Monday, March 9, 2015

How To Win Your Social Security Disability Claim? Simple, Find The Right Judge.

Disability Claim Denied? Find the Right Judge

Nine percent of the judges who hear appeals grant benefits 90% of the time, costing taxpayers tens of billions.

To all parties involved in a trial, the slam of a gavel should indicate that justice has been served. Unfortunately, this is often not the case with Social Security Disability (SSDI and SSI) appeals. A system designed to serve society’s vulnerable has morphed into a benefit bonanza that costs taxpayers billions of dollars more than it should. The disability trust fund will become insolvent in 2016, and Congress would be wise to begin much needed reform.
A disability applicant whose claim is rejected during the Social Security Administration’s (SSA) first two stages ( before State Disability Determination Services)  can appeal the decision to administrative-law judges (ALJ). These judges must impartially balance the claims of the applicant against the interests of taxpayers.
Over the past decade judicial impartiality has declined significantly, as many administrative-law judges uncritically approve most claims. In 2008 judges on average approved about 70% of claims before them, according to the Social Security Administration. Nine percent of judges approved more than 90% of benefit requests that landed on their desks.
Do nine out of every 10 applicants appealing denied claims need societal support? There are reasons for skepticism. The data show that judges who are generous in granting benefits are consistently generous over time—which is suspicious, since each year they should hear a random set of new cases. The more discerning judges—those who award benefits less than 90% of the time—are more unpredictable from year to year.
(Photo: Getty Images/Illustration Works)
If the judges with award rates topping 90% are removed from the data, the rate of denial increases by 2%-3% annually. That amounts to 98,000 claims from 2005-11. Assuming an average lifetime award of $250,000, taxpayers would have saved $23 billion over those six years had the worst judges left the bench. If we lower the threshold to exclude judges with award rates north of 85%, these savings increase to $41 billion.
Former Social Security Commissioner Michael Astrue, who took office in 2007, made much-needed changes. Incompetent incumbents saw their influence diluted by new judges drawn from fresh candidate lists. Judicial decisions are now randomly reviewed to ensure that the court remains impartial and fair to taxpayers. Judges were limited to hearing 1,000 cases a year (the figure has since been lowered to 700), and individuals are allowed only one disability application at a time.
Mr. Astrue’s reforms have produced good results. In 2011 judges with award rates exceeding 90% heard a mere 4% of all cases, a 63.6% decline from 2008. But Mr. Astrue’s term expired in 2013, and these changes can easily be undone, either intentionally by future administrators, or unintentionally as bad habits slip back into the system.
His program to increase accountability and judicial turnover should be made permanent. Congress should also institute 15-year term limits for judges, who currently enjoy lifetime tenure, to ensure that fresh legal minds are joining the stale judicial aristocracy. A term of a decade and a half is long enough to insulate judges and prevent undue political influence.
The system faces a huge backlog, made worse by claimants who play adjudication roulette, filing and then withdrawing appeals in hopes of drawing a generous judge. Congress can limit this gamesmanship by allowing only one application per claimant in a three-year period. Because judges must marshal more documentation for a denial than an approval, they have an incentive to grant benefits to keep the system chugging along. The agency can fix this by further limiting the number of cases each judge must decide to 500 from 700.
The system is further complicated because even if a claimant has legal counsel, the judge must advocate on the claimant’s behalf. This dual role should be ended. Most claimants—85%—now have third-party representation. These professionals should be held responsible for getting supporting materials into court expeditiously and completely so the record can be closed in a timely manner.
Even under better legal rules, judges will still face rigid and outdated guidelines for granting benefits. The framework they must follow—known as the Medical Vocational Grid (known as The Listings)—is formulaic to the point of senselessness. For instance, the bar to benefits approval is lower for someone who doesn’t speak English, on the theory that it is difficult to find a job without the language. But that English rule is also applied to claimants from Puerto Rico, where the language of business is Spanish.
These guidelines (in The Listings) also do not give due consideration to actual labor market experience, dictating a looser approval standard for someone with only a high-school degree, even if the person has succeeded in the labor force for decades.
The framework (of The Listings) was developed in the late 1950s, for the previous generation’s workforce, and hasn’t been updated since 1978. Decades ago workers ages 50 or 55 might have been considered retiring, but this is no longer generally the case. Novel job-training programs also make it easier than ever for workers to move into new fields and make up for low levels of education, and new disability criteria would account for these changes.
These solutions would begin to deliver meaningful reform to Social Security disability awards. They can restore dignity and efficacy to a troubled system.
 (BY Mark J. Warshawsky And Ross A. Marchand
(Mr. Warshawsky is a visiting scholar at the Mercatus Center of George Mason University and a former member of the Social Security Advisory Board from 2006 to 2012. Mr. Marchand is a first-year economics graduate student at George Mason University.)

4 comments:

Anonymous said...

