Statement of Witold Skwierczynski, President, National Council of SSA Field Operations Locals, Chicago, Illinois,
and Representative, American Federation of Government Employees, Social Security General Committee, AFL-CIO, Baltimore, Maryland

Before the Subcommittee on Social Security,
 House Committee on Ways and Means

Hearing on Social Security Disability Programs' Challenges and Opportunities

June 11, 2002

Chairman Shaw, Ranking Member Matsui, and members of the Social Security Subcommittees, I thank you for the opportunity to present this statement regarding Social Security's disability programs and the challenges that face SSA and Congress. As a representative of the AFGE Social Security General Committee and President of the National Council of SSA Field Operations Locals, I speak on behalf of approximately 50,000 Social Security Administration (SSA) employees in over 1400 facilities.  These employees work in Field Offices, Offices of Hearings & Appeals, Program Service Centers, Teleservice Centers, Regional Offices of Quality Assurance, and other facilities throughout the country where retirement and disability benefit applications and appeal requests are received, processed, and reviewed.

In previous testimony before the Social Security Subcommittee, we have commended the Social Security Advisory Board (SSAB) for its continual perseverance addressing improvements necessary to strengthen SSA's capability to answer the demands of the public it serves. Prior to becoming SSA Commissioner, Jo Anne Barnhart was a member of the SSAB. The Social Security Advisory Board has confronted a number of important issues, including changes in the disability programs, the Agency's quality of service to the public, the need to safeguard the public's funds as well as the administration of the Supplemental Security Income (SSI) program.  AFGE is committed to working with Commissioner Barnhart and Congress regarding these complex issues, as well as other issues continuing to present challenges to SSA and its employees.

Commitment to Staffing and Resources

The disability program is growing rapidly.  Approximately 10 million Americans and their families depend upon SSA's disability programs.  As baby boomers grow older, there is an increased likelihood of their filing for disability benefits.  This causes the amount of resources dedicated to SSA disability programs to significantly increase.  Last year, almost 70 percent of SSA's administrative budget was spent accomplishing disability work.  Unfortunately, without serious changes in the current administrative process, along with additional staffing and resources needed to adequately receive and process this work, disability service to the taxpayer will deteriorate.

SSA will be unable to continue to timely and efficiently process disability claims unless the Administration and Congress provide additional resources.   Absent appropriate financing for additional staff, SSA cannot guarantee providing timely payment of benefits, correct administration of complex regulations as well as training and mentoring both current employees and new workers. President Bush's FY 2003 budget request not only falls short of providing the resources necessary to begin addressing this crisis, but calls for a reduction in workyears.   AFGE believes a shortage of over 5500 positions currently exists in field offices and TSCs across the country.  This shortage has already proven to be a recipe for disaster in providing adequate service.  Backlogs of disability claims have created lengthier processing times. Callers are unable to get through on the toll free number and phones in field offices are frequently unanswered. The most recent example of last week's 800 number accessibility will demonstrate my point.  Because of the tremendous backlogs in SSA’s Processing Service Centers (PSCs), employees who assist our understaffed Teleservice Centers were unable to provide assistance during the busiest week of the month. This resulted in unacceptable levels of service.  In fact, SSA has indicated that no PSC employees will be answering the 800 number for the rest of the fiscal year.  This will cause 800 number performance levels to further deteriorate.  The Government Performance Results Act goal for SSA’s 800 number service is an overall 5-minute access rate of 92%.   Last week, the 800 number 5 minute access rate slipped to an average of 82%.  Occasionally last week the 5 minute access rate was as low as 68%.    As I have previously testified, the public can expect to wait up to several hours in many SSA reception areas across the country before being interviewed.  Employees are forced to rush through the interviews, and stress levels have escalated to an unacceptable degree according to employee surveys

Senior SSA officials have testified at various times to this Committee and other committees, that without process improvements, the Agency will need 20,000 additional Full Time Equivalent Employees (FTEs) to maintain previous service levels.  Eighteen years of staffing cuts has been the primary cause for SSA’s deteriorating service.  During this time FTE levels plummeted from 86,000 to 62,000. Most of the cut was in direct service workers in the field.  Recently the Social Security Advisory Board (SSAB) has issued multiple reports, which criticize SSAs inadequate staffing and resources.  The Board has concluded that such resource deficiencies have adversely affected the Agency's ability to provide adequate service. In January 2001, the SSAB urged the President to provide sufficient funding for SSA to enable it to improve its service to the public.  In September 2001, the SSAB contacted the House and Senate Appropriation Committees reiterating its concerns previously addressed to President Bush.  It is unfortunate that those cries for help seem to have fallen on deaf ears.

