A new U.S. Senate subcommittee report raises serious concerns about the
quality of decision making on applications for Social Security Disability
Insurance benefits. The findings underscore the need for an applicant
to have an experienced advocate at every stage of the process. A
knowledgeable SSDI attorney can act as his or her client’s watchdog before the Social Security
Administration, or SSA, by looking at whether the agency is appropriately
developing and evaluating the claim for disability insurance.
The SSDI Program
SSDI is a federal program that provides monthly payments to people disabled
from working by physical or mental impairments, or combinations of impairments,
that will either prevent them from working for at least a year or result
in death. An eligible claimant must also meet certain detailed financial
requirements that basically ask whether he or she has worked fairly recently
and been employed on a mostly regular basis over the years.
SSDI by the Numbers
According to the Associated Press, roughly 11 million beneficiaries get
monthly SSDI benefits of slightly under $1,000 monthly on average. Problematically
in a time of tight budgets, the SSDI rolls have increased almost 25 percent
in the past five years. Apparently this type of increase is consistent
with previous patterns in comparably tough economic times.
Decision Making Under Pressure
The SSA is subject to the current pressure on government to do more with
less, and to do it better. In fairness this is no easy task when it comes
to fairly evaluating SSDI applications to determine, according to detailed
Social Security laws and regulations, whether claimants meet the definition
of disability and properly qualify for benefits. The subcommittee report
states that “many” must wait up to two years for final decisions
to be made on their SSDI applications, a tough thing to ask of people
who are sick, disabled and sometimes dying without regular incomes.
But the medical evidence in a complicated disability claim can consist
of hundreds of pages of detailed doctor and hospital records. To do an
adequate evaluation of such a case, the review cannot be cursory or quick.
Enough time for thoughtful consideration of the evidence is needed to
properly evaluate it according to Social Security law and standards by
an administrative law judge or other government evaluator.
The Subcommittee Study
U.S. Senate Permanent Subcommittee on Investigations issued its minority staff report on “improving the quality”
of SSDI decisions in conjunction with a large study it conducted that
reviewed 300 cases decided by the SSA at all stages of the application
process that has three levels of appeal within the agency if needed (and
later court review options):
- Initial application
- Administrative law judge, or ALJ, hearing
- Appeals Council review
A few of the important findings of fact in the report based on the reviewed
- More than 25 percent of the cases did not properly handle “insufficient,
contradictory, or incomplete evidence.”
- Some ALJs did not sufficiently consider the impact of relevant issues like
substance abuse and obesity on medical impairment.
- Sometimes ALJ hearings lasted less than 10 minutes and did not include
testimony necessary to resolve complex claims with contradictory written evidence.
As the SSA struggles to properly handle the flood of complex disability
cases before it, each and every SSDI applicant would benefit from the
representation of a skilled lawyer to discern at every step whether the
agency is doing the claimant’s case justice under the law.