Driven to reduce a huge backlog of disability
claims, Social Security is pushing judges to award benefits to people
who may not deserve them, several current and former judges told
Congress Thursday June 27, 2013.
Judge Larry Butler, an administrative law judge (ALJ) from Fort Myers, Fla., called the system “paying down the backlog.”
(For a complete explanation of the term "paying down the backlog" see socialNsecurity by Judge L. Steverson, USALJ (Ret.)
The approval rates
among ALJs can be quite arbitrary. One ALJ might reverse 9 out of 10 cases
and another might deny 9 out of 10 cases. It all depends on the luck of the
draw.
There
is a practice called “Paying Down The Back Log”. This is where a judge just
reverses every case on his docket and grants benefits to the claimant. Some
ALJs have been known to do this with no regard at all for the merits of the
case. Judges have been known to pay 200 cases or more on-the –record in this
manner. Sometimes the Commissioner will take action to stop them. Other times
he does not. (Steverson, Judge London, socialNsecurity, p. 19)http://www.amazon.com/Judge-London-Steverson/e/B006WQKFJM
(AP)
A former Social Security Judge, J.E. Sullivan,
said, “The only thing that matters in the adjudication process is
signing that final decision.” Sullivan is now an administrative law
judge for the Department of Transportation.
The House Oversight and Government Reform
Committee is investigating why many judges have high approval rates for
claims already rejected twice by field offices or state agencies. Two
current and two former judges spoke at a subcommittee hearing.
The number of people receiving Social Security
disability benefits has increased by 44 percent over the past decade,
pushing the trust fund that supports the program to the brink of
insolvency.
Social Security officials say the primary reason
for the increase is a surge in baby boomers who are more prone to
disability as they age. Deputy Social Security Commissioner Glenn Sklar
noted that the vast majority of disability claims are initially denied.
“I think the data kind of speaks for itself,” Sklar told lawmakers.
To qualify for benefits, people are supposed to
have disabilities that prevent them from working and are expected to
last at least a year or result in death.
According to Social Security data, there were
errors in 22 percent of the cases decided in 2011, Sklar said. He said
some errors were procedural and did not necessarily result in incorrect
decisions.
“The true wrong rate would be less than 10 percent,” Sklar said.
Nearly 11 million disabled workers, spouses and
children get Social Security disability benefits. That compares with 7.6
million a decade ago. The average monthly benefit for a disabled worker
is $1,130.
An additional 8.3 million people get Supplemental Security Income, a separately funded disability program for low-income people.
Social Security disability claims are first
processed through a network of local Social Security Administration
field offices and state agencies called Disability Determination
Services. About two-thirds of initial claims are rejected, according to
agency statistics. If your claim is rejected, you can ask the field
office or state agency to reconsider. If your claim is rejected again,
you can appeal to an administrative law judge, who is employed by Social
Security.
In 2007, the average processing time for a
hearing was 512 days. Today it is 375 days, Sklar said. The agency has
reduced the wait time even as the number of applications has increased.
But the judges who testified Thursday said the quality of their
decisions has suffered. So far this budget year, the vast majority of
judges have approved benefits in more than half the cases they’ve
decided, even though they were reviewing applications typically rejected
twice by state agencies, according to Social Security data.
Of the 1,560 judges who have decided at least 50
cases since October, 195 judges approved benefits in at least 75
percent of their cases, according to the data analyzed by congressional
investigators.
“The Social Security Administration has failed
to take steps to address the problem of rapid disability growth,
probably because the agency has failed to recognize many of the
problems,” said Rep. James Lankford, R-Okla., the subcommittee chairman.
None of the judges who testified spoke of being
specifically ordered to award claims. Three said they had been pressured
to decide cases without fully reviewing medical files.
The judges described a system in which there is
very little incentive to deny claims, but lots of pressure to approve
them. It requires more documentation to deny a claim than to approve
one, said Sullivan, the former Social Security judge. Also, rejected
claims can be appealed while approved claims are not.
“There’s a tremendous amount of pressure to push
cases out the door as soon as possible,” Sullivan said in an interview
after the hearing. “There’s a push to pay mentality.”
Butler, the current judge, told the
subcommittee, “I think you need to look at the issue of paying down the
backlog. It’s not media hype, its real and for six years it’s been going
on.”
(AALJ President Randy Frye and Marilyn Zahm)
The Association Of Administrative Law Judges(AALJ), union representing administrative law judges,
says judges are required to decide 500 to 700 cases a year in an effort
to reduce the hearings backlog. The union says the requirement is an
illegal quota that leads judges to sometimes award benefits they might
otherwise deny just to keep up with the flow of cases. according to a
federal lawsuit filed by the judges’ union in April.