Unless Congress acts to increase SSA's administrative budget, the Agency's service levels will continue to decline.

SSA's Disability Programs

AFGE believes that immediate attention needs to be given to three specific issues regarding the SSA disability benefit program: providing proper staffing and resource allocations, ensuring consistent disability decisions in a more expeditious manner and maintaining quality in person service and assistance at the field office level.

SSA's disability programs are at the heart of the Agency’s many challenges.  AFGE is just one of many voices that has insisted upon reform of SSA's seriously flawed disability structure.     

However, institutional problems continue to be overlooked.  SSA's ethos of discouraging open discussion of problems continues to exist.  Communication between headquarters and operations in the field remains poor.  Workgroups designed to address problem areas or workloads no longer include either the union or the employees who actually do the work. These employees in field offices and teleservice centers who have been working at SSA’s frontlines serving the public, know what is wrong and what is needed.  The open door policy between the Commissioner and the Union has does not exist.  These actions have caused SSA employees to doubt Commissioner Barnhart's sincerity and will ultimately cause employees to mistrust any changes implemented without their participation and input.  AFGE understands that long-lasting progress will only be achieved with the assistance of those who not only understand the problems, but also have the institutional experience and knowledge to repair SSA's disability programs.  Certainly much more can be accomplished in a constructive manner with open two-way communications.  The union remains committed to such a process.

SSA must develop and implement a new quality management system that will routinely produce information the Agency needs to properly guide disability policy.  Equity and consistency in disability decision-making does not exist today.  Claimant’s chances of being approved for disability benefits depend on where they live and the amount of their resources. 

For example, SSA records appear to suggest that those who have the resources to obtain medical attention early and often have a better chance of being approved for benefits than those who have a limited income or resources.  (See Chart Below)  Nationwide, those applying for Social Security disability have a much greater chance of being approved than those who may only apply for the Supplement Security Income (SSI) program.  SSA records clearly expose the inconsistencies of the State DDS decisions.  More than 70 percent of Social Security disability claims for benefits are approved in New Hampshire, while only less than 38 percent of those who file for benefit in Oklahoma are approved.  Of those who applied for SSI benefits, New Hampshire soars with an allowance rate of over 63%.  However, less fortunate are those from Kansas, Missouri, Louisiana and Georgia.  Less than 35 percent of the SSI applications in these states are approved by the respective State Disability Determination service (DDS).  The reconsideration process is fraught with inconsistencies.  Reconsideration claims in Missouri and Pennsylvania result in a 40% reversal rate.  Conversely, reconsiderations in East Los Angeles, Kentucky, New York and Oklahoma result in less than 15% approval rate.  Reconsideration of an SSI application is less likely to be approved than TII cases. 

As an illustration, following is a compilation of different states and the variance from state to state in allowance and denial rates:

 

T2
Initial

T16
Initial

Concurrent
Initial

T2 Recon

T16 Recon

 

