Statement of Linda Fullerton, Social Security Disability Coalition, Rochester, New York

Second Wave Of Disaster Ahead

While the majority of Americans were shocked at the reaction of the Federal government in the aftermath of hurricane Katrina, I was not surprised at all.  I have been personally devastated by the Federal government, and have seen the horrifying results of their incompetence on a grand scale for the past few years.  My personal story can be found here - Please check out my website at:       

http://www.frontiernet.net/~lindaf1/bump.html

Nowhere is this more evident, yet rarely mentioned, than in the way the Social Security Administration treats the disabled population of this country.  Americans saw in a major way since hurricane Katrina struck, how the poor and disabled were left to die in the streets when they needed help the most.  The SSA has been systematically destroying disabled Americans for decades, and Congress as a whole has failed miserably to do anything about it. 

While Commissioner Barnhart's proposed revamp of the Social Security Disability program was a great gesture during the week of the ADA anniversary, it does not go far enough, fast enough for those who desperately need to access disability benefits and whose very lives depend on them.  Even many Social Security Administration employees themselves do not agree with the Commissioner’s current proposals, as they too see what a detriment they are to the lives of disability claimants.  SSA employees, as well as many disability organiations such as mine, have been kept out of these hearing proceedings, yet we are the ones most affected by the outcome.  This needs to change immediately.  Our organization is one who has provided constant feedback throughout this whole process to the commissioner's staff.  The majority of our members are those who are actually receiving, or are going through the horrendous claims process itself, trying to get Social Security Disability benefits, so we know first hand where the problems are. 

The SSDI/SSI program is currently set up to discourage and destroy as many claimants as possible so benefits do not have to be paid out to them.  Over 68% of claims are denied at the initial filing for benefits.  To date the SSA has determined that it can take up to 1153 days (3-1/4 years) or longer for a claim to be processed if it is denied at every level which often occurs.  That waiting time is about to increase as the SSA Commissioner has made proposals which will force thousands more into the already backlogged Federal Court system.  The disabled are also made to wait 2 years to get vital Medicare benefits while healthy citizens can access them immediately upon reaching retirement age.  The poverty that often results from waiting for these Federal claims to be approved and Medicare benefits, forces thousands into already over burdened state Medicaid and Social Service programs who would never have needed them, had they had their claims approved in a timely manner.  Then once their SSDI/SSI benefits are finally received, many states require the disabled to pay back any state benefits that they received, yet healthy Americans are not required to do so.  This creates a cycle of endless poverty, where they now have to now rely on both state and Federal programs to survive, and from which they can never recover, since they can no longer work. They are then viewed, as the world just witnessed first hand, as “disposable” citizens.  Yet, the thousands of our horror stories of homelessness, bankruptcy, destruction and death at the hands of the SSA, do not make the news. 

My years of pleas to the President and Congress to get these people help have been, with a few exceptions, virtually ignored.  I shudder to think of how many more lives will be further devastated or lost, when the mentally and physically disabled victims of Katrina, encounter their next experience with the Federal government as they apply for their SSDI/SSI benefits.  We ask that Congress act now to fix the SSDI/SSI system properly, without further harm to this extremely fragile population.   We as claimants who have actually gone through the SSDI system, want to be part of a group who actually continues to participate in the Social Security Disability New Approach program, and all hearings relating to all aspects of Social Security reform.  We want to have major input and influence on the decision making process before any final decisions/changes/laws are instituted by the SSA Commissioner or members of Congress.  This is absolutely necessary, since nobody knows better about the flaws in the system and possible solutions to those problems, then those who are forced to go through it and deal with the consequences when it does not function properly.  We are your mothers, fathers, sisters, brothers, friends, and many of us are veterans who have served this country.  Wake up America – at any point in time, this could be you or someone you love!

