Commissioner O’Malley Takes on The Social Security Administration’s Overpayment Crisis

 The Social Security Administration’s (“SSA’s”) Commissioner, Martin O’ Malley, has announced a plan to attack the overpayment crisis. Commissioner O’Malley is leading SSA by taking 4 key steps to prevent the severe injustices that beneficiaries have faced for decades when SSA makes accounting errors.   

 Starting Monday, March 25, 2024, SSA will drastically change the overpayment recovery process with these four major changes:

1.       SSA will no longer take 100 percent of a claimant’s monthly Social Security benefit by default if a beneficiary fails to respond to an overpayment reimbursement request. Instead, SSA will only withhold 10 percent of the monthly benefit to satisfy the debt, making the repayment process like the repayment process used when it comes to the Supplemental Security Income program.

2.       SSA no longer will put the burden on the beneficiary to prove the beneficiary was not at fault when it comes to the overpayment. I am assuming this means SSA will have to prove fault.

3.       SSA will allow a beneficiary 60 months, opposed to 36 months, to repay an overpayment, if the beneficiary provides a verbal summary of their income, resources and expenses. Means-tested SSI recipients do not need to even provide a verbal summary to get the additional two years to repay benefits.

If you have ever dealt with SSA before, you know that this third step will NEVER work. SSA will simply claim that the beneficiary never verbally notified them of the desire to have a 60-month repayment plan. I highly recommend that you send in your request for 60 months by BOTH certified mail and by fax, so you have two receipts. Otherwise, SSA may (and by may…I mean will) claim you never contacted them. SSA always says they hate duplicates…..well I hate my weekly calls with them when they claim they never received paperwork that we submitted to them on multiple occasions. Protect yourself and make sure you have written proof that you requested a 60 month repayment plan and that your local office received said request.  

4.       Commissioner O’Malley also promised that SSA will make it easier for beneficiaries to request a waiver if they believe they were not at fault for the overpayment. No additional details were offered of how SSA plans to do this, but given Commissioner O’Malley fondness for technology, I assume that beneficiaries will be able to complete a waiver form online. If SSA is truly trying to make waiver forms accessible, online waiver submissions would be a must.

The press release is certainly promising, but I am a strong believer that actions speak louder than press releases. Let’s see where we are in a year and if there has been progress in the overpayment situation.

Now Commissioner O’Malley, what are you going to do to fix the atrocious consultative examiner (“CE”) process? That is by far the biggest issue that SSA must fix for the disability process to have any legitimacy. I wish fixing the corrupted CE system was his first order of business, but tackling overpayments is a good start.

 

 

 

 

 

 

Got a question that you need answered? Please check out our website at www.westcoastdisability.com . We try to provide you with valuable information on our website that may help you navigate the Social Security Disability process. Also, feel free to shoot me an email at megan@westcoastdisability.com or call us at (800) 459-3017 x 101.

Processing Timeframes For SSDI/SSI claims

 If you have noticed that it seems to be taking longer to get disability decisions from the Social Security Administration ("SSA"), you are not alone. Depending on where you live, initial applications are still taking about 4 to 9 months to process. The national average waiting time for applications in January of 2024 was 231 day, or about 7.45 months. The fact that I represent claimants primarily in Southern California, one of the more populated areas of the country, means most of my clients are waiting for close to 9 months (if not longer) to get their initial determinations.  This isn't unusual. I have practiced Social Security Disability Insurance and Supplemental Security Income law for 20 years come June of 2024 and this is par for the course.

Where I am seeing significant delays, however, is at the reconsideration level, which is the second stage of the process. Most people receive an initial application denial and have to go through the reconsideration process. In fact, SSA granted 39 percent of initial applications for 2023, which means 61 percent of claimants had to request reconsideration if they wanted to continue to try to obtain disability benefits. This is the stage that I am noticing unusual delays....in Southern California at least. Historically, reconsideration decisions were also issued within 4 to 9 months of SSA receiving a request for reconsideration.  However, we have been seeing cases sit for 10 to 11 months pretty regularly at the reconsideration stage in Southern California over the last year or so. 

SSA actually contracts with Disability Determination Services ("DDS), a branch of the Department of Social Services to provide the medical development of SSDI/SSI cases at both the initial application and reconsideration levels. This is because SSA does not have the staff to provide the medical development at the lower levels of the disability process. 

Several California DDS offices have told me that they were ordered by SSA to pull reconsideration staff to work on initial applications due to complaints from government officials that it was taking too long  for people to get initial determinations from SSA. Pulling staff has created a bottleneck at the reconsideration level.  It hasn't "fixed" the process at all. It just pushed the delays to another stage. It isn't DDS's fault either. They haven't been given an adequate budget or enough staff to work up the volume of cases they are assigned to process from SSA. 

