GAO: Rising claims, fewer employees feed SSA disability backlog

With more people applying for Social Security disability claims, the process slows to a crawl when applicants seek a hearing to consider their case more closely. The Government Accountability Office evaluated the claims process as of the end of fiscal 2006 to determine where the Social Security Administration should focus its activities. Claims for Social Security disability benefits continue to backlog in various stages of the process, reaching 576,000 at the end of fiscal 2006. Most of the backlog — or 72 percent — occurs at the hearing level, GAO said in a report released Jan. 7. SSA said last month that disability hearing backlogs now stand at 750,000. Disability benefits provide cash for living expenses when people with severe physical or mental impairments can no longer work. After an individual applies for disability benefits, the claim may go through an initial determination. If the claim is denied, the claimant can proceed to a different group for reconsideration, and if dissatisfied with that decision, request a hearing and go from there to an appeals council. Rising numbers of disability claims, staff losses and turnovers, and management weaknesses have contributed to the backlog and claimants' longer waits for resolution, GAO said. An overall loss of experienced staff combined with increasing workloads and resource constraints can reduce the success of any initiative aimed at reducing backlogs, GAO said. “Unfortunately, SSA also has a history of implementing initiatives to improve claims processing that have been poorly executed and therefore compounded its problems,” said Daniel Bertoni, director of GAO’s education, workforce and income security issues. SSA introduced reforms in 2006 under the Disability Service Improvement initiative, but suspended the national rollout to concentrate on reducing the backlog of pending hearing requests and bringing SSA’s electronic case processing system into full operation, which should smooth the processing of disability claims.SSA has used an electronic folder system, a component of the electronic disability process, but did not implement the e-pulling function at hearing offices. That function automatically eliminates duplicate documents and organizes the remaining documents. Although SSA has planned a test to implement e-pulling in April, technicians must still perform this time-consuming activity manually. SSA also expects to have the electronic folder system implemented for the appeals council. To reduce the number of existing hearings backlog, SSA is updating its medical eligibility criteria, expediting cases where eligibility is clear, improving the electronic processing system and focusing on resolving claims at the hearing level through a number of targeted actions. Besides automating file assembly at the hearings level, SSA also will allow electronic signatures on approved cases, provide for employees’ shared access to the folder, and expand Internet support and functionality for claimants or their representatives. GAO recommended that SSA better track backlogs in the reconsideration stage, which may have some bearing on the gridlock of claims in the hearings stage, and plan, carry out and evaluate initiatives to reduce them. SSA said it had already taken steps to improve the likelihood of success of future initiatives. SSA launched the National Hearing Center on Dec. 17 with seven administrative law judges hearing cases via videoconferencing and using electronic disability folders. The center will initially hear cases for the Atlanta, Cleveland and Detroit hearing offices, areas of the country where the wait for a hearing can be two years or more. More administrative law judges may be added over time so the center will be able to assist more offices. Although SSA agreed with GAO’s recommendations, the agency believed GAO did not sufficiently emphasize the need for more funding. “The lack of resources has played a significant role in the reasons for the pending workloads,” SSA Commissioner Michael Astrue said in a response letter. Since 2001, Congress has reduced SSA’s budget while increasing its workload outside of its core mission, such as activities related to the Medicare Prescription Drug Program and verification of employee work eligibility for immigration purposes. In fiscal 2008 spending just signed into law, the agency received about $150 million more than last year with plans to hire 150 administrative law judges to help shrink the case backlog.