Social Security Disability New Approach Program Proposals Meager At Best - Major Reform Still Needed

First of all, I must say that the women I spoke with on the Commsioner’s staff  - Sonia De La Vara and Mary Chatel were very responsive and helpful to my organization as we tried to submit feedback to the Commissioner during the New Approach process.  They are to be highly commended for their hard work and in my estimation are shining examples of how all SS employees should be.  We are also very pleased to see the establishment of a QDD process (quick disability determination) for the obviously disabled which is long overdue, especially for those who suffer from terminal illness, who currently in many cases, die before they get approved for benefits.  That being said, I was shocked to see that the Commissioner herself, has vastly ignored the feedback that was submitted from our group as she moves forward with her proposed changes to the SSDI program.  

High priority should be given to increase SSA staffing levels, and provide better employee training, in all phases of the disability process, especially in the initial contact phases with field offices and DSS offices across the board. Instead we are hearing that staff levels are being reduced as backlogs in the system are increasing!  More effort should be made to thoroughly review a disability claim at the start, giving more proper weight to claimants treating physicians, which is part of Social Security law, but is often not followed when making decisions throughout the claims process.  There should be more effort on the part of SS to assist applicants throughout the entire disability claim process, including ongoing contact with claims examiners, assistance with developing the medical file to ensure all pertinent  medical evidence is in file, and that the claimant is contacted if anything is lacking, before making a decision on their claim.

The establishment of a Federal Reviewing Official (RO) level of review, that would issue decisions based on review of record, is also a welcome change, as we feel that currently not enough time is spent looking at the medical records supplied by applicants and this results in premature denials and more ALJ hearings. 

To date the Social Security Administration has determined that it can take up to 1153 days (3-1/4 years) for a claim to be processed if it is denied at every level which often occurs.  The Commissioner has stated that she hopes to reduce that wait time by 25% or down to 2-1/4 years.  While any reduction in wait time is good, this is still appalling, and shows that she is totally out of touch with the realities that disability applicants face.  I am sure that if she, or anyone else in the Federal government had to endure living under the conditions that a 2-1/4 year wait time for benefits brings, in addition to the hardships caused by one’s disabling conditions, they could not fix the system fast enough. 

We are not in favor of any changes that would result in more hearings, lesser back payments or a greater reliance on attorneys for claimants to receive benefits.  The Commissioner has proposed that a record would be closed after an ALJ issues a decision and new/material evidence would only be allowed to be submitted under certain limited circumstances.  This is totally unacceptable, given that a great number of ALJ decisions are currently appealed due to rampant bias against claimants, fraudulent behavior and poor performance by the ALJ’s currently serving. 

While the commissioner states that the quality review process will be improved, it often adds at least an additional 4 week waiting period to claims processing, and often targets approvals rather than denials and in the future should focus more on why cases are denied rather than approved.  To better streamline her current Review of Decisions proposals and to further speed up the claims process – the DRB (Decision Review Board and Federal Quality Review processes should be combined.  

We also feel that the CDR process (Continuing Disability Review) process needs to be looked at as well.  Claimants with obvious incurable chronic conditions should not have to endure the stress of these reviews, (a further detriment to their health) as the nature of these diseases cause a patient to gradually deteriorate over time – not improve.  Many who under SS guidelines, still qualify for benefits are being forced into hearing situations and overpayment issues due to mistakes or outright fraud on the part of the SSA, again to purposely keep people from these vital benefits.  It is also a major waste of time and SS resources that could be used elsewhere in the system.  It is said that these reviews are done to prevent fraud.  Trust me, nobody in their right mind would want to live under the conditions that the majority of SSD claimants and recipients are forced to endure.  The majority would much rather have their health back and the jobs that once had before their lives were changed by illness or accidents. 

Any corporation in this country who ran their business this poorly, would be out of business in it’s first year!  As evidenced by the Commissioner's current press release, most of our concerns were largely ignored or the solutions were severely lacking.  SSA Customer service is extremely poor and in major need of improvement across the board.  Here is just a small sampling of the constant complaints we receive about the Social Security Disability system and its employees:

Severe understaffing of SSD workers at all levels of the program

Extraordinary wait times between the different phases of the disability claims process

Employees being rude/insensitive to claimants

Employees outright refusing to provide information to claimants or do not have the knowledge to do so

Employees not returning calls

Employees greatly lacking in knowledge of and in some cases purposely violating Social Security and Federal Regulations (including Freedom of Information Act and SSD Pre-Hearing review process).  