  Allow Deny Allow Deny Allow Deny Allow Deny Allow Deny
NATIONAL AVERAGE 47.4 52.6 39.5 60.5 30.4 69.6 19.0 81.0 16.0 84.0
BOSTON Region 56.8 43.2 43.6 56.4 34.5 65.5 30.0 70.0 25.6 74.4
 New Hampshire* 70.3 29.7 63.6 36.4 56.2 43.8 33.3 66.7 33.3 66.7
 Connecticut 55.7 44.3 39.2 60.8 32.3 67.7 30.4 69.6 21.6 78.4
New York  Region 48.5 51.5 40.8 59.2 34.5 59.2 15.1 84.9 13.5 86.5
  New York* 51.5 48.5 39.9 60.1 33.4 66.6 12.2 81.3 12.6 87.4
   Albany 55.0 45.0 36.2 63.8 32.6 67.4 22.0 78.0 19.4 80.6
   Puerto Rico 34.6 65.4 - - - - 16.3 83.7 - -
Philadelphia Region 53.1 46.9 43.7 56.3 34.6 65.4 20.3 79.7 16.7 83.3
   Maryland 49.8 50.2 38.6 61.4 30.4 69.6 25.3 74.7 18.0 82.0
   PA* 60.2 39.8 48.6 51.4 40.7 59.3 40.6 59.4 29.2 70.8
Atlanta Region 40.3 59.7 35.8 64.2 27.0 73.0 16.3 83.7 14.0 86.0
  Alabama* 48.8 51.2 37.7 62.3 33.3 66.4 34.7 65.3 33.5 66.5
  Georgia 38.2 61.8 34.0 66.0 25.7 74.3 17.9 82.1 14.5 85.5
  Kentucky 37.3 62.7 35.0 65.0 23.8 76.2 10.9 90.1 9.8 90.2
  Birmingham 50.8 49.2 40.3 59.7 35.1 64.9 35.1 64.9 34.0 66.0
  Florida 41.7 58.3 41.6 58.4 30.7 59.3 20.5 79.5 19.6 80.4
  Miami 42.3 57.7 49.3 50.7 35.4 64.6 21.7 79.3 26.4 73.6
Chicago Region 47.3 52.7 36.4 63.6 30.1 69.9 19.8 80.2 15.0 85.0
  Illinois 49.3 50.7 38.1 61.9 31.8 68.2 18.7 81.3 15.9 84.1
  Michigan* 49.8 50.2 35.3 64.7 31.9 68.1 32.3 67.7 24.7 75.3
  Wisconsin 52.0 48.0 37.2 62.8 30.3 69.7 31.7 68.2 16.8 83.2
Dallas Region 41.3 58.7 36.7 63.3 29.6 70.4 18.7 81.3 17.3 82.7
 Louisiana* 43.3 56.7 30.9 69.1 30.7 69.3 39.9 61.0 27.6 72.4
  Texas 40.0 60.0 40.0 60.0 30.5 69.5 18.7 81.3 18.5 81.5
  New Mexico 49.1 50.9 41.3 58.7 32.2 67.8 23.2 76.8 20.9 79.1
  Oklahoma 39.3 60.7 36.7 63.3 27.7 72.3 14.3 85.7 12.6 87.4
  Shreveport 42.8 57.2 31.6 68.4 28.7 71.3 21.4 78.6 29.5 70.5
Kansas City Region 54.3 45.7 34.4 65.6 27.0 72.0 23.8 76.2 15.5 84.5
  Missouri* 56.8 43.2 33.0 66.0 28.6 71.4 44.8 55.2 35.3 65.7
  Kansas 47.2 52.8 34.7 65.3 22.1 77.9 23.5 76.5 14.6 85.4
Denver Region 43.6 56.4 41.1 58.9 25.2 74.8 14.2 85.8 9.7 90.3
  Colorado* 46.6 53.4 42.2 57.8 27.6 72.4 27.6 72.4 15.7 84.3
  N. Dakota 45.4 54.6 37.3 62.7 22.0 77.0 17.2 82.8 8.5 91.5
  S. Dakota 48.2 51.8 36.5 63.5 23.0 76.0 18.8 81.2 12.8 87.2
San Francisco Region 52.8 47.2 46.2 53.8 37.1 62.9 25.2 74.8 22.5 77.5
  Arizona 59.3 40.7 51.8 48.2 43.3 56.7 38.7 61.3 33.8 66.2
  California 50.9 49.1 45.7 54.3 34.4 65.6 22.1 77.9 18.6 81.4
  Bay Area 56.0 44.0 52.6 47.4 43.2 56.8 28.5 71.5 20.8 79.2
  L.A. East 42.7 57.3 44.0 55.0 32.1 67.9 12.4 87.6 12.2 87.8
  L. A. West* 59.8 40.2 49.9 50.1 42.0 57.0 31.2 68.8 22.5 77.5
  L.A. North* 58.7 41.3 49.3 50.7 40.0 60.0 31.8 68.2 42.2 57.8
  L. A. South 42.0 57.0 49.2 60.8 31.4 68.6 19.7 80.3 19.9 80.1
  Sacramento 48.6 51.4 42.2 57.8 30.2 69.8 23.6 76.4 31.6 78.4
Seattle Region 50.0 50.0 43.6 56.4 21.2 68.8 22.2 77.8 16.1 83.9
  Alaska* 57.4 42.6 52.3 47.7 38.1 61.9 50.0 50.0 0.00 100.0
  Oregon 49.7 50.3 40.7 59.3 28.3 71.7 24.1 75.9 16.2 83.8
  Washington 49.9 50.1 44.3 55.7 32.5 67.5 22.0 78.0 15.8 84.2
  Seattle 50.1 49.9 49.8 50.2 36.6 63.4 24.3 75.7 16.1 83.9

* "Prototype" sites

In a system where contributions are made equitably, such wildly divergent allowance rates raise significant questions regarding the accuracy and fairness of the decision making process.   The American taxpayers are entitled to quality consistent decisions whether they live in California or New Jersey.  The significant differences between SSA and SSI disability approval rates leads one to conclude that wealth is a factor in the decision making process. We strongly encourage Congress to hold hearings in the near future to address these very important issues.

