were to reduce this amount, we would not be able to meet all
of the performance commitments laid out in the President's budget. As
in prior years, I would need to balance our workloads in making
resource allocations.
Question: The President's budget proposes funding outside
recommended caps on discretionary budget authority for several
government-wide program integrity activities. This would include $201
million for FY 2007 for the SSA's continuing disability reviews. In the
past, Representative E. Clay Shaw introduced legislation that would
fund continuing disability reviews outside discretionary caps. Are you
and the Office of Management and Budget discussing this proposal with
the Budget Committee? If so, what has been the reaction?
Answer: Of the total $9.496 billion proposed for Social Security's
administrative expenses in FY 2007, the President's budget proposed to
provide $201 million outside of the discretionary spending caps
specifically designated for CDRs. The Administration recognizes that
CDRs result in far greater savings for the Social Security trust funds
than they cost. In FY 1996 through FY 2002, Congress provided funding
for CDRs in this manner, enabling us to successfully eliminate a
significant CDR backlog and contribute to deficit reduction.
For FY 2007, neither the Senate nor the House-passed budget
resolutions include the proposed cap adjustment for SSA.
Question: In your testimony, you mentioned that because of your
resource constraints for the past few years, your Agency has had to cut
back on the number of continuing disability reviews (CDRs) it will
conduct. These reviews are important, as they ensure only those who
continue to be disabled stay on the rolls and also generate trust fund
savings--$10 for every $1 invested. How large is the existing CDR
backlog? If the Agency receives the President's budget request, but
without the $201 million funded outside recommended discretionary caps,
what progress will you be able to make in eliminating this backlog?
Answer: As I said in my testimony on May 11, 2006, as well as in
response to your first question, I believe that, as Commissioner of
Social Security, my primary responsibility is to ensure that benefits
are paid as timely as possible. This means that workloads such as
processing retirement and disability claims have priority over other
workloads, including stewardship activities such as CDRs and SSI non-
medical redeterminations. In addition, this year I have committed to
direct as much of our funding as is needed to achieve successful
implementation of the Medicare prescription drug program. As a result,
we estimate that the existing backlog at the end of FY 2006 will be
approximately 800,000 CDRs. This backlog includes a mixture of Social
Security and SSI cases.
If the budget request is reduced by the $201 million that the
President has requested for CDR processing outside of the discretionary
spending cap, it would dramatically reduce the number of CDRs we could
process in FY 2007.
Question: At the end of December 2005, the period for comments on
the proposed rule to revise the Ticket to Work program closed. When do
you expect to issue the final rule? Once the final rule is issued, when
would you expect to implement it?
Answer: We expect to publish the final Ticket regulation in the
fall of 2006 and plan to implement the program shortly thereafter.
Question: I was pleased to see in your testimony that you have
taken steps to address a longstanding problem--the lack of timely
posting of earnings reported by the Social Security beneficiaries.
Clearly the benefits of your e-Work system and twofold: 1) to reduce
overpayments and 2) to add a measure of certainty for those who wish to
work that their wages will not result in an overpayment. Could you
provide us with details on how the e-Work system is replacing the old
labor-intensive system? Does the SSA plan to expand e-Work to cover
Supplemental Security Income (SSI) recipients as well as dually-
entitled persons? If so, what is the timeline for that expansion? In
addition, how many cases is the SSA waiting to process where a
beneficiary has reported earnings, or where the SSA data-matching
operations identify a beneficiary who may have earnings? How long does
it take between the time of such a report or identification until the
SSA is able to process the earnings and, if necessary, adjust the
benefit payment? Is the average amount of overpayment due to disability
beneficiaries' earnings declining as a result of the availability of
the e-Work tool?
Could you provide us with details on how the e-Work system is
replacing the old labor-intensive systems?
Answer: e-Work is a web-based computer program designed to assist
in the development and adjudication of Social Security disability
(Title II) work CDRs. Prior to e-Work there were various stand alone
programs that were housed on the shared drive of the local offices.
Employees entered data into these programs to document wage reports
that were provided by the public.
e-Work replaced these processes and now provides us with a fully
automated method of handling and monitoring return-to-work actions.
Because it is a structured, policy-driven automation tool, it has
helped to improve the accuracy of work determinations by providing
consistent developmental direction rather than relying solely on the
experience of the adjudicator. Notices to the public, including
receipts of work reports, are fully automated and are complete and
consistent. Because it allows employees in all of our offices the
ability to view and process work reports, it also has enabled us to be
more responsive to the questions that might be received on specific
cases, regardless of where the person resides and which component is
contacted.
Question: Does the SSA plan to expand e-Work to cvover Supplemental
Secuity Income (SSI) recipients as well as dually-entitled persons?
Answer: SSA is working to improve collection of earnings
information within the SSI Program. One improvement under development
is the new Supplemental Security Income Monthly Wage Verification
(SSIMWV) system. SSIMWV will streamline the inputs of monthly wage
information associated with the SSI Program, including the recording of
the data's source, posting of wages to multiple SSI records when
required, and the generation of follow-up notices.
Question: If so, what is the timeline for that expansion?
Answer: SSIMWV was made available in 10 percent of field offices
nationwide in April 2005. An enhanced version will be made available to
these offices in July 2006. Nationwide rollout of SSIMWV is contingent
on how the enhanced version functions in the test sites.
Question: In addition, how many cases is the SSA waiting to process
where a beneficiary has reported earnings, or where the SSA data-
matching operations identify a beneficiary who may have earnings?
Answer: As of May 14, 2006, there were 192,577 work reviews pending
nationwide. Information pertaining to data matching operations to
identify beneficiaries with earnings is not yet available via
management information (MI) systems currently established within e-
Work. The MI system in e-Work was developed and made available December
2005, and because of its infant stage, the software only provides basic
data information regarding work reviews. The e-Work MI system does not
interface with wage data matching systems at this time, but this
function is on the list of processes we wish to add in future
enhancements of the program.
Question: How long does it take between the time of such a report
or identification until SSA is able to process the earnings and, if
necessary, adjust the benefit payment? Is the average amount of
overpayment due to disability beneficiaries' earnings declining as a
result of the availability of the e-Work tool?
Answer: A mechanism to gauge the full case processing timeframe,
from the point wages have been submitted to the time when the work CDR
has been completed, has not yet been developed. Further, we do not have
the data available to substantiate the effect of e-Work on either
preventing or identifying overpayments.
Question: You mentioned that your Agency has had an admirable track
record in annual productivity gains, while processing increased
workloads. Could you describe to us the changes your Agency has made to
its business processes to achieve a cumulative productivity increase of
12.6 percent since fiscal year 2001?
Answer: Our productivity improvement has been achieved through
technology and process improvements and through the hard work of our
dedicated and committed staff. While we have ongoing process changes
that should yield future productivity savings, such as the new
Electronic Disability process and the Disability Service Improvement
(DSI) initiative, much of our productivity improvement to date can be
associated with a multitude of automation efforts impacting most, if
not all, of our workloads.
For example, signature proxy, launched in June 2004, has improved
benefit application services to claimants who file online, by phone, or
in person. This process removes the requirement for a ``wet'' signature
on benefit applications and continues the Agency's progress toward a
totally electronic environment. By the end of FY 2005, this innovation
resulted in more than 2.4 million electronic records that would
otherwise have been created as paper, saving costs related to both
processing time and storage.
Through changes like this, we have been able to consistently become
more efficient from year to year.
Question: You mentioned that your Agency has hired approximately
18,350 new permanent employees over the last 5 years. I have also seen
that you expect fully 40 percent of your 65,000 Member work force to be
eligible to retire by 2014. That still leaves a net loss in total
employment. Could you discuss your strategy to meet the expected
increase in demand for your Agency's services as the baby boom ages? As
a result of the tremendous growth in the popularity of your Agency's
online services, do you expect that some of this demand will be met
electronically?
Answer: Although approximately 42 percent (or 27,000) of our
current work force is projected to retire by 2014, we believe that the
success of our balanced recruitment and hiring methods has created
solid internal mechanisms for current and future work force
replacements.
The men and women of Social Security will continue to provide
dedicated service to the public and will continue to look for ways to
improve productivity. These efforts are enhanced by our ability to
leverage technology and automation advancements. For example, we have
improved the disability process by moving to an electronic disability
claims file through Accelerated Electronic Disability (eDib); and, we
have more than tripled the number of transactions that we process
electronically over the Internet.
And, as the public--especially the baby boomers that are nearing
retirement--become accustomed to conducting business online, we are
finding that increasing numbers of individuals prefer to do business
via the Internet. Thus, I would expect that method of providing service
to continue to be used with increasing frequency.
Question: Last month's report by the Inspector General raises
concerns about the amount of benefits your Agency is paying to people
who are not eligible for them. How do you plan to address the concerns
raised by the report, and what are your goals for reducing overpayments
in the next fiscal year? Also, how do you plan to accomplish these goas
so that you do not discourage disability beneficiaries from attempting
to return to work?
Answer: We believe that by reducing overpayments, and the fear of
being overpaid, we will be encouraging, rather than discouraging, work
activity. We are focused on encouraging work activity, as well as the
prompt reporting of this work activity; faster identification of those
who may not report work activity; controlling the workload to make sure
it is not delayed; and expediting (through automation and improved
policies and procedures) the processing of those workloads. These
actions, in addition to public education, will reduce overpayments
without imposing an increased burden on our beneficiaries or
discouraging their work efforts.
Question: In your testimony, I note that from fiscal year 2004 to
2005, your Agency has experienced an impressive increase of about 175
percent in the number of transactions conducted online. Do you plan to
add more improvements to your Agency's website, so that the American
people can access more services from the SSA 24/7?
Answer: Increased usage of our electronic applications has
continued steadily through FY 2006. As of April 2006, the volume of
successful electronic transactions of 1,317,200 represents 138-percent
growth over the FY 2004 baseline. By the end of the fiscal year, our
goal is to achieve 300-percent growth over the FY 2004 baseline or 2.2
million electronic transactions. The volume of electronically initiated
transactions currently represents about 7 percent of our total incoming
work.
We strive to provide the public with ``always on'' service via our
website. Our website is available 24 hours a day, 7 days a week, and
our online applications are accessible 20 hours per day on weekdays and
15 to 18 hours per day on weekends. We are planning to make
improvements to the website during the next few years, with specific
improvements for next year subject to approval in July 2006.
Question: We have heard complaints from some people about how long
the disability determination process is taking at the Department of
Veterans Affairs. So much so that some veterans are looking to the Ways
and Means Committee to allow their tax records to be amended
retroactively for the three past open tax years in current law. I
believe the better course of action would be to have these cases
settled faster than that. Do you have lessons learned that you think
should be shared with the VA? How long has it taken the SSA to plan and
implement the changes you have made so far, and when do you think the
disability process will be fully computerized nationwide?
Answer: Because SSA's disability determination process differs from
the process used by the Department of Veterans Affairs (VA), it is
difficult to translate our experience in developing the DSI regulation
into ``lessons learned'' that would be both appropriate and useful to
the VA. As we begin to implement our new regulation later this summer,
we will, of course, gain more insight into how best to improve the
disability determination process.
With regard to your question about how long it has taken us to plan
and implement the changes we have made so far, I first presented the
basic concepts underlying the new disability determination process to
Congress in September 2003. Over the last 2 years, we met with hundreds
of interested parties and individuals during the development of the new
regulation. The final regulation on DSI was published in March of this
year.
Concerning our plans to make DSI available nationwide, we will roll
out the process in a measured and careful manner. Gradual
implementation will allow us to monitor the effects that our changes
are having on the entire disability determination process, and lessons
learned during the early stages of implementation will allow us to
proceed in an increasingly efficient and effective manner in the later
stages of implementation. Efforts are underway to be ready to implement
DSI in the Boston region in August. We anticipate that nationwide
implementation of DSI will take 5 years.
I want to stress that we could not make these changes without eDib,
which replaces our old paper-based disability claims process and
enables us to handle all new claims in an expedited manner. The
electronic claims folder is being used in all 50 State Disability
Determination Services (DDS), and over 90 percent of DDS staff
currently adjudicate cases in an electronic environment. We are
reaching the final stages of the national rollout of eDib that began in
2004, and by the end of this year I expect each of the DDSs and the
Office of Disability Adjudication and Review (formerly our Office of
Hearing and Appeals) to be using electronic folders for new disability
claims on a regular basis throughout the country.
Question: The SSA is piloting a program in New York and New Jersey
that uses an electronic asset verification system to help confirm that
individuals who apply for SSI benefits are eligible. Under the pilot
program, has the SSA detected cases that might have been overpaid
without the verification system? How much in savings has been achieved
so far under the pilot? Do you have plans to use the asset verification
system nationwide, and if so, when?
Answer: We have been piloting a financial account verification
system in field offices located in New York and New Jersey. Part of
this pilot involved a comprehensive study to measure the value of such
a system for SSI applicants as well as recipients already on the
payment rolls. This study did identify a small percentage (about 5
percent) of applicants and recipients who were overpaid based on this
financial account verification system that, without this system, would
not have been detected. The average amount of overpayment for these
overpaid study cases was $3,654. Therefore, for the 3,287 study cases
only, we saved about $805,000 in incorrect SSI payments. Although the
percentage of incorrect payments detected through the financial account
verification system is relatively small, if we project these results to
the full population of SSI applicants/recipients, we believe
significant program savings could be achieved.
We are continuing to analyze the study results with an eye to the
potential return on investment that nationwide implementation might
yield relative to our other stewardship activities.
Question: Please provide an update on the hiring of Administrative
Law Judges (ALJs) since the Azdell litigation was resolved, your plans
and timeframe for returning to a full corps of ALJs, the status of the
registry of ALJ candidates maintained by the Office of Personnel
Management, and the anticipated timeline for producing a new registry.
Answer: The U.S. Court of Appeals for the Federal Circuit issued a
decision in favor of the Office of Personnel Management (OPM) on
February 20, 2003. Since that time, we filled 102 ALJ positions in
2004, 98 in 2005, and I expect to hire 42 ALJs in 2006. I had planned
to hire 100 ALJs this year, but because we received $294 million less
than the President requested, we revised our plans.
With regard to the new registry, on December 13, 2005, OPM
published a Notice of Proposed Rulemaking (NPRM) to revise the ALJ
program. The NPRM was open for public comment through February 13,
2006, and OPM tells us that the regulation will be final in about 3
months. We understand that the test will become available at that time,
and OPM will administer the exam. Based on this information, we hope to
have a new registry for ALJs by the end of this year.
Question: The SSA has reported that it will not be able to replace
every employee who leaves the Agency this year due to budget
constraints, and the President's FY 2007 budget request reflects a
reduction of more than 2,500 workers. Given these limitations, how does
the SSA intend to implement the new Federal Reviewing Official
component of the Disability Service Improvement plan, including hiring
and training the reviewing officials and their support staff, and
providing for necessary infrastructure?
Answer: The central goal of the new disability determination
process is to arrive at the correct decision on each claim as early in
the process as possible. DSI replaces the current four-step
adjudicative process (i.e., DDS initial decision, DDS reconsideration
decision, ALJ hearing and Appeals Council review) with a new three-step
process (i.e., DDS initial decision, Federal Reviewing Official
decision and ALJ hearing) followed by a discretionary review by the
Decision Review Board. During FY 2007, implementation of SSA's new DSI
process for making disability determinations will take place only in
the Boston Region.
Because initial disability claims in the Boston Region currently
represent less than 4 percent of all initial disability claims filed in
the Nation, the immediate staffing and support demands for the new
Federal Reviewing Official component of the DSI process can be easily
met without disrupting any ongoing operations of the Agency. It is
anticipated that successful implementation of the DSI process will
result in significant improvement in the timeliness of case
decisionmaking, which will, in turn, allow sufficient resources now
committed to the latter stages of the disability determination process
to be shifted to support the expanded staffing earlier.
[Questions submitted by Representative Becerra to the
Honorable Jo Anne B. Barnhart and her responses follow:]
Question: How many DAC Beneficiaries are there? Could you provide
subtotals according to the basis of their entitlement--i.e. by a
parent's retirement, disability or death? How many received SSI
benefits prior to their DAC entitlement?
Answer: As of December 2005, the numbers of childhood disability
beneficiaries (also commonly referred to as DAC beneficiaries) by basis
of entitlement were:
Total 768,535
Retired worker 191,979
Deceased worker 507,961
Disabled worker 68,595
Using a 10 percent sample as of December 2005, we estimate that
approximately 448,530 of these DAC beneficiaries received Supplemental
Security Income (SSI) benefits prior to their DAC entitlement.
Question: How does SSA ensure that potential DAC Beneficiaries,
their parents or other guardians--as well as community organizations
and others who work with them--are aware of the availability of this
benefit? Please describe all outreach and information activities
conducted by SSA to alert potential beneficiaries, their parents or
other representatives (e.g. guardians, representative payees or
trustees), and community organizations who work with this population.
Answer: Social Security is very diligent in ensuring that claims
technicians explore all possibilities for benefit entitlement. We ask
on every claim (including all retirement, disability, lump sum death
payment, and survivor claims) if there is any child over the age of 18
who has a disability that began before age 22 so that we can ensure
that a Childhood Disability Benefit (CDB) claim is taken if
appropriate. In addition, when a child attains age 18 in the Title XVI
program, we redetermine the child's eligibility under the adult
disability criteria. During these interviews, we also explore
entitlement to other benefits to which the individual may be entitled,
including entitlement to CDB.
We also provide speakers nationwide, through a network of local
offices, to conduct seminars for disability organizations, support
groups, hospitals, and social workers interested in educating their
Members, their employees and their patients and families about Social
Security's disability programs. Social Security employs 1,300 field
office managers and almost 150 full-time public affairs specialists to
educate Americans on Social Security programs. Each year, working in
their local communities, these professionals deliver thousands of
speeches, write numerous newspaper articles, and participate in
countless radio and television interviews where they discuss all
aspects of Social Security, including benefits provided through the
program. Speakers can be requested either online at
www.socialsecurity.gov/organizations or by contacting any local Social
Security field office.
We participate in over 90 national conferences each year, providing
attendees with information about the various programs administered by
Social Security. This year Social Security will be attending over 50
conferences, at which we will be reaching out specifically to
disability organizations and medical provider groups in an effort to
educate and inform.
We actively partner with organizations, schools, and advocacy
groups that work with the disabled community. We maintain these
relationships by educating these various groups about our programs,
including CDBs. As noted above, we do this by conducting seminars and
workshops, writing articles for newsletters, and establishing
partnerships. These partnerships allow us to spread the word about our
disability programs and the work incentives for those already enrolled
in our programs.
Additionally, we maintain informative pamphlets and brochures on
our disability programs along with Medicare and Medicaid services.
These are distributed to schools, centers for the developmentally
disabled, and community centers, which are all places that disabled
children and their families attend. We also maintain on our website
extensive information on our programs and other help for students with
disabilities. We are making changes to our website so that disabled
adult children and the people who are helping them can more easily see
that these benefits are potentially available to them. We created on
the front page of our website a new link entitled ``Adults disabled
before age 22'' and added a new page to the website discussing these
benefits. We also have added a separate question about these benefits
to our list of ``frequently asked questions'' about disability, which
we also link to the new web page.
Question: When a worker applies for Social Security retirement or
disability benefits, or a spouse applies for survivors benefits, does
SSA probe for whether there might be a potentially eligible DAC
beneficiary? If so, is this true for all application settings--field
office, telephone, and online? If not, why not?
Answer: When a worker or a spouse applies for any type of Social
Security benefit, the question about children with disabilities is
investigated with every claim. This is true for all application
settings, either in the field office, telephone, or online. In fact,
the interviewer or person filing online cannot continue through the
path of a claim without answering this essential question.
Question: When a disabled adult applies for SSI benefits, does SSA
probe for whether he or she might be eligible for DAC benefits, either
at that time or in the future? If the individual is not immediately
eligible (because his or her parents are not retired, disabled, or
deceased), is any kind of notation put on the file to flag for future
DAC entitlement?
Answer: The SSI application is also an application for any Title II
benefit to which the applicant is eligible, including CDBs. Existing
procedure specifically instructs SSI interviewers to investigate
eligibility for such benefits. The SSI application also asks about
other Members of the household. This gives the interviewer the
opportunity to explore leads for other benefits that could be
available. If future entitlement is indicated, the interviewer can
annotate the remarks portion of the application. These questions
concerning children and children with disabilities will be addressed,
in the future, in the event that the parent files for retirement or
disability benefits, or if the parent dies. If the disabled adult
remains eligible for SSI benefits, we will check potential eligibility
for CDB during each SSI redetermination.
Social Security is currently working on systems enhancements that
would collect and store parental information for disabled adults who
became disabled prior to age 22. Using this information, the system
would periodically interface with the Master Beneficiary Record and
Social Security's death records to determine if the SSI recipient is
eligible for CDB on the parent's record.
Question: Can DAC benefits be applied for online? If not, please
explain why.
Answer: Childhood disability benefits cannot be applied for online.
At the present time our online services do not include filing for
survivor's or auxiliary child's benefits. Any claimant seeking benefits
on a worker's record must establish his/her relationship to the worker.
