Articles from prior issues of The Advocate

November/December 1998

Willman Outlines NCDDD Observations and Concerns
by Ken Forbes, Oregon DDS

“OUTSIDE OBSERVERS NOTE THAT NADE has flourished as an organization and has become much more powerful over the years, “ stated NCDDD President Doug Willman. He described the National Council of Disability Determinations Directors (NCDDD) as the management staff corollary to NADE. He prefaced his remarks, speaking in behalf of NCDDD, stating that his term as president would end in eight days. He began by commenting on Associate Commissioner of Disability Ken Nibali’s presentation in terms of what may have gone unnoticed. “What wasn’t in Ken Nibali’s presentation? Hoopla. No silver bullets to solve the problems. No proposals for programs that have been developed on high.” He asked, “What did Nibali actually present? A request from NADE about how to solve the problems.” He stated that speaks volumes for how far NADE has come.

Observation #1:

Redesign started as a plan to replace the entire disability process. Most of the plans and pilots have faded and are not active. However, the Full Process Model (FPM) is alive and well. It involves several redesign concepts such as the Pre-Decision Interview (PDI), Single Decision Maker (SDM) and the Adjudication Officer (AO). Administrators have been concerned about the FPM and specifically the way in which SSA announced their plan implementation. Benefits of this include reduction of appeal rate and some earlier final decisions. Time is the major cost factor. PDIs and narrative rationales in each case will add significant time to the DDS level of claim processing. About 25 per cent more resources will be needed to make this work. What do we save? The time and cost involved in doing reconsideration reviews. Can we afford it? Probably not. Many states may not be able to bring in additional resources because of the hiring limits imposed by their state governments. The FPM may work with elimination of the AO but this is a huge gamble since it will still have a huge impact on the Office of Hearings and Appeals (OHA). NCDDD is making the recommendation to SSA that they modify the reconsideration process as an alternative to the FPM. Willman expressed hope that SSA will not commit to the FPM without assuring the DDSs have resources to address the caseload. Otherwise, they will bury us under a workload that we do not have the resources to handle.

Observation #2:

The objective of process unification was to produce similar results on similar cases at all levels of adjudication. There is some hope that the initiatives are working since we are seeing a decreasing allowance rate at OHA and slightly increasing rate of DDS initial allowances. A key was the review of OHA decisions. Though it only deals with about one case per Administrative Law Judge (ALJ) per month – not a lot of feedback - the early results suggest it is making a difference. SSA rulings were the Process Unification actions that most clearly resulted in changes. The rulings changed the way evidence is gathered, the amount of information required and what we do with it. It takes a significant amount of additional resources to process claims as required under the rulings. Unfortunately, we cannot do it all perfectly in every case and this results in lawsuits. Each lawsuit could be the nucleus of a frenzy of lawsuits attacking the fact that DDSs are not performing all the requirements of the rulings.

Observation #3:

All states are different and their computer systems, even within (VERSA, WANG/LEVY, etc.) are designed to meet the needs of the individual states. SSA wanted to develop a single system to replace all the systems in all the states. NCDDD has continuously expressed concerns. Now, SSA has obtained a consultant review which essentially says the Reengineered Disability System (RDS) will not work. DDSs have the ability to continue working with existing systems and even enhance their current systems. The goal is to automate all states and to work toward consistency of data and information. The consortia are the keys to major effect on this issue with SSA. The consortia were established to allow all DDSs, regardless of the claim processing software, to speak with one voice about what all DDSs' need in a computer system.

Lastly, Willman offered some musings. PPWY may not be the statistic god to worship in the future since we seem to have thrown overboard some critically important aspects of the work. Too little DDS involvement in policy formation at SSA has resulted in policies not consistent with the actual ability to do the job. Willman indicated that he is still concerned about unfunded mandates.