As long as inconsistent medical decisions continue to be made by the State DDSs, the backlogs at the hearing levels may never be completely resolved.  In some areas, the rate of hearing reversals is as high as 60%. 

SSA has spent millions of dollars testing new disability initiatives in an effort to address some of the serious problems with the disability process.  One of those initiatives is the "Prototype" pilot.  Approximately 25% of SSA’s national initial disability claims workload was included in the Prototype, which was conducted in State DDS facilities for Alabama,

Alaska, California (Los Angeles North DDS & Los Angeles West DDS branches only), Colorado, Louisiana, Michigan, Missouri, New Hampshire, New York, and Pennsylvania. The Prototype features were designed to:

Recently, Commissioner Barnhart announced her decision to expand the Single Decision Maker aspect of the Prototype pilot and to eliminate the Claimant Conference portion of the initial disability claims in the 10 Prototype states.  These decisions were made prior to the completion of the pilot and before an analysis of final data regarding the pilot.  The decision to eliminate the Claimant Conference appears to have been made solely due to the additional time that conducting such a conference adds to the processing time for initial disability claims.  No data has been provided to the union which measures the impact of the claimant conference on the decision making process.  Claimant conferences were intended to partially replace the loss of the Reconsideration appellate opportunity.  Eliminating such conferences will, undoubtedly, result in additional hearings requests by denied claimants.  Since there is a severe backlog of hearings cases, this is an undesirable result.  The 2001 Interim Report on the Prototype indicated that claimant satisfaction was much lower than claimant satisfaction for the Disability Claims Manager (DCM) pilot.  The interim report also indicated that Prototype productivity was less than the current process, employee satisfaction was not especially high and that, although final results were not available, the total program costs of the Prototype appeared higher than the current process and the elimination of the Reconsideration leads to more hearing requests than the current process.  In addition, the Prototype did nothing to resolve the state to state disparity in the disability claims allowance rates.

The elimination of the reconsideration and the elimination of the Claimant Conference in Prototype states does not appear to be the solution to the disability problem in SSA. It is particularly puzzling that SSA leadership appears enamored with the Disability Prototype and its lukewarm results while it scuttled the DCM, which exceeded the current process in numerous respects, especially processing time.

As I emphasized in previous testimony before the Social Security Subcommittee in June 2001, the Disability Claims Manager (DCM) pilot (another SSA initiative) proved to be highly successful in addressing these problems in the disability program.  Processing time was significantly better.  In fact, the DCM processing time of 62 days was almost ½ of SSA’s initial disability claim processing time goal of 120 days.  Customer service dramatically improved. Claimants expressed record high satisfaction rates for the DCM.  The public likes the DCM caseworker approach and wants it retained in the current process.   Although SSA contended that the DCM would cost more than the current process, no valid data exists showing this conclusion.  Also, the pilot was prematurely terminated before valid statistical data could be compiled regarding full program costs. It is unfortunate that, since the last time I testified before the SSA Subcommittee, then Acting Commissioner, Larry Massanari, decided not to implement the most successful new disability initiative, the DCM.  The DCM was a positive step to ensuring the public that consistent and equitable disability decisions are made. Tragically, no actions were taken to implement any of these successes, and the pilot was terminated.    Congress should demand that SSA justify the elimination of this successful and innovative experiment.  It is part of the answer to the disability problem.

It is apparent that the primary reason that SSA terminated the DCM pilot was due to State resistance.  Such resistance certainly was not based on a poor pilot result.  Instead the decision appears to be based on political considerations and the fear of losing work.  Congress should be very concerned when SSA spends $ millions for a process that demonstrably improves the disability processing time yet is rejected for political reasons.  The concerns of the states are understandable in view of their unacceptably poor performance regarding decision consistency from state to state and their poor processing time in comparison to the DCM.  However, the only real criteria should be the level of service that is provided to the claimant.  Using customer service as a measure, the DCM exceeds State DDS performance in virtually every category.