For some categories of children, dependency on the worker must also be
proven. Both can be very complex and sensitive. In an in-person
setting, a trained adjudicator using targeted lead and appropriate
follow-up questions and explanations can elicit the necessary
information. In the Internet self-help arena, all related information
would need to be elicited through detailed questions and associated
help screens. Our experience suggests that adjudicator recontact would
be necessary to confirm the child's relationship in many cases, thus
detracting from the purpose of the online application. However, we
continue to evaluate the feasibility for including these types of
claims online.
It should be noted that the disability report form, which is a
critical part of the CDB application process, can be completed online
by the beneficiary, his or her representative, or an organization, to
be accessed by the claims technician and included with the claim. This
facilitates the claims process for these applicants.
Question: Has SSA undertaken any analysis aimed at determining
whether all potentially eligible DAC beneficiaries are receiving
benefits? If so, what are the results? If not, why not? Has SSA
evaluated its outreach activities in order to assure that they are
effective and that the DAC benefit is not underutilized? If so, are any
additional steps planned to improve outreach?
Answer: Social Security is always looking to improve our processes
and outreach to ensure that disabled individuals receive all the
benefits to which they are entitled. In fact, we have done some
analysis on cases where some potentially eligible disabled individuals
might have been entitled to CDBs. We are currently reviewing these
cases to ensure that CDBs will be paid to these individuals, as
appropriate.
Social Security has always had a forward-thinking approach about
outreach efforts and activities. All Social Security regions have
public affairs specialists who conduct numerous outreach activities
with organizations committed to helping the disabled community,
including disabled children. We are continually monitoring and
evaluating our outreach activities so that we are responsive to the
needs of the communities within each servicing field office.
Additionally, all of these specialists attend annual conferences that
offer training on a variety of topics specifically geared toward
ensuring that they are providing essential Social Security program
information to all the key organizations in their communities.
Question: Could SSA and state-administered SSI supplementation
programs provide written notices describing the DAC benefit, the
grounds for eligibility and the application process to disabled minor
and adult recipients of SSI and to appropriate third parties, such as
parents, conservators, trustees and representative payees? Could such
information be included with other notices or letters sent to disabled
SSI recipients and their representatives? Based on your experience,
would written notifications be an effective outreach tool?
Answer: We will explore the possibility of including information
about CDBs in notices to SSI recipients and their representative
payees. The target group would be individuals disabled prior to age 22
who remain unmarried.
However, currently during the SSI application and redetermination
process, Social Security does ask questions to determine if eligibility
for other benefits exists. We also provide a written referral (Social
Security Administration Supplemental Security Income Referral Notice
for Social Security Benefits) when the SSI applicant is potentially
eligible for Social Security benefits, including CDBs.
Additionally, we have numerous publications that provide
information on all of our programs and their benefits. The 100-page
booklet, ``Understanding Supplemental Security Income,'' includes a
chapter that provides information for SSI applicants, beneficiaries,
and their representatives about potential eligibility for Social
Security benefits, including CDBs. The booklet is published in English
and Spanish and is provided to other agencies, community organizations,
and Members of the public upon request. Social Security's publication,
``Benefits for Children with Disabilities,'' is geared toward providing
information to parents and care givers of individuals who have been
disabled since childhood. It helps individuals decide if their child,
or someone they know, may be eligible for Social Security or SSI. There
are links to both publications on Social Security's Web site
www.socialsecurity.gov.
[Submissions for the record follow:]
Statement of Witold Skwierczynski, American Federation of Government
Employees, Social Security General Committee, and National Council of
Social Security Administration Field
Operations Locals
Chairman McCrery, Ranking Member Levin, and members of the Social
Security Subcommittee, I respectfully submit this statement regarding
Social Security's Service Delivery Challenges that face the Social
Security Administration. As a representative of AFGE Social Security
General Committee and President of the National Council of SSA Field
Operations Locals, I speak on behalf of approximately 50,000 Social
Security Administration (SSA) employees in over 1500 facilities. These
employees work in Field Offices, Offices of Hearings & Appeals, Program
Service Centers, Teleservice Centers, Regional Offices of Quality
Assurance, and other facilities throughout the country where
retirement, survivor and disability benefit applications and appeal
requests are received, processed, and reviewed.
SSA employees are dedicated to providing the highest quality of
service to the public in a compassionate manner. AFGE represents
employees who are committed to serving our communities in the face of a
significant increase of work and decrease of staff. However, the severe
cuts in budget and staff have had a detrimental effect on employee
morale and, also, the ability for SSA to fulfill Congressional
mandates.
Although SSA's workloads have increased by 12.6 percent over the
last 5 years, and 2.7 percent in FY 05, Congress appropriated $300
million less for SSA than proposed in the President's FY06 budget
request. The result was a 2368 reduction in budgeted work years. While
SSA's proposed budget requests have compared favorably compared to many
other agencies, AFGE is concerned that the recent budget cuts may
result in dangerous levels of inadequate service to the public and
stewardship of the programs under SSA's jurisdiction.
In February 2006, SSA informed AFGE that the budget cuts would be
absorbed in staffing resources. Additionally, Commissioner Barnhart
imposed a hiring reduction wherein the Agency will replace only 1 of 3
employees engaged in direct public service who leave SSA. In recent
weeks, AFGE has received reports that the replacement ratio for
employees in field offices may have dropped to one hire for every 8
employees who leave the Agency. (SSA has failed to communicate this
staffing replacement decision to the Union.)
AFGE is very disturbed by the reports we have received of the
public's inability to access SSA's 800 number. AFGE has requested
documentation of the SSA 800 number's lost call and waiting time rates.
However, those reports are not being made available to the Union. AFGE
has received reports that many field offices around the country have,
also experienced a substantial increase in interviews. It has been
reported that in some locations there are lines of 100-200 people that
wait all day and some never even get inside of the Social Security
office. The waiting process begins again the next day in these
locations. It is disturbing that the public's waiting times in these
offices can be measured in days, rather than minutes or hours. However,
SSA officials will not take appropriate action to verify the actual
time the public waits to get into the office. SSA waiting times are
measured only after the public enters the office and registers through
the Visitor Intake Process. Additionally, we are told that SSA
officials are not taking appropriate action to protect the filing dates
of potential applicant's who cannot attain access to the office or
speak to an SSA employee because of these long lines. These actions may
result in a loss of benefits for the potential applicant.
SSA Workloads
In FY 2006, SSA workers will process approximately:
6.5 million claims for benefits;
528,000 Medicare Part D low income subsidy applications;
560,000 hearings;
18 million new and replacement Social Security cards;
261 million earnings items for workers' earnings records;
58 million transactions through SSA's 800-number;
42 million visitors to our field offices;
1.2 million continuing disability reviews (CDR);
1.2 million non-disability Supplemental Security Income
(SSI) re-determinations.
These workloads total more than 346.5 million actions processed by
SSA employees.
Continuing Disability Reviews (CDRs)
SSA must consistently and accurately evaluate initial and ongoing
eligibility for beneficiaries with disabilities. CDRs are a cost-
effective program integrity workload, which saves $10 in program
benefits for every $1 spent in administering them. However, the
Subcommittee heard Commissioner Barnhart testify that SSA will perform
fewer CDRs in FY 2006. Because of the budget cuts, she imposed a
moratorium on CDR production in February 2006.
Commissioner Barnhart has also stated to the Subcommittee that an
increase in the number of CDRs conducted in FY 2007 will result in
greater program savings. AFGE believes that unless Congress
significantly increases the appropriations to SSA for administrative
expenses beyond the President's request, there will be insufficient
staff to process the CDR workload. President Bush proposed deeper cuts
of 2412 work years in the FY 07 budget. AFGE believes CDRs will
continue to backlog. This will ultimately affect the integrity of SSA's
disability programs as many beneficiaries will continue to receive
Social Security and Supplemental Security Income (SSI) disability
benefits although they are no longer qualified for such benefits. The
CDR moratorium will result in additional overpayments and unnecessary
trust fund expenditures. Much of these improper payments will never be
recovered by the Agency.
Supplemental Security Income
SSA has a continuing responsibility to periodically review SSI
eligibility. It also has responsibility to recover SSI overpayments, to
combat fraud, and to develop and carry out program management policies.
In February 2006, Commissioner Barnhart placed caps on the total number
of redeterminations that could be processed in FY 06, resulting in a
virtual shutdown of redetermination production. Redeterminations save
the Agency an average of $10 per $1 of expenditure. Again, Commissioner
Barnhart blamed budget cuts by Congress for her decision to limit SSI
redeterminations in FY06. Without these ongoing reviews of SSI
benefits, SSA's ability to improve and maintain the integrity of the
SSI program is severely compromised and recipients will experience both
significant overpayments and underpayments.
Statistical Manipulation
Despite severe budgetary constraints, the Commissioner instituted a
policy change in 2004 which directed SSA employees to take and process
disability claims from individuals who were clearly not eligible for
benefits. This policy requires SSA Claims Representatives to take and
process concurrent Title II (SSA) and Title XVI (SSI) claims whenever
anyone filed for disability benefits. Interviewers can usually
determine through questioning potential eligiblity for benefits. If
they can't, or if dual eligibility appears possible, SSA employees have
always been trained to take and process concurrent SSA-SSI claims.
However, requiring such claims in every situation results in an
enormous amount of unnecessary work. Claims for individuals who are
obviously ineligible for either Title II or Title XVI disability
benefits are taken as ``technical denials'' which can be processed in a
few days. Many claimants object to filing both applications.
Interviewers are told to take these claims anyway.
SSA states that instructions to take concurrent Title II and Title
XVI applications for every disability claimant are intended to prevent
a recurrence of the Special Title II Disability Workload fiasco wherein
approximately = million Title XVI recipients are owed billions of
dollars in retroactive Title II benefits. However, this injustice
occurred due to gross program mismanagement. SSA, despite knowledge of
the problem, refuses to take the necessary action to both program the
computer system and also emphasize processing of systems alerts which
indicate Title II eligibility. In fact, SSA appears to have little
actual concern for the 500,000 SSI recipients who appear eligible for
retroactive Title II benefits. Plans to clear up this work backlog are
projected to be completed well into the next decade. Congress should
certainly demand that this outrageous situation be rectified
immediately; otherwise, many of these destitute SSI beneficiaries will
die prior to receiving their retroactive benefits.
Special Title II workloads are low on SSA's priority list. Instead,
the Union feels that the real purpose of wasting government resources
to process unnecessary disability claims is to create a false picture
of the health of the Agency. SSA achieves a substantial reduction in
processing time by adding the short processing time of technical
denials to the processing time of claims that require a disability
decision. Thus, SSA can report to Congress that processing time for
disability cases is 93 days. This appears to be an improvement over the
120 day processing time of 5 years ago. However, the real time for
processing legitimate disability claims is much higher. Congress should
demand an end to this practice and that the Agency provide separate
statistical reports regarding processing time for claims that require a
disability decision vs claims that don't (i.e., technical denials).
SSA argues that technological improvements such as the Electronic
Disability Claims System (EDCS) have reduced processing time. SSA's
budget request contains millions of dollars for technological
improvements which arguably result in better service. However, the
statistics are unreliable. Congress must demand accountability.
Processing time must reflect the actual time it takes to process
``real'' disability claims. When resources are limited, how can we
afford to do unnecessary work?
Another problem that is of concern regarding taking claims from
obviously ineligible claimants is the excessively intrusive information
that the government is gathering from its citizens and maintaining on
databases. Why should someone who files for SSA disability benefits
supply information to the government regarding their income, resources,
assets, etc, that are determining factors for Title XVI entitlement,
when this person is clearly ineligible? Such an invasion of privacy is
unwarranted and not in the public interest.
Also, how can Commissioner Barnhart place a moratorium on CDRs and
redeterminations when the Agency is demanding that its employees
process thousands of unnecessary claims? This is an outrageous waste of
government resources and should be investigated by Congress.
New Medicare Workloads
Although SSA has experienced staff cuts for FY06 and is projected
to experience additional cuts in FY 07 of 2412 work years based on the
President's proposed budget, SSA workers have been given additional
responsibilities under the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003 (MMA). SSA's 2005 budget provided for a
modest increase in staffing levels to prepare for the implementation of
Medicare Part D. Unfortunately while Congress appropriated some staff
for Medicare Part D, SSA total work years were reduced in FY06. The end
result was more work and less staff and overtime--not a recipe for
success.
AFGE has received reports that the ongoing confusion and
communication problems experienced by the public have had a significant
adverse impact on both SSA's 800 number and field offices interview
waiting times.
SSA workers have reported the public's complaints of not being able
to access our 800 number due to constant busy signals. Once access is
gained, long waits in queue occur. SSA workers reported that the public
had the misperception that SSA administers Medicare Part D. This
resulted in great frustration when SSA workers properly referred calls
to the Center for Medicare and Medicaid Services (CMS). SSA field
office employees reported a heavy overflow of callers and visitors
seeking advice due to their failure to understand the complexities of
Medicare Part D. To date SSA workers have processed nearly 4 million
subsidy application for Medicare Part D. AFGE applauds the
professionalism and patience of the 800 number agents and field office
employees who struggled to provide quality service under the stressful
environment of these circumstances. Unfortunately, the Commissioner did
not make an effective case for more staff to process this new workload.
Instead 800# workers experienced severe leave restrictions and
increased scrutiny of their work performance. Punishing overworked
employees for the Agency's failure to obtain sufficient resources is a
misguided approach.
Although the initial enrollment period has elapsed, the impact of
the MMA will continue to put a drain on SSA resources. The MMA requires
redeterminations of Medicare Part D subsidy applications. AFGE
understands those redeterminations should begin in FY06. Yet,
Commissioner Barnhart has suspended processing of the SSI scheduled
redeterminations for FY06 and possibly FY07 because of cuts to SSA's
budgets. AFGE seriously doubts that SSA will be able to initiate
Medicare Part D redeterminations in FY06.
Congress should be very concerned about the integrity compromises
that this will present for this program. Without a major increase of
staffing, Medicare Part D may become one of the many SSA programs where
integrity takes a back seat to expediency.
As Commissioner Barnhart has testified, SSA will face new Medicare
challenges at the beginning of FY 2007. Section 811 of the MMA
establishes a new Medicare Part B tax for those with higher incomes.
Beginning in January 2007, the federal Part B tax will be increased
so that beneficiaries with higher incomes pay higher Part B premiums.
This will affect beneficiaries who have income of more than $80,000 if
they are single and more than $160,000 for married couples. MMA
requires SSA to use IRS data to determine who is affected and the
amount of the additional premium they will have to pay.
Unfortunately, the IRS data that SSA will receive will be 2 to 3
years old. This will provide good cause for many Medicare beneficiaries
to provide more recent tax return data to determine the correct
premium. MMA allows beneficiaries to request corrected premiums when
they have a life-changing event that significantly reduces their income
or to provide corrected or amended tax returns.
The implementation of Medicare Part B will certainly cause an
increase of calls and visits to SSA offices. Congress provided no
additional staff for SSA to process this new Medicare Part B workload.
In fact, the President's FY 07 proposed budget cuts work years. The
Agency projects up to 5 million Medicare Part B beneficiaries who may
be impacted by the increased Medicare tax. Many will appeal their tax
determinations since their incomes have changed in the last 2 or 3
years. This means lengthy interviews and more work with less staff.
AFGE is very concerned with the Administration's communication plan
regarding Medicare Part B. The Federal Register notice is not a
document that is well read by the general public. The Federal Register
should not be the public's first and only notice of such changes that
affect the cost of medical insurance.
SSA should engage in a well publicized communication campaign to
inform the public of these changes. Without such a campaign, the first
official and personal notice that the beneficiaries receive in November
may cause an unnecessary influx in calls and visits to Social Security
offices that have limited resources. Commissioner Barnhart severely
limited Christmas and holiday leave for 800 number workers last year
because of the implementation of Medicare Part D. This may have been
avoided if an in-depth public relations campaign had been accomplished
prior to implementation. SSA has already notified teleservice center
employees of their intentions to limit 800 number workers' Christmas
and holiday leave to just 10% of the workforce again this year. This is
unfair and unjust treatment of the more than 7000 employees who answer
800# calls who are being made to pay the price for Agency's lack of
preparation.
The Commissioner has testified that the impact of calls relating to
Medicare Part B is foreseeable. However, she has not offered a public
education plan to diminish the need to call or visit an SSA office.
AFGE strongly urges Congress to demand such a plan from the
Commissioner. Both the public and SSA workers deserve efforts to reduce
the impact of this event.
Legislative Mandates
The implementation of the Intelligence Reform and Terrorism
Prevention Act of 2004 (IRTPA) required SSA to verify all original
Social Security number requests. Since implementation of this
legislation in December 2005, the impact of this legislation on SSA's
operations and resources has been significant, resulting in increased:
number of visits to Social Security field offices;
SSA contacts with State and Local vital record
custodians;
costs to verify and purchase necessary vital records;
length of the Social Security number process
The implementation of IRTPA did not involve a public relations
campaign to educate the public on the new identity requirements for
Social Security numbers. The lack of public education created chaos and
frustration for the public. SSA estimates that over \1/3\ of the
interviews regarding Social Security Number issues were repeat
interviews. The lack of coordination with the State and local vital
record custodians has caused more work time to resolve problems and
complete processing the Social Security number requests.
Unfortunately, Congress did not provide additional funding to SSA
to implement the IRTPA. This has caused an added hardship on a
workforce that has many other workloads.
Commissioner Barnhart's Disability Initiative
AFGE continues to be very concerned about the Commissioner's plans
to move forward with her disability initiative.
Currently 55 million Americans have a disability, of which 8.3
million Americans and their families receive Social Security Disability
Insurance (SSDI) (17.1% of all Social Security benefits are paid to
disabled beneficiaries and their families.) Some disabilities are long
term (e.g., broken back) while others are permanent (e.g., blindness,
quadriplegia).
As explained previously, real processing time for initial
disability claims that require a disability decision is unknown.
However, processing time for hearings appeals has dramatically
increased. Prior administrations attempted to develop different methods
to streamline the disability determination process. Some pilot
projects, such as the Disability Claims Manager, were considered to be
successful (i.e., resulted in applicants receiving benefits twice as
fast) and were overwhelmingly supported by the public. However,
Commissioner Barnhart refused to implement those pilots and instead
developed a new, untested approach to alter the process. It is the
Union's belief that the Commissioner's approach will do little to get
benefits to the disabled applicant faster or improve service. The
commissioner's plan eliminates one appeal step and implements new legal
barriers to obtaining benefits:
The rules provide for the establishment of a Quick Claims
Unit for claims filed by individuals who have obvious disabilities.
Claims that are sent to this unit are targeted to have a completed
disability decision within 20 days. The union favors the establishment
of such a unit. The union opposes placement of the unit in the State
Disability Determination Service (DDS). This is an unnecessary handoff.
Employees who work in SSA field offices are entirely capable of being
trained to make such disability determinations. The DCM pilot proved
that fact. SSA public surveys indicate that there is overwhelming
desire from the public that disability decisions be made by the person
who interviews them. The Quick Decision Units provide the Agency with
an opportunity to streamline the process by eliminating a handoff and,
at the same time, satisfy the public desire for a caseworker to be
empowered to decide both the disability and non-disability portions of
their claim. Allowing federal employees in field offices to make
disability decisions would require Congress to change the exclusivity
portions of the law that currently reserve such decisions to the state.
It is time for Congress to enact such a change in the law and improve
public service.
In place of the current Reconsideration process,
attorneys (Federal Reviewing Officials) will review cases and write a
``legal decision'' that will serve as the SSA's legal position on the
case. In spite of the Commissioner's hiring freeze for direct service
positions and her claim of budget shortages, an army of attorneys are
being hired as this statement is written. The trust fund (SSA) and
general revenue (SSI) impact of eliminating reconsiderations and
replacing them with a reviewing official review is unknown. Failure to
pilot this change is risky and reckless. Substantial deviation from the
current disability approval rates could lead to unwarranted
expenditures or, conversely, more stringent policy decisions regarding
the definition of a disability.
The Administrative Law Judge (ALJ) will now be limited in
what he/she can consider as evidence from the claimant as all medical
evidence must be presented five days prior to the hearing. The ALJ is
limited in what he/she can consider good cause for late medical
evidence notwithstanding its relevance. Prior to the Commissioner's new
approach, the ALJ was allowed total discretion to accept and evaluate
evidence. Under the new rules the ALJ's written decision must explain
in detail why he/she agrees or disagrees with the substantive findings
and overall rationale of the Federal Reviewing Official's legal
decision. The ALJ must rebut SSA's legal decision if benefits are to be
awarded to a claimant. One can anticipate that hearing reversal rates
will decrease due to the pressure on the ALJ to uphold the Reviewing
Official decision.
The disability application or ``record'' will be closed
effective with the ALJ's decision, prohibiting U.S. District Courts
from accepting or considering relevant and material evidence that might
prove that the claimant is disabled. This likely will result in
thousands of new disability claims each year in the form of
reapplications. This subtle bureaucratic change realistically could
result in the loss of significant retroactive benefits for those who
refile with evidence of disability with an onset date within the scope
of the previous application. There is no reason to close the record at
any time other than to reduce the ability of claimants to present
relevant evidence to support their claim. This will surely lead to
decisions to deny benefits to claimants who are disabled under the law.
Some of the adverse affects of this new closing of the record
regulations are:
Loss of complete or partial coverage for Social
Security Disability Insurance
Loss of coverage for Medicare benefits entirely
Loss of retroactive Medicaid and Medicare coverage
for a period of time covered by current rules (from the date
the claim was initially filed to the date of the subsequent
application).