Former Social Security Commissioner Michael Astrue, who took office in 2007, like every Commissioner before him tries his own brand or reform. He made changes to the System. Trying to reduce the Backlog, he tinkered with the personnel system. He went after the ALJs. He blamed the ALJs for everything. He was a "blame the Judges first" man.
His reforms produced minor and temporary results. The Backlog was reduced for a moment in time. His program to increase accountability and judicial turnover were a disaster. He removed good experienced ALJ and replaced them with new, inexperienced and easily manipulated recruits who could be told how to decide cases. The new ALJs lack proper judicial temperament, and that is what Astrue was after. Along with Linda DeSoto he marked every ALJ with 15 to 20 years experience on teh job for removal. They were ordered to retire or resign. Any who refused were brought up on charges. the charges were flimsy and ridiculous; such as, receivin personl mail and magazines at the Office, using the OHA office address on their official business card (that were designed, ordered, and printed by the SSA Agency), inappropriate pictures stored on their personal computers (pc), looking at inappropriate wed sites during office hours, writing letters on obsolete stationary with SSA letterheads, and using their titles (U. S. Administrative Law Judge) when signing personal letters Moreover, if any cases went to NLRB Hearings, the Agency suborned perjury, and disobeyed their own Agency Rules. Astrue's policies were a disaster.

Anonymous said...

Former Social Security Commissioner Michael Astrue, who took office in 2007, like every Commissioner before him tried his own brand of reform. He made changes to the Social Security Operating System.
Trying to reduce the Backlog, he tinkered with the personnel system. Mostly, he went after the ALJs. He blamed the ALJs for everything. He was a "blame the Judges first" man.
His reforms produced minor and temporary results. The Backlog was reduced for a moment in time. His programs to increase accountability and judicial turnover were a disaster.
He removed good experienced ALJs and replaced them with new, inexperienced and easily manipulated ALJ recruits who could be told how to decide cases.
He had a formula for how many claimants should be granted benefits and how many should be denied. The new ALJs lack proper judicial temperament, and that is what Astrue was after.
He wanted to take away the judicial independence of the judges. It was a numbers game, and a highly volume business. Along with Linda DeSoto he marked every ALJ with 15 to 20 years experience on the job for removal. Experienced and senior male judges were forced to retire so that less experienced militant female judges could be installed as Chief ALJ in the Hearing Offices. This was most prevalent in California, in the Ninth Region.
Linda DeSoto proudly bragged about the number of judges on her "Hit List" that she had to get rid of. At any one time there were 25 or more judges on her Hit List.
Judges were ordered to retire or resign. Any who refused were brought up on charges. The charges were flimsy and ridiculous; such as, receiving personal mail and magazines at the Office, using the OHA Office address on their official business cards (that were designed, ordered, and printed by the SSA Agency), storing pictures deemed inappropriate on their personal computers (pc), looking at inappropriate web sites during office or after hours, writing letters on obsolete stationary with SSA letterheads, and using their titles (U. S. Administrative Law Judge) when signing personal letters. Judges' offices were searched on weekends when they were not present. Their phones conversations were monitored. Their privacy was invaded. Their computers were seized without notice or warning. Some judges went to lunch and came back to the office to find their computers had been taken by Astrue's henchmen. They were locked out of their personal offices. The locks to the main SSA work place were changed and ALJs were given the new office key. Moreover, if any cases went to NLRB Hearings, the Agency suborned perjury, and disobeyed their own Agency Rules. Astrue's policies were a disaster. He demoralized the ALJ corps, and morale among the judges plummeted. As a result the administrative staff was confused and frustrated. This atmosphere caused efficiency to suffer and increased the Backlog.

Anonymous said...

The framework they must follow—known as the Medical Vocational Grid (known as The Listings)—is formulaic to the point of senselessness. For instance, the bar to benefits approval is lower for someone who doesn’t speak English, on the theory that it is difficult to find a job without the language. But that English rule is also applied to claimants from Puerto Rico, where the language of business is Spanish.
These guidelines (in The Listings) also do not give due consideration to actual labor market experience, dictating a looser approval standard for someone with only a high-school degree, even if the person has succeeded in the labor force for decades.
The framework (of The Listings) was developed in the late 1950s, for the previous generation’s workforce, and hasn’t been updated since 1978.
Until 1990 The Listings declared anyone who was addicted to drugs or alcohol was incapacitated and could not engage in substantial gainful employment. So every person who filed for Social Security disability and alleged drug or alcohol addiction was granted benefits.

Anonymous said...

Up until about 1995 every person in America and its Territories and Possessions who filed for Social Security Disability Benefits (SSI and SSID) was granted benefits. All the winos, alcoholics and misfits with the slightest mental impairment were conclusive presumed to be incapable of engaging in Substantial Gainful Activity (SGA) and therefore were entitled to draw Social Security Benefits according to Social Security Regulations.
Those Regulations were contained in the Listings. All SSA Judges were duty bound and required to follow them. Many healthy people who were injured and could not work were denied benefits when the drunks and derelicts of American society were granted benefits. It bordered on a public scandal.
The Regulations they followed were known as the Medical Vocational Grids or simply The Listings. They were not always logical; like a camel is a horse designed by a committee. The Listings were designed by Social Security scholars.
For instance, the bar to benefits approval was and still is lower for someone who doesn’t speak English, on the theory that it is difficult to work in America when you cannot speak English.
These guidelines (in The Listings) also do not give due consideration to actual labor market experience, dictating a looser approval standard for someone with only a high-school degree, even if the person has succeeded in the labor force for decades.
The framework (of The Listings) was developed in the late 1950s, for the previous generation’s workforce, and hasn’t been updated since 1978.