AFGE has recommended to Commissioner Barnhart that she reconsider former Acting Commissioner Massanari's decision and implement the position of the DCM at SSA as soon as possible.  AFGE is willing to work with the Commissioner in an incremental approach to achieving this goal.   AFGE understands that there will need to be changes in policy, processes and institutional arrangements, as well as funding to implement this very valuable and successful position at SSA.  Legislative amendments to the Social Security Act would be necessary to allow SSA workers to make disability decisions; however the crisis in disability processing requires immediate, as well as long-term changes.  When trained to make medical decisions, SSA employees can provide immediate relief to backlogged Disability Determination Agencies, and provide faster and better service to the public by serving as a single point of contact.  The pilot demonstrates that the public loves the DCM, employees enthusiastically support it and that it provides substantially better service than the current disability product.  It is the responsibility of Congress to take the necessary action to assure the DCM is part of the solution to the disability problem.

As a short term approach not requiring legislative change, AFGE is supportive of the “Technical Expert for Disability” position.  This position would provide high quality, trained field office employees the tools to assist disability claimants in both programmatic and medical issues, provide professional personalized service to applicants, focus the disability interview, make or recommend disability decisions, and assist the DDS’s in their development and backlogs.

Another tested initiative that would save considerable disability processing time is the Adjudicative Officer (AO).  This position was intended to assist Administrative Law Judges to reduce the number of hearings and to prepare cases for efficient and expeditious hearings.  AO’s were empowered to gather additional evidence and to make favorable decisions without hearings when the evidence submitted indicated that such a decision was appropriate.  The pilot indicated that many hearings requests were quickly adjudicated by AO’s.  These workers reduced the processing time for hearing requests.  The AO’s met the same fate as the DCM’s.  SSA cancelled the initiative.  When processing time can be legitimately reduced, why is SSA terminating a methodology that achieves that objective?  SSA should reexamine this position.

Ticket to Work

Another prominent challenge for SSA, as well as a legislative mandate, is complying with the provisions of the Ticket to Work and Work Incentives Improvement Act of 1999 (TWWIIA).  SSA has, in fact, redefined its mission to include promoting the employment of Social Security beneficiaries with disabilities. By the year 2005, SSA's goal is to increase the number of beneficiaries who can attain steady employment and leave the disability rolls by 100%.  Currently, less than one-half of one percent of Social Security Disability and SSI recipients return to work and whose benefits are terminated.  If only an additional one-half of one percent of recipients were to cease receiving benefits due to employment, savings to the Trust Funds and Treasury would total $3.5 billion over the worklife of these beneficiaries.

Section 121 of this legislation directs SSA to establish “a corps of trained, accessible and responsive work incentives specialists within the Social Security Administration.”  As members of this subcommittee are well aware, this legislation mandating specialists within SSA is the result of many years of poor service on the part of SSA in providing accurate information on employment supports and failing to process cases timely or accurately.  SSA created the Employment Support Representative (ESR) position as this work incentives specialist. The pilot of 32 ESRs testing models of how best to service the disabled community concluded in August 2001. 

The final Evaluation Report of the ESR position was completed in November 2001. Findings of the report were clear that the ESR was most effective in serving organizations and beneficiaries when situated in field offices serving the communities.  Beneficiaries and community organizations were overwhelmingly appreciative of the services the ESR performed, finding them to be compassionate, responsive, accessible, and highly knowledgeable.   The investments of the ESRs in outreach programs have led to increased trust of SSA by the communities, and increased program knowledge on the part of professionals and consumers. There is a great deal of interest on the part of organizations for a further rollout to service every localityThe pilot proved that Congress was correct when it insisted that SSA improve its service to disabled beneficiaries seeking to return to work.

Furthermore, the ESRs were able to develop a single point of contact with beneficiaries, monitor their work progress in a timely and supportive manner, and process work reports and work-issue Continuing Disability Reviews (CDRs) timely, greatly reducing large benefit overpayments and anxiety on the part of the beneficiary. ESRs gave many examples of customers who, with ESR guidance, were able to reliably predict the outcome of their work activity and viewed benefit cessation as a mark of achievement.

