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FUBAR: SSA's dysfunctional disability claims process

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Walter F. Wouk
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The Social Security Administration (SSA) should be the first line of defense for American workers who become "involuntarily retired" because of illness or injury. However, there is nothing "social" or "secure" in the way the administration functions today.

About 43-million people visited SSA Field Offices for assistance in 2007. Since that time SSA Field Offices continue to receive more and more customers. This year SSA Field Offices are expected to see more than a million more customers than last year; and officials estimate they'll receive 3.3 million new disability claims over the next year,.

SSA administers two programs for disabled individuals. Title II is Social Security Disability Insurance (SSDI), which is funded by a worker's contribution to FICA. Title XVI (SSI) is Federal Welfare; eligibility is based upon need.

A Joint Hearing on Eliminating the Disability Backlog determined that Social Security disability backlogs are at an all-time high, with the average "wait time" lasting 499 days, and in some regions upwards of 700 days. At the same time, the SSA staffing levels are at their lowest levels since 1972. According to SSA's Budget Appendix for FY 2009, SSA's civilian full-time staff employment for Fiscal Year 2009 will essentially remain unchanged, leaving it at this low level.[1] All this translates into unreasonable delays in Social Security disability claims processing, with thousands of people with disabilities facing tremendous economic hardship, including bankruptcy, homelessness and, in some cases, suicide.

Despite this, the SSA has an unwritten policy of requiring claims representatives to take Supplemental Security Income (SSI) claims from all applicants for Social Security Disability (SSD) benefits, even if they are clearly ineligible for the Federal Welfare benefit.

This policy violates the claimant's privacy by including questions regarding the individual's personal information in the application process for SSD benefits, without informing the claimant why the information is needed. Claims representatives are required to glean information about the claimant's family income, bank accounts, life insurance policies, property, investments, etc., in order to get enough information to process and deny an SSI claim for excess income or resources.

SSA does this to artificially inflate its claims processing times. For example, an SSI disability claim that is denied in one day because of excess income still gets counted as a bona fide disability claim when SSA computes its overall processing time. Some SSA personnel have created bogus claims in order to improve processing time statistics.

According to Witold Skwierczynski, the President of the National Council of SSA Field Operations Locals, in June 2009, the Manager of the Independence, Missouri, Social Security Office became concerned when he realized that his office would not meet his quota of SSI claims for the month, so he checked the agency's computer system to find out who had filed for Social Security Disability, but not SSI. He then manufactured 38 bogus SSI claims by answering questions on the applications without contacting the applicants. The manager was not held accountable for his criminal actions.[2]

SSA's policy of requiring claims representatives to take bogus SSI claims is a waste of their time, a waste of tax-payer dollars and it often delays the payment of past-due SSDI benefits due to claimants who are awarded benefits.

The majority of SSD awards are processed at SSA Program Service Centers PCs. Once an SSI claim is taken, an SSI Windfall Offset indicator is input to the computer record to prevent a claimant from being paid both SSDI and SSI benefits for the same time period. Once the "indicator" is input to the claimant's record, the local office cannot remove it -- the Program Service Center must do it --and that is the problem.

The staff at SSA PCs have little or no knowledge of the SSI program, so they must wait for the local office to advise them of the disposition of the SSI claim, and that is very difficult to accomplish because every office within the PC's jurisdiction is trying to contact the PC. Consequently, the only option for the local SSA office is to leave a telephone message or send a memo and hope that someone gets the message.

On July 30, 2010, SSA announced that phones to PC-7, an office in Baltimore where Social Security disability claims for the New York region are implemented, are being turned off. Benefit authorizers, employees who implement disability allowances, are 90 days behind. Claims authorizers, a different category of employees who implement disability allowances are 115 days behind.[3] This is a direct consequence of SSA's bogus SSI claims policy, which makes the majority of claims Windfall Offset cases.

The communication problem is compounded by the requirement that SSA pay the disability claimant within 60-days of receiving a favorable decision on a claim. The PCs meet this requirement by releasing the recurring monthly benefit and withholding the past-due benefit until they learn the status of the SSI claim.

Once the PC does that, the clock stops ticking on the claim and the payment of the past-due benefit is no longer a priority. The PC can -- and will -- delay processing the past-due benefit for an indefinite period.

If the PC isn't prompted (by a claimant's congressional representative) to pay the past-due benefit, it could take six months or more for the claimant to be paid. And it doesn't take a "Rocket Scientist" to figure out that individuals who have been unable to work for a year or two -- or more -- are in desperate need of all the benefits due to them; and delaying the payment of past-due benefits is nothing less than malfeasance.

There is no legitimate reason for the Social Security Administration's policy of taking federal welfare claims from each and every applicant for Social Security Disability benefits. SSA officials know this -- they don't care -- and millions of disabled individuals are paying the price for their indifference.

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I'm a Vietnam Veteran, live and let live progressive, fan of Thomas Paine, MST3K, Punk Rock, the Adirondacks, and warm and fuzzy pubs..

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