Social Security Promises to Improve “Accuracy and Consistency” of Disability Rulings Following Audit

 Posted on January 13,2018 in Social Security Disability

Social Security relies on administrative law judges (ALJs) to review initial decisions on whether to grant or deny applications for disability benefits. As any Social Security disability attorney can tell you, ALJs can vary wildly in their allowance rates—i.e., how frequently they award disability benefits. The federal government has noticed this as well, and Social Security now claims they will take steps to ensure greater “accuracy and consistency” from their ALJ's across the board.

GAO Finds 46 Percent Variation in ALJ Allowance Rates

The U.S. Government Accountability Office is the independent auditing arm of Congress. The GAO is charged with investigating government agencies, such as the Social Security Administration, and reporting to Congress and the public on their activities. In December 2017, the GAO issued a report to the House Ways and Means Committee Subcommittee on Social Security regarding the variation in allowance rates among ALJs.

Overall, the GAO found that allowance rates “could vary by as much as 46 percentage points if different judges heard a typical claim.” Specifically, the GAO studied allowance rates for cases heard between the government's 2007 and 2015 fiscal years. During this period, the GAO said the average allowance rate for all ALJs “fell 15 percentage points,” from 70 percent in 2008 to 55 percent in 2015.

The GAO also said there were “certain claimant characteristics” that made it more or less likely an ALJ would award disability benefits. For example:

• A 55-year-old applicant was more than 4 times as likely to be awarded disability benefits than a 35-year-old applicant;
• Applicants whose primary impairments were heart failure or multiple sclerosis were 4 to 5 times more likely to receive disability benefits than someone with asthma;
• If an applicant had a “critical or terminal illness,” he or she was 1.4 times more likely to receive a favorable disability ruling than someone with a non-critical impairment;
• College-educated individuals were “slightly” more likely to receive a favorable decision from the ALJ; and
• Perhaps most notably, the GAO said disability applicants who had representatives at the hearing, such as an attorney or family member, were approved for disability benefits “at a rate nearly 3 times higher than those without representatives.”

But even accounting for these and other claimant-based factors, the GAO said the Social Security Administration still needed to take further action to evaluate the “quality assurance” of its disability review process. To that end, the GAO recommended the Commissioner of Social Security “develop a set of public performance measures, to include accuracy and consistency, as well as timeliness, of administrative law judges.” Additionally, the SSA should “systematically evaluate its various quality assurance reviews and take steps to reduce or better manage any unnecessary overlap among them.”

A Social Security Disability Attorney Can Help

In response to the GAO's report, the SSA said it agreed with the recommendations presented and would provide “policy guidance and training for judges” going forward. Whether or not this translates into ALJs granting more disability claims remains to be seen.

If there is one critical takeaway from the GAO report, it is that working with an experienced Chicago disability benefits lawyer can make a huge difference when appearing before an ALJ. If you have a pending or potential Social Security case and need help, contact Pearson Disability Law, LLC, at 312-999-0999 to schedule an initial consultation.

Source:

https://www.gao.gov/products/GAO-18-37