Both SSA and AFGE agree that hundreds of millions of dollars in benefit overpayments would be saved nationally if work issues are reported and worked promptly.  SSA projects a large increase in work CDR activity, especially in the early stages of the Ticket to Work implementation.  Even discounting the potential effect of Ticket related workloads, work issue CDRs processed in field offices have been increasing at an average annual rate of over 35% for the past three years.  Anecdotal evidence from employees throughout the country indicates that work issue CDRs are backlogged for up to several years in field offices.  Overpayments on these cases can reach $250,000 for an office, and employees have encountered overpayments on individual records reaching $100,000.  Unfortunately, the Union is unaware of any statistical data regarding the numbers of work CDRs processed, the number pending and the cessation rate due to work activity.  SSA should be required to maintain and produce such data.  In processing medical issue CDRs, SSA contends that for every dollar spent, seven to twelve dollars in benefits are saved.  The cost savings are greater for "work" CDRs since the cost of medical decision making is eliminated.  Investing in the ESR position is a perfect example of applying stewardship responsibilities effectively and investing resources in a cost effective manner.

The Evaluation Report recommends that the ESR job should be made a permanent position within SSA.  The report also recommended that the ESR position be expanded to as many SSA offices as possible. The Report cautions: “Failure to institutionalize a position to perform the duties that the ESR has piloted could in effect deny the public and community the opportunity to interact with an accessible and responsive SSA specialist.  This could eliminate an important element in SSA’s plan to improve its employment support service delivery to the public.  It could also negatively affect our ability to effectively train and advise other SSA staff in the provisions of the law, with implications for increased incorrect payments and the denial of benefits to beneficiaries.” 

Unfortunately, SSA is reluctant to implement the ESR position due to the shortages of staff and resources in field offices.  These intolerable resource deficits leave SSA in the position of ineffectively implementing the Ticket to Work and continuing to provide the current level of service.  This is an impossible situation.

AFGE believes an Agency decision not to implement the ESR would be a tragic mistake when the ESR has proven to be a winner for all parties.  For SSA, it shows superb service to the public, provides stewardship in reducing benefits and overpayments, and results in SSA compliance with the legislative mandate for work incentive specialists within SSA.  For the public, it provides stellar service, a single point of contact, and assists beneficiaries in leaving the disability rolls.  For the taxpayer, it saves money and extends Trust Fund solvency.

Section 121 of PL 106-170 authorized $23,000,000 to be appropriated to establish a community based work incentives planning and assistance program for disabled beneficiaries, and to develop a corps of work incentives specialists with SSA, for each of the fiscal years 2000 through 2004.  SSA allocated all of the appropriated resources to grants outside the Agency.  AFGE requests that Congress direct SSA to appropriate additional funding to meet the requirements of the Ticket to Work and Work Incentives Improvement Act.  This provision of the legislation also requires continuous adequate funding beyond FY 2004.  Otherwise, the most effective method of providing consistent, accurate information and assistance on work incentive programs will not be accessible to disabled beneficiaries.  It is outrageous that budget constraints for SSA's Administration Expenses will inhibit the success of the ESR, a Ticket to Work initiative, which is designed to generate Trust Fund Savings.  It would cost approximately 120 million to staff SSA's 1300 field offices with 1500 ESRs.  The potential return of  $3.5 billion indicates that this would be a prudent expenditure.

Special T2 Disability Workload

Inadequate staffing and resources influences SSA work priorities.  While ignoring or putting off the inevitable can provide a temporary solution to a staffing and resource problem, the consequences can be severe and compromise the Agency's integrity.   In addition to this being self-evident with the 800 number service, inadequate staff is also the cause for the "Special T2 Disability Workload."  This resource shortage will be a great challenge for the new Commissioner, this Congress, and the employees of SSA as it begins to tackle the "Special T2 Disability Workload."

A study done by an SSA employee in the early 1990s revealed that a serious computer processing error existed in the Agency’s software.  At that time, SSA became aware that the Social Security and SSI programs were not properly interfacing, resulting in a failure to properly identify SSI recipients who may be eligible for Social Security and Medicare benefits retroactively to 1974.  From 1974 until the early 1990’s, the SSI application did not solicit information that would identify individuals who would be eligible for Social Security benefits.  SSA officials neglected to take the necessary action to correct this problem until recently.  As a result of this systems failure, hundreds of thousands of SSI recipients and their families were not paid the proper Social Security benefits.  This placed the burden of benefits solely on SSI, Medicaid, and State and County welfare programs instead of the Social Security trust fund.