Such uncertainty regarding a key element of this change in the
appellate process causes the Union to strongly suggest piloting any of
these changes. Commissioner Barnhart has rejected pilots. Besides
piloting the Reviewing Official step replacing the reconsideration, the
Union feels that the Agency should pilot the decision to require that
the reviewing official be an attorney. This decision ignores the fact
that there are many highly qualified non-attorney employees in both SSA
and the DDS's who are fully capable of deciding disability appeals and
writing logical decisions. The Commissioner both insults the current
workforce and creates difficult legal barriers for claimants to
overcome in appeals. In an attorney dominated process (i.e., Reviewing
Official and ALJ) claimants will almost be required to hire an attorney
to manage their appeals at the earliest level. This adds an element of
litigation that does not currently exist in the reconsideration appeal.
The Commissioner will replace the Appeals Council Review with a
Decision Review Board (DRB). The DRB will be appointed by the
Commissioner to review and correct ALJ decisions including approved
claims. The DRB will not review decisions by state officials (DDSs) or
federal Reviewing Officials (FRO). This will prevent processing payment
of an approved claim and will render the ALJ's decision as not final.
The process by which cases will be selected for review will be entirely
at the DRB discretion and will provide the DRB with carte blanche
authority to pick cases in a non-random manner. Such unregulated
authority is an invitation for abuse
The Appeals Council currently either reverses or remands 30% of
claims that they review.
Eliminating an appeal where such a large number of cases are either
reversed or where all the evidence was not properly assessed insures
that many claimants will be denied benefits that would be approved
under the current system. Is this the desire of Congress? Does Congress
really want to scale back the SSA disability program so that claimants
approved under the current system are now denied benefits?
A claimant's last appeal, U.S. District Court, requires
legal representation. This will severely disadvantage claimants who
lack the financial resources to either hire an attorney or travel to
District Court. Additionally, the U.S. District Court system which is
already overwhelmed is not prepared to absorb this influx of additional
cases.
Commissioner Barnhart's new approach fails to address the problems
and inadequacies of the State Disability Determination Services (DDS),
which is responsible for the initial disability decision in all claims.
There is no consistency in State DDS disability determinations. The
taxpayer's chances of being approved for disability benefits continue
to depend more on where they live and their income.
For example, State Agency Operations records indicate that those
who can obtain medical attention early and often have a better chance
of being approved for benefits than those who have a limited income or
resources. (See Chart Below) Nationwide, those applying for Social
Security disability have a much greater chance of being approved than
those who may only apply for the Supplement Security Income (SSI)
program. State Agency records clearly expose the inconsistencies of the
State DDS decisions.
More than 66 percent of Social Security disability claims for
benefits are approved in the Washington DC DDS, while only less than 28
percent of those who file for benefits are approved in the South
Carolina DDS. Of those who applied for SSI benefits, the State of New
Hampshire leads with more than a 59 percent allowance rate. However,
residents from the States of Michigan, Ohio, Iowa and Georgia are
approved less than 35 % of the time by their respective DDS. The
concurrent disability process shows inexplicable variable allowance
rates depending on the state of residence. Allowance rates are low in
every state. The states of New Hampshire, Arizona and the District of
Columbia approve more than 43 percent of the concurrent claims. Less
than 18 percent of those filing concurrent disability claims are
approved in Iowa, Missouri, and South Carolina.
As an illustration, following is a compilation of the allowance
rates in a sample of states:
----------------------------------------------------------------------------------------------------------------
T2 Initial T16 Initial Concurrent Initial
-----------------------------------------------------------------
Allow Deny Allow Deny Allow Deny
----------------------------------------------------------------------------------------------------------------
NATIONAL AVERAGE 44.2 55.8 36.4 63.6 25.3 74.7
----------------------------------------------------------------------------------------------------------------
BOSTON Region 53.7 46.3 43.6 56.4 33 68
----------------------------------------------------------------------------------------------------------------
Boston, MA 56.9 43.1 48.7 51.3 36.6 63.4
----------------------------------------------------------------------------------------------------------------
New Hampshire 63.8 36.2 59.2 40.8 48.2 51.8
----------------------------------------------------------------------------------------------------------------
Connecticut 47.3 52.7 34.3 66.7 23.5 76.5
----------------------------------------------------------------------------------------------------------------
New York Region 51.4 48.6 42.8 57.2 33 67
----------------------------------------------------------------------------------------------------------------
Buffalo, NY 47 53 33.8 66.2 23 77
----------------------------------------------------------------------------------------------------------------
Newark, NJ 60.8 39.6 42.1 57.9 34.9 65.1
----------------------------------------------------------------------------------------------------------------
Puerto Rico 34.2 65.8 -- -- -- --
----------------------------------------------------------------------------------------------------------------
Philadelphia Region 51.7 48.3 40.3 59.7 28.9 71.1
----------------------------------------------------------------------------------------------------------------
Maryland 49.9 50.1 35.4 64.6 24.9 75.1
----------------------------------------------------------------------------------------------------------------
PA 53.3 46.7 41.8 58.2 28.1 71.9
----------------------------------------------------------------------------------------------------------------
VA, DC 66.1 33.9 54.8 45.2 45.5 54.5
----------------------------------------------------------------------------------------------------------------
Atlanta Region 34.9 65.1 30.1 69.9 21.2 78.8
----------------------------------------------------------------------------------------------------------------
Georgia 30.3 69.7 27.1 72.9 19.1 80.9
----------------------------------------------------------------------------------------------------------------
Kentucky 39.4 60.6 33.3 66.7 21.1 78.9
----------------------------------------------------------------------------------------------------------------
Birmingham 38.4 61.6 27.5 72.5 20.7 79.3
----------------------------------------------------------------------------------------------------------------
Florida 38.5 61.5 35.5 64.5 26.4 73.6
----------------------------------------------------------------------------------------------------------------
Miami 43.7 56.3 44.8 55.2 35.6 64.4
----------------------------------------------------------------------------------------------------------------
S. Carolina 28.2 71.8 26 74 17.7 82.3
----------------------------------------------------------------------------------------------------------------
Chicago Region 41.9 58.1 30.8 69.2 21.4 78.6
----------------------------------------------------------------------------------------------------------------
Illinois 43.8 56.2 30.4 69.6 23.9 76.1
----------------------------------------------------------------------------------------------------------------
Michigan 39.3 60.7 29.9 70.1 19.7 80.3
----------------------------------------------------------------------------------------------------------------
Detroit 32 68 26.4 73.6 16.5 83.5
----------------------------------------------------------------------------------------------------------------
Ohio 39.4 60.6 27.1 72.9 19.1 80.9
----------------------------------------------------------------------------------------------------------------
Wisconsin 46.9 53.1 34 66 21.4 78.6
----------------------------------------------------------------------------------------------------------------
Dallas Region 44.2 55.8 39.2 60.8 28.2 71.8
----------------------------------------------------------------------------------------------------------------
Texas 42.7 57.3 41.6 58.4 28.6 71.4
----------------------------------------------------------------------------------------------------------------
New Mexico 47 53 44.8 55.2 31.2 68.8
----------------------------------------------------------------------------------------------------------------
Oklahoma 43.1 56.7 36.8 63.2 24.4 75.6
----------------------------------------------------------------------------------------------------------------
Shreveport 53.8 46.2 37.3 62.7 35.3 64.7
----------------------------------------------------------------------------------------------------------------
Kansas City Region 43.6 56.4 30.5 69.5 17.9 82.1
----------------------------------------------------------------------------------------------------------------
Missouri 42.9 57.1 29.8 70.2 17.4 82.6
----------------------------------------------------------------------------------------------------------------
Iowa 45.5 54.5 32.3 67.7 16.4 83.6
----------------------------------------------------------------------------------------------------------------
Denver Region 38.5 61.5 39.1 60.9 21.5 78.5
----------------------------------------------------------------------------------------------------------------
Colorado 35 65 38.6 61.4 20.5 79.5
----------------------------------------------------------------------------------------------------------------
N. Dakota 51.2 48.8 39.6 60.4 28.1 71.9
----------------------------------------------------------------------------------------------------------------
S. Dakota 45.4 54.6 34.9 65.1 18.9 81.1
----------------------------------------------------------------------------------------------------------------
San Francisco Region 50.9 49.1 44.4 55.6 32.4 67.4
----------------------------------------------------------------------------------------------------------------
Arizona 59.3 40.7 51.8 48.2 43.3 56.7
----------------------------------------------------------------------------------------------------------------
California 50.8 49.2 43.9 56.1 31.8 68.2
----------------------------------------------------------------------------------------------------------------
Bay Area 60.6 39.4 52.5 47.5 36.6 63.4
----------------------------------------------------------------------------------------------------------------
L. A. East 49.4 50.6 49.8 50.2 37.4 92.5
----------------------------------------------------------------------------------------------------------------
L. A. West 54.4 45.6 49.6 50.4 34.5 65.5
----------------------------------------------------------------------------------------------------------------
Central Valley 48.1 51.9 39.3 60.7 28.2 71.8
----------------------------------------------------------------------------------------------------------------
Sacramento 54 46 38 62 29.7 70.3
----------------------------------------------------------------------------------------------------------------
Seattle Region 43.1 56.9 41.3 58.7 24.3 75.7
----------------------------------------------------------------------------------------------------------------
Oregon 35.4 64.6 34.7 65.3 18.8 81.2
----------------------------------------------------------------------------------------------------------------
Seattle 45.4 54.6 45.4 54.6 27.1 72.9
----------------------------------------------------------------------------------------------------------------
In a system where everyone is taxed equally, this is difficult to
explain or justify. Claimants are entitled to quality consistent
decisions not withstanding their state of residence or whether they are
filing for Social Security or SSI disability benefits.
According to GAO,\1\ a majority of DDSs do not conduct long-term,
comprehensive workforce planning, which should include key strategies
for recruiting, retaining, training and otherwise developing a
workforce capable of meeting long term goals. The State DDS' lack
uniform minimum qualifications for examiners, have high turnover rates
for employees and do not provide ongoing training for examiners. This
seems to be mostly attributed to State employee pay and benefit scales
and budget constraints.
---------------------------------------------------------------------------
\1\ GAO-04-121
---------------------------------------------------------------------------
AFGE is convinced that SSA is not able to correct these problems.
AFGE has expressed these very concerns to the Subcommittee for several
years and has seen little improvement with the State DDS situation.
AFGE has recently become aware of the preliminary Systems Impact
Assessment of SSA program modifications needed to accommodate the new
disability determination process. The modifications considered
necessary will be massive, leaving few programs untouched. Some of the
systems changes may or may not require outside contractors; the changes
will involve modifications to State DDS systems, which will have to be
coordinated; SSA firewalls will require safeguarding; all software
written for such modifications will require approval and such approval
from the Architectural Review Board is not certain; and programs should
require extensive testing before use.
AFGE finds the extent of these required modifications to be
alarming. Is it reasonable, to begin implementation in the Boston
Region before such systems changes can be made? SSA's budgets for FY06
and FY07 do not provide the money that will be needed to accomplish the
systems changes necessary. Where do the resources come from to make
these changes?
With staffing cuts and heavy workloads that continue to rise, is it
reasonable to use resources for an untested, unpiloted theory, rather
than to provide staffing on the front lines to improve public service?
AFGE believes the answer is clearly NO.
Commissioner Barnhart's approach fails to implement new
communication or adjudicative techniques either that improve service to
the disabled claimant or result in a more accurate or expeditious
decision. More importantly, these changes will not protect the rights
and interests of people with disabilities.
The record should be clarified with regards to Commissioner
Barnhart's statement that she met with the organizations that represent
SSA employees. She did. She held one meeting with all 6 SSA council
presidents for the purpose of introducing her plan. That was 3 years
ago. Ms. Barnhart was not receptive to our constructive criticisms. The
leadership of six bargaining councils has more than 150 years of
specialized experience with SSA and represents 50,000 bargaining unit
employees. She refused to include experienced bargaining unit employees
in strategy sessions or workgroups that helped design the new plan. The
Union rejected this plan and Ms. Barnhart has since refused to meet
and/or discuss any subject matter with AFGE. Ms. Barnhart does not have
the support or the buy-in of SSA workers. In fact, SSA employees
overwhelmingly oppose this disability plan.
Effects on SSA Workers
The constant pressure to accomplish workloads with inadequate staff
has taken its toll on the employee morale at SSA. AFGE if very
concerned about the stressful working conditions of SSA employees and
the long term effects of such conditions on employee health.
SSA employees have always risen to the challenge of meeting the
public service needs, and processing escalating workloads timely. SSA
workers understand that budget shortages are often not under the
control of their managers.
AFGE believes the plummeting employee morale at SSA is caused by
issues that are in the control of the Commissioner. Such issues
include:
Implementation of unannounced service observations of 800
number personnel, which would automatically elevate stress factors on
the job, adding additional pressure when understaffing is a known
problem.
Implementation of leave restrictions and/or limitations
for vacations and holidays.
Numeric Performance goals which require 800# operators to
be ``plugged in'' for certain minimum periods and require employees to
interview a minimum number of claimants per day.
Recent changes in the labor contract demanded by the
Commissioner, which require employees to do SSA work instead of care
for emergency situations in their families such as unforeseen child
care emergencies.
Refusal to meet with employee's union representatives to
discuss and resolve issues.
Disempowering employees by not soliciting their ideas
when considering and implementing new programs (i.e., Disability
Initiative, Medicare Part D) and eliminating prior employee involvement
in the awards and merit promotion process.
At a time when SSA employees should be encouraged because of huge
public demands and when employees have largely met these demands, the
Commissioner has chosen to take a hard line, punitive approach with
employees.
SSA has also informed AFGE of its intention to implement a new
performance appraisal system in October 2006. This will be a 3 tiered
performance system, similar to a performance system SSA used many years
ago. Like the former tiered appraisal system, this will be a huge drain
on management resources. The current appraisal system has resulted in
increased productivity, high levels of accuracy, low Agency
administrative overhead expenses and widespread public satisfaction.
SSA wants to change the appraisal system to one which emphasizes
statistical performance, competition and, inevitably, manipulation of
data. Why SSA wants to create an adversarial environment at the
worksite is a mystery to many.
SSA may argue that the union agreed to a new appraisal system in
contract negotiations. The truth is that the nature of the appraisal
system is largely a management right which SSA made quite clear during
negotiations. The bottom line is that despite the budget squeeze, SSA
employees have come through in the clutch for the Agency and for
America. Why create a different system which will cause work place
conflict rather than cooperation? Congress should ask the Commissioner
to reconsider this appraisal system which will result in great turmoil
at the job site.
In Conclusion
There will always be budget priorities. However, both workers and
employers contribute to the Social Security system and are entitled to
receive high quality service. It is entirely appropriate that spending
for the administration of SSA programs be set at a level that fits the
needs of Social Security's contributors and beneficiaries, rather than
an arbitrary level that fits within the current political process.
In 2000, then Chairman Shaw and Rep. Benjamin Cardin reintroduced
the Social Security Preparedness Act of 2000 (formerly H.R. 5447), a
bipartisan bill to prepare Social Security for the retiring baby
boomers. AFGE strongly encourages this Subcommittee to reconsider
introducing legislation that will provide SSA with the appropriate
funding level to process all claims and all post-entitlement workloads
timely.
Taking SSA's administrative expenses ``off-budget'' has vast
support, not only from AFGE and SSA workers, but from senior and
disability advocacy organizations. This would include AARP, the
National Committee to Preserve Social Security and Medicare, the
Alliance for Retired Americans, the Consortium for Citizens with
Disabilities, and the Social Security Disability Coalition, just to
name a few.
AFGE believes that by taking these costs OFF-BUDGET with the rest
of the Social Security program, Social Security funds will be protected
for the future and allow for new legislation, such as the Medicare
Prescription Drug, Improvement, and Modernization Act of 2003 and the
Intelligence Reform and Terrorism Prevention Act of 2004 to be
implemented without comprising public service integrity. We believe
this can be accomplished with strict congressional oversight to ensure
the administrative resources are being spent efficiently.
AFGE is committed to serve, as we always have in the past, as not
only the employees' advocate, but also as a watchdog for clients, for
taxpayers, and for their elected representatives.
Statement of Consortium for Citizens with Disabilities Social Security
Task Force
This statement for the record is submitted by Ethel Zelenske on
behalf of the Consortium for Citizens with Disabilities Social Security
Task Force. CCD is a working coalition of national consumer, advocacy,
provider and professional organizations working together with, and on
behalf of, the 54 million children and adults with disabilities and
their families in the United States. The CCD Social Security Task Force
focuses on disability policy issues in the Title II disability program
and in the Title XVI Supplemental Security Income (SSI) program.
The topic of this hearing is especially important to people with
disabilities who rely upon the Social Security Administration: to
adjudicate completely and fairly their applications for disability
benefits; for payment of their monthly Social Security and Supplemental
Security Income benefits; to withhold their Medicare Part B and Part D
premiums from their benefits; to determine their eligibility for Part D
drug subsidies, also known as ``extra help;'' and to make accurate and
timely determinations on post-entitlement issues that may arise in
their cases. Like millions of others across the nation, people with
disabilities count upon SSA to issue Social Security numbers for their
newborn children, to issue replacement SSN cards when needed, to record
and maintain their earnings records, to correctly answer their
questions when they call the ``800'' number, and to meet with them when
they visit one of the approximately 1,300 SSA field offices with
questions or reports.
This statement addresses four key points related to SSA's
administrative challenges.
First, SSA is doing a good job with limited resources. There is
much that remains to be done and some workloads that need more
attention, but Commissioner Barnhart has made great strides in
improving the agency's technological capacity in ways that will help it
accomplish its work. We are concerned, however, that SSA does not have
adequate funds for the current fiscal year and will not have sufficient
funding under its proposed budget for fiscal year 2007. SSA's budget
materials for FY 2007 indicate that at the funding levels being
requested, the recent progress will not be able to be sustained.
Second, we believe that SSA needs more funding to provide the level
of post-entitlement work that is required in both the Social Security
and SSI programs. By ``post-entitlement'' work, we mean the contacts
that SSA has (or should have) with a beneficiary once the person begins
to receive Social Security or SSI benefits.
Third, we are concerned that SSA have sufficient funds to maintain
the level of continuing disability reviews (CDRs) that it should be
doing in Social Security and SSI disability cases. These reviews are
essential to maintaining the integrity of the disability determination
process.
Fourth, without additional resources, SSA is not going to be able
to keep up with the technological challenges it faces. SSA's future
success may be threatened by Congressional interest in adding to its
workload, especially in verifying employee SSNs and immigration status,
unless SSA is provided with adequate additional resources to address
the new workloads over the long term. Further, Congress should try to
identify a way to ensure that SSA's budget is not reduced arbitrarily
through across-the-board cuts or affected in ways that compromise the
service that SSA provides, as a result of pressure from very tight
ceilings on total discretionary funding.
The remainder of this statement discusses these points in greater
detail.
I. SSA is doing a good job with limited resources. But there is much
that still needs to be done, and SSA will not be able to
sustain recent progress as the funding levels that have been
requested.
Overall, SSA currently is a well-managed agency. Commissioner
Barnhart has taken numerous steps to improve SSA's technology and
procedures so the agency is better able to accomplish its missions.
However, we are concerned that SSA does not have adequate resources to
meet all of its current responsibilities, including some of importance
to people with disabilities.
Of greatest concern, even with the increase that SSA seeks for FY
2007, SSA will need to reduce its staff. SSA is seeking $387 million
more for fiscal year 2007 than it has received for fiscal year 2006,
but this figure will not even leave the agency staffing whole. This
budget request will result in a loss of 2,545 full-time staff
positions/work years.\1\ This is a result of increased costs for
salaries and benefits for existing staff. As a result, we believe SSA
needs more funds than it is seeking.
---------------------------------------------------------------------------
\1\ See FY 2007 President's Budget, February 6, 2006, Congressional
Briefings (hereinafter, ``SSA FY 2007 Congressoinal Briefings,'' page
11, ``SSA's FY 2007 Administrative Budget: Full-Time Equivalents and
Workyears.'' The chart provides the following information:
2006 2007 +/-
estimate estimate
SSA FTEs (including OIG) 63,998 62,036 -1,962
SSA overtime and lump sum leave 2,398 1,948 -450
DDS Workyears 14,398 14,265 -133
Total SSA/DDS Workyears 80,794 78,249 -2,545
---------------------------------------------------------------------------
These staffing reductions may translate into SSA being less able to
do post-entitlement work and not being able to reduce the backlogs in
the administrative appeals process. Both of those tasks require
sufficient commitments of staff time. Without adequate staffing, these
are areas of work that tend to stagnate quickly, resulting in increased
backlogs or, with post-entitlement work, cases being ignored.
SSA's progress in reducing delays related to administrative appeals
is projected to slow down--actually to worsen in some cases--in fiscal
year 2006. For example, in fiscal year 2005, SSA's average processing
time for initial disability claims was 93 days. SSA had proposed to
reduce that figure to 91 days in the President's fiscal year 2006
budget, but with its enacted fiscal year 2006 appropriation, SSA
expects only to maintain, not reduce, this processing time--keeping it
at 93 days. Further, SSA is not proposing to reduce this figure in
fiscal year 2007, when it will again be 93 days.
