Disabled? For benefits, apply, keep waiting

By Michael Mishak

Sunday, Aug. 16, 2009 | 2 a.m.

The Social Security Administration is being slammed by a surge in disability and retirement claims that is threatening to shortchange applicants and cripple a system that, even before the downturn, was starved for resources.

To cope with the growing tsunami, the agency is putting pressure on its ranks of administrative law judges, both here and nationally, to clear a massive backlog of disability appeals cases. But the union representing those judges says the hearing officers are overworked — and that some, under threat of disciplinary action, have been cutting procedural corners to hit the agency’s mandate of 500 to 700 cases a year.

Since October, the number of people waiting to have a claim processed has jumped more than 30 percent, from about 556,000 to 736,000 last month. Although most of those initial claims will be denied, many will end up before an administrative law judge on appeal. Nearly 750,000 people are waiting for a hearing before overwhelmed judges.

“No one ever says, ‘do a sloppy job,’ ” said Marilyn Zahm, executive vice president of the Association of Administrative Law Judges. “But to pretend you can keep pumping out decision after decision and spend the requisite amount of time on each case is foolish. That’s shortchanging people, and the system will lack integrity if you do not require everyone to do a good job.”

Where the growth is

The disability program, available to people who can no longer work due to injury or illness, is the fastest growing segment of Social Security, with spending on benefits growing at almost twice the rate of retirement benefits. Officials attribute the surge in claims to newly unemployed workers who continued to work despite an injury and to Baby Boomers reaching their most injury-prone years.

Also, there are laid-off workers looking for any available income.

Zahm, speaking on behalf of the judges, said they are being called to account by the Social Security Administration for their failure to meet a case threshold the union considers unreasonable. Some have been told to submit written plans on how they intend to reach the minimum of 500 cases, she said. Others have simply been told to hit the target, period.

Social Security Commissioner Michael Astrue has said that 500 to 700 cases per judge is a reasonable standard, telling the Associated Press last month that some judges were “not holding their weight.” In a written response to a Sun query, the agency said more than half its administrative law judges meet the standard.

An agency spokeswoman noted that Nevada judges exceed the mandate, deciding on average 547 cases per year.

But the judges union insists the expectations are unrealistic — and that judges will feel the bind even more as new appeals cases roll in.

No more corners to cut

In some regions, Zahm said, agency officials have raised the threshold floor.

“Corners are being cut in order to accommodate a backlog and at the end of the day everyone is going to suffer,” she said. “People have a right to expect due process ... At a certain point, no more corners can be cut.”

The fear, she said, is that legitimate claims may be rejected or fraudulent claims accepted in the rush to do business.

Indeed, the pressure and disciplinary threats have caused some judges to take shortcuts, Zahm said.

“Hearings are being shortened, not all information in the file is being reviewed, not all medical reports are being obtained, and full and legally defensible decisions may not be rendered, either because due consideration hasn’t been given or the decision is poorly written,” she said. “When people have too much work to do in the amount of time allotted to do it, you get sloppy work.”

In a report on the disability case backlog, the judges union warned against increasing a judge’s workload, noting the estimated cost of each case to the Social Security Trust Fund: $250,000, including Medicare costs. “Disability hearings deal with the lives of real people, not inanimate objects on an assembly line,” the report said. “Each case deserves adequate time and attention.”

Time-consuming process

In Nevada, the number of disability claims has jumped 23.2 percent this year, from about 15,100 last year to more that 18,600 in July. The number of people appealing rejected claims has increased 33.5 percent, from about 3,400 to more than 4,500. More than 2,200 people here are waiting for a hearing.

On average, it takes the state nearly three months to process an initial disability claim. And although that measure has improved this year, the progress may not last. Nevada is one of roughly a dozen states requiring furloughs for state employees who process claims. The average age of cases here, from claim to final ruling, is nearly 16 months — slightly better than the national average.

Cases go to other states

To improve service in Nevada, the Social Security Administration says it has transferred about 1,000 Las Vegas cases since March to hearing offices in other states “that have the capacity to handle them.” The agency plans to hire three more judges for Nevada next year, doubling the number of administrative law judges here.

Although welcoming additional hires, the union says it wants systemic changes. Among its recommendations: allowing government attorneys and claimants to discuss — and possibly resolve — cases before they reach the hearing level. Today, judges are independent arbiters who are responsible for much of a case’s fact-finding.

Nationally, agency officials estimate they’ll receive 3.3 million new disability claims over the next year. Congress has boosted the Social Security Administration’s budget and the economic stimulus package gave the agency $500 million to help cut the appeals backlog.

Kathryn Olson, staff director for the House Ways and Means Subcommittee on Social Security, told judges at a recent forum organized by their union, “You just need the money to properly administer the program. Too much pressure to crank out cases really does undermine the integrity of the process.”

Commissioner Astrue has pledged to cut the backlog to normal levels by 2013.

Information from the Associated Press was used in this story.