Articles from prior issues of The Advocate

May/June, 1996

STATEMENT OF THE NATIONAL ASSOCIATION OF DISABILITY EXAMINERS TO THE HOUSE JUDICIARY SUBCOMMITTEE ON COMMERCIAL AND ADMINISTRATIVE LAW

STATEMENT OF THE NATIONAL ASSOCIATION OF DISABILITY EXAMINERS

TO THE HOUSE JUDICIARY SUBCOMMITTEE ON COMMERCIAL AND ADMINISTRATIVE LAW

by Larry DeVantier, President and Martha Marshall, Legislative Committee Chair

Friday April 12, 1996

Chairman Gekas and members of the Subcommittee, members of the National Association of Disability Examiners (NADE) have grave concerns about H.R. 1802, the Reorganization of the Federal Administrative Judiciary Act. We appreciate this opportunity to express those concerns.

NADE is a professional association whose members include disability examiners, physicians, support staff and administrators who are employed in the State Disability Determination Services (DDSs). The DDSs have responsibility for adjudicating Social Security disability claims under Title II and Title XVI of the Social Security Act. Our membership also includes physicians, psychologists and other professionals not in the DDSs (including federal employees) who work with and are interested in the disability program. We believe the diversity of our membership and our experience in working directly with the disability program provides us with a unique understanding of that program. It is our members who are responsible for making the system work efficiently and effectively -- serving both the claimant/beneficiary and the taxpaying public. While we have not previously testified before the Judiciary Committee or this Subcommittee we have provided numerous testimonies to other Committees both in the House and the Senate on issues related to the Social Security and Supplemental Security Income (SSI) disability programs. Much of that testimony has involved the causes of and problems resulting from, the marked discrepancy between Administrative Law Judge (ALJ) and DDS decisions. These differences --and the resulting problems-- will be markedly increased if a separate ALJ corps were to be established.

One of the most significant problems facing the Social Security disability program in recent years has been the loss of public faith in the process. In large part this is due to the huge discrepancy between DDS and ALJ decisions. Although SSA’s Office of Program and Integrity Reviews shows a DDS accuracy rate of 96.7% for allowances and 93.6% for denials, the ALJs are reversing DDS decisions at a rate of 60% or more. While there may be multiple explanations for this marked difference in outcome, it is clear that the system is flawed. In an attempt to restore public faith in the program, as well as to streamline the process, the Social Security Administration has recently begun a major Redesign (Reengineering) initiative. While our members have serious reservations about many of the features of the Redesign initiative we uniformly support one of its key elements -- process unification.

Process unification is designed not to compromise ALJ independence, but to increase consistency between DDS and ALJ decisions. Although there will never be complete agreement between these two components, the current level of inconsistency cannot continue. A recent study of ALJ reversals of DDS denials (findings of the Disability Hearings Quality Review Process-September, 1994) revealed that 59% of these ALJ allowances were insupportable on medical grounds. In a wrap-up presentation in June, 1995, this rate was placed at 70%. At the same time 29% of DDS denials were found to be insupportable, As this report correctly notes, “In considering the findings presented here, it is important to keep in mind that the cases which reach the hearing level (i.e. appealed reconsideration denials) are generally the most complex and judgmental and, therefore, the most difficult to adjudicate because of the issues involved. As such, it is not surprising to find some differences of opinion between adjudicators and quality reviewers as to the decisional outcome.” That does not, however, account for the vast discrepancies found. In addition, SSA’s February 1996 Report to Congress on Rising Cost of Social Security Disability Insurance Benefits identifies “...what seems to be a long-term increase in rates of appeals and a continuing increase in award rates at the hearing level...” as one of the principal causes of the rising costs to the Disability Insurance (DI) Trust Fund. It is clear from these studies that process unification (consistency throughout the adjudicative process) is essential to program integrity, to the return of public confidence and to fiscal responsibility. It is hoped that this can be accomplished by cross training and related activities designed to ensure uniform understanding and application of binding adjudication policy at all levels of adjudication. An independent ALJ corps would seriously hamper that effort. ALJ expertise and administrative accountability would be lost, training efforts would be compromised, and program costs would continue to rise. And without process unification SSA’s Redesign initiative has no hope of succeeding.

In an effort to promote uniform, national consistency in the disability program NADE has long advocated establishment of a Social Security Court. If an independent ALJ corps is established and/or process unification cannot be achieved we would strongly support legislation to 1) establish a Social Security Court, 2) replace ALJs with hearing adjudicators and 3)close the record for receipt of evidence prior to the hearing.

Thank you for giving us the opportunity to comment on this issue which is of grave importance to our members and of vital interest to the integrity of the disability program.