States With The Most People Receiving Social Security Disability Benefits

English: A collection of pictograms. Three of them used by the United States National Park Service. A package containing those three and all NPS symbols is available at the Open Icon Library (Photo credit: Wikipedia)

The number of Americans receiving Social Security Disability Insurance (SSDI) more-than doubled over the past two decades, from 5.2 million to 11.7 million by the end of 2011.
The number of residents receiving disability insurance from the
Social Security Administration (SSA) varies from state to state. In West
Virginia, close to one in every 10 people aged 18 to 64 was receiving
SSDI benefits from the federal government, more than three times the
rate in states like Utah and Alaska.
The proportion of eligible workers applying for disability benefits
also has doubled in the past 10 years, according to the SSA. Two main
reasons are driving the increase, explains The National Association of
Social Security Claimants’ Representatives. First, baby boomers are
entering years in which they are more prone to disability. Second, women
who began to work in greater numbers in the 1970s and 1980s are also
now eligible for disability through Social Security for the first time.
However, changing demographics only partially explain the increase.
Tad DeHaven, budget analyst at the Cato Institute, a libertarian think
tank, explained that the recession played a major role in the growth in
disability claims. “When you see unemployment rates rising, you see
disability moving with it,” DeHaven noted.
In fact, states with the highest disability claims tend to have the
highest poverty rates and the fewest jobs offering competitive wages.
Seven of the 10 states with the most residents receiving disability have
among the highest poverty rates in the country. The number of jobs in
these states in manufacturing and retail, which tend to pay modest
wages, are above the national average. Meanwhile, jobs in finance and professional occupations are scarce.
While it is true that disability claims rise when the economy is in
trouble, disability claims also skew the unemployment rate. The vast
majority of disability claimants do not work and are therefore not
counted as part of the labor force, which the government uses to
calculate unemployment. Of the 10 states with highest proportion of 18
to 64 year olds on Social Security disability, seven have among the
lowest labor force participation rates in the country. Unemployment
rates in these states, six of which are already above the national
average, would be even higher if those on disability were counted.
In principle, the reason Americans apply for disability is because
their health prevents them from working. A review of a recent
Gallup-Healthways survey shows that nearly these states with the highest
rates of disability are in the top 10 for serious conditions, including
heart attacks, diabetes, hypertension and recurring knee, leg and back
pain. West Virginia, the state with the highest disability rate, had
either the highest or the second-highest rate in the country for all of
these conditions.
Residents in these states find it hard to get a job that will pay
much more than disability with their work experience, education and
health condition, explained Gary Burtless, economist and senior fellow
at the Brookings Institution. “In states like Alabama and West
Virginia,” Burtless said, “lots of the workers are going to be in
occupations where the next job they obtain — if they do stick it out and
work through the pain and the disability — is one that is going to pay
considerably less than the last job that they held.”
To determine the 10 states with the most residents getting disability
benefits, 24/7 Wall St. relied on figures published by the Social
Security Administration in its Annual Statistical Report on the Social
Security Disability Insurance Program for December 2011, the most recent
available data. We only considered the number of claimants and average
payment from the SSA. Unlike SSA, Supplemental Security Income, another
federal disability program, provides financial support to low-income
residents, children and senior citizens, regardless of work history.
Statistics on labor force participation and average annual unemployment
rates were provided by the Bureau of Labor Statistics for 2011. Figures
for the percentage of residents suffering from a specific disease or
condition are from the Gallup-Healthways Well Being Index. Education,
income and poverty statistics are from the U.S. Census Bureau.
These are the states with the most Americans on disability.
10. Michigan
> Pct. receiving disability benefits: 6.0%
> Pct. with recurring neck and back pain: 32.3% (12th highest)
