Wednesday, July 04, 2007

Social Security disability - why not conferencing and collaboration at the reconsideration level?

Decision makers at SSA’s first level of appellate review (“reconsideration” in most states) find it hard to assess claimants’ credibility and subjective symptoms because they do not see the claimant. Therefore cases which turn on these questions tend to get passed upstairs to Administrative Law Judges (ALJs) instead of being awarded by reconsideration level decision makers. These cases typically are ones that don’t satisfy a Listing and require assessment of residual functional capacity (RFC).

Being passed up to an ALJ can add between 9 and 28 months to the process of getting a decision, according to SSA figures dated May 25, 2007 obtained by the National Organization of Social Security Claimants’ Representatives (NOSSCR).

Put another way, claimants whose cases require assessment of credibility or subjective symptoms potentially wait up to 28 months for decisions that might take only 3 months if rendered at the reconsideration level. This is avoided in only the best documented cases.

Here is evidence of a fundamental flaw in SSA’s disability decision process: SSA seems ill-equipped to render a favorable decision at the reconsideration level in that class of cases that do not satisfy a Listing and require assessment of credibility or subjective symptoms.

Is it equal or fair treatment when one class of disabled claimants can get awards in 3 to 6 months, while another class can only get awards in 9 to 28 months.

SSA can remedy this flaw. If claimants and their representatives meet with SSA reconsideration decision makers in person or by video-conference, the reconsideration decision maker can see and speak with claimants and determine their credibility and authenticity of subjective symptoms. We understand that most Social Security district offices have video conferencing capability. Moreover, SSA and claimants when conferencing can freely discuss the need for additional evidence and collaborate in obtaining it quickly. This would not only mean quicker awards for disabled people, but also fewer cases being added unnecessarily to the caseloads of Administrative Law Judges (ALJs).

If only 10 percent of appeals had been removed from the ALJ caseload in 2006, this would have meant 50,080 fewer requests for a hearing. The 2006 ALJ caseload would have been 450,726 instead of 500,806. Most important, many disabled individuals would have received desperately needed cash and medical benefits much sooner.