Claimants getting conflicting/erroneous information depending on whom they happen to talk to at Social Security – causing confusion for claimants and in some cases major problems including improper payments

Complaints of lack of attention or totally ignoring - medical records provided and claimants concerns by Field Officers, IME doctors and ALJ’s. 

Fraud on the part of DDS/OHA offices, ALJ’s, IME’s – purposely manipulating/ignoring information provided to deny claims.

Complaints of lost files and files being purposely thrown in the trash

Complaints of having other claimants information improperly filed/mixed in where it doesn’t belong causing breach of security

Complaints of backlogs at payment processing centers for initial payments once claim is approved

Federal Quality Review process adding even more wait time to claims processing, increasing backlogs, no ability to follow up on claim in this phase

Poor/little coordination of information between the different departments and phases of the disability process

These complaints refer to all phases of the SSD process including local office, Disability Determinations, Office of Hearings and Appeals, Payment Processing Centers and the Social Security main office in MD (800 number).

NOTE: These Federal regulations are being violated on a daily basis all over the country:

 CODE OF FEDERAL REGULATIONS PART 404—FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- )

404.1642 Processing time standards                                                                                                            http://www.ssa.gov/OP_Home/cfr20/404/404-1642.htm

(a) General. Title II processing time refers to the average number of days, including Saturdays, Sundays, and holidays, it takes a State agency to process an initial disability claim from the day the case folder is received in the State agency until the day it is released to us by the State agency. Title XVI processing time refers to the average number of days, including Saturdays, Sundays, and holidays, from the day of receipt of the initial disability claim in the State agency until systems input of a presumptive disability decision or the day the case folder is released to us by the State agency, whichever is earlier.

(b) Target levels. The processing time target levels are:

(1) 37 days for title II initial claims.

(2) 43 days for title XVI initial claims.

(c) Threshold levels. The processing time threshold levels are:

(1) 49.5 days for title II initial claims.

(2) 57.9 days for title XVI initial claims.
[46 FR 29204, May 29, 1981, as amended at 56 FR 11020, Mar. 14, 1991]

404.1643 Performance accuracy standard 

http://www.ssa.gov/OP_Home/cfr20/404/404-1643.htm

(a) General. Performance accuracy refers to the percentage of cases that do not have to be returned to State agencies for further development or correction of decisions based on evidence in the files and as such represents the reliability of State agency adjudication. The definition of performance accuracy includes the measurement of factors that have a potential for affecting a decision, as well as the correctness of the decision. For example, if a particular item of medical evidence should have been in the file but was not included, even though its inclusion does not change the result in the case, that is a performance error. Performance accuracy, therefore, is a higher standard than decisional accuracy. As a result, the percentage of correct decisions is significantly higher than what is reflected in the error rate established by SSA's quality assurance system.

(b) Target level. The State agency initial performance accuracy target level for combined title II and title XVI cases is 97 percent with a corresponding decision accuracy rate of 99 percent.

(c) Intermediate Goals. These goals will be established annually by SSA's regional commissioner after negotiation with the State and should be used as stepping stones to progress towards our targeted level of performance.

(d) Threshold levels. The State agency initial performance accuracy threshold level for combined title II and title XVI cases is 90.6 percent.

The following list of reforms and concerns was compiled and submitted to the Commissioner's staff early on, based on the actual experiences of our members and those who have signed the Social Security Disability Reform petition:

We want disability benefits determinations to be based solely on the physical or mental disability of the applicant.  Neither age, education or any other factors should ever be considered when evaluating whether or not a person is disabled.  If a person cannot work due to their medical conditions – they CAN’T work no matter what their age, or how many degrees they have.  This is blatant discrimination, and yet this is a standard practice when deciding Social Security Disability determinations and should be considered a violation of our Constitution.  This practice should be addressed and eliminated immediately.