One DDS office told me last week that they just started assigning analysts for appeals filed on June 1, 2023. Another office told me it is taking them 6 to 8 months to even assign an analyst to a case. Once an analyst is assigned to assess a case, it is taking 3 to 4 months to get a decision. Thus, Southern California claimants are waiting 9 to 12 months to get decisions at the reconsideration stage in many cases. 

What is so frustrating is that reconsideration almost always results in a denial, as SSA only grants 15 percent (yes, 15 percent) of claims at the reconsideration stage, which is why I call reconsideration "the trash can." For years, practitioners have argued that SSA should eliminate the stage and allow us to go directly to a hearing if a claimant is initially denied. For a while, SSA looked into eliminating the reconsideration stage and allowed some prototype cases to go straight to the hearing level if an initial application was denied. However, the Commissioner ultimately decided that reconsideration was a necessary stage of the process and eliminated the prototype case test program.

Once denied at the reconsideration stage, a claimant must request a hearing at the Office of Hearings Operations ("OHO"). In California, there is data showing that claimants are getting hearings scheduled within 325 days (San Bernardino) up to 689 days (Santa Barbara). Santa Barbara is definitely taking close to 2 years to schedule  a hearing, but most of my clients seem to be getting their hearings scheduled at other hearing offices within 10 to 12 months. This is because I do not dispute the format of the hearing. Unless there is a reason that the Judge needs to physically see my client, I am happy to do phone or video hearings if it means my client's claim will be heard faster. If you demand an in-person hearing, clearly the waiting periods will be longer because more Judges are conducting hearings virtually, than in-person, post-Covid. I do not expect that fact to change. The Judges at OHO grant about 45 percent of the claimants based on statistics for 2023.

If you are denied at the hearing level, then you must file an appeal with the Appeals Council ("AC"). The AC only overturns 1 percent of the Judge's denials and it is currently taking the AC 15 to 18 months to make a decision. If denied by the AC, you have completed SSA's administrative processes and your only option is to file a complaint in a Federal District Court assigned to your jurisdiction.  

Got a question about SSDI or SSI that you need us to answer? Please check out our website at www.westcoastdisability.com . We try to provide you with helpful information on our website that will allow you to successfully navigate the Social Security Disability process. Also, feel free to email me your questions at megan@westcoastdisability.com or call me at (800) 459-3017 x 101.

 

The Media Continues to Investigate SSA's Systemic Struggles

 A news article was published by Ms. Sharon Jayson, at the AARP, on January 17, 2024. It is an excellent piece that realistically discusses the failure of the Social Security Administration ("SSA") and the Department of Social Services (“DSS”) to process disability cases in a timely manner. It is the most recent piece in a slew of articles and television stories that have been circulating about SSA's continued problems processing claims due to staffing and budgetary issues. Here is a link to the full article: https://www.aarp.org/retirement/social-security/info-2024/disability-claim-wait-times.html.

Media outlets have been particularly focused on the SSA’s processing when it comes to collecting delinquent overpayments, which in some instances, SSA has in fact caused by not processing the benefits properly. Anderson Cooper reported on the overpayment issue a couple of months ago and the news story is also an accurate portrayal of what is taking place at SSA. Here is a link to the video: https://www.youtube.com/watch?v=sIYsZw0PtlI .

While I find it depressing to find that SSA’s ability to process benefits effectively and efficiently continues to decline, I applaud the media for recognizing the newsworthiness of what is honestly beginning to look like the fall of the Social Security Disability system.

A Federal Agency cannot thrive without appropriate staffing and a healthy budget. While I do not see a way that SSA can be “fixed” without a complete overall of the system at this point, I do think the national news coverage is helping to wake up our nation.  

I do hope the national news outfits continue to write about the decline of the Social Security Disability system. I am really hoping that a journalist catches the scent of the whole consultative examination circus that is taking place at SSA and DSS currently. SSA has always used consultative examiners (“CEs”) to assess disability. CEs are vendors, hired by DSS, and paid for by SSA, to assess claimants’ disabilities. However, CEs are no longer performing thorough evaluations. They tend to last about 13 to 15 minutes and these CEs are almost never provided any medical records to truly evaluate a claimant’s disability. However, SSA is not really after an objective opinion backed by evidence. In the lion share of cases, SSA is purchasing these examinations, simply to justify a denial.  I consider the CE process to currently be the most corrupt aspect of the SSA/DDS system and it would be eye-opening for a national journalist to expose the whole CE process.

I thank all the journalists who are taking the time to report on the continued problems when it comes to the SSA. Keep it up and keep digging up the dirt because I promise you, there are many more stories that we as a country need to know about when it comes to the SSA system.

Got a question that you need answered? Please check out our website at www.westcoastdisability.com . We try to provide you with valuable information on our website that may help you navigate the Social Security Disability process. Also, feel free to shoot me an email at megan@westcoastdisability.com or call us at (800) 459-3017 x 101.