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U.S. Congressman Sam Johnson (R-TX), Chairman of the House Committee on Ways and Means Subcommittee on Social Security today announced the fourth hearing in the series entitled, “Securing the Future of the Disability Insurance Program.” This hearing will focus on the disability appeals process. The hearing will take place on Wednesday, June 27, 2012, in room B-318 Rayburn House Office Building, beginning at 2:00 p.m.
In view of the limited time available to hear witnesses, oral testimony at this hearing will be from invited witnesses only. However, any individual or organization not scheduled for an oral appearance may submit a written statement for consideration by the Subcommittee and for inclusion in the printed record of the hearing.
Applications for disability benefits have reached historic levels resulting from more women in the workforce, the recession and slow recovery, and baby boomers reaching their disability-prone years. The 2012 Annual Report of the Board of Trustees projects that the Disability Insurance (DI) program will be unable to pay full benefits beginning in 2016.
In fiscal year (FY) 2011, the examiners at the State Disability Determination Services (DDS) made an initial determination on almost 3.3 million disability claims. According to the Social Security Administration’s (SSA) longitudinal data, 79 percent of all disability benefit awards are made at the DDS.
Claims that are not approved by the DDS, whether at the initial or reconsideration level, can be appealed to the hearing level, where the claimant has the opportunity for a face-to-face hearing before an Administrative Law Judge (ALJ). In FY 2011, 662,765 hearing requests were completed with 58 percent of requests awarded, 29 percent denied, and 13 percent dismissed. The average waiting time for an ALJ decision is 354 days. Today, 77 percent of ALJs are meeting the agency’s annual productivity expectation of 500-700 cases. Currently, individual ALJ award rates vary from 1 to 99 percent.
Individuals whose claims are denied by an ALJ may appeal to the SSA’s Appeals Council (AC), which is the final step in the administrative process. In addition, the AC may on its own motion review an ALJ decision. In FY 2011, the AC made 103,681 decisions, awarding benefits in 2 percent of its cases, denying benefits in 74 percent, and remanding 21 percent back to the ALJ level. Individuals who are denied at the AC may pursue an appeal through the federal district court, the federal court of appeals, and the U.S. Supreme Court. In FY 2011, the federal courts decided 13,271 cases, awarding benefits in 3 percent of cases, denying benefits in 42 percent, and remanding back to the SSA 46 percent of cases. Of those remanded cases, 67 percent were subsequently allowed by an ALJ.
Further, over years the federal circuit courts have issued decisions that conflict with the SSA’s interpretation of the Social Security Act (Act). In response, the SSA may appeal the decision or implement the circuit court’s decision through an acquiescence ruling. While such rulings allow cases to be treated similarly within the circuit, the result is that claimants are treated differently in different circuits. There are currently 42 acquiescence rulings in effect.
Under the Act, the ALJ decides on behalf of the Commissioner whether benefits are due, and is required to apply the SSA’s regulations and policies; under the Administrative Procedure Act (APA), the ALJ is an independent decision-maker whose work product cannot be questioned. This tension between the Act and the APA makes program oversight and quality review of outcomes difficult for the agency to assess and manage.
In announcing the hearing, Social Security Subcommittee Chairman Sam Johnson (R-TX) said, “Those sidelined from working because of a disability must be able to count on a fair and timely hearing by a Social Security judge. Americans need to know that the same rules apply to everyone. This hearing will tell us whether the appeals process we have today works and if not, what changes ought to be made.”
FOCUS OF THE HEARING
The hearing will focus on the Social Security appeals process including its history, legal requirements, and the degree to which the current process provides fair, accurate, and consistent outcomes while balancing the needs of claimants and taxpayers.
DETAILS FOR SUBMISSION OF WRITTEN COMMENTS:
Please Note: Any person(s) and/or organization(s) wishing to submit for the hearing record must follow the appropriate link on the hearing page of the Committee website and complete the informational forms. From the Committee homepage, http://waysandmeans.house.gov, select “Hearings.” Select the hearing for which you would like to submit, and click on the link entitled, “Click here to provide a submission for the record.” Once you have followed the online instructions, submit all requested information. ATTACH your submission as a Word or WordPerfect document, in compliance with the formatting requirements listed below, by the close of business on Wednesday, July 11, 2012. Finally, please note that due to the change in House mail policy, the U.S. Capitol Police will refuse sealed-package deliveries to all House Office Buildings. For questions, or if you encounter technical problems, please call (202) 225-1721 or (202) 225-3625.
The Committee relies on electronic submissions for printing the official hearing record. As always, submissions will be included in the record according to the discretion of the Committee. The Committee will not alter the content of your submission, but we reserve the right to format it according to our guidelines. Any submission provided to the Committee by a witness, any supplementary materials submitted for the printed record, and any written comments in response to a request for written comments must conform to the guidelines listed below. Any submission or supplementary item not in compliance with these guidelines will not be printed, but will be maintained in the Committee files for review and use by the Committee.
1. All submissions and supplementary materials must be provided in Word or WordPerfect format and MUST NOT exceed a total of 10 pages, including attachments. Witnesses and submitters are advised that the Committee relies on electronic submissions for printing the official hearing record.
2. Copies of whole documents submitted as exhibit material will not be accepted for printing. Instead, exhibit material should be referenced and quoted or paraphrased. All exhibit material not meeting these specifications will be maintained in the Committee files for review and use by the Committee.
3. All submissions must include a list of all clients, persons and/or organizations on whose behalf the witness appears. A supplemental sheet must accompany each submission listing the name, company, address, telephone, and fax numbers of each witness.
The Committee seeks to make its facilities accessible to persons with disabilities. If you are in need of special accommodations, please call 202-225-1721 or 202-226-3411 TTD/TTY in advance of the event (four business days notice is requested). Questions with regard to special accommodation needs in general (including availability of Committee materials in alternative formats) may be directed to the Committee as noted above.
Note: All Committee advisories and news releases are available on the World Wide Web at http://www.waysandmeans.house.gov/