Filed Under:Health Insurance, Disability

Witness: Set tougher SSDI procedural rules

David Hatfield, a retired administrative law judge, says one simple way to make the Social Security Disability Insurance (SSDI) claim determination system work better and faster would be to make the claimants come to hearings with more information.

Hatfield testified today at a hearing on the SSDI program organized by the House Ways and Means Social Security subcommittee. 

The subcommittee has been holding a series of hearings on the notoriously slow SSDI claim determination program. SSDI managers have tried to create a streamlined determination system for some claimants with extremely severe, clear-cut disabilities, but others find that getting through the process can take years.

Kathy Ruffing, a policy specialist at the Center on Budget and Policy Priorities, testified that one way to improve the SSDI claim administration process would be for Congress to improve financial support for the program administrators.

Congress typically treats the Social Security Administration (SSA) budget as "discretionary spending," even when SSA staffers need money to increase program efficiency or root out fraud and abuse, Ruffing said.

Investigations of claimants who have been getting SSDI benefits for years and might have recovered "are estimated to reduce eventual benefit payments by nearly $10 for every $1 in increased administrative funding, by removing from the rolls people who are no longer eligible," Ruffing said.

Hatfield said another clear-cut program is that the administrative procedures were designed years ago, when only 10 percent of the claimants had lawyers or other professional advisors. 

Today, more than 80 percent of claimants arrive with professional advisors, Hatfield said.

"The representatives have very few requirements or responsibilities imposed on them," Hatfield said. "While the present rules need to remain for unrepresented claimants, I strongly recommend exceptions to those rules when a claimant is represented. They would not only reflect the current reality but would promote better due process hearings, leading to better and more consistent decision making."

The SSA should, for example, required the claimant's representative to obtain and submit all missing evidence; submit all of the evidence required before the hearing; and provide a "good cause statement" explaining why any evidence submitted late has come in late, Hatfield said.

Today, "too often, hearings become essentially discovery proceedings, where salient facts and evidence are being introduced for the first time," Hatfield said. "This naturally protracts the process and some decisions are issued without consideration of all the facts." 

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