More troubling, the average processing time for hearing decisions
at the Administrative Law Judge level was 415 days in fiscal year 2005.
That is far too long. Yet, in fiscal year 2006, SSA expects that the
average time frame will climb to 467 days, an additional 52 days.\2\
SSA expects this to be the average figure in fiscal year 2007 as well.
While this will include processing an additional 17,000 hearing
decisions in fiscal year 2007, SSA should be provided sufficient funds
to reduce the delays while also processing more decisions.\3\ This
suggests that SSA is not asking for sufficient funds in its overall
Limitation on Administrative Expenses (LAE) request to reduce these
delays.
---------------------------------------------------------------------------
\2\ SSA, SSA FY 2007 Congressional Briefings, pages 8 and 14.
\3\ SSA processed 519,000 cases at the appeals level through ALJ
decision in fiscal year 2005 and expects to process 560,000 cases
through the ALJ decision in fiscal year 2006 and 577,000 cases through
the ALJ decision in fiscal year 2007. Id., pp. 9 and 15.
---------------------------------------------------------------------------
II. SSA doe snot have the resources it needs to fully address its post-
entitlemment workloads.
Not surprisingly, with millions of new applications each year, SSA
emphasizes the importance of processing applications, determining
eligibility, and providing benefits. Once a person begins to receive
monthly benefits, there are many reasons why SSA may need to respond to
contacts from the person or to initiate a contact. This is known as
``post-entitlement work'' and generally does not receive the priority
it should. All too often, when SSA is short on staff and local offices
are overwhelmed by incoming applications and inquiries, they are less
attentive to post-entitlement issues. For people with disabilities,
this can discourage efforts to return to work, undermining an important
national goal of assisting people with disabilities to secure and
maintain employment. Also, the lack of resources results in diminished
accessibility to the process for people with disabilities. For example,
one ongoing problem has been the lack of communications in accessible
formats for recipients who are blind or visually impaired or deaf-
blind.
One example of post-entitlement work that has fallen by the wayside
in the past is the processing of earnings reports filed by people with
disabilities. For many years, beneficiaries of Social Security or SSI
disability payments who wish to return to work have found that they can
end up owing SSA substantial sums as a result of overpayments for which
they were not at fault. Typically, this has happened when the
individual calls SSA and reports work and earnings or brings the
information into an SSA field office, but SSA fails to input the
information into its computer system and does not make the needed
adjustments in the person's benefits. Then, months or years later,
after a computer match with earnings records, SSA determines that the
person was overpaid and sends a notice to this effect. All too often,
after receiving the overpayment notice, the beneficiary will tell SSA
that he or she reported the income as required and SSA will reply that
it has no record of the reports.
Depending on which program the person participates in--Social
Security or SSI--discovery that the person is working may result in
complete loss of cash benefits (Social Security) or a reduction in cash
assistance (SSI). It also can affect the person's health care coverage.
To collect the overpayment, SSA may decide to withhold all or a portion
of any current benefits owed, or SSA may demand repayment from the
beneficiary if the person is not currently eligible for benefits. The
result of this is that some individuals with disabilities are wary of
attempting to return to work, out of fear that this may give rise to
the overpayment scenario and result in a loss of economic stability and
potentially of health care coverage upon which they rely. As a result
of this long-term administrative problem, anecdotal evidence indicates
that there is a widespread belief among people with disabilities that
it is too risky to attempt to return to work, because the beneficiary
may end up in a frightening bureaucratic morass of overpayment notices,
demands for repayment, and benefit termination.
Recently, SSA has been making some significant progress on this
issue. It has developed the ``e-Work'' system, a new computer process
through which SSA staff record reports of earnings from Social Security
disability beneficiaries. The system is designed so that office
managers know when there is additional work to be done on the case in
order to ensure that the information is input completely into the
system and acted upon in a timely manner. SSA is working on a parallel
system for SSI, but that system is not yet operational. As a result of
SSA's effort on ``e-Work,'' SSA theoretically and practically is
situated to resolve this long-standing problem and hopefully to
eliminate a serious work disincentive. But that will not occur if this
work is not given priority. Without the staffing needed to conduct this
post-entitlement work, we are concerned that these cases will continue
to not be processed in a timely manner.
SSA's ability to respond to work reports submitted by Social
Security and SSI disability beneficiaries in a timely manner is
essential if progress is to be made in realizing Congress' goal of
reducing work disincentives in the Social Security and SSI disability
programs and encouraging more beneficiaries to attempt to return to
work. With the increases expected in applications from retirees and
people with disabilities over the next few years--and the staff
reductions already being built into SSA's budget request--the
encouraging work now underway on earnings reports is likely to be
pushed to the side if SSA does not have sufficient funding to do the
requisite post-entitlement work.
III. SSA needs additional funds to conduct more continuing disability
reviews and to remain current on SSI redeterminations.
In 1984, Congress corrected some very troubling problems that were
occurring--individuals with severe disabilities were being arbitrarily
terminated from the program--by developing and enacting the current
continuing disability review (CDR) rules. It is essential both to
beneficiaries and to SSA that Congress provide SSA with sufficient
funds to conduct these reviews.
In fiscal year 2007, SSA seeks a total of $490 million to conduct
continuing disability reviews. This includes $289 million in base
funding and another $201 million in additional funds.\4\ SSA has
reported that each dollar spent on CDRs returns $10 in benefit savings
to the program.\5\
---------------------------------------------------------------------------
\4\ The $289 million in base funding includes $60 million for SSI
CDRs and $229 million for Social Security disability CDRs. The $201
million in additional funding being requested for fiscal year 2007
includes $60 million for SSI CDRs and $141 million for Social Security
disability CDRs. Social Security Administration: Fiscal Year 2007,
Justification of Estimates for Appropriations Committees, Social
Security Administration, SSA Pub. No. 22-017, February 2006, page 63,
footnote 2.
\5\ See SSA: The Fiscal Year 2007 Budget Press Release, SSA, page
12.
---------------------------------------------------------------------------
Failure to provide SSA with adequate funds to stay current with the
processing of continuing disability reviews would, over time, diminish
the integrity and accuracy of the disability programs. To protect
program integrity and avert improper payments, it is essential that SSA
conduct ongoing, regular reviews (CDRs) to determine whether recipients
with disabilities continue to be eligible.
Failure to conduct the full complement of CDRs would have adverse
consequences for the federal budget and the deficit. As noted, SSA has
determined that CDRs result in $10 in program savings for each $1 spent
in administrative costs in conducting these reviews. SSA estimates that
the CDRs it conducted in 2002 ``are expected to yield $6 billion in
lifetime program savings.'' \6\ To put this figure in context, of the
one million Social Security continuing disability reviews that SSA
conducted in fiscal year 2001, SSA continued benefits in 96 percent of
the cases reviewed and terminated benefits in four percent of the
cases.\7\ Even though the great majority of CDRs result in continuation
of benefits, the savings from those CDRs that result in terminations
are substantial because of the size of the program and the value of the
benefits provided.
---------------------------------------------------------------------------
\6\ Social Security Administration: Fiscal Year 2005: Justification
of Estimates for the Appropriations Committee, SSA Pub. No. 22-017,
February 2004, page 74.
\7\ 2004 Green Book, Committee on Ways and Means, U.S. House of
Representatives, Table I-44, page I-70.
---------------------------------------------------------------------------
The number of CDRs that SSA will conduct is directly related to
whether SSA receives the additional funds it needs to conduct these
reviews. SSA conducted 537,000 medical CDRs in fiscal year 2005 and had
proposed to conduct 750,000 such reviews in fiscal year 2006. However,
that number has been reduced to 360,000 for fiscal year 2006 due to the
lower level of appropriations provided for SSA. In fiscal year 2007,
with some funds sought outside the discretionary caps through a cap
adjustment, SSA hopes to do 597,000 CDRs.\8\ We urge Congress to ensure
the funding is there to undertake these reviews.
---------------------------------------------------------------------------
\8\ SSA FY 2007 Congressional Briefings, pages 9, 15. The President
seeks $201 million for CDRs in fiscal year 2007 and $213 million in
fiscal year 2008 that would be outside the normal ceiling on
discretionary appropriations. The budget proposal also includes $289
million for CDRs within the discretionary ceiling in fiscal year 2007.
See also, footnote 4, above.
---------------------------------------------------------------------------
IV. SSA's future success depends on Congress acting to find ways to
boost its budget now--and to significantly supplement its
budget over the long term as caseloads grow and when new
workloads otherwise are added.
SSA's appropriation competes with that for other programs under the
Labor, Health and Human Services, Education and Related Agencies
Appropriations Subcommittee. In addition, when there is an across-the-
board cut in funding, SSA is affected. Finally, new work often is added
by Congress, without new funds provided to undertake the required work.
When Congress imposed the across-the-board cut on discretionary
funding for fiscal year 2006, SSA lost close to $91 million.\9\
Although the President originally requested $9.403 billion for SSA for
fiscal year 2006, Congress had appropriated $9.199 billion prior to the
across-the-board cut. With the loss of the additional $91 million, SSA
received almost $300 million less than the President requested.\10\
---------------------------------------------------------------------------
\9\ Social Security Adminitrations: Fiscal Year 2007: Justification
of Estimates for Appropriations Committees, SSA Office of Budget, SSA
Pub. No. 22-017, February 2006, page 75.
\10\ SSA requested $9,403,000,000 in fiscal year 2006. Congress
appropriated $9,199,400,00 and then rescinded $90,794,000 in Public Law
109-148, Department of Defense Appropriations Act of 2005. Social
Security Administration: Fiscal Year 2007, Justification of Estimates
for Appropriations Committees, Social Security Administration, SSA Pub.
No. 22-017, February 2006, pages 75-77 and footnote 22.
---------------------------------------------------------------------------
In addition, Congress sometimes passes provisions that show savings
in entitlement costs while failing to recognize the administrative
costs to SSA of implementing those provisions. Three recent examples
are:
1. The Deficit Reduction Act (DRA) signed into law on February 8,
2006 requires that SSA conduct pre-effectuation reviews on 20 percent
of initial SSI allowances at the state disability determination service
level in fiscal year 2006. This number grows to 50 percent of
allowances in fiscal year 2008 and thereafter.\11\ These are cases in
which SSA has determined that the person is eligible for benefits and
SSA now must review a percentage of those decisions prior to finalizing
the allowances. Under the new rules, SSA must review these cases for
accuracy (and possibly change its decision) prior to issuing the
decision.
---------------------------------------------------------------------------
\11\ Section 7501, Deficit Reduction Act of 2005, Pub. L. 109-171,
signed February 8, 2006.
---------------------------------------------------------------------------
2. Also in the DRA, Congress changed how SSI lump sum benefits are
to be paid to recipients. Under the change, SSA is required to issue
lump sum retroactive awards beginning with a first payment equivalent
to three months of benefits. This previously had been 12 months.\12\
The underlying provision that the DRA changed makes clear that in cases
where the amount of the first installment payment works a hardship for
the individual because he or she has debts that need to be repaid, SSA
will provide a higher amount to help cover these debts.\13\ Until now,
because the first installment equaled up to 12 months of benefits, few
new SSI recipients apparently have needed to avail themselves of the
ability to request that SSA issue a different, higher amount. Now that
the first installment will be limited to three months of SSI benefits
(even though SSI disability beneficiaries may have been made to wait
much longer than that to begin receiving benefits and thus may have
incurred substantial debts), it is likely that many more beneficiaries
will need to ask SSA to make the special determination and issue a
larger first payment. This will be a new workload for SSA staff.
---------------------------------------------------------------------------
\12\ Id., Section 7502.
\13\ Section 1631(a)(10)(B)(iii), 42 U.S.C. 1383(a)(10)(B)(iii).
---------------------------------------------------------------------------
3. In the Social Security Protection Act of 2004, Congress
expanded SSA's workload related to ``fleeing felons.''\14\ Since
January 2005, the ban on felons and probation and parole violators
receiving benefits applies not only to SSI (the rule has applied since
1996 in SSI) but also to Social Security beneficiaries. Also, there now
is a ``good cause'' exception that allows payment of benefits under
certain circumstances. It may sound simple to do a computer match,
determine that a person is a fleeing felon or violating probation or
parole and then terminate benefits, but these are people who sometimes
have serious mental impairments or terminal illnesses and they may
require assistance in figuring out what happened and how to respond.
They may need to meet with SSA staff in the field offices to understand
the process and what action they need to take, as well as to determine
if they are eligible for continuation of benefits under the ``good
cause'' exception. Staff time is a valuable SSA resource, one that it
needs more of. The less time that SSA spends on these cases, the more
that individuals can be harmed by inappropriate applications of the
rule.
---------------------------------------------------------------------------
\14\ Section 203, Pub. L. 108-203.
In none of these cases did Congress provide separate funding for
SSA to do the additional work. The assumption is that SSA will work it
out and, if needed, will seek additional funding as part of its next
annual request. That would make sense if it were not for the tight
discretionary spending ceilings the budget resolutions are imposing and
the fact that SSA's budget must compete with the budgets of many
smaller but important discretionary programs that are in the Labor,
HHS, and Education appropriations bill. Unless Congress acts to
identify another way to secure additional funds for SSA on a reliable
basis--not simply for a year or two, as happened with the additional
Medicare Part D funds--we worry that SSA's workload will continue to
grow but its administrative funding will not follow suit.
An example of potential long-term costs are the efforts to expand
employer verification of Social Security Numbers (SSNs) to employers
and employees, as Congress is currently contemplating. Without
expressing an opinion on these proposals, should Congress pass such a
law, it is essential that it provide funds for SSA to implement this
very large increase in workload--not just for a year or two, but out
past 2010 when CBO says the caseload costs would rise very
substantially.\15\ If Congress does not do this, then one can
anticipate that something else important at SSA will not get done or
will be done inadequately. Would it be the continuing disability
reviews? Longer processing times for applications? Longer times to
issue SSNs and replacement SSNs?
---------------------------------------------------------------------------
\15\ CBO estimates that the cost to SSA of implementing its
responsibilities under HR 4437, the Border Protection, Antiterrorism,
and Illegal Immigration Control Act of 2005, would be $200 million over
the 2006 to 2010 period. SSA's costs will continue at high levels
outside the five-year window; CBO estimates that SSA's costs will be
about $640 million over the 2006 to 2015 period. ``Under the bill, the
agency's cost to process employment verification inquiries would
increase substantially after 2010 when all private employers would be
required to check the eligibility of their entire workforce by 2012.''
CBO Cost Estimate on HR 4437, December 13, 2005, page 4, http://
www.cbo.gov/ftpdocs/69xx/doc6954/hr4437.pdf.
---------------------------------------------------------------------------
Conclusion
The CCD Social Security Task Force believes that SSA has been
making strides in addressing delays in the disability determination
process and in the post-entitlement workloads but recognizes that much
more is needed. And, we worry that SSA will not be provided sufficient
funds to conduct the continuing disability reviews. We are concerned
that, at the level of funding provided in fiscal year 2006 and the
level requested for fiscal year 2007, some progress that already has
been made will be eroded. We urge Congress to ensure that SSA receives
adequate funds to maintain and improve upon its vital work.
ON BEHALF OF:
American Association of People with Disabilities
American Association on Mental Retardation
American Council of the Blind
American Network of Community Options and Resources
Association of University Centers on Disabilities
Bazelon Center for Mental Health Law
Brain Injury Association of America
Center on Budget and Policy Priorities
National Alliance on Mental Illness
National Association of Councils on Developmental Disabilities
National Association of Disability Representatives
National Multiple Sclerosis Society
National Organization of Social Security Claimants' Representatives
Research Institute for Independent Living
Title II Community AIDS National Network
The Arc of the United States
United Cerebral Palsy
United Spinal Association
Statement of Michael A. Steinberg, Michael Steinberg and Associates,
Tampa, Florida
Mr. Chairman and Members of the Subcommittee on Social Security:
Thank you for the opportunity to present a written statement for
the printed record of the above referenced hearing.
I am an attorney who has been practicing in the area of Social
Security Disability law for over 23 years. I have written articles for
periodicals and have lectured at National Social Security Disability
Law Conferences. I have handled thousands of cases at all levels of the
administrative and appeals process. Although my office is located in
Tampa, Florida, I have handled cases for claimants throughout the
country.
When I first started practicing, the waiting time for a hearing
before an Administrative Law Judge was just a few months. In 1983, we
all knew that as the babyboomers began to age, more claims for
disability would be filed and that Social Security needed to be
prepared for the increased workload.
As time went on, the volume of claims grew as expected, as well as
the backlog. In the late 1980's and early 1990's, I recall speaking
with my Congressman, Sam Gibbons, who at the time was on this
committee, about the delays in processing claims. It certain cases, he
would write to the local Office of Hearings and Appeals inquiring as to
the status, and somehow, those cases would be expedited. Nonetheless,
nothing effective was done to reduce the backlog and the delays. They
just kept getting worse.
When Congressman Jim Davis was running for the U.S. House of
Representatives for the first time, I was Chairman of the Social
Security Subcommittee of the Hillsborough County Bar Association. In
one of our meetings we invited him to speak and we asked him what he
would do about the delays in processing disability claims. He vowed to
work toward reducing the waiting period for claimants. The backlog
continued to grow.
Over the past year, several of my clients died while their claims
were pending. In fact the day before this hearing, I received a call
from the daughter of a client who advised that her mother died the
night before. This woman had hypertension, but could not afford proper
medical care. While waiting for her hearing she had a stroke. Perhaps
she would be alive today had she been approved for disability benefits
and Medicaid earlier.
During the time it takes to process their disability claims, many
people lose their homes and have to move in with relatives or friends.
Quite a few end up living on the streets.
Today, in most cases, the time it takes for a hearing to be held
and a decision rendered is more than 2 years from the date of the
Request for Hearing. This is unacceptable.
Congress can make all kinds of excuses for the delays. Some blame
the millions of undocumented aliens tying up personnel and resources.
Others say that the Medicare, Part D Plan has diverted Social Security
employees who would otherwise be working on disability claims. Still,
other say that Congress and Social Security were not prepared for the
increase in Social Security Disability and SSI claims. Such claims
demonstrate either ignorance or are disingenuous.
Everyone of us who has been involved with this program for the past
several decades, including members of the Social Security Advisory
Board, Congress, Commissioners of Social Security, and Social Security
Disability attorneys, have known for a long time that insufficient
funds have been appropriated to Social Security to process Disability
and SSI claims in a fair and timely basis.
Regardless of what procedural changes are made or clever names are
given to process changes, without sufficient personnel, the backlog and
delays will continue to increase.
In my opinion, there is one effective way to reverse this trend and
that is to enact legislation to amend the Social Security Act to
provide for interim benefits for those people who have waited more than
a certain period of time (for example, 18 months) to receive a hearing
and decision. In order to prevent overpayments, Congress will then be
required to appropriate sufficient money to Social Security so they can
do the job they are mandated to do.
Thank you for your consideration of the above and the attached.
Statement of Shari Bratt, National Association of Disability Examiners,
Lincoln, Nebraska
Chairman McCrery and members of the Committee, thank you for
providing this opportunity for the National Association of Disability
Examiners (NADE) to present our views on Social Security Service
Delivery Challenges.
NADE is a professional association whose purpose is to promote the
art and science of disability evaluation. The majority of our members
work in the state Disability Determination Service (DDS) agencies and
thus are on the ``front-line'' of the disability evaluation process.
However, our membership also includes SSA Central Office personnel,
attorneys, physicians, and claimant advocates. It is the diversity of
our membership, combined with our extensive program knowledge and
``hands on'' experience, which enables NADE to offer a perspective on
disability issues that is both unique and which reflects a programmatic
realism.
NADE members, whether in the state DDSs, the SSA Regional Office,
SSA Headquarters, OHA offices or in the private sector, are deeply
concerned about the integrity and efficiency of both the Social
Security and the SSI disability programs. Simply stated, we believe
that those who are entitled to disability benefits under the law should
receive them; those who are not, should not. We also believe decisions
should be reached in a timely, efficient and equitable manner.
The challenges facing the Social Security Administration involve
all of the various programs administered by the agency. Significant
challenges facing SSA in the disability program include the proposed
Disability Service Improvement regulation (DSI), the implementation of
the electronic disability process (eDib), management of the Continuing
Disability Review (CDR) program, the impact of the Supplemental
Security Income (SSI) Pre-effectuation Reviews required under the
Deficit Reduction Act of 2005 and the continuing hardships imposed by
the Five Month Waiting Period and the 24 month Medicare Waiting Period.
Disability Service Improvement (DSI) Regulation
In July 2005, the Social Security Administration published a Notice
of Proposed Rule Making to improve the disability determination
process. NADE believes that one of the most important challenges facing
SSA is the need for an effective and affordable disability claims
process. We have some ongoing concerns about the DSI as it has been
proposed in the final regulation.
NADE agrees that changes in the disability determination process
are needed to reduce processing time, particularly at certain steps in
the process. The processing delays of greatest concern currently occur
in association with the appeals process at the Administrative Law Judge
(ALJ) level. It currently takes approximately 1,100 days to process an
average claim for any individual who goes through every stage of the
process. This is unconscionable and certainly needs reform. However, we
would like to point out that only about 150 days of the current
processing time take place in the DDS, yet the regulation appears to
make the most changes at this step, by introducing quick decision units
and eliminating the reconsideration step. It is our belief that this
regulation, as written, will do little to change the extensively long
delays that occur when an individual submits a request for an
administrative law judge hearing. In fact, NADE believes that the
insertion of two new federal bureaucracies--the Medical Vocational
Expert Unit and the Reviewing Official--have the potential to
significantly increase the amount of time it takes to arrive at a
disability decision, especially at the first appeal step.
