COMMITTEE ON WAYS AND MEANS DAN ROSTENKOWSKI, Illinois, Chairman SAM M. GIBBONS, Florida CHARLES B. RANGEL, New York THOMAS J. DOWNEY, New York FRANK J. GUARINI, New Jersey ROBERT T. MATSUI, California BENJAMIN L. CARDIN, Maryland JIM MCDERMOTT, Washington BILL ARCHER, Texas GUY VANDER JAGT, Michigan DICK SCHULZE, Pennsylvania BILL GRADISON, Ohio BILL THOMAS, California RAYMOND J. MCGRATH, New York ROD CHANDLER, Washington E. CLAY SHAW, JR., Florida DON SUNDQUIST, Tennessee U.S. Department of Health and Human Services, Social Security Administra- tion, Hon. Louis D. Enoff, Principal Deputy Commissioner of Social Securi- U.S. General Accounting Office, Joseph F. Delfico, Director, Income Security Issues, Human Resources Division and Barry Tice, Assistant Director, Dis- Administrative Conference of the United States, Marshall J. Breger American Federation of Government Employees, AFL-CIO, John Gage Archer, Hon. Bill, a Representative in Congress from the State of Texas Breger, Marshall J., Administrative Conference of the United States Christopher, Tom, National Association of Disability Examiners........ Gage, John, American Federation of Government Employees, AFL-CIO National Committee To Preserve Social Security and Medicare, Max Richt- 175 Sweeney, Eileen P., National Senior Citizens Law Center 104 143 Allsup Inc., Belleville, Ill., James F. Allsup, letter American Association of Retired Persons, statement and attachments Bryant, David R., Chicago, Ill., letter.. Consortium for Citizens with Disabilities Social Security Task Force: Ameri- can Foundation for the Blind; Association for Retarded Citizens of the United States; American Association of University Affiliated Programs; Epilepsy Foundation of America; Mental Health Law Project; National Association of Private Residential Resources; National Association of Pro- tection and Advocacy Systems; National Association of State Mental Retar- dation Program Directors; National Head Injury Foundation; National Mental Health Association; and Paralyzed Veterans of America, Martha E. Council of State Administrators of Vocational Rehabilitation, James B. Grif- fith and Joil A. Southwell, joint letter...... Evers, Gregory W., Charleston, W. Va., letter Florida Rural Legal Services, Inc., Douglas L. Wilson, Immokalee, Fla., state- Franklin Pierce Law Center, Concord, N.H., Bruce E. Friedman, letter..... Harlan, Timothy C., Columbia, Mo., letter, Hughes, Hon. William J., Chairman, Subcommittee on Retirement Income and Employment, Select Committee on Aging, and a Representative in 201 SOCIAL SECURITY ADMINISTRATION DISABILITY DETERMINATION AND APPEALS PROCESS THURSDAY, MAY 2, 1991 HOUSE OF REPRESENTATIVES, COMMITTEE ON WAYS AND MEANS, SUBCOMMITTEE ON SOCIAL SECURITY, Washington, D.C. The subcommittee met, pursuant to notice, at 10:30 a.m., in room B-318, Rayburn House Office Building, Hon. Andy Jacobs, Jr. (chairman of the subcommittee) presiding. [The press releases announcing the hearing follow:] (1) SUBCOMMITTEE ON SOCIAL SECURITY, COMMITTEE ON WAYS AND MEANS, Andy Jacobs, Jr. (D., Ind.), Chairman, Subcommittee on Social Security, Committee on Ways and Means, U.S. House of Representatives, announced today that the Subcommittee will hold a hearing on the Social Security Administration (SSA) disability determination and appeals process. The hearing is part of the Committee on Ways and Means' major oversight initiative for the 102nd Congress, which examines the efficiency and effectiveness of programs within the Committee's jurisdiction. This hearing will focus on means of improving the accuracy of SSA decisions on disability claims and streamlining agency appeal procedures. It will be held on Thursday, May 2, 1991, beginning at 10:00 a.m., in room B-318 of Rayburn House Office Building. BACKGROUND When an individual applies for social security disability benefits, his application is evaluated by a State Disability Determination Service (DDS). Funded by SSA, these agencies collect medical evidence of the claimant's condition and assess his potential to work. When a DDS denies an application, the claimant may apply for so-called reconsideration - a review of his file by another DDS examiner. If this review confirms SSA's original decision, the claimant may then request a hearing before an administrative law judge (ALJ). - In recent years, these procedures have been criticized on two counts, the accuracy of decisions and extended delays. As evidence of inaccuracy, critics cite ALJS' high rate of reversal of SSA decisions. While only about 15 percent of initial decisions appealed are reversed at the reconsideration level, the ALJ reversal rate for decisions appealed from reconsideration has consistently exceeded 50 percent over the past decade; and in 1990, it reached nearly two-thirds, or 63 percent. The second problem, long delays, is reflected in SSA's statistics on claims processing. These statistics show that it currently takes more than three months for SSA to reach an initial decision on a typical disability case; that another two months is required for reconsideration; and that disabled claimants must wait on average a full seven months for an ALJ decision. To address these problems, Chairman Jacobs recently introduced H.R. 1799, the Disability Appeals Process Reform Act of 1991. H.R. 1799 would: (1) require SSA to provide initial face-to-face interviews for all applicants for disability benefits; (2) eliminate reconsideration; and (3) direct SSA to develop more comprehensive initial evidence of the claimant's condition. This information would include: relevant physician, hospital and clinic records; detailed statements from claimants themselves; reports by non-medical professionals such as physical therapists; and statements by claimants' families and friends. FOCUS OF THE HEARING The hearing will seek to identify factors that account for inaccuracy and delays in SSA decision making and to identify measures that would address both these problems. Witnesses are invited to give specific attention to the following issues: Why are SSA disability determinations so frequently reversed on * Can SSA decision making be improved by expanding the information on which decisions are based? If so, what additional * What can be done to improve the timeliness of SSA decisions? (MORE) |