> 2011 labor force participation: 60.3% (7th lowest)
> 2011 unemployment: 10.4% (tied for 6th highest)
At the end of 2011, disabled workers in Michigan received in total $390 million a month from SSDI,
more than all but five other states. The state not only had a
relatively high number of disabled workers, but also paid them more than
most states. On average, disabled workers in Michigan received $1,166
per month in December 2011 from SSDI, more than in all but three other
states. Nearly 23% of these recipients received more than $1,600 per
month from the program, more than anywhere in the country except New
Jersey. Between 2006 and 2011, Michigan’s labor force participation rate
declined by five percentage points, from 65.3% to just 60.3% of the
population.
9. Missouri
> Pct. receiving disability benefits: 6.1%
> Pct. with recurring neck and back pain: 30.5% (24th lowest)
> 2011 labor force participation rate: 65.0% (25th highest)
> 2011 unemployment rate: 8.4% (22nd highest)
Missouri had an average unemployment rate of 8.4% in 2011, lower than
the nationwide rate of 8.9%. Many jobless adults were actively seeking a
job, a fact that qualifies them received Medicaid or Temporary
Assistance for Needy Families (TANF). Still, Missouri was contemplating a
welfare transfer program that would move Medicaid and TANF recipients–
who must be be employed or taking steps towards employment — onto
federal disability programs. To assist in implementing the plan,
Missouri would hire
Public Consulting Group, which touts its ability to improve the rate at
which states’ residents are approved for disability benefits. Opponents
of the plan say the initiative would trap families in poverty.
8. South Carolina
> Pct. of working age population with benefits: 6.3%
> Pct. with recurring neck and back pain: 30.1% (20th lowest)
> 2011 labor force participation rate: 60.0% (6th lowest)
> 2011 unemployment rate: 10.4% (tied for 6th highest)
South Carolina had one of the nation’s highest poverty rates in 2011,
when nearly 19% of the population lived below the poverty line. It also
had one of the nation’s lowest median annual household incomes, at just
over $42,000. South Carolina not only had one of the nation’s highest
average unemployment rates in 2011, but also one of the lowest labor
force participation rate (unemployed workers actively seeking a job).
Meanwhile, few other states had a larger percentage of workers receiving
SSDI benefits, which does not require recipients to actively look for a
job. State residents were among the most likely to attribute their disability
to diseases affecting the musculoskeletal and circulatory systems, such
as back pain. South Carolina residents were among the most likely to
have high cholesterol or blood pressure, or to have been diagnosed with
diabetes in 2012.
7. Tennessee
> Pct. of working age population with benefits: 6.5%
> Pct. with recurring neck and back pain: 32.4% (11th highest)
> 2011 labor force participation rate: 62.7% (16th lowest)
> 2011 unemployment rate: 9.3% (15th highest)
Tennessee had more than 260,000 Social Security disability
beneficiaries between the ages of 18 and 64 as of the end of 2011. As a
result, disabled workers in the state received a total of $261.5
million in December 2011 from SSDI. Beneficiaries in Tennessee were
among the most likely in the nation to receive benefits due to diseases
of the circulatory system. According to a Gallup-Healthways survey,
state residents were among the most likely in the nation to have
diabetes or high cholesterol or to have had a heart attack in 2012.
6. Maine
> Pct. of working age population with benefits: 7.4%
> Pct. with recurring neck and back pain: 33.0% (10th highest)
> 2011 labor force participation rate: 65.2% (24th highest)
> 2011 unemployment rate: 7.7% (22nd lowest)
Although a large percentage of Maine residents received SSDI benefits
in December 2011, the typical payment was limited. The monthly disability benefit
in Maine was just $1,030 on average, the lowest in the nation. Just
11.5% of those with benefits received at least $1,600, the lowest
proportion in the nation and well below the 17.2% nationwide that
December. More than 43% of residents who received disability at the end
of 2011 were diagnosed as disabled due to a mental disorder, one of the
highest in the nation and well above the 35.8% average for all areas.
5. Mississippi
> Pct. of working age population with benefits: 7.7%
> Pct. with recurring neck and back pain: 30.3% (23rd lowest)
> 2011 labor force participation rate: 59.6% (4th lowest)
> 2011 unemployment rate: 10.5% (4th highest)
Mississippi had the highest poverty rate in 2011 with 22.6% of
residents living below the poverty line. Additionally, the state’s