For the past decade, SSA has attempted to redesign the disability
claims process in an effort to create a new process that will result in
more timely and accurate disability decisions. Results of numerous
tests undertaken by SSA to improve the disability process have not
produced the results expected.
There is a pervasive public perception that ``almost everyone'' is
denied disability benefits at the initial and reconsideration levels,
and that claimants are found disabled only when they reach the
Administrative Law Judge level of appeal. This perception is totally
inaccurate as SSA statistics show that 75-80 out of 100 disability
beneficiaries were allowed benefits by the DDS. Numerous references are
made in the regulation about ``making the right decision as early in
the process as possible.'' NADE certainly supports that goal, but we
wish to point out that sometimes the right decision is a denial of
benefits.
Quick Decision Determination (QDD) claims--In the regulation,
appropriate QDD claims would be identified and referred to special
units within the DDSs for expedited action with a goal of processing
the claim within 20 days.
In our considerable practical experience with such cases, we have
found that the complexity of these cases is minimal and we believe that
the expertise of the more experienced disability adjudicators is best
allocated to process more complex cases. If the disability
determination is made by the most experienced disability adjudicators
to process QDD cases, then NADE believes that it is not necessary to
require a medical consultant's signature on fully favorable allowances.
A Single Decision Maker (SDM) pilot is in place in 20 states and is
effective in reducing program costs, increasing efficiency and
decreasing processing time. At the very least, the SDM authority should
be continued for the QDD cases.
It is imperative that predictive software used to identify QDD
cases be manageable and that it accurately identify the appropriate
cases for quick determinations. Selection criteria should include
issues other than diagnosis, including involvement in current
treatment, current insured status and a specifically identifiable
impairment proven most likely to result in a totally favorable
allowance decision.
It is important to note that in Title II claims, those persons
found disabled under the Social Security Disability program must
complete a five month waiting period to receive benefits. A disability
allowance decision, no matter how quickly it is processed, will not
solve the problem of having to wait five full calendar months before
being able to receive any cash benefits.
Specialists and Training (Reviewing Official and Medical Vocational
Expert Units)--NADE is concerned that the Disability Process
Improvement Initiative, with its increased reliance on medical
specialists and attorneys, and its elimination of the triage approach
currently being used in 20 DDSs, could increase both administrative and
program costs. The first level of appeal following a denial by the DDS
is to be handled by a Reviewing Official who is an attorney, rather
than by a trained disability adjudicator, such as a disability hearing
officer. If medical specialists replace programmatically trained DDS
medical consultants, the disability program's administrative costs will
almost certainly increase. We also suspect program costs will increase
as more claims are allowed on appeal by individuals who lack the
requisite medical and vocational training to view such claims from the
perspective of SSA's definition of disability.
Adjudicators evaluating Social Security and SSI disability claims
must appropriately and interchangeably, during the course of
adjudication, apply the ``logic'' of a doctor, a lawyer, or
rehabilitation counselor, following SSA's complex regulations and
policies to arrive at a disability decision. Training in all of these
areas is critical to effectively adjudicate these cases accurately and
in a timely manner. Failure to do so carries enormous consequences for
the Social Security Administration and the huge number of citizens who
call upon the Agency for assistance. NADE places a high value on
initial and on-going continuing education training to maintain and
enhance disability expertise in the Social Security disability program.
If the RO component will be responsible for obtaining additional
medical evidence, an extensive administrative support structure will
need to be developed to obtain medical evidence of record and to
implement, maintain and monitor a separate consultative examination
process in addition to the system already in place at the DDS.
Reviewing Official--The regulation stipulates establishing a
federal Reviewing Official (RO) as an interim step between the DDS
decision and the Office of Hearings and Appeals (OHA). An interim step
outlining the facts of the case and requiring resolution of issues
involved could help improve the quality and consistency of decisions
between the DDS and OHA components. NADE supports an interim step
because of the structure it imposes, the potential for improving
consistency of decisions, reducing processing time on appeals, and
correcting obvious decisional errors at the initial level.
There is little, if any data to support a conclusion that the
interim step between the DDS decision and OHA must be handled by an
attorney. Assessment of eligibility under the Social Security
Disability program requires that the adjudicator at every level possess
a great deal of program, medical and legal knowledge. As currently
outlined in the regulation, the only qualification indicated for a
Reviewing Official is that he/she be an attorney. Individuals who are
hired into this new position without previous experience in the
disability program will require extensive training and mentoring for a
period of a least one year. It is also unclear in the proposal who
would be responsible for training and supervision of the RO.
NADE feels that a review at this interim step should be conducted
by a medically and programmatically trained individual such as a
disability hearing officer (DHO). The DHO has received additional
training in conducting administrative and evidentiary hearings,
decision writing, and making findings of fact, along with detailed case
analysis and program information. The DHO currently makes complex
medical-vocational-legal decisions using the Medical Improvement Review
Standard (MIRS). There is currently a training program in place for
DHOs through a contract that SSA has with McGeorge School of Law. The
DHO training program could be easily adapted to train experienced
disability professionals who already have extensive medical and
vocational expertise and disability program knowledge, to perform RO
duties. Since a DHO infrastructure is already in place, national
implementation of the DHO alternative could occur quickly and
effectively. Using an already established structure will prevent costly
and less claimant-friendly federal bureaucracy. There will be extreme
cost considerations if attorneys are to fill these positions as is
currently suggested
SSA previously piloted a disability redesign project called the
Adjudicative Officer. These pilots proved that non-attorneys could
produce a high quality product and a well documented and well reasoned
case for the Office of Hearings and Appeals Administrative Law Judge.
Medical Vocational Expert Unit--NADE believes the Medical
Vocational Expert Unit (MVEU) can provide DDSs with additional access
to medical and vocational expertise. Qualification standards for
inclusion in the MVEU should not exclude the knowledgeable state agency
medical consultant. DDS medical consultants are trained in program
requirements and the majority of cases they review include multiple
impairments. Having specialists review impairments individually is a
time consuming, costly proposal. Specialty consultants with limited
scope and experience cannot fully assess the combined effects of
multiple impairments on the claimant's functioning. DDS medical
consultants are not only medical specialists--physicians,
psychologists, and speech/language pathologists--they are also SSA
program specialists.
Adjudication of cases that have more than a single impairment
require assessment of how all impairments, alone or in combination
affect an individual's ability to function. The use of specialists
alone would result in numerous hand-offs, adding significantly to
processing time. This would also decrease the quality of decisions if
there were no method in place to pull all of the specialty conditions
together into an overall, global assessment of their impact on
functioning.
Although members of the MVEU will surely be qualified to treat
patients in their respective fields of specialty, they will also
require extensive training in the area of determining disability.
Evaluating disability for Social Security purposes is a far different
area of expertise than treating patients. There is a very real
difference between clinical and regulatory medicine, and it takes at
least a year to become proficient in Social Security disability rules
and regulations. Again, the responsibility for training, mentoring, and
supervising these experts is not established in the proposed rules.
While NADE supports the concept of the MVEU being used to supplement
the expertise of the medical consultant at the DDS, we feel that most
cases at the initial level of adjudication should continue to be
reviewed and evaluated by state agency medical consultants.
NADE recognizes that the qualification standards for medical
experts have not yet been determined, but we are concerned that primary
care medical consultants will be excluded from the MVEU. At risk of
exclusion also appear to be administrative or semi-retired physicians
who may not choose to keep up their clinical board certification.
Currently, all DDSs have a contingent of state agency medical
consultants. In some states, they are state employees, and in other
states, they are under contract. These consultants possess a wealth of
knowledge and experience, not only in the medical field and in
specialty areas, but in the SSA disability program, as well as
important knowledge of state health care systems. They are an extremely
valuable resource to the DDSs and the Social Security disability
program as a whole. It is difficult for the DDS to recruit and retain
good medical consultants, and it is NADE's hope that any established
new qualification standards do not make it even more difficult to do
so.
Electronic Disability Process (eDib)
In initial comments about a new disability approach, the
Commissioner indicated the foundation for the approach was the
successful implementation of an electronic folder system. NADE fully
agrees with the Commissioner on this fact. NADE remains very supportive
of these new technologies as a means for more efficient service to the
public. The proposed disability process improvements are predicated on
the new electronic folder system. For eDib to be successful, it is
critically important that adequate infrastructure support and proper
equipment is in place to make the process work effectively and
efficiently. Until eDib is fully implemented nationwide, it is
impossible to determine critical service delivery issues that impact on
daily case processing. NADE supports continued rollout of an electronic
disability folder for the obvious reasons of administrative cost
savings in terms of postage and folder storage, as well as time savings
from mailing and retrieving paper folders. At the same time, it must be
recognized that an electronic disability case process may have a
negative impact on case production capacities at the DDS level.
While eDib may be rolled out nationally, it is not in use by all
adjudicators in all components, and it remains to be seen how the
system will handle the increased volume of work and number of users
when it is implemented completely in all components of disability case
processing. Until eDib is fully operational, (including predictive
software to identify Quick Disability Decisions) we do not believe it
is appropriate to make widespread changes in the adjudicative process.
The full implementation of eDib in itself may result in a significant
reduction in processing time at all levels of adjudication without
additional sweeping changes to the adjudicative process.
Because eDib is still a work in progress, refinements, upgrades and
improvements are frequently necessary. The impact on the system as a
whole when these refinements are accomplished is unpredictable, but
presently they frequently result in a slowing or shutting down of the
system, or parts thereof. Since DDSs process over 2.5 million cases on
an annual basis, any shut down of the system equates to a significant
loss of production capacity. Even a shut-down of only 5 minutes a day
equates to over 1,250 work hours lost on a daily basis due to system
instability. Currently, many DDSs experience far more than 5 minutes
per day of system instability problems.
In addition, some upgrades and improvements to the system require
that the adjudicator relearn basic functionality which again impacts on
the ability of the DDSs to process the large volume of cases they
receive in a year. Upgrades to the system are essential to insure that
the system operates as efficiently as possible, but it must be
recognized that there is a resource impact every time a change is made.
While NADE recognizes the need for, and supports, SSA's commitment
to move to an electronic disability claims process, this tool will not
replace the highly skilled and trained disability adjudicator who
evaluates the claim and determines an individual's eligibility for
disability benefits in accordance with SSA's rules and regulations.
Continuing Disability Reviews (CDR)
Limited resources have forced SSA to reduce the number of CDRs
performed this year. There is a past history of the agency falling
behind in these critical reviews. It took a great deal of effort by all
components of SSA to reach a point where these reviews were being
conducted as scheduled. There is now a real danger that we will again
find ourselves in the position of having backlogs of overdue CDRs.
While there are increased program costs (including overtime, additional
purchase of medical evidence, claimant transportation costs and
increased utilization of contract medical consultants), there is a
potential significant savings in program costs with the elimination of
benefits paid to claimants who are found to be no longer eligible under
the SSA Disability program requirements. The estimate is that for every
$1 spent on conducting CDRs, $10 of program funds is saved. While
necessary given the current budget situation, the decision to reduce
the number of CDRs has been described as ``penny-wise and pound-
foolish''. We agree. It is essential to program integrity that these
reviews be conducted in a timely manner. Experience has shown that
dedicated funding for CDRs is the best means of getting ``current''
with the CDR backlog.
SSI Pre-Effectuation Reviews
The Deficit Reduction Act of 2005 includes the following
requirement:
`(e)(1) The Commissioner of Social Security shall review
determinations, made by State agencies pursuant to subsection (a) in
connection with applications for benefits under this title on the basis
of blindness or disability, that individuals who have attained 18 years
of age are blind or disabled as of a specified onset date. The
Commissioner of Social Security shall review such a determination
before any action is taken to implement the determination.
`(2)(A) In carrying out paragraph (1), the Commissioner of Social
Security shall review--
`(i) at least 20 percent of all determinations referred to in
paragraph (1) that are made in fiscal year 2006;
`(ii) at least 40 percent of all such determinations that are made
in fiscal year 2007; and
`(iii) at least 50 percent of all such determinations that are made
in fiscal year 2008 or thereafter.
`(B) In carrying out subparagraph (A), the Commissioner of Social
Security shall, to the extent feasible, select for review the
determinations which the Commissioner of Social Security identifies as
being the most likely to be incorrect.'.
The implementation of SSI Pre-Effectuation Reviews will have an
impact on program costs, utilization of resources and processing time.
Budgets and agency goals must be adjusted to reflect this impact.
Five month Waiting Period and 24 month Medicare Waiting Period
It is important to note that in Title II claims, those persons
found disabled under the Social Security Disability program must
complete a five month waiting period to receive benefits. A disability
allowance decision, no matter how quickly it is processed, will not
solve the problem of having to wait five full calendar months before
being able to receive any cash benefits. NADE believes that requiring
some individuals to serve a waiting period before becoming eligible to
receive disability cash benefits while not requiring others to serve
the same (or any type of a) waiting period is a gross inequity to
American citizens with disabilities and a disservice to the American
public.
In addition, members of the National Association of Disability
Examiners are deeply concerned about the hardship the 24 month Medicare
waiting period creates for these disabled individuals, and their
families, at one of the most vulnerable periods of their lives. Most
Social Security disability beneficiaries have serious health problems,
low incomes and limited access to health insurance. Many cannot afford
private health insurance due to the high cost secondary to their pre-
existing health conditions.
NADE supports the elimination or, at the very least a reduction, of
the Five Month and 24 Month (Title II) Medicare Waiting Periods.
Summary
Any national rollout of DSI must be closely monitored and
the process must be adjusted to accommodate the ``real world''
application of the regulation.
Single Decision Maker authority should be continued, at
least for QDD cases.
The Disability Hearing Officer should be utilized in the
current infrastructure as an interim appeals step. It is not necessary
that this position be filled by an attorney.
Qualification standards for inclusion in the MVEU should
not exclude the knowledgeable state agency medical or vocational
consultants. Board certification is not a practical standard and, if
required for State Agency Medical Consultants, could significantly
reduce the effectiveness and efficiency of the DDS medical review.
Necessary programmatic training and ongoing
administrative support for the ROs and MVEUs will result in significant
expense.
Resources should not be diverted from eDib until the
system is fully operational in all DDS locations. It is critical that
necessary refinements be made to the system in order for it to produce
the anticipated and desired efficiencies.
Dedicated funding is necessary in order to avoid the
costly possibility of again having a backlog of overdue CDRs.
There must be recognition that the implementation of SSI
Pre-effectuation reviews will have an impact on the DDSs budget and
processing time.
The five month cash benefit and 24 month Medicare waiting
periods for Social Security disability beneficiaries should be
eliminated or reduced.
Statement of Richard E. Warsinskey, National Council of Social Security
Management Associations Inc.
Chairman McCrery, Congressman Levin and Members of the
Subcommittee, my name is Richard Warsinskey and I represent the
National Council of Social Security Management Associations (NCSSMA). I
have been the manager of the Social Security office in Downtown
Cleveland, Ohio for 11 years and have worked for the Social Security
Administration for 30 years. On behalf of our membership, I am pleased
to have the opportunity to submit this testimony to the Subcommittee.
The NCSSMA is a membership organization of nearly 3,400 Social
Security Administration (SSA) managers and supervisors who provide
leadership in SSA's 1,374 Field Offices and Teleservice Centers
throughout the country. We are the front-line service providers for SSA
in communities all over the nation. We are also the federal employees
with whom many of your staff work to resolve problems and issues for
your constituents who receive Social Security retirement, survivors or
disability benefits, or Supplemental Security Income. From the time our
organization was founded over thirty-five years ago, the NCSSMA has
been a strong advocate of locally delivered services nationwide to meet
the variety of needs of beneficiaries, claimants, and the general
public. We consider our top priority to be a strong and stable Social
Security Administration that delivers quality service to the people we
serve--your constituents.
SSA is facing many service delivery challenges this year. My
testimony today will focus on the following areas: limited resources
and ever-increasing workloads and responsibilities.
Resources
The President's Fiscal Year 2007 budget proposes $9.496 billion for
the Social Security Administration's Limitation on Administrative
Expenses (LAE) account. This account, which is included as part of the
Labor, Health and Human Services, and Education Appropriations Bill,
supplies the resources for SSA's administrative budget. The budget
request for FY 2007 represents less than a 1.0% increase over the
amount requested for FY 2006. The Agency did not receive the full
President's budget request for FY 2006--the final appropriation was
reduced by nearly $300 million during the appropriations process.
The Commissioner of Social Security is required by law to submit
her own budget. This budget reflects what she sees as the level of
funding necessary to meet the Agency's service delivery improvements
and fiscal stewardship plans through 2011. This budget also factors in
that SSA has received less than the President's budget request in
recent years, thus leading to the need for additional resources in
future years to meet the full service delivery plan. The budget amount
submitted by the Commissioner of Social Security to the President for
SSA's FY 2007 administrative expenses was $10.23 billion. The budget
submitted by the Commissioner takes into consideration the increasing
workloads and new mandates that are confronting the Agency. The budget
shortfalls in comparison to the Agency's real needs, increased
workloads, and new mandates have, and will continue to have, a
tremendous impact on SSA's service delivery.
It is important to note that SSA's administrative budget
constitutes less than 2% of program expenditures for the current fiscal
year which is an outstanding value. This becomes all the more
noteworthy when compared to private sector insurance companies which,
as pointed out in a report issued by the Social Security Advisory
Board, commonly have cost ratios of 10 to 20 percent or more. Certainly
the American people deserve to have the Social Security
Administration's excellent service while maintaining such value.
A good example of this value can be seen by the service SSA
provided after the hurricanes this past fall. SSA detailed people
throughout the country and moved a huge amount of equipment around to
assist people in receiving their benefits after the hurricanes.
Commenting on SSA's efforts the Social Security Advisory Board wrote,
``. . . we have been continually impressed by the commitment and
expertise of the agency, its management, and its employees at all
levels to providing excellent service to the beneficiaries who depend
on Social Security. Last year's hurricanes showed that commitment to be
deep and solid.'' ``The agency and its employees... have every reason
to be proud of their preparedness, resourcefulness, and dedication in
meeting the needs of the population they serve under the most trying
circumstances.''
Increasing Workloads
The following are some key current and future workload trends that
are impacting SSA:
In 1999 SSA had 311,000 hearings pending. As of the end
of April there are now about 727,000 hearings pending, an increase of
133%. The average hearing processing time continues to go up.
Current processing times are 481 days, up from 443 days
last fiscal year. The average Administrative Law Judge has
approximately 709 cases pending per available judge. As a result the
average time to receive a hearing decision is often more than two
years.
SSA's Program Service Centers (PSCs) have seen their
pending cases more than double in the past two years, increasing by
about 275,000 cases. The PSC backlogs have been exacerbated because so
many of the employees must assist in answering the 1-800 number.
Waiting times in Field Offices rose dramatically for the first six
weeks of the year. Walk-in traffic increased by approximately 40% for
the first six weeks of the year. Since then traffic has moderated
somewhat but walk-in traffic is currently up an estimated 20%.
SSA's 1-800 number has received nearly 4 million more
calls this year compared to the same time last year.
Failure to receive an adequate appropriation led the
Commissioner to make the difficult but unavoidable decision to cut back
on processing Medical Continuing Disability Reviews. This year SSA has
reduced the number by about 390,000. SSA estimates that every one
dollar spent on a Continuing Disability Review saves ten dollars in
program costs. SSA also estimates that the CDRs conducted in 2002 are
expected to yield $6 billion in lifetime program savings.
Failure to receive an adequate appropriation led SSA to
make the decision to cut back on processing SSI redeterminations by
approximately 808,000 this year. SSA estimates that every one dollar
spent on an SSI redetermination saves seven dollars in program costs.
In FY 2005, SSA processed 64% more new claims for Title
II and Title XVI disability claims than it did in FY 2000.
SSA will process an increasing number of retirement
claims as the baby boom generation retires. Last year SSA Field Offices
processed 16% more retirement claims than the previous year.
In August 2006, SSA will send out an estimated 2 million
letters for those that qualified for Extra Help for Part D Medicare to
determine whether the amount of Extra Help will change. Many of these
cases will need to be reworked by SSA Field Offices.
This fall, SSA will also mail out an estimated 2 million
letters for those potentially affected by the Income-Related increased
Medicare Part B Premiums. Many of those affected will contact SSA Field
Offices and Teleservice Centers with questions and will require
assistance in determining the correct premium to pay.
Increasing Responsibilities
One of the areas where SSA Field Offices have seen the most
significant impact on their workloads and on the public has been due to
the implementation of the Intelligence Reform and Terrorism Prevention
Act of 2004 (IRTPA) on December 17, 2005. This law significantly
strengthened the rules for issuing new and replacement Social Security
numbers and cards. Immediately after this law went into effect, SSA
Field Offices throughout the country saw a dramatic increase in waiting
times and number of visitors. This is due to the need to complete a
much more intensive interview of those applying for Social Security
numbers. This more intensive interview process and review of documents
has led to an increased number of visitors that must go home and return
with additional documents, sometimes multiple times.