Under Title XVI of the Social Security Act, SSI recipients are required to apply for all benefits for which they are eligible.  SSA is responsible for identifying and paying the recipient once they achieve insured status for Social Security benefits.  Eligibility for Social Security benefits reduces the State's obligation to supplement the SSI and Medicaid programs.  For example, in the cases SSA has identified, the average retroactivity is 8 years. This means that the states will be reimbursed an average of 8 years of past payments that States have made on SSI.  In addition, using Social Security data, these individuals would have been eligible for Medicare retroactively for 6 years and Medicare would have been the primary insurance provider rather than Medicaid.  Thus, the burden for paying for medical services would shift from State budgets to Medicare.  Therefore, SSA owes millions of dollars in back payments to the States and the U.S. Treasury General Fund.

In March of this year, the AFGE National Council of Social Security Field Operations Locals made Congress aware of this very serious situation.  This issue impacts not only the Social Security and Supplemental Income (SSI) beneficiaries in every state and/or Congressional district, but affects SSA reimbursements of revenue due states for erroneous SSI and Medicaid payments.

SSA has identified approximately 505,000 impoverished individuals to date who appear to be entitled to Social Security and Medicare benefits. Of those cases identified, some may have a retroactivity period that can date as far back as 1974; however, the average retroactivity involved is estimated to be about eight years.  Because of the limited number of cases reviewed, we believe that a complete and thorough audit of all SSI cases should be evaluated for possible entitlement to Social Security benefits. It is important to notify you that these numbers do not reflect the countless thousands of spouses, widows and/or children that may be eligible for Social Security benefits due to the Agency’s failure to correctly enforce the eligibility requirements for SSI beneficiaries.

 The cases identified in the Special T2 Disability Workload are complex and require careful screening and diligent review by FO personnel. Development of trial work periods, substantial gainful activity, and workers compensation will be very time consuming.   Most of these cases will require new medical determinations.  If SSA's original medical file no longer exists, medical records will have to be redeveloped.  Once approved for T2 benefits, the majority of these cases will require extensive manual computations.  The complexity of these cases will be overwhelming.  For example, all historic legislative changes that have occurred since 1973 will have to be considered to determine proper payment due to the disabled individual, spouse, widow, children, survivors and/or estates.  Initial attempts to process these cases indicate that each case takes an average of 12 hours to properly screen.  This time estimate does not include the time needed to make a disability decision and the time necessary to process and adjudicate auxiliary claims (e.g., mothers/father’s and children).

Based on SSA's current work measurement system, the minimum amount of time to review and adjudicate the simplest of these cases will take 22-25 work hours.  This would result in a minimum of 2,400 work years to fully develop and adjudicate the first 210,000 cases.  However, most cases will not be simple. 

SSA's mission requires that the Agency pay each eligible beneficiary timely and accurately.  Depriving poor SSI recipients accurate benefits adversely affects their struggle for survival. 

Without additional resources, addressing this workload will have an enormously detrimental impact on service to current applicants and beneficiaries.   AFGE recommends that SSA, with Congressional oversight, take immediate action to:

Summary

There will always be budget priorities, whether it's reducing the deficit or increasing our military opposition to terrorists.   However, both workers and employers contribute to the self-financed Social Security system and are entitled to receive high quality service.   It is entirely appropriate that spending for the administration of SSA programs be set at a level that fits the needs of Social Security's contributors and beneficiaries, rather than an arbitrary level that fits within the current political process.

Mr. Chairman, you and Human Resources Subcommittee Ranking Member Benjamin Cardin reintroduced the Social Security Preparedness Act of 2000 (formerly H.R.5447), a bipartisan bill to prepare Social Security for the retiring baby boomers.   AFGE strongly encourages each of your committees to reconsider introducing legislation that will provide SSA with the appropriate funding level to process claims and post-entitlement workloads timely and accurately.   AFGE believes that by taking these costs OFF-BUDGET with the rest of the Social Security program, Social Security funds will be protected for the future.   This will permit new legislation, such as Ticket To Work, to be fully implemented without comprising public service integrity.   We believe this can be accomplished with strict congressional oversight to ensure that the administrative resources are being spent efficiently. 

AFGE is committed to serve, as we always have in the past, as not only the employees’ advocate, but also as a watchdog for clients, taxpayers, and their elected representatives.