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Judges claim SSA 'quotas' force rushed, costly claims approvals

Jun. 27, 2013 - 06:00AM   |  
By SEAN REILLY   |   Comments
J.E. Sullivan, a former Social Security Administration judge, said the agency has a 'factory-type' adjudication process that leads judges to make 'poorly considered and rushed decisions' to grant disability benefits.
J.E. Sullivan, a former Social Security Administration judge, said the agency has a 'factory-type' adjudication process that leads judges to make 'poorly considered and rushed decisions' to grant disability benefits. (Thomas Brown / Staff)

The Social Security Administration is costing taxpayers millions of dollars by pressing for quick decisions of complicated appeals of disability benefit claims, several administrative law judges told a congressional oversight panel Thursday.

“Instead of managing a meaningful adjudication program, SSA has substituted a factory-type production process,” said J.E. Sullivan, a former Social Security judge who now works at the Transportation Department. As a result, she said, judges make “poorly considered and rushed decisions” to grant benefits.

Management pressure to keep down the case backlog may lead judges to approve claims because it’s easier than denying them, said Drew Swank, another former SSA judge.

“If a claimant is paid, the case disappears, the backlog shrinks and nobody ever complains,” Swank said at the hearing of the House Oversight and Government Reform subcommittee on energy, health care and entitlements. Swank is now at the Labor Department; both he and Sullivan said they were speaking for themselves.

The dispute recently triggered a lawsuit from the union that represents judges. But their assessment was disputed by Glenn Sklar, SSA deputy commissioner of disability adjudication and review.

Compared with 2007, when the agency began an overhaul of the appeals program, there are “significantly fewer” judges who approve more than 85 percent of the claims that come before them, Sklar said, adding that overall allowance and denial rates have become more consistent. After peaking at 512 days in fiscal 2007, the average case processing time this year so far stands at 375 days, Sklar said. SSA has more than 1,500 administrative law judges, a spokeswoman said later.

Each year, those judges hear hundreds of thousands of appeals for disability insurance and Supplemental Security Income (SSI) from applicants whose claims have initially been turned down. About 12 million people are on the two programs, which are budgeted for a total of almost $196 billion in President Obama’s fiscal 2014 spending request. The disability insurance trust fund, which is funded by a payroll tax, is projected to run out of money in 2016, according to the latest annual SSA trustees report.

In the April lawsuit, the Association of Administrative Law Judges seeks to end what it calls “an illegal production quota” requiring each judge to decide 500 to 700 cases per year. That target has nothing to do with the complexity of the case mix assigned to individual judges, but instead stems from commitments from SSA senior management to the Office of Management and Budget “in exchange for fiscal year funding at a given level,“ the suit says. SSA lawyers are scheduled to file a court response to the union’s charges by mid-July.

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