All SSD case decisions must be determined within three months of original filing date.  When it is impossible to do so a maximum of six months will be allowed for appeals, hearings etc – NO EXCEPTIONS.  Failure to do so on the part of SSD will constitute a fine of $500 per week for every week over the six month period - payable to claimant in addition to their awarded benefit payments and due immediately along with their retro pay upon approval of their claim.  SSD will also be held financially responsible for people who lose property, automobiles, IRA’s, pension funds, who incur a compromised credit rating or lose their health insurance as a result of any delay in processing of their claim, which may occur during or after (if there is failure to fully process claim within six months) the initial six month allotted processing period .

Waiting period for initial payment of benefits should be reduced to two weeks after first date of filing instead of the current five month waiting period.  The withholding of five months of benefits greatly adds to the financial burden of a claimant, and compromises their financial status to a point, that most can never recover from due to their inability to work.  There is no good reason given for this huge withholding of benefits, and even the states do better than this, when processing claims for unemployment insurance – withholding amounts are often only a few weeks at most.  Also prime rate bank interest should be paid on all retro payments from first date of filing, due to claimants, as they are losing this as well while waiting for their benefits to be approved.

A majority of SSD claimants are forced to file for welfare, food stamps and Medicaid, another horrendous process, after they have lost everything due to the inadequacies in the Social Security Disability offices and huge claims processing backlog.  If a healthy person files for Social Service programs and then gets a job, they do not have to reimburse the state once they find a job, for the funds they were given while looking for work - why are disabled people being discriminated against?  Claimants who file for Social Service programs while waiting to get SSD benefits, in many states have to pay back the state out of their meager SSD/SSI benefits once approved, which in most cases keeps them below the poverty level and forces them to continue to use state funded services.  They are almost never able to better themselves and now have to rely on two funded programs instead of just one.  This practice should be eliminated.  In all states there should be immediate approval for social services (food stamps, cash assistance, medical assistance, etc) benefits for SSD claimants that does not have to be paid back out of their SSD benefits once approved.

Immediate eligibility for Medicare/Medicaid upon disability approval with NO waiting period instead of the current 2 years.  The current two year waiting period causes even further harm to an applicant’s already compromised health and even greater financial burden on a population who can least afford it, since they cannot work. This also forces many to have to file for Medicaid/Social Service programs who otherwise may not have needed these services if Medicare was provided immediately upon approval of disability benefits. 

If we provide sufficient medical documents when we originally file for benefits why should we ever be denied at the initial stage, have to hire lawyers, wait years for hearings, go before administrative law judges and be treated like criminals on trial?

Too much weight at the initial time of filing, is put on the independent medical examiner’s and SS caseworker’s opinion of a claim.  The independent medical examiner only sees you for a few minutes and has no idea how a patient’s medical problems affect their lives after only a brief visit with them.  The caseworker at the DDS office never sees a claimant.  The decisions should be based with much more weight on the claimant’s own treating physicians opinions and medical records.  In cases where SSD required medical exams are necessary, they should only be performed by board certified independent doctors who are specialists in the disabling condition that a claimant has (example – Rheumatologists for autoimmune disorders, Psychologists and Psychiatrists for mental disorders). 

SSD required medical exams should only be performed by board certified independent doctors who are specialists in the disease that claimant has (example – Rheumatologists for autoimmune disorders, Psychologists and Psychiatrists for mental disorders). Independent medical exams requested by Social Security must only be required to be performed by doctors who are located within a 15 mile radius of a claimants residence.  If that is not possible – Social Security must provide for transportation or travel expenses incurred for this travel by the claimant.

All Americans should be entitled to easy access (unless it could be proven that it is detrimental to their health) and be given FREE copies of their medical records including doctor’s notes at all times.  This is crucial information for all citizens to have to ensure that they are receiving proper healthcare and a major factor when a person applies for Social Security Disability.

ALL doctors should be required by law, before they receive their medical license, and made a part of their continuing education program to keep their license, to attend seminars provided free of charge by the SSA, in proper procedures for writing medical reports and filling out forms for Social Security Disability and SSD claimants.