median annual household income that year was the lowest in the nation at
slightly less than $37,000. Many residents could not find a job even if
they were actively looking. In 2011, Mississippi’s average unemployment
rate was the nation’s fourth highest. Additionally, a mere 59.6% of the
population participated in the workforce as of 2011, the fourth lowest
percentage of all states. Potentially related to the state’s high levels
of poverty, as well as obesity, 11.3% of SSDI beneficiaries suffered
from a circulatory system disease in December 2011. This was the highest
of any state, and well above the 7.7% of beneficiaries nationally.
Also Read: Workers Taking the Most Sick Days
4. Kentucky
> Pct. of working age population with benefits: 8.1%
> Pct. with recurring neck and back pain: 34.8% (5th highest)
> 2011 labor force participation rate: 61.5% (10th lowest)
> 2011 unemployment rate: 9.5% (12th highest)
More than 19% of Kentucky’s population lived in poverty in 2011, a
higher percentage than all but four states. Many people in Kentucky may
not have the means to get well-paying work. Just 83.1% of people have at
least a high school diploma, the sixth lowest percentage of all states.
Meanwhile, just 21.1% of adults have at least a bachelor’s degree, the
fifth lowest percentage of all states. As of 2011, just 61.5% of
Kentuckians were considered to be in the labor force, among the lowest
rates in the nation. In a well-publicized case, a Kentucky judge, David
Daugherty, was accused in a civil suit filed in February of improperly
approving Social Security benefits in order to help local attorney Eric
Conn, arguably the most prominent disability lawyer in the region,
receive millions of dollars from the federal government for handling these cases.
3. Alabama
> Pct. of working age population with benefits: 8.1%
> Pct. with recurring neck and back pain: 34.6% (6th highest)
> 2011 labor force participation rate: 58.5% (2nd lowest)
> 2011 unemployment rate: 8.7% (19th highest)
Alabama was one of the nation’s poorest states as of 2011, with a
median annual income of just $41,415. Additionally, educational
attainment in the state was limited, with just 82.7% of all residents
holding a high school diploma and just 22.3% a college
degree in 2011. That year, the state’s average unemployment rate was
8.7%, slightly lower than the U.S. average rate of 8.9% for the year.
However, just 58.5% of the population participated in the labor force as
of 2011, lower than all states except for West Virginia. In December
2011, SSDI recipients in Alabama were far more likely to receive
payments due to diseases of the circulatory system or the
musculoskeletal system than recipients in the large majority of other
states. Alabamians were among the most likely Americans surveyed in 2012
to state they had experienced a heart attack or were diabetic.
2. Arkansas
> Pct. of working age population with benefits: 8.2%
> Pct. with recurring neck and back pain: 36.1% (2nd highest)
> 2011 labor force participation rate: 60.4% (8th lowest)
> 2011 unemployment rate: 7.9% (24th lowest)
In 2011, the median annual income
in Arkansas was just $38,758, the third lowest of all states in the
United States. Arkansas is also among the least educated states in the
country. Workers with limited education and who are out of work
generally have a harder time getting back to work. For instance, just
20.3% of Arkansas residents had at least a bachelor’s degree, lower than
all but two other states. An estimated 31.6% of SSDI recipients in
Arkansas had musculoskeletal system disease in December 2011, more than
any other state except for Alabama. Meanwhile, more than 9% of
recipients had diseases involving the circulatory system, higher than
all but six other states.
1. West Virginia
> Pct. of working age population with benefits: 9.0%
> Pct. with recurring neck and back pain: 39.0% (the highest)
> 2011 labor force participation rate: 54.1% (the lowest)
> 2011 unemployment rate: 7.8% (23rd lowest)
No state had a higher percentage of working age people receiving SSDI
benefits than West Virginia. In addition, the benefits received from by
the federal government were more generous compared to most states. The
average monthly benefit of more than $1,140 in 2011 was the 10th highest
of all states. Almost 21% of recipients received monthly benefits of at
least $1,600, a higher percentage than all but three states. Like most
states on this list, West Virginia is among the less-educated states in
the country. Just 18.5% of the adult population had a bachelor’s degree,
the lowest percentage of all states. Also, few residents in the state
had jobs. Just 54.1% of residents were considered part of the labor
force in 2011, by far the lowest percentage of any state in the nation.
(SOURCE: WSJ)