We estimate that nearly one-third of the people currently coming
into SSA Field Offices to apply for an original or duplicate Social
Security number card have to return to the office with additional
documentation for their card. We have seen countless numbers of people
leaving our offices angry and frustrated because of the inconvenience.
Last year SSA processed 13.4 million requests for Social Security
cards. If one-third of the public has to obtain additional
documentation and return to an SSA Field Office to complete the
interview process this is affecting nearly 4.5 million people.
Some of the challenges faced by Field Offices can be seen by one
Louisiana office which reports:
A major impediment to providing acceptable service to the public
has been our increase in daily visitors to the office, the majority of
which are there to apply for Social Security cards. In the first
quarter of 2006, we had 10,938 visitors for Social Security cards.
During that same time period, we processed 7,184 cards. Based on these
numbers, 52.25% of our visitors needing a Social Security card
consisted of repeat traffic.
Overall, we had 20,208 visitors to our office in the first quarter
of 2006. 10,938 of these visitors were here for Social Security cards
which equates to 54.1% of all visitors to the office during that
quarter.
To meet the demand for Social Security cards, we have two service
representatives (windows 1 and 2) who do nothing but Social Security
card requests all day. If the volume becomes too great, we bring in two
more service representatives to focus solely on this workload (windows
3 and 4). Four other service representatives are engaged in meeting and
dealing with the rest of the public that is not in the office to file a
claim, and two are answering the phones.
The same office in Louisiana also reported the following lingering
effects from Hurricane Katrina:
Still receiving mail for 87 beneficiaries/recipients (all
types of mail--not just SSA-related) at the Field Office
Receiving death notices from New Orleans area funeral
homes
70% increase in non-receipts of checks from the same time
last year
37% increase in Social Security Title II changes from the
same time last year
As these increased demands on SSA facilities throughout the country
have hit the Agency, we are faced with a reduction in staffing of 500
positions this year and an estimated 2,000 people next year. This
reduction in staffing will occur even if SSA's LAE account is funded at
the full level of $9.496 billion as proposed in the President's budget.
It is estimated that SSA will have 500 fewer employees on duty next
year than before the Agency started working on Medicare Part D cases.
Moving forward, we realize that we no longer have the large workloads
associated with the start up of Part D. Although resources were
provided by the Congress in Fiscal Years 2004-2006 to address the
initial workload related to Medicare Part D, there are still incredible
challenges to be met in addressing the ongoing Medicare Part D
workloads, rule changes in issuing Social Security number cards, and
new Medicare Part B premium increase cases, as well as increased
retirement and disability claims and telephone calls.
There has been an increasing awareness of the approaching
retirement wave in all Federal Agencies. For SSA this is especially
serious. Not only does the Agency have a significant number of
employees currently eligible to retire, but the training time to create
a proficient field employee is very long. The complex program features
and the wide range of benefits and entitlements, in addition to the
programmatic complexity of many issues occurring after a person is
drawing benefits mean many employees do not achieve journeyman
proficiency for at least three and more likely five years. This problem
will be exacerbated by the loss of institutional knowledge when the
senior employees retire.
SSA Field Offices receive about the same number of telephone calls
as SSA's 1-800 number. This is because many people prefer to talk to
the local Field Office and because all letters that are mailed out must
include the local Field Office telephone number on the letter. Yet most
local Field Offices do not have adequate staff to answer telephone
calls. In the NCSSMA's 2005 Survey of Management, 78% of the 2,400
respondents stated they did not have enough staff to provide adequate
local telephone service. In addition, Field Office telephones systems
are antiquated and desperately need to be replaced. Field Offices
nationwide are forced to cannibalize parts to keep some telephone
systems running.
SSA has also made enormous investments in the electronic Disability
Claims Process (e-Dib) which will revolutionize the way the Agency
handles disability claims. While these changes will lead to significant
savings and improve processing times down the line, it is actually a
more labor-intensive process and results in longer interview times for
local Field Offices. In fact it takes nearly 30 minutes longer to take
an interview under e-Dib because of the amount of information that must
be formatted electronically.
The $9.496 billion requested by the President for FY 2007 is
insufficient to fully address all backlogs and increasing workloads
described above. We do understand the fiscal constraints of today's
budget environment, but at a minimum, it is absolutely critical that
Congress match the President's FY 2007 budget request for SSA. Each
year that SSA receives less than adequate funding for the LAE account
has a compounding negative effect on our workloads. This compounding
has meant that we have over 8,000 fewer work years than we would have
received had we received the full level of funding recommended in
recent years in the President's budget.
This staffing shortage is one of the key reasons for massive
backlogs in the Hearings Offices and Program Service Centers,
reductions in processing stewardship workloads such as SSI
redeterminations and Continuing Disability Reviews in Field Offices,
major strains on Field Office employees to handle the increased walk-in
traffic, and for Field Offices and Teleservice Centers to handle the
nearly 135 million calls per year.
The key problem is that SSA is being given more and more
responsibilities without sufficient funding to handle these
responsibilities. On the horizon is another enormous workload that SSA
could receive due to language in the Border Security Act that could
require the Agency to verify approximately 50 million Social Security
numbers a year. SSA would need additional funds to administer the
provisions of this bill if it becomes law. The Agency also needs
additional funds for IRTPA, ongoing workloads associated with Medicare
Part D, and the upcoming Income-Related Medicare Part B premium changes
that take effect in January 2007.
SSA is making every effort it can to address these increasing
mandates. Our Agency's productivity continues to rise, and in fact has
risen at least 2% a year this decade. When you invest the people's
money in SSA they get their money's worth and much more. Think of the
hundreds of millions of dollars that would be saved if SSA could
process more Continuing Disability Reviews and SSI redeterminations.
This is simply not possible without additional funding.
Supplemental Appropriation
The Senate has included a provision in the FY 2006 Hurricane-War
Supplemental Appropriations Bill that would provide $38 million to the
Social Security Administration. We strongly support this additional
funding. This funding will help cover additional expenses SSA had to
incur due to the hurricanes in 2005. SSA assisted more than 528,000
individuals in FEMA Disaster Recovery Centers and shelters and helped
countless others at local Field Offices. SSA's additional expenses
include the need for temporary space, renovating damaged offices and
replacing damaged furniture and equipment. SSA also had to cover
additional overtime and travel expenses for details that assisted in
these workloads. The Agency also incurred costs to help employees who
were forced to relocate due to damaged or destroyed homes and offices.
Unfortunately for SSA, the Agency's final budget for FY 2006 was
already $300 million below the President's FY 2006 request. The reduced
level of funding provided for FY 2006 makes it very difficult for the
Agency to absorb the additional costs of the hurricanes and their
aftermath. The additional $38 million would help deal with the
reductions in service and additional delays which have occurred
throughout SSA's Field Offices.
Conclusion
SSA is facing an enormous challenge to keep up with all of its
workloads. Without additional funding backlogs will increase and we
will not be able to provide the level of service we believe the
American public deserves. At a minimum, SSA needs to receive the FY
2007 budget proposed by the President. We applaud Commissioner
Barnhart's ongoing efforts to request adequate resources for SSA. We
also strongly support the Senate's request for an additional $38
million in supplemental appropriations for FY 2006. It is imperative
that our Agency receives additional funds for new tasks we are given
such as those mandated by IRTPA and the proposed Border Security Act,
which has the potential to task SSA with a new and immense workload.
Without additional funding for these new workloads, the Agency will
have to delay processing various existing workloads, leading to even
more backlogs and delays. Ultimately, this will lead to increased
costs.
We understand the current budgetary constraints, but we hope that
when Congress is making decisions about how limited appropriated funds
should be allocated, you and your colleagues keep in mind that SSA has
a reputation as an Agency that gets results, and it has earned that
reputation. As the only face of government a broad number of Americans
ever see, it is important to retain confidence in our government by
providing these Americans with the efficient, accurate, and
compassionate service they deserve.
On behalf of the members of the NCSSMA, I thank you again for the
opportunity to submit this testimony to the Subcommittee.
Statement of National Council on Disability
Americans with Disabilities remain underemployed, despite the fact
that many are willing and able to work. Although the Social Security
Administration (SSA) has instituted a number of incentives to reduce
the numerous obstacles to employment faced by its Supplemental Security
Income (SSI) and Social Security Disability Insurance (DI)
beneficiaries, such efforts have had little impact because few
beneficiaries are aware of these incentives and how they affect
benefits and access to health care.
The National Council on Disability's (NCD) findings reinforce what
has been known for decades by SSI and SSDI beneficiaries with
disabilities who want to enter, re-enter, or increase their employment
within the U.S. workforce. The major findings in NCD's report include:
The Social Security Administration's demonstration
authority has not resulted in the validation of evidence-based
practices that promote employment or return to work for beneficiaries.
The culture of SSA is not geared toward providing
rehabilitation services and returning individuals to work or promoting
work for SSI recipients. The complexity of program rules, coupled with
the inability of the agency to accurately track and record post-
eligibility earnings, frequently penalizes beneficiaries who attempt to
enter or re-enter employment.
The definition of disability in the current SSA
eligibility process is based on a 50 year old conceptualization of
disability that is in direct conflict with the policy premises of more
recent federal policies and programs. The present eligibility
determination process fails to acknowledge the concepts of partial
disability or temporary disability. Rather than facilitating early
intervention services by making rehabilitation services available to
individuals early in the disability process, it delays eligibility for
those services that might enable individuals to return to work.
SSA is not and should not be solely responsible for
providing all of the services and supports necessary to enable
beneficiaries to enter employment and return to work. Coordination and
collaboration across multiple federal and state agencies remains a
significant challenge for the agency.
NCD considers the most important recommendations in this report to
be in the areas of beneficiary perspective and self-direction; income
issues and incentives; and coordination and collaboration among
multiple public and private systems. NCD's report recommendations
include the following:
Congress and SSA should implement a series of procedural
reforms to reduce overpayment to beneficiaries by increasing the use of
electronic quarterly earnings data, piloting the creation of
centralized work Continuing Disability Review processing cadres, and
enhancing efforts to educate beneficiaries on reporting requirements,
the impact of wages on benefits, and available work incentives. One way
of addressing the last part of this recommendation would be to allow
beneficiaries to access benefits planning services through an
integrated, coordinated program across multiple federal systems.
Congress and SSA should address current shortcomings in
the Ticket to Work program by expanding eligibility to include
beneficiaries whose conditions are expected to improve, and to
beneficiaries under the age of 18. Further, Ticket to Work regulations
should be modified to ensure that Ticket assignment practices do not
violate the voluntary nature of the program and beneficiary rights to
give informed consent.
Congress should modify the current Title II disability
legislation to eliminate Substantial Gainful Activity (SGA) as a post-
entitlement consideration for continued eligibility and provide a
gradual reduction in DI cash benefits based on increases in earned
income.
Congress should direct SSA to simplify regulatory
earnings definitions and wage verification processes so they are
consistent across the SSI and DI programs, as well as modify
regulations related to the treatment of earnings in the DI program by
applying the same rules currently applied in the SSI program.
Congress should direct SSA develop and test program
additions and regulatory modifications that will enable SSI
beneficiaries to accumulate assets beyond existing limits through
protected accounts and other savings programs. Also, SSA should change
current program rules and work with other federal agencies to modify
and expand the value of Individual Development Accounts for all
beneficiaries with disabilities.
SSA should modify Ticket to Work program regulations to
allow the SSA Vocational Rehabilitation traditional Cost Reimbursement
Program to carry on as a parallel program to the Employment Network
Outcome or Outcome Milestone payment mechanisms and ensure that an EN
is able to accept a Ticket from a beneficiary and refer that individual
to a VR agency for services without having to reimburse VR for those
services.
Congress should direct SSA to work with the Department of
Education to expand the current Student Earned Income Exclusion and the
Plan for Achieving Self Support programs to encourage involvement of
transitioning beneficiaries in postsecondary education and training.
SSA should implement a policy change that would disregard all earned
income and asset accumulation limits of transitioning beneficiaries for
at least one year after post secondary education or training is
completed.
The Centers for Medicare and Medicaid Services and SSA
should work closely together to modify existing program regulations in
order to uncouple Medicare and Medicaid coverage from SSI or DI cash
payments; eliminate the many employment disincentives built into CMS's
Medicaid waiver, Medicaid Buy-in, and Health Insurance Premium Payment
programs; and work collaboratively with public and private insurance
providers and business representatives to design insurance partnerships
that will expand access to health care for individuals with
disabilities.
The release of this report today is yet another call for the
leadership of this country and those designing disability policy, to
recognize that most social security beneficiaries, indeed most
Americans, want to work. With the appropriate supports, including a
forward thinking income support program, this can happen.
______
The Social Security Administration's Efforts to Promote Employment for
People with Disabilities
New Solutions for Old Problems
National Council on Disability
November 30, 2005
National Council on Disability
1331 F Street, NW, Suite 850
Washington, DC 20004
This report is also available in alternative formats and on the
award-winning National Council on Disability (NCD) Web site
(www.ncd.gov).
Publication date: November 30, 2005
The views contained in this report do not necessarily represent
those of the Administration as this and all NCD documents are not
subject to the A-19 Executive Branch review process.
Web Address for complete report:
http://www.ncd.gov/newsroom/publications/2005/ssa-promoteemployment.htm
Executive Summary
Americans with disabilities remain underemployed, despite the fact
that many are willing and able to work. Although the Social Security
Administration (SSA) has instituted a number of incentives to reduce
the numerous obstacles to employment faced by its Supplemental Security
Income (SSI) and Social Security Disability Insurance (DI)
beneficiaries, such efforts have had little impact because few
beneficiaries are aware of these incentives and how they affect
benefits and access to health care.
Introduction to the Problem
Social Security beneficiaries with disabilities must spend months
or even years convincing SSA that they are unable to work as a
condition of eligibility. Yet, upon their receipt of benefits, SSA
begins to communicate to beneficiaries that work is an expectation for
them. Congress and SSA have developed a variety of work incentives and
special programs designed to encourage beneficiaries to attempt to
obtain and sustain employment. Yet SSA's efforts to eliminate work
disincentives have often added to the complexity of the entire program,
confusing beneficiaries and making them leery of any actions that might
unknowingly jeopardize their benefits.
Current SSA benefit amounts are quite small and merely allow
beneficiaries to live at a basic subsistence level. SSI resource limits
make it very difficult to accumulate the financial resources necessary
to move toward economic self-sufficiency. Tying eligibility for
Medicaid or Medicare to eligibility for SSA benefits forces individuals
with high-cost medical needs who could otherwise work to choose between
pursuing a career and retaining the medical insurance that sustains
their very lives.
The fear of losing benefits and medical insurance through an
unsuccessful employment attempt starts well before adulthood with SSI
beneficiaries. Many SSI recipients first apply for benefits as children
while enrolled in public schools. These individuals often remain on the
rolls well into adulthood, with very few transitioning from high school
into substantial employment after graduation (GAO, 1996b; GAO, 1998b).
Failure to focus on Social Security and other public benefits during
transition is not only a missed opportunity, but harm may be caused
when students and family members are not educated or prepared for the
effect of earnings on cash benefits and medical insurance (Miller and
O'Mara, 2003).
There is also the problem with poor educational attainment of DI
beneficiaries who enter the disability system later in life. Efforts to
help this population return to work are stymied by their lack of
education and marketable job skills--particularly in today's highly
competitive information economy. It is now more important than ever
that people of all ages have access to higher education and the
financial means with which to pay for training and education (Moore,
2003).
Response of Congress and the Social Security Administration to the
Problem
Well aware of the enormity and seeming intractability of this
problem, Congress and SSA have initiated multiple efforts to promote
employment and return to work among SSA beneficiaries. In recent years,
a number of work incentives for SSI and DI beneficiaries have been
implemented, allowing individuals to keep more of their earnings while
retaining their benefits. Work incentives are aimed at reducing the
risks and costs associated with the loss of benefit support and medical
services as a result of returning to work. Some of the most commonly
used incentives are Section 1619(a) and (b) provisions; impairment-
related work expenses (IRWE); trial work period (TWP); Plan for
Achieving Self-Support (PASS); extended period of eligibility (EPE);
and continued payment under a vocational rehabilitation program.
However, despite efforts by SSA and the Federal Government that
have led to more favorable conditions for returning to work, most SSI
and DI beneficiaries continue to stay on the disability rolls. The work
incentives offered by SSA remain largely underutilized; in March 2000,
of the total number of eligible working beneficiaries, only 0.3 percent
were using PASS, 2.8 percent were using IRWEs, 7.5 percent were
receiving Section 1619(a) cash benefits, and 20.4 percent were
receiving Section 1619(b) extended Medicare coverage (SSA, 2000). The
major reasons cited for the extreme underutilization of these work
incentives by beneficiaries were (1) few beneficiaries knew that the
work incentives existed, and (2) those who were aware of the incentives
thought they were complex, difficult to understand, and of limited use
when entering low-paying employment (GAO, 1999).
The Office of Program Development and Research (OPDR) and the
Office of Employment Support Programs (OESP) under the Deputy
Commissioner for Disability and Income Security Programs are primarily
responsible for the implementation of multiple components of the Ticket
to Work and Work Incentives Improvement Act of 1999 (TWWIIA). The
TWWIIA provides a number of new program opportunities and work
incentives for both SSI and DI beneficiaries, including the Ticket to
Work (TTW) and Self-Sufficiency Program; development of a work-
incentives support plan through the creation of national network of
Benefits Planning, Assistance, and Outreach (BPAO) programs; and new
work incentives, including expedited reinstatement (EXR) of benefits
and postponement of continuing disability reviews.
The National Council on Disability's Study of the Problem
It is not known whether the new TWWIIA programs will have any more
success than past attempts by SSA to impact the employment rate and
earnings of beneficiaries. What is clear is that there has not been, in
recent times, a comprehensive, research-based examination of the
practices that are most likely to support the employment of SSI and DI
beneficiaries. This study has been undertaken in response to the need
for such a comprehensive analysis. The study was designed to address
four research questions:
1. What are the evidence-based practices that promote the return
to work of working-age beneficiaries of DI and SSI programs?
2. What policy changes are needed, given recent trends in program
participation and employment?
3. Are there proven and documented practices that work better for
some populations of people with disabilities and not others?
4. Which factors ensure that documented and evidence-based
practices could be adapted/adopted by SSA and other entities that seek
to ensure the employment of people with disabilities? Which factors
prevent adaptation/adoption?
A four-step approach was taken to implement the study. First, a
comprehensive literature synthesis was completed through a review of
published and unpublished literature. Second, detailed structured
interviews were conducted with key stakeholders, including SSA
beneficiaries, federal SSA officials, representatives of other federal
agencies, consumer and advocacy organizations, service organizations,
community service providers, and business representatives. Third, a
preliminary list of findings, evidence-based practices, and
recommendations based on the literature review and structured
interviews was used to develop seven topic papers. These papers were
used to facilitate discussion and obtain reaction from participants who
were invited to a consensus-building conference at the end of January
2005. Individuals with disabilities (including current and former SSI
and DI beneficiaries), advocacy organizations, service providers, and
policymakers who attended the conference had the opportunity to further
develop the recommendations that appear throughout the report.
Major Findings of the Study
Purpose and Mission of SSA's Disability Benefit Programs
Our nation's current disability benefit programs are based on a
policy principle that assumes that the presence of a significant
disability and lack of substantial earnings equates to a complete
inability to work. The current SSA eligibility determination process
thwarts return-to-work efforts, because applicants are required to
demonstrate a complete inability to engage in substantial gainful
activity (SGA) in order to qualify for benefits. The definition fails
to recognize that, for many consumers, disability is a dynamic
condition. The length of the application process in our current
programs actually contributes to the ineffectiveness of our return-to-
work efforts and our inability to intervene early in the disability
process.
For DI individuals, lack of a gradual reduction in benefits as
earnings increase and lack of attachment to the DI and Medicare
programs after an individual has maintained employment for an extended
period of time make return to work unfeasible. For SSI beneficiaries,
the program's stringent asset limitations thwart efforts toward asset
development and economic self-sufficiency. Inconsistencies in program
provisions lead to confusion and inequities for beneficiaries of both
programs.
Beneficiary Perspective and Self-Direction
To receive benefits, applicants must characterize their situation
as an inability to work long-term. They must demonstrate that they are
unable to work in any significant way. Once they are determined to be
eligible for disability benefits, beneficiaries face a host of complex
program rules and policies related to continuing eligibility for cash
benefits and access to health care. Many beneficiaries are confused or
uninformed about the impact of return to work on their life situation
and have shied away from opportunities to become self-sufficient
through work.
Beneficiaries report that their experience with SSA is often
unfavorable. Insufficient staffing has led to long lines and poor
services. Misinformation is frequent, and mistrust common. Local SSA
field office staff members are overburdened with accurate and timely
processing of post-entitlement earnings reporting, which often leads to
overpayments to beneficiaries. Beneficiaries do not trust SSA to make
appropriate and timely decisions. There is prevalent fear that work
attempts would result in either a determination that the disability had
ended or the need to repay benefits.
SSA has implemented many legislative changes, program
modifications, training initiatives, and automation efforts in the past
15 years to improve its customer service. Although efforts to
streamline processing and improve customer service should be lauded,
they have not significantly improved beneficiaries' ability to direct
and control their own careers.