The Social Security Administration says the agency’s administrative law judges (ALJs) should decide 500 to 700 disability cases a year. The agency calls the standard a productivity goal, but a lawsuit filed in April 2013 by the Social Security Judges against the Commissioner and the Agency claims it is an illegal quota that requires judges to decide an average of more than two cases per workday.
‘‘When the goals are too high, the easy way out is to pay the case,’’ said Randall Frye, president of the Association of Administrative Law Judges (AALJ) and a judge in Charlotte, N.C. ‘‘Paying the case
is a decision that might be three pages long. When you deny benefits,
it’s usually a 15- or 20-page denial that takes a lot more time and
effort.’’The Social Security Administration says the agency’s administrative law judges (ALJs) should decide 500 to 700 disability cases a year. The agency calls the standard a productivity goal, but a lawsuit filed in April 2013 by the Social Security Judges against the Commissioner and the Agency claims it is an illegal quota that requires judges to decide an average of more than two cases per workday.
The lawsuit raises serious questions about the integrity of the disability hearing process by the very people in charge of running it. It comes as the disability program faces serious financial problems.
The agency denies there is a case quota for judges and says the standard is a productivity goal.
“I find it interesting that there is so much wringing of the hands about a judge who pays almost 100% of his cases, as if the agency didn’t know about it, as if the agency wasn’t complicit in it, as if the agency didn’t encourage it,” said Marilyn Zahm, a Social Security judge in Buffalo, NY who is an executive vice president of the Association of Administrative Law Judges (AALJ), the judges’ union.
Judge Zahm had a lot more to say in an interview in October 2009. (Read the entire interview starting at page 430 in my book, socialNsecurity, available at http://www.amazon.com/SocialNsecurity-ebook/dp/B006VOQIKK
“I find it interesting that there is so much wringing of the hands about a judge who pays almost 100% of his cases, as if the agency didn’t know about it, as if the agency wasn’t complicit in it, as if the agency didn’t encourage it,” said Marilyn Zahm, a Social Security judge in Buffalo, NY who is an executive vice president of the Association of Administrative Law Judges (AALJ), the judges’ union.
Judge Zahm had a lot more to say in an interview in October 2009. (Read the entire interview starting at page 430 in my book, socialNsecurity, available at http://www.amazon.com/SocialNsecurity-ebook/dp/B006VOQIKK
If Congress doesn’t act, the trust fund that
supports Social Security disability will run out of money in 2016,
according to projections by Social Security’s trustees. At that point,
the system will collect only enough money in payroll taxes to pay 80
percent of benefits, triggering an automatic 20 percent cut in benefits.
Congress could redirect money from Social
Security’s much bigger retirement program to shore up the disability
program, as it did in 1994. But that would worsen the finances of the
retirement program, which is facing its own long-term financial
problems. (AP)
Several current and former Administrative Law Judges (“ALJs”) testified before Congress that the Social Security Administration is purportedly pushing ALJs to award benefits (or grant benefits) in an effort to reduce the rather large backlog of disability claims in the system. This further feeds the misperception that ALJs are approving claims willy-nilly left and right. Just as there are Judges who have high approval rates or grant rates (the percentage of claims approved out of all claims disposed), there are Judges who have extremely low grant rates and deny the vast majority of claims that they decide.
Several current and former Administrative Law Judges (“ALJs”) testified before Congress that the Social Security Administration is purportedly pushing ALJs to award benefits (or grant benefits) in an effort to reduce the rather large backlog of disability claims in the system. This further feeds the misperception that ALJs are approving claims willy-nilly left and right. Just as there are Judges who have high approval rates or grant rates (the percentage of claims approved out of all claims disposed), there are Judges who have extremely low grant rates and deny the vast majority of claims that they decide.
Judge Daugherty in the Huntington West Virginia Hearing Office paid 90+% of of his cases and processed 80 to 100 cases per month, mostly without holding hearings. When he held assembly-line hearings, they lasted no more than 15 minutes each. The Office numbers looked good to the Commissioner of Social Security. But the other ALJ who held 8 hearings a day of an hours duration each could only produce 20 decisions per month. He did not help to "pay down the backlog" and make the Office look good to the Commissioner; so, he was investigated and maybe brought up on charges for time and attendance violations. ALJ Daugherty was rewarded and the other ALJ was punished. That was what the Social Security System wanted and condoned and that is how the System worked until complaints from disgruntled staff members led to a Congressional Investigation. Judge Daugherty is not a 'Lone Ranger'. Other ALJs in other Hearing Offices are doing the same thing. They are paying down the backlog.
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