More Federal funding is necessary to create a universal network between Social Security, SSD/SSI and all outlets that handle these cases so that claimant’s info is easily available to caseworkers handling claims no matter what level/stage they are at in the system.  All SSA forms and reports should be made available online for claimants, medical professionals, SSD caseworkers and attorneys, and be uniform throughout the system.  One universal form should be used by claimants, doctors, attorneys and SSD caseworkers, which will save time, create ease in tracking status, updating info and reduce duplication of paperwork.  Forms should be revised to be more comprehensive for evaluating a claimant’s disability and better coordinated with the SS Doctor’s Bluebook Listing of Impairments. 

Institute a lost records fine – if Social Security loses a claimants records or files an immediate $1000 fine must be paid to claimant. 

Review of records by claimant should be available at any time during all stages of the SSD determination process.  Before a denial is issued at any stage, the applicant should be contacted as to ALL the sources being used to make the judgment.  It must be accompanied by a detailed report as to why a denial might be imminent, who made the determination and a phone number or address where they could be contacted.  In case info is missing or they were given inaccurate information the applicant can provide the corrected or missing information before a determination is made.  This would eliminate many cases from having to advance to the hearing and appeals phase.

The SSA “Bluebook” listing of diseases that qualify a person for disability should be updated more frequently to include newly discovered crippling diseases such as the many autoimmune disorders that are ravaging our citizens.  SSD's current 3 year earnings window calculation method fails to recognize slowly progressive conditions which force people to gradually work/earn less for periods longer than 3 years, thus those with such conditions never receive their 'healthy' earnings peak rate.

The claims process should be set up so there is no need whatsoever for claimant paid legal representation when filing for benefits and very little need for cases to advance to the hearing and appeal stage since that is where the major backlog and wait time exists. The need of lawyers/reps to navigate the system and file claims, and the high SSD cap on a lawyer's retro commission is also a disincentive to expeditious claim processing, since purposely delaying the claims process will cause the cap to max out - more money to the lawyer/rep for dragging their feet adding another cost burden to claimants.  Instead, SS should provide claimants with a listing in every state, of FREE Social Security Disability advocates/reps when a claim is originally filed in case their services may be needed.

Audio and/or videotaping of Social Security Disability ALJ hearings and during IME exams allowed at all times to avoid improper conduct by judges and doctors.  A copy of court transcript should automatically be provided to claimant or their representative within one month of hearing date FREE of charge.

Strict code of conduct for Administrative Law Judges in determining cases and in the courtroom.  Fines to be imposed for inappropriate conduct towards claimants.

We have heard that there is a proposal to give SSD recipients a limited amount of time to collect their benefits. We are very concerned with the changes that could take place.  Since every patient is different and their disabilities are as well, this type of “cookie cutter” approach is out of the question.  We especially feel that people with psychological injuries or illness would be a target for this type of action.  Some medical plans pay 80% for treatment of biological mental heath conditions, but currently Medicare only pays 50% for an appointment with a psychiatrist.  This often prohibits patients from getting proper treatment and comply with rules for continual care on disability.  The current disability review process in itself is very detrimental to a patient’s health.  Many people suffer from chronic conditions that have NO cures and over time these diseases grow progressively worse with no hope of recovery or returning to the work force.  The threat of possible benefits cut off, and stress of a review by Social Security again is very detrimental to a recipients health.  This factor needs to be taken into consideration when reforming the CDR process.  In those cases total elimination of CDR’s should be considered or a longer period of time between reviews such as 10-15 years rather then every 3-7 years, as is currently the case.  This would save the SSA a great deal of time, money and paperwork which could then be used to get new claimants through the system faster. 

Until the majority of these reforms are implemented and these issues are addressed, disabled Americans will continue to suffer at the hands of a Federal government program that was originally put in place to help, not harm them.  Currently many SSD applicants are losing all their financial resources and even their lives while waiting to get their benefits – these injustices and systematic destruction  of disabled Americans has to be stopped immediately.  We are watching, we are waiting, we are disabled and we vote!

Social Security Disability Reform Petition – read the horror stories from all over the nation:

http://www.petitiononline.com/SSDC/petition.html

Social Security Disability Coalition – offering FREE knowledge and support with a focus on SSD reform:

http://groups.msn.com/SocialSecurityDisabilityCoalition

Please check out my website at:

http://www.frontiernet.net/~lindaf1/bump.html                    

“I am disabled and my vote counts too!”