Commissioner Barnhart Presents Her Approach
to Improving the Disability Determination Process
Jo Anne Barnhart, Commissioner of Social Security, today presented
an approach to improving the disability determination process that
would shorten decision times, pay benefits to people who are obviously
disabled much earlier in the process and test new incentives for
those with disabilities who wish to remain in, or return to, the
“Clearly, the current process for determining eligibility must
change. People are waiting too long to get benefits,” Commissioner
Barnhart said. “Today I present an approach that uses 21st
century technology to speed up processing times and to create accountability
at every step in the disability process.”
Commissioner Barnhart’s approach is the result of more than a year
and a half of study and discussions with groups involved in the
disability process – including Social Security employees from across
the country, state Disability Determination Services (DDS), Administrative
Law Judges (ALJs), health care providers, the federal courts, claimant
attorneys and representatives, claimant advocacy groups, Members
of Congress and concerned members of the public.
Under the current process, it takes an average of 628 days for
a Social Security disability application that is denied and appealed
at each step to reach final agency action. (To read more about
the current disability process and associated delays, visit www.socialsecurity.gov/disability/disability_process_welcome.htm).
“My goals for improving the disability program are to make the
correct decision as early in the process as possible and to expand
employment opportunities for people with disabilities,” Commissioner
Barnhart said. “My approach would enable us to do that.”
“Designing my approach for improving the process is the first step
of what I believe must be – and will continue to make – a collaborative
process,” said Commissioner Barnhart. “I will work within
the Administration, with Congress, the state Disability Determination
Services and interested organizations and advocacy groups before
putting pen to paper to write proposed regulations. To be
successful, perspectives from all parts of the system must be considered.”
None of the suggested changes would require legislative action;
none would adversely affect the employment status of current Social
Security or DDS employees.
Commissioner Barnhart’s approach is predicated on successful rollout
of the Accelerated electronic Disability process (AeDib).
AeDib creates an electronic folder for the claimant’s application,
medical information and other data. AeDib will eliminate numerous
time delays and financial costs related to locating the paper file,
maintaining its contents and mailing them from office to office.
The Social Security Administration is currently piloting AeDib in
three states, and will phase in its use nationwide during an 18-month
At a hearing before the House Ways and Means Subcommittee on Social
Security, Commissioner Barnhart described highlights of her approach.
- The establishment of expert units and screening for “quick
decision.” New medical expert units would be organized
by areas of clinical specialty (e.g., orthopedic, pediatric, psychiatric)
and located in Social Security Regional offices. These units
would provide assistance for disability decision makers at all
levels of the determination process (DDS examiners, ALJs, etc).
Through a “quick decision” process, these units would screen claims
for applicants who are obviously significantly disabled (e.g.,
ALS, end-stage renal disease, aggressive cancers) and approve
them before they are sent to a state DDS.
- DDS examiners would be required to more fully document and
explain the basis for a decision to deny a disability claim.
The DDS reconsideration stage of the current appeal process would
be eliminated. Federal Disability Quality Branches, which
presently review DDS decisions, will be replaced by an in-line
quality review and a centralized quality control. As a result
of “quick decision” and elimination of reconsideration, the DDS
would be able to devote freed-up resources to better documentation
- The creation of the Federal Reviewing Official position.
If a claim is denied by the DDS, the claimant would be able to
ask for an independent review by a Federal Reviewing Official.
The Reviewing Official, an attorney, after a thorough examination
of the record, would either approve or deny the claim. If
the claim is not allowed, the Reviewing Official would prepare
a written report outlining the reasons the claim should be denied
or outlining the evidence needed to successfully support the claim.
This report would be provided to the claimant. If
the Reviewing Official’s decision is appealed, a de novo
hearing would be scheduled before an ALJ, who would also receive
a copy of the report.
- Closing the record following the ALJ hearing. Following
a hearing, the ALJ will issue a written opinion explaining the
basis for the decision, and the record will be closed. The
Appeals Council stage of the current process is eliminated.
- Quality control for disability claims will be centralized,
with end-of-the-line reviews and an Oversight Panel.
An Oversight Panel, consisting of two ALJs and one Administrative
Appeals Judge, would examine the case after quality review.
If the Oversight Panel affirms the ALJ decision, that decision
would become a final agency action. If the Oversight Panel
reverses the ALJ decision, that decision would become a final
agency action. Claimants would continue to be able to appeal
any final agency action to Federal district court.
Social Security has developed a Service Delivery Plan to eliminate
backlogs within a 5-year period. The President’s FY 2004 Budget
Request provides significant additional funding to begin to eliminate
these backlogs. Backlogs at the DDS have already been reduced.
Progress is being made at hearing and Appeals Council levels.
Social Security plans to conduct several demonstration projects
aimed at helping people with disabilities return to work.
These projects would support the President’s New Freedom Initiative
and provide work incentives and opportunities earlier in the process.
They would include: early intervention demonstration projects
that provide medical and cash benefits and employment supports to
applicants who elect to pursue work rather than disability benefits;
temporary allowance demonstration projects that provide immediate
cash and medical benefits for a specified period to applicants who
are highly likely to benefit from aggressive medical care; interim
medical benefits demonstration projects that provide health
insurance coverage to certain uninsured applicants whose medical
condition is likely to improve with medical treatment; and ongoing
employment supports to assist beneficiaries who wish to obtain
and sustain work will also be tested.
# # #
Copies of most SSA press releases, as well as other Social Security
information and statistics,
are available at SSAs Internet site, Social Security
Online, at http://www.socialsecurity.gov.
Also look there for information on subscribing to SSAs
free electronic newsletter, Social Security eNews.
SSA Press Office 449
Altmeyer Bldg. 6401 Security Blvd. Baltimore, MD 21235
410-965-8904 FAX 410-966-9973