Social Security ALJs Sue Commissioner Alleging Unfair Labor Practices

Social Security’s disability program is overwhelmed by so many claims that judges sometimes award benefits they might otherwise deny just to keep up with the flow of cases, according to a lawsuit filed by the judges themselves. This practice is referred to as "paying down the backlog".
(http://www.amazon.com/SocialNsecurity-ebook/dp/B006VOQIKK)

The Social Security Administration says the agency’s administrative law judges (ALJs) should decide 500 to 700 disability cases a year. The agency calls the standard a productivity goal, but a lawsuit filed by the Social Security Judges against the Commissioner and the Agency claims it is an illegal quota that requires judges to decide an average of more than two cases per workday.

                                        (Marilyn Zahm and Randy Frye)
‘‘When the goals are too high, the easy way out is to pay the case,’’ said Randall Frye, president of the Association of Administrative Law Judges (AALJ) and a judge in Charlotte, N.C. ‘‘Paying the case is a decision that might be three pages long. When you deny benefits, it’s usually a 15- or 20-page denial that takes a lot more time and effort.’’

The lawsuit raises serious questions about the integrity of the disability hearing process by the very people in charge of running it. It comes as the disability program faces serious financial problems.


Commissioner Astrue's story has not changed much, if at all, since he appeared before Congress in May 2007 and April 2008. (His statements and testimony are recorded in detail in my book, socialNsecurity, beginning at page 443. Available at  http://www.amazon.com/SocialNsecurity-ebook/dp/B006VOQIKK

 He is still blaming the judges, asking for more money, more judges, and more time to reduce the backlog. Since 2007 the number of judges has gone from 1200 to 1500 and the backlog continues to grow. And Mr. Astrue continues to make excuses.
Mr. Astrue wants to have it both ways. "I find it interesting that there is so much wringing of the hands about a judge who pays almost 100% of his cases, as if the agency didn't know about it, as if the agency wasn't complicit in it, as if the agency didn't encourage it," said Marilyn Zahm, a Social Security judge in Buffalo, NY who is an executive vice president of the Association of Administrative Law Judges (AALJ), the judges' union.
Judge Zahm had a lot more to say in an interview in October 2009. (Read the entire interview starting at page 430 in my book, socialNsecurity, available at  http://www.amazon.com/SocialNsecurity-ebook/dp/B006VOQIKK

It is a bit surprising that Judge Zahm would be so out-spoken, considering the minimum amount of work she does and the large amount of money she is paid. According to Social Security records Judge Zahm issued only 26 decisions for the 9 months between September 2010 and June 2011. At a salary of $167,000.00 per year, she earned $6,423.00 per decision. An average hearing lasts about 30 minutes; so, her hourly wage for that period was about $12,846.00. That is a nice salary for so little work.
However, Judge Zahm is only the Vice President of the AALJ. Perhaps, the President, Judge Randy Frye, sets a better example. According to Social Security records Judge Frye issued only 37 decisions for the 9 months between September 2010 and June 2011. At a salary of $167,000.00 per year, he earned $4,513.50 per decision. An average hearing lasts about 30 minutes; so, his hourly wage for that period was about $9,027.00. That is also a nice salary for so little work.
Judges Zahm and Frye are not unique. During the same period Judge Mark Anderson issued only 3 decisions; Judge JoAnn Andersen issued only 5 decisions; Judge William King held only 4 hearings and issued 1 decision. He was busy traveling between California and Hawaii to conduct the hearings.
These statistics came from an SSA report which contains raw data from SSA's Case Processing and Management System without regard to the amount of time Administrative Law Judges devote to actual adjudication. In other words, factors which would affect the number of dispositions (e.g., management and administrative responsibilities, special assignments, part-time status, union representational duties, retirements, deaths or extended leave, etc.) have not been taken into account.
Here is what Commissioner Astrue is failing to say. The 1500 SSA ALJs earn approximately $167,000 a year each. The salaries of those ALJs is $2 billion 505 million a year. That figure does not include the about $3 billion a year which pays the salaries of the ALJs support staff and Commissioner Astrue's salary and that of his support staff. Also 20% of the ALJs do not hold any hearings.
Some ALJs decide 200 cases per month without holding hearings. They award benefits in 100% of their cases, trying to "pay down the backlog" like the judge in Huntington, W.Va., who awarded benefits in every case he saw in the first six months of fiscal 2011.
A GS-9 lawyer could perform the same function at a fraction of the cost. A GS-9 lawyer earns about $40,000 a year. The cost to the taxpayer of 1500 such lawyers would be only $60 million a year. That is much less than the $2 and a half billion in salaries to 1500 ALJs. That is where the cuts should begin, not with benefits to claimants.
Just 4 years ago in the middle of the economic downturn there were 1200 ALJs. Today there are upwards to 1500 according to Michael Astrue. The backlog of cases waiting to be heard has not decreased, despite pressure from Mr. Astrue to force the ALJs to "pay down the backlog". Yet, Mr. Astrue kept hiring more judges at $167 thousand a year.
Former Commissioner Astrue could be vague in his testimony before Congress. We can be specific as to who the ALJs are and how many cases they decide each month and their reversal rates.
(See http://www.ssa.gov/appeals/DataSets/03_ALJ_Disposition_Data.html.)
A court-by-court analysis of close to two million Social Security Administration (SSA) claims has documented extensive and hard-to-explain disparities in the way the administrative law judges (ALJs) within the agency's separate hearing offices decide whether individuals will be granted or denied disability benefits.
(http://trac.syr.edu/tracreports/ssa/254/)