Income Issues and Incentives
A multitude of rules regarding employment income, continued
eligibility for disability benefits, waiting periods, earnings
reporting, management of benefit payments, and management of assets
(among many others) come into play once an individual is determined to
be eligible for DI or SSI. SSA rules regarding employment and income
are such that many beneficiaries will actually be worse off financially
if they work full time. Disincentives to employment in the current
benefits programs include a sudden loss of cash benefits as a result of
earnings above the SGA level for DI beneficiaries. Despite a number of
programs that are designed to encourage asset building among SSI
beneficiaries, it remains very difficult for beneficiaries to save and
accumulate resources under SSI, which contributes to long-term
impoverishment and dependence on public benefits.
Over the past decade, SSA has devoted considerable resources to
promoting employment and return to work among SSI and DI beneficiaries.
The agency has aggressively implemented a number of new initiatives
authorized under the TWWIIA, such as the Ticket to Work and Self-
Sufficiency Program, the BPAO program, area work incentive
coordinators, and Protection and Advocacy for Beneficiaries of Social
Security. It has modified program rules to provide increased work
incentives to beneficiaries, such as the EXR and protection from
continuing disability review provisions of TWWIIA, indexing the SGA
threshold, and increasing the level of earnings allowed during the
Trial Work Period (TWP). The agency has also launched or is planning to
initiate a number of demonstrations that will test the efficacy of new
modifications to work incentives within the DI program and services
targeted toward youth with disabilities. Yet, while SSA has taken steps
to improve its return-to-work services through the provision of work
incentives, these efforts are hampered by the underlying program rules
that were designed for individuals assumed to be permanently retired
from the workforce and individuals who were viewed as unable or
unlikely to work in the future.
Coordination and Collaboration Among Systems
Expansion of the disability programs and the poor employment rates
of adults with disabilities have become major concerns for SSA and
disability policymakers across the country. Too often, the alarming
growth of the Social Security disability rolls has been represented and
perceived as SSA's problem to solve in isolation, when in fact it is a
larger societal problem with myriad complex causes. Receipt of Social
Security disability benefits is merely the last stop on a long journey
that many people with disabilities make from the point of disability
onset to the point at which disability is so severe that work is not
possible. All along this journey, individuals encounter the policies
and practices of the other systems involved in disability and
employment issues. When these systems fail to stem the progression of
disability or work at cross-purposes with one another to prevent
successful employment retention or return to work, it is the Social
Security disability system that bears the eventual brunt of this
failure. Any meaningful effort to slow down or reverse this relentless
march toward federal disability benefits will require significant and
sustained collaboration and coordination among SSA and the other
federal agencies with a stake in developing disability and employment
policy.
The complex obstacles to employment faced by SSA beneficiaries
require a comprehensive set of solutions. New approaches must be
identified that emphasize beneficiary control of career planning and
the ability to access self-selected services and supports. Public and
private health care providers must develop new collaborations and new
approaches to combining coverage from multiple sources to improve
program efficiencies. SSA must continue to work with the Rehabilitation
Services Administration (RSA) and the Department of Labor (DOL) to
improve implementation of the TTW program and identify new approaches
that will overcome the traditional inability of SSA beneficiaries to
benefit from services provided by the nation's employment and training
programs. Secondary and postsecondary educational institutions must
emphasize benefits counseling and financial management training as the
foundation for beneficiary self-direction and economic self-
sufficiency. Federal agencies and the business community must realize
that collaborative approaches to incorporating beneficiaries into the
workforce are needed as a way to reduce dependence on federal benefits
while simultaneously enhancing the productivity and competitiveness of
large and small business.
Recommendations
A total of 38 specific recommendations have been developed in the
areas of Beneficiary Perspective and Self-Direction, Income Issues and
Incentives, and Coordination and Collaboration Among Multiple Public
and Private Systems. The recommendations are presented and justified in
Chapters III, IV, and V of the report, and a complete list is provided
in Chapter VI. The key recommendations resulting from the study are
summarized below.
Beneficiary Perspective and Self-Direction Customer Service--SSA
should take immediate steps to improve the services provided to
beneficiaries by improving the accessibility of SSA field offices and
Web sites; redesigning field office personnel roles, staffing patterns
and work assignments; continuing efforts to automate work reporting
procedures; and enhancing outreach efforts to beneficiaries.
Ticket to Work Program--Congress and SSA should address current
shortcomings in the TTW program by (1) expanding Ticket eligibility to
include beneficiaries whose conditions are expected to improve and who
have not had at least one continuing disability review (CDR), childhood
SSI beneficiaries who have attained age 18 but who have not had a
redetermination under the adult disability standard, and beneficiaries
who have not attained age 18; (2) modifying the TTW regulations to
ensure that Ticket assignment practices do not violate the voluntary
nature of the program and beneficiary rights to grant informed consent;
and (3) implementing a strong national marketing program to inform
beneficiaries about TTW and other SSA programs.
Facilitate Beneficiary Choice--Congress should authorize and direct
SSA, the Rehabilitation Services Administration (RSA), the Centers for
Medicare and Medicaid Services (CMS), the Department of Housing and
Urban Development (HUD), and the Department of Labor Employment and
Training Administration (DOLETA) to develop and implement an integrated
benefits planning and assistance program that coordinates resources and
oversight across several agencies that enables beneficiaries to access
benefit planning services within multiple federal systems. Congress
should also authorize and direct these agencies to consider changes to
the existing BPAO initiative to improve the accuracy and quality of
services provided to individual beneficiaries.
Reduce SSA Overpayments to Beneficiaries--Congress and SSA should
implement a series of procedural reforms to reduce overpayment to
beneficiaries by increasing the use of electronic quarterly earnings
data and automated improvements to expedite the processing of work
activity and earnings; piloting the creation of centralized work CDR
processing in cadres similar to PASS and Special Disability Workload
Cadres; and enhancing efforts to educate beneficiaries on reporting
requirements, the impact of wages on benefits, and available work
incentives.
Eliminate the Marriage Penalty--Congress and SSA should undertake a
complete review of the SSI program and make program modifications that
eliminate the financial disincentive to marriage inherent in the
present program, including amending the current Title XVI disability
legislation to modify the manner in which 1619(b) eligibility is
applied to eligible couples.
Income Issues and Incentives
Ease the SGA Cash Cliff for DI Beneficiaries--Congress should
modify the current Title II disability legislation to eliminate SGA as
a post-entitlement consideration for continued eligibility for Title II
disability benefits and provide for a gradual reduction in DI cash
benefits based on increases in earned income.
Reduce Restrictions on Assets for SSI Beneficiaries--Congress
should direct SSA to (1) develop and test program additions and
regulatory modifications that will enable SSI beneficiaries to
accumulate assets beyond existing limits through protected accounts and
other savings programs, and (2) change current program rules and work
with other federal agencies to modify and expand the value of
individual development account (IDA) programs to SSA beneficiaries.
Decrease the Complexity of the DI/SSI Program Rules Governing
Income and Resources--Congress should direct SSA to (1) simplify
regulatory earnings definitions and wage verification processes so that
they are consistent across the SSI and DI programs, and (2) direct SSA
to modify regulations related to the treatment of earnings in the DI
program by applying the same rules currently applied in the SSI
program.
Coordination and Collaboration Among Multiple Public and Private
Systems
Health Care Systems--Centers for Medicare and Medicaid Services
(CMS) and SSA should work together closely to (1) modify existing
program regulations in order to uncouple Medicare and Medicaid coverage
from DI/SSI cash payments; (2) identify and eliminate the many
employment disincentives currently built into the Medicaid waiver,
Medicaid buy-in, and Health Insurance Premium Payment (HIPP) programs;
(3) expand benefits counseling services to include the full range of
financial education and advisement services; and (4) work
collaboratively with public and private insurance providers and
business representatives to design public-private insurance
partnerships that will expand access to health care for individuals
with disabilities.
Vocational Rehabilitation (VR) System--SSA should modify TTW
program regulations to allow the SSA's traditional VR cost
reimbursement program to carry on as a parallel program to the
Employment Network (EN) outcome or outcome-milestone payment
mechanisms, and ensure that an EN is able to accept Ticket assignment
from a beneficiary, refer that individual to the VR agency for needed
services, and not be required to reimburse the VR agency for those
services.
Federal Employment and Training System--Congress, SSA, and the
Department of Labor should undertake an analysis of the impact of
allowing DOL One-Stop Career Centers to receive cost reimbursement
payments for successfully serving beneficiaries under the TTW program,
evaluate the impact of the Workforce Investment Act (WIA) performance
standards on beneficiary participation in WIA programs, and design and
test a set of waivers that will assist beneficiaries in accessing and
benefiting from WIA core and intensive services, as well as individual
training accounts.
Educational System--Congress should direct SSA to work with the
Department of Education (ED) to (1) ensure that benefits planning and
financial management services are available to the transition-aged
population; (2) expand the current student earned income exclusion
(SEIE) and the Plan for Achieving Self-Support (PASS) to encourage
involvement of SSA beneficiaries in postsecondary education and
training; and (3) implement a policy change that would disregard all
earned income and asset accumulation limits for beneficiaries who are
transitioning from secondary education to postsecondary education or
employment for at least one year after education or training is
completed.
Employers, Business Community, and Private Insurance Industry--
Congress should direct SSA and the Department of the Treasury to (1)
evaluate the possible effects of a disabled person tax credit as a
means of increasing the use of disability management programs in
business to prevent progression of injured and disabled workers onto
the public disability rolls, and (2) collaborate with Department of
Labor's Employment and Training Administration (DOLETA), the Small
Business Administration (SBA), and the Rehabilitation Services
Administration (RSA) to develop and implement an employer outreach
program targeted toward small and mid-size businesses.
Statement of Hal Daub, Social Security Advisory Board
Chairman McCrery, Representative Levin, Members of the
Subcommittee. I am pleased, as Chairman of the Social Security Advisory
Board, to submit to you this statement concerning the Service Delivery
Challenges that now face the Social Security Administration.
This is a timely and important hearing. I think most Americans are
aware of the Social Security Administration in much the same way that
we are aware of the sun in the sky. If asked, we would, of course, say
that we know it exists and that it is important to the proper
functioning of our lives, but we mostly just expect it to be there and
to operate smoothly. When we need a Social Security number, we expect
to be able to get one. As we work, we expect that our wages will be
properly tracked. Those who are retired and drawing benefits expect
them to be paid in the right amount and at the right time. Those who
become disabled or suffer the loss of a breadwinner expect that they
can turn to the agency and have their eligibility accurately and
promptly adjudicated.
To a very great extent, the Social Security Administration lives up
to and, in many cases, exceeds these expectations. As an excellent
example, I would mention last year's hurricanes. We all have heard a
great deal about the things that went wrong. But one of the things that
went right was the way that the Social Security Administration
responded to that crisis by making extraordinary efforts that kept its
payments and other services flowing to the affected population.
But while the Social Security Administration and its employees have
a well deserved reputation as a ``can-do'' organization that handles
both routine and crisis challenges with efficiency and great commitment
to public service, it is also very much a large scale production
operation that cannot meet all of its challenges adequately unless it
is given adequate resources to do so.
The massiveness of the agency's routine operations is, I think, not
well understood. It provides benefits to over 53 million Americans
every month. Now that may not seem like such a big challenge. The
largest part of that workload is retirement benefits and most of those
now are paid by direct deposit rather than by physical checks. But,
that is not really a static workload. People move. People die. Family
circumstances that affect entitlement can change. People in certain
categories have benefits that may vary from month to month depending on
their earnings or income. The Social Security Administration has to
keep track of these changes, update its benefit rolls, send out
explanations, handle phone inquiries and office visits asking about
these changes. On a typical day, the agency has to process more than
300 thousand actions of this kind.
Beyond maintaining the benefit rolls, one of the most important
things that the Social Security Administration does is to handle new
claims. And again, the magnitude of this operation is so large that it
is difficult to comprehend. Every week, the agency gets something like
150 thousand new benefit claims. That's about 8 million per year. Now
the Social Security Administration has done an excellent job of
leveraging technology to help it handle this huge workload. Lots of
information is available on its website to help people understand what
benefits there are and how to claim them. More and more of these claims
are actually being filed on the Internet and those who do not have
Internet access--or, perhaps, do not trust it--can often file their
claims by telephone. However, technology can take you only so far. For
most of us, reaching the age for claiming Social Security benefits is
an important life event, and many want to go to their local Social
Security field office to talk with a human being and make sure they are
making the right choices. And, even for retirees, there are important
choices in this very complex program. Between age 62 and 70, how much
your permanent benefit rate will be depends on just which month in that
period you choose to have it start. If you are under 66, the amount you
work may affect your benefits. And Social Security also handles your
choice of whether or not to enroll in Part B of Medicare when you reach
age 65. So even the so-called ``simple claims'' are not so simple.
But it is in the disability area that the Social Security
Administration faces the most significant administrative challenges. A
disability claim--and there are about 2.5 million of them each year--is
inherently far more complicated than other claims. For retirement and
survivors claims the availability and evaluation of evidentiary factors
is generally straightforward: age, relationship, the fact of death--
all, generally, can be shown by official records, and wage history
information is maintained in the agency's own databases. But a
disability claim involves a complex interview where the claimant
explains the nature of the impairment and why he or she thinks it
prevents employment. The claimant's prior work history and educational
background also must be recorded. All the doctors and hospitals and
clinics that have provided treatment are contacted to provide their
medical findings. In many cases, the claimant will be asked to undergo
a medical examination by an agency consultant. The claim passes through
many hands. Generally, it is filed and the initial interview conducted
at an SSA field office. It then goes to a State disability
determination agency which gathers the evidence so that a lay
disability examiner and a medical professional can jointly decide
whether the claimant meets the statutory definition of disability.
Because disability is often not clear cut, a large portion of claims go
on to a lengthy appeals process that may involve a reconsideration by
the State agency, a hearing before an administrative law judge, further
administrative review by the Appeals Council, and, in a relatively
small but still significant number of cases, review by a Federal
District Court.
Again, the agency has been making strong efforts to increase its
efficiency in handling this difficult and complex caseload. Even as
millions of claims continue to come in the door, it undertook over the
past couple years to develop a sophisticated new electronic processing
system for disability claims which should, when fully implemented,
reduce the costs of handling, storing, and transporting the bulky paper
claims folders previously used. This new ``eDib'' system also holds
promise of improving the agency's ability to process claims and
implement effective quality management measures. But still, the nature
of the program will continue to involve the labor-intensive functions
of identifying, gathering, and evaluating evidence for a necessarily
subjective determination. The agency has been able to make impressive
productivity gains over the past several years, but with the baby boom
generation now approaching its most disability prone years, the
administrative challenge will continue to grow.
So adequate resources will always be an important factor in the
Social Security Administration's ability to meet its administrative
challenges. And, despite its significant record of achievement, it does
not now have adequate resources to keep up with all its workloads.
In 1994, Congress decided that the Social Security Administration
should become an independent agency of the government. In the
legislation that Congress and the President enacted into law, you gave
the Commissioner the responsibility of drawing up budgets based on the
agency's workforce needs and required that these be submitted to the
Congress along with the President's request. Based on this requirement,
the Social Security Administration has been submitting budgets which
would allow it to gradually bring down its backlogs to normal levels.
The pattern has been for the President's budget to include much, but
not quite all, of the requested funding, and for the Congress to
appropriate at a level below the President's recommendation. For the
current fiscal year, for example, the Social Security Administration
told Congress that a service delivery budget level of $10.1 billion was
the amount needed to meet its ongoing responsibilities including a
glide path to the elimination of backlogs. The President recommended
that Congress allow $9.4 billion. And the actual administrative funding
level approved by the Congress was $9.1 billion.
The Social Security Administration does its best to continue to
provide a high level of public service with the resources it does
receive. But, when resources are not adequate, workloads will and do
suffer. This obviously puts the Commissioner of Social Security into a
difficult position of deciding what gets done and what gets left
undone. Some things that get left undone are important stewardship
activities. Some of those who go on the disability rolls will recover,
but it takes resources to carry out continuing disability reviews. Some
of those who are needy and apply for Supplemental Security Income will
have changed circumstances that lessen (or perhaps increase) their
entitlement. It takes resources to conduct redeterminations. The
actuaries have found that a dollar spent on disability reviews yields
ten dollars in long-term benefit savings and a dollar spent on SSI
redeterminations has a sevenfold return on investment. So failing to
provide adequate resources to carry out these stewardship
responsibilities really is not beneficial to either the Federal budget
or the trust funds.
But it is not just stewardship that suffers when resources are
inadequate. Members of the public coming into Social Security offices
to do business such as filing a claim or getting a Social Security card
find themselves waiting longer than necessary. Telephone calls,
especially those to field offices with inadequate staff and obsolete
equipment, are not answered and voice mail messages are not returned
promptly and, in some cases, are not returned at all.
Again, it is in the complex and difficult disability area that
service to the public especially suffers when resources are
insufficient to enable the agency to keep up with growing workloads.
The number of initial disability claims awaiting a decision is over
650,000 and growing. In 1980, Congress directed SSA to promulgate
performance standards for State Disability Determination Services.
SSA's regulations set a target average processing time for Social
Security disability claims of 37 days with 50 days as the outside
threshold of what is ``acceptable.'' In the past three months, the
average time was over 92 days.
The situation in the hearings process is even more serious. At the
end of 1999, there were 265,000 Social Security claimants awaiting a
hearing on their appeals. By the end of 2003, that had more than
doubled to 556,000. And the backlog continues to grow. It is now over
725,000 and by the end of this fiscal year will reach 756,000. That is
three-quarters of a million Americans with severe disabilities who have
already waited 3 or 4 months to get a decision on their claim and will
now face, on average, another year and a quarter awaiting a decision on
their appeal. And most of them will ultimately be found eligible.
So, just to carry out its basic ongoing responsibilities, the
Social Security Administration must have adequate resources. But even
as it struggles with a less than optimal funding level and still
attempts to make those investments in technology and improvements in
process that will make it better able to cope efficiently with its
workloads, SSA finds its workloads growing because the public and the
Congress tend to look to this ``can do'' agency when new needs arise.
The public expected and received extraordinary efforts from the Social
Security Administration when the hurricanes were shutting down many
other services. The agency met the challenge, but at a cost. Last
year's hurricanes absorbed an unplanned for expenditure of over $70
million that will reduce the agency's capacity to use overtime for some
of its ongoing workloads. A few months back, the period for enrollment
in the new Medicare prescription drug program began. Even though this
was not properly a Social Security Administration responsibility, the
agency has a presence in the community and is trusted as a source of
information. As a result, its field offices were swamped with visitors
and its 800 number experienced a huge spike in calls. Again, this
absorbed resources that reduce the agency's ability to do its own work.
In 2004, legislation was enacted requiring increased evidentiary
standards for issuing new and replacement Social Security cards. This
does not sound like a huge burden, but the agency processes 18 million
cards each year. Field offices tell us that many of those who visit the
office for a Social Security card now need to make a return visit to
bring additional documents.
Legislation has been passed by the House that would mandate that
employers verify the accuracy of the Social Security numbers presented
to them by their workers. If Congress ultimately does decide to take
this step or some variant of it, it is important to be aware that this
does represent another administrative challenge for the Social Security
Administration. The challenge is not so much in setting up and
operating the verification system itself--the agency already provides
such services on a voluntary basis--but rather in the spillover impact
as Social Security deals with the many cases where the verification
will be negative and workers will need to straighten out their records.
This certainly may have some beneficial results in terms of reducing
the amount of wages that cannot now be properly credited, but, like all
administrative burdens, it is not free. It will take administrative
resources, and unless those are provided, it will detract from the
ability of the agency to provide other services to the public.
I would like to take a moment to discuss the administrative
challenges that the Congress placed upon the Social Security
Administration in connection with the Medicare prescription drug
program. Recognizing Social Security's presence in American communities
and its reputation for providing effective and efficient public
service, you gave it the responsibility for soliciting and adjudicating
applications for the extra assistance provided to lower income
beneficiaries in meeting their prescription drug costs. But you very
wisely, I believe, recognized that this would be a significant
administrative challenge and, to avoid an adverse impact on the
agency's other important workloads, you included additional
administrative funds as an integral part of the same legislation that
gave the Social Security Administration this new mandate. I think that
should become a model for the future and one that you should insist
that other Committees follow if they propose changes that have the
effect of increasing the Social Security Administration's
administrative tasks.
In reports issued by the Social Security Advisory Board in 1999 and
again in 2002, the Board urged that the administrative budget for the
Social Security Administration should be ``excluded from any cap that
sets an arbitrary limit on discretionary spending.'' We also said that
the Board does not in any sense mean that the agency's budget should be
exempt from close scrutiny by the Congress. The Social Security program
and the Social Security trust funds are very important to the workers
who bear the burden of paying Social Security taxes and to the
beneficiaries who depend upon the program for economic security. The
Congress has a responsibility to assure both that this core
responsibility of government is adequately resourced and efficiently
carried out and that proper levels of benefit and administrative
expenditure are maintained. Unfortunately, there is a shortcoming in
our current budgetary processes that seems to result in the worst of
both worlds. In a more rational process, the agency would be able to
devote sufficient resources to its stewardship responsibilities to
generate a reduction in improper payments that could in turn be
redirected to carrying out its responsibilities for providing
excellence in all aspects of its service to the public. I would urge
the Subcommittee to find ways to resolve this problem.
Statement of Social Security Disability Coalition, Rochester, New York
As a Social Security Disability and Medicare recipient myself, I
wish to discuss below my concerns on how Social Security service
delivery challenges affect those two programs.
Social Security Disability Program Issues
As a person who has gone through the Social Security Disability
process myself, I know first hand the financial, physical and emotional
devastation that the current SSDI process can cause. As President/Co-
Founder of the Social Security Disability Coalition and author of the
Social Security Disability Reform Petition, I see on a daily basis the
devastating affect, that problems with this program, has on others all
over the country. I believe that many of the problems an SSD/SSI
applicant faces are due to insufficient staffing levels and poor
training of current staff. Since our lives are most directly affected
by the inadequacies of the SSA, and must deal with the consequences
when it does not function properly, we know first hand where the
problems are, and the possible solutions to correct them. SSA customer
service is extremely poor and in major need of improvement across the
board. The Social Security Disability claims process in particular,
which should be done quickly, easily, with the utmost respect and
compassion for this nation's most fragile population, has instead
turned into one of dread, tedium, disrespect and devastation. Here is
just a small sampling of the constant complaints we receive and issues
we face when applying for our SSD/SSI benefits:
Severe understaffing of SSD workers at all levels of the
program
Extraordinary wait times between the different phases of
the disability claims process
Employees not returning calls, outright refusing to
provide information to claimants (due to high work volume/stress
levels?)
Employees greatly lacking in knowledge of Social
Security/Federal Regulations--including Freedom of Information Act,
Privacy Act, SSD Pre-Hearing review, and hearing on the record
processes (due to poor training?)
Complaints of lack of attention or totally ignoring--
claimants concerns and medical records provided (due to high work
volume/stress levels?)
Claimants getting conflicting/erroneous information
depending on whom they happen to talk to at Social Security--causing
confusion for claimants and major problems including improper payments
and financial penalties (due to poor training?)
Fraud on the part of DDS/OHA offices, ALJ's, IME's--
purposely manipulating/ignoring information provided to deny claims
(rubber stamping of denials to move paperwork off their desks due to
high volume of claims and not enough workers?)
Complaints of lost files and files being purposely thrown
in the trash (moving paperwork off their desks due to high volume of
claims and not enough workers?)
Complaints of having other claimants information
improperly filed/mixed in where it doesn't belong causing breach of
security (high stress/work volumes can lead to increased mistakes by
workers)
Complaints of backlogs at payment processing centers for
initial payments once claim is approved (not enough workers?)
Employees being rude/insensitive to claimants (due to
high stress levels?)
Poor/little coordination of information between the
different departments and phases of the disability process
These complaints refer to all phases of the SSD process including
local office, Disability Determinations, Office of Hearings and
Appeals, Payment Processing Centers and the Social Security main office
in MD (800 number).
High priority should be given to increase SSA staffing levels, and
provide better employee training, in all phases of the disability
process, especially in the initial contact phases with field offices
and DSS offices across the board. Instead we are hearing that staff
levels are being reduced as backlogs in the system are increasing! We
fear that inadequate staffing levels and increased work load have
caused and will continue to cause ``rubber stamping'' of SSD case
denials across all phases of the disability program in order to meet
paperwork processing goals. Another fear is that we will again
experience the ``disappearance'' or dumping of case files as was
discovered in Milwaukee a few years back.
From GAO/T-HEHS-00-22-10/21/99--SSA Has Had Mixed Success In Efforts To
Improve Caseload Management:
``The cost of administering the disability programs reflects the
demanding nature of the process: in fiscal year 1998, SSA spent about
4.3 billion, or almost 66 percent of its administrative budget on its
disability programs, even though disability beneficiaries are only
21percent of the agencies total number of beneficiaries.''
``The disability process has proved to be a lengthy one that can
confuse and frustrate applicants. Since the early 1990's, claimants
applying for disability benefits have had to wait over a year for a
final decision on their eligibility.''
``. . . because of the multiple levels and decision points in the
process, a great deal of time can pass while a claimant's file is
passed from one SSA employee or office to another. Moreover as a result
of these multiple handoffs, and the general complexity of the process,
SSA believes claimants have had difficulty obtaining meaningful
information about the status of their claims.''
``Long-standing problems with this process were exacerbated when
the number of claims for disability benefits increased dramtically
between fiscal years 1991 and 1993--from about 3 million to 3.9
million, or almost 32 percent. As a result, SSA's disability workload
began to accumulate during this period. Most dramatically, the number
of pending hearings almost doubled between 1991 and 1993 from 183, 471
to 357,564.''
``At the end of 1998, there were still over 380,000 backlogged
hearings. Moreover, SSA expects claims to begin to increase in the near
future as the baby boom generation approaches its disability-prone
years.''
``The current process also permits inconsistent decision between
the initial and appeals levels. In 1996, about two-thirds of all those
whose claims were denied at the reconsideration level filed an appeal,
and of these, about 65 percent received favorable decisions at the
hearing level. SSA has determined that at the initial level, denial
cases are more error-prone than are allowance cases.
``This inconsistency of decisions has raised questions about the
fairness, integrity, and cost of SSA's disability program. In fiscal
year 1998, the cost of making a determination at the DDS level was $547
per case, while the cost of an ALJ decision was an additional $1385.''
From--20 CFR Parts 404, 405, 416, and 422
Administrative Review Process for Adjudicating Initial Disability
Claims--Final Rule
RIN 0960-AG31
http://a257.g.akamaitech.net/7/257/2442/01jan20061800/
edocket.access.gpo.gov/2006/06-3011.htm
[Federal Register: March 31, 2006 (Volume 71, Number 62)]
[Rules and Regulations]
[Page 16423-16462]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr31mr06-22]
Part II--20 CFR Parts 404, 405, 416, and 422
During the five decades that have elapsed since its enactment, the
DI program has provided many millions of disabled American workers and
their families with critically needed income support. The SSI program,
enacted 34 years ago, has similarly helped many millions of low income
disabled individuals meet their basic needs. These two programs are a
vital part of the nation's social insurance and income support systems.
The number of disability beneficiaries in our programs has grown
significantly over the years. In January 2005, nearly eight million
disabled workers and their dependents received DI benefits, double the
number of beneficiaries in 1985 (about a 100% increase). Nearly six
million disabled adults and children received SSI disability payments,
more than double the number in 1985 (a 130% increase). The adjudication
of disability claims now constitutes the major part of our workload and
nearly every one of our components has a role in administering the
disability programs. In fiscal year 2005, the State disability
determination services (DDSs) processed more than 2.6 million initial
claims for DI benefits and SSI based on disability or blindness. Our
hearing offices processed approximately 500,000 disability claims on
behalf of claimants who appealed their denials.
Yet with these numbers there is talk of cutting staff levels even
further? I am sad to say that since these reports were originally
released, that things have gotten much worse by far, and the outlook,
even with the institution of the SSA Commissioner's new regulations, is
extremely grim.
Medicare Program Issues
In a recent GAO report GAO-06-715T--Quality of CMS Communications
to Beneficiaries on the Prescription Drug Benefit Could Be Improved--
released on 5/4/06, those eligible for Medicare Part D are experiences
serious problems due to poor service delivery. One-third of calls to
the 1-800-MEDICARE Help Line received inaccurate, incomplete or
inappropriate responses. Some callers had to wait up to 55 minutes to
get through before actually speaking to someone (based on 500 calls
made by GAO).
Another GAO report GAO-05-130--Accuracy of Responses from the 1-
800-Medicare Help Line Should Be Improved--released on 12/8/04, 29% of
calls received an inaccurate response and 10% received no response at
all (based on 420 calls in July 2004). This report also states that
``Training for CSR's meets CMS's requirements, but is not sufficient to
ensure that CSR's are able to answer questions accurately on the help
line.''
Since Medicare penalizes beneficiaries who do not meet sign up
guidelines and deadlines for the rest of their lives, these mistakes
create a serious financial burden on those who can least afford it.
Personally, my own mother has been forced to pay higher Medicare
premiums for the rest of her life now, because of the inaccurate
Medicare information she received. We taxpayers should not have to pay
for the mistakes of poorly trained government employees.
In an effort to correct some of these proglems I suggest the following
be done immediately:
Congress needs to increase funding for all Social Security/Medicare
programs so more properly trained staff are put in place to handle the
increased work load that the Social Security/Medicare programs are
facing. The number of people eligible for these benefits is only going
to increase over time as the American population ages at a faster pace
compared to decades of the past.
Since millions of disabled and elderly Americans rely on Social
Security Disability, SSI, SS retirement benefits and Medicare as their
sole source of income, health insurance and prescription coverage, it
is imperative that Congress act immediately to make sure that these
programs are administered with the highest priority in regards to
expediency, efficiency and accuracy. Anything less than that could
result in disaster, even death for this very fragile population.
A major bottleneck in the disability process is the state DDS
offices and their inability to process SSD/SSI claims properly. As a
result these Federal regulations are constantly being violated on a
daily basis:
Code Of Federal Regulations Part 404--Federal Old-Age, Survivors
And Disability Insurance (1950--):
404.1642 Processing time standards http://www.ssa.gov/OP_Home/
cfr20/404/404-1642.htm
(a) General. Title II processing time refers to the average number
of days, including Saturdays, Sundays, and holidays, it takes a State
agency to process an initial disability claim from the day the case
folder is received in the State agency until the day it is released to
us by the State agency. Title XVI processing time refers to the average
number of days, including Saturdays, Sundays, and holidays, from the
day of receipt of the initial disability claim in the State agency
until systems input of a presumptive disability decision or the day the
case folder is released to us by the State agency, whichever is
earlier.
(b) Target levels. The processing time target levels are:
(1) 37 days for title II initial claims.
(2) 43 days for title XVI initial claims.
(c) Threshold levels. The processing time threshold levels are:
(1) 49.5 days for title II initial claims.
(2) 57.9 days for title XVI initial claims.[46 FR 29204, May 29,
1981, as amended at 56 FR 11020, Mar. 14, 1991]
404.1643 Performance accuracy standard http://www.ssa.gov/OP_Home/
cfr20/404/404-1643.htm
(a) General. Performance accuracy refers to the percentage of cases
that do not have to be returned to State agencies for further
development or correction of decisions based on evidence in the files
and as such represents the reliability of State agency adjudication.
The definition of performance accuracy includes the measurement of
factors that have a potential for affecting a decision, as well as the
correctness of the decision. For example, if a particular item of
medical evidence should have been in the file but was not included,
even though its inclusion does not change the result in the case, that
is a performance error. Performance accuracy, therefore, is a higher
standard than decisional accuracy. As a result, the percentage of
correct decisions is significantly higher than what is reflected in the
error rate established by SSA's quality assurance system.
(b) Target level. The State agency initial performance accuracy
target level for combined title II and title XVI cases is 97 percent
with a corresponding decision accuracy rate of 99 percent.
(c) Intermediate Goals. These goals will be established annually by
SSA's regional commissioner after negotiation with the State and should
be used as stepping stones to progress towards our targeted level of
performance.
(d) Threshold levels. The State agency initial performance accuracy
threshold level for combined title II and title XVI cases is 90.6
percent.
To date the Social Security Administration has determined that it
can take up to 1153 days (3\1/4\ years) for a claim to be processed if
it is denied at every level which often occurs. The SS Commissioner has
stated that she hopes to reduce that wait time by 25% or down to 2\1/4\
years, yet she has passed regulations which will force thousands more
into the already backlogged Federal Court system which could end up
increasing wait times to even longer than the 3\1/4\ years. This is
appalling, and shows that she is totally out of touch with the
realities that disability applicants face. I am sure that if she, or
anyone else in the Federal government had to endure living under the
conditions that a 2\1/4\ year or longer wait time for benefits brings,
in addition to the hardships caused by one's disabling conditions, they
could not fix the system fast enough.
We ask that the SSA create the position of Disability Claims
Manager--New decision maker position to combine the disability claims
responsibilities of SSA field office personnel with DDS staff and that
position be a Federal employees instead of State contract employee to
insure proper training and consistency of operations and disability
decisions throughout the country. It is more than apparent that the
states have been greatly lacking in their duties of processing SSD/SSI
claims in a swift and proper manner.
In order to correct these Federal regulation violations and speed
up the claims process, more effort should be made to thoroughly review
a disability claim at the start, giving more proper weight to claimants
treating physicians opinions and medical records, which is part of
Social Security law, but is often not followed when making decisions
throughout the claims process. Too much weight at the initial time of
filing, is put on the independent medical examiner's and SS
caseworker's opinion of a claim. The independent medical examiner only
sees the claimant for a few minutes and has no idea how a patient's
medical problems affect their lives after only a brief visit with them.
The caseworker at the DDS office never sees a claimant. Often claimants
are sent to doctors who are not even qualified to comment on a
patient's disabling conditions as their medical expertise is not
appropriate for the conditions that the claimant has. In cases where
SSD required medical exams are necessary, they should only be performed
by board certified independent doctors who are specialists in the
claimant's disabling conditions (example--Rheumatologists for
autoimmune disorders, Psychologists and Psychiatrists for mental
disorders). Independent medical exams requested by Social Security must
only be required to be performed by doctors who are located within a 15
mile radius of a claimants residence. If that is not possible--Social
Security must provide for transportation or travel expenses incurred
for this travel by the claimant. If more attention was given to the
patient's treating physician's reports and test results, it would cut
down on the need for SS to spend money on Independent Medical
examinations. When an IME is necessary, sending the claimant to a
proper IM examiner for their conditions, would save time and money for
the SSA and reduce unnecessary stress to the claimant, instead of
wasting these resources on unqualified examiners. We also agree with
the establishment of a Federal Reviewing Official (RO) level of review,
that would issue decisions based on review of record. As mentioned
previously, we feel that currently not enough time is spent looking at
the medical records supplied by applicants and this results in
premature denials and more ALJ hearings.
There should be more effort on the part of SS to assist applicants
throughout the entire disability claim process, including ongoing
contact with claims examiners and assistance with developing the
medical file to ensure all pertinent medical evidence is in the file.
We ask that Congress institute some new requirements. First, review of
records by a claimant should be available at any time during all stages
of the SSD/SSI determination process, not only after a case is denied
the first time, which is currently the case. Also before a denial is
issued at any phase of their claim, the applicant must be contacted
immediately, and given a detailed report as to why a denial might be
imminent, who made the determination, and a phone number, fax number
and address, where ALL the sources being used to make the judgment can
be contacted. This way for anything that the SSA file is missing, or
inaccurate information was given, the applicant can now provide the
missing or corrected information before a determination is made. We
also ask that when a denial is imminent, that the applicant be given an
additional 3 week time period to submit new evidence in order to
further prove their disability status. Currently, SSD/SSI cases take so
long to process, that a majority of claimant's conditions worsen from
the time it takes to initially file a claim, until a final decision is
made on it. Since claim status is very hard to track throughout the
claims process, it makes it very difficult for applicants to submit new
evidence to further prove their disabilities as their health conditions
deteriorate over time. Ease of claim status tracking and better
communication throughout the claims process would eliminate many cases
from having to advance to the hearing and appeals phase, which again
would save the SSA time and money to be used elsewhere in the system.
The Federal quality review process often adds at least an
additional 4 week waiting period to claims processing, and often
targets approvals rather than denials and in the future should focus
more on why cases are denied rather than approved. To better streamline
and to further speed up the claims process--the DRB (Decision Review
Board and Federal Quality Review processes should be combined.
More Federal funding is necessary to create a universal network
between Social Security, SSD/SSI and all outlets that handle these
cases so that claimant's info is easily available to caseworkers
handling claims no matter what level/stage they are at in the system.
Even with the institution of E-Dib there are still many problems in
this area. All SSA forms and reports should be made available online
for claimants, medical professionals, SSD caseworkers and attorneys,
and be uniform throughout the system. One universal form should be used
by claimants, doctors, attorneys and SSD/SSI caseworkers, which will
save time, create ease in tracking status, updating info and reduce
duplication of paperwork. Forms should be revised to be more
comprehensive for evaluating a claimant's disability and better
coordinated with the SS Doctor's Bluebook Listing of Impairments.
A majority of SSD claimants are forced to file for welfare, food
stamps and Medicaid, another horrendous process, after they have lost
everything due to the inadequacies in the Social Security Disability
offices and huge claims processing backlog. Congress should pass
regulations that all SSD/SSI case decisions must be determined within
three months of original filing date. When it is absolutely impossible
to do so, a maximum of six months will be allowed for appeals, hearings
etc--NO EXCEPTIONS. Failure to do so on the part of the SSA, will
constitute a fine of $500 per week, for every week over the six month
period--payable to claimant in addition to their awarded benefit
payments, and will be paid immediately along with their retro pay upon
approval of their claim. In addition the SSA will also be held
financially responsible for approved claimants who lose property,
automobiles, IRA's, pension funds, who incur a compromised credit
rating or lose their health insurance as a result of any delay/failure
to fully process their claim within the initial allotted three month
processing period. If a claimant is denied during the three month
period but appeals and is finally found to be disabled SSA must retro
equivalent compensation of losses incurred by the claimant from
original disability date of eligibility.
Institute a lost records fine--if Social Security loses a claimants
records or files an immediate $1000 fine must be paid to the claimant.
Fines of this nature would dramatically cut down the number of lost
files by the SSA.
We are not in favor of any changes that would result in more
hearings, lesser back payments or a greater reliance on attorneys for
claimants to receive benefits. The claims process should be set up so
there is no need whatsoever for claimant paid legal representation when
filing for benefits and very little need for cases to advance to the
hearing and appeal stage since that is where the major backlog and wait
time exists. A great number of ALJ decisions are currently appealed due
to rampant bias against claimants, fraudulent behavior and poor
performance by the ALJ's currently serving. The need of lawyers/reps to
navigate the system and file claims, and the high SSD cap on a lawyer's
retro commission is also a disincentive to expeditious claim
processing, since purposely delaying the claims process will cause the
cap to max out--more money to the lawyer/rep for dragging their feet
adding another cost burden to claimants. Instead, SS should provide
claimants with a listing in every state, of FREE Social Security
Disability advocates/reps when a claim is originally filed in case
their services may be needed.
The current continuing disability review/CDR process in itself--the
threat of possible benefits cut off, and stress of a review by Social
Security again, is very detrimental to a patient's health. Many who
under SS guidelines, still qualify for benefits are being forced into
hearing situations and overpayment issues due to mistakes or outright
fraud on the part of the SSA, which cuts then off from receiving their
vital benefits. Many people suffer from chronic conditions that have NO
cures and over time these diseases grow progressively worse with no
hope of recovery or returning to the work force. This factor needs to
be taken into consideration when reforming the CDR process. In those
cases, total elimination of CDR's should be considered or a longer
period of time between reviews such as 10-15 years rather then every 3-
7 years, which is currently the case. This would save the SSA a great
deal of time, money and paperwork which could then be used to get new
claimants through the system faster. It is often said that these
reviews are done to prevent fraud. Nobody in their right mind would
want to live under the conditions that the majority of SSD claimants
and recipients are forced to endure. Most would much rather have their
health back and the jobs that once had before their lives were changed
by illness or accidents.
The Ticket To Work program needs to be revised--SSA forces the
disabled to go through years of abuse trying to prove that they can no
longer work ANY job in the national economy due to the severity of
their illnesses in order to be approved for benefits. Then, sometimes
weeks after they are finally approved for SSD/SSI benefits, after their
health and finances have been totally destroyed beyond repair, they
receive a ``Ticket To Work'' packet in the mail. A cruel joke to say
the least, and a total waste of SS funds. It is no wonder why many
disabled Americans distrust the Federal Government! If more resources
were put into processing disability claims faster, the chances of
possible health improvement and eventual return to any sort of work
activity would be greatly increased.
Congress needs to pass regulations now that prevent tax payer
contributions and SS budgets for Social Security programs to be used
for anything else other than to pay Social Security benefits and funds
necessary to administer its programs properly.
Currently disabled Americans are forced to wait 2 years to be
covered under Medicare A, B, or D. Congress needs to legislate a change
to remove the 24 month waiting period so that coverage under all parts
of Medicare would start immediately for ALL SSDI/SSI recipients, upon
disability date of eligibility.
Congress should pass legislation to remove ALL late enrollment
penalties for ANY part (A, B, or D) of the Medicare program. Medicare
is supposed to be there to keep people healthy, not force them into
having coverage, and penalize them into poverty for the rest of their
lives, if they miss a sign up deadline. Medicare should be a healthcare
program that rivals any private insurance coverage offered, and one
that people would rush to sign up for on their own without the fear of
penalties.
Until these issues are addressed, disabled Americans will continue
to suffer at the hands of a Federal government program that was
originally put in place to help, not harm them. Current census data
states that 18% of the US population is disabled and surely that number
will continue to rise. As we head into a crucial election time in
November, it is extremely important for the current and future members
of Congress to take our concerns very seriously. We may be disabled but
we still vote!
Social Security Disability Reform Petition--read the horror stories
from all over the nation:
http://www.petitiononline.com/SSDC/petition.html
Social Security Disability Coalition--offering FREE knowledge and
support with a focus on SSD reform:
http://groups.msn.com/Social SecurityDisabilityCoalition
Please check out my website at:
http://www.frontiernet.net/ lindaf1/bump.html
``I am disabled and my vote counts too!''