                                                             (Carolyn Colvin)
The lawsuit was filed by the AALJ and three judges on April 18, 2013 in Federal District Court in Chicago. It names the agency and Acting Social Security Commissioner Carolyn Colvin as defendants. Colvin took over in February after Commissioner Michael Astrue’s six-year term expired.

 In an interview, Former Commissioner Michael  Astrue disputed the union’s claims.

                                                          (Michael Astrue)
Social Security’s disability program is overwhelmed by so many claims that judges sometimes award benefits they might otherwise deny just to keep up with the flow of cases, according to a lawsuit filed by the judges themselves. This practice is referred to as "paying down the backlog".

"What’s really happening here is that the judges’ union doesn’t want accountability of its members and it’s been trying to sell this story to the media and to the Congress and to the agency for a very long time,’’ Astrue said. ‘‘And no one’s buying it because it’s not true, and no federal judge is going to buy this story, either.’’

‘‘There are a very small number of malcontents who want to litigate or put political pressure on the agency rather than do their work,’’ Astrue said.

The union represents 1,400 administrative law judges. Its lawsuit describes a disability system in crisis.

About 3.2 million people applied for disability benefits last year, a 25 percent increase from a decade before. Claims have increased in part because of aging baby boomers. As people get older, they become more prone to disabilities.

Disability claims also typically increase when the economy sours. Some people who manage to work despite their disabilities get laid off and apply for benefits, while others apply out of economic desperation.

When people apply for Social Security disability benefits, their cases are initially reviewed by the State Disability Determination Service (DDS), which reject most claims. If your claim is rejected, you can appeal to an ALJ. But the hearing process takes an average of 373 days — a little more than a year — according to agency statistics.

Astrue said the average processing time for a hearing peaked at 542 days shortly after he took over the agency. He said public outcry over the "backlog" led him to adopt productivity (that is, assign quotas) standards in 2007, which helped reduce the wait time (that is, forced ALJs to "pay down the backlog").

The hearing process, which is closed to the public, is different from a civil lawsuit or a criminal trial. There is no lawyer for the government. Instead, judges are expected to be impartial decision-makers while protecting the interest of taxpayers and ensuring that applicants get fair hearings. Most applicants have legal representation by the time their claim results in a hearing.

Social Security Disability hearings are not trials. They are more in the nature of fact finding inquiries. They are presided over by an administrative law judge (ALJ), who is trained in the law. At a hearing only one side of the case is present and represented by an attorney or a paralegal. That is the claimant’s side.

If only one side of a controversy is present for the hearing, then why does the claimant need to have a judge presiding? When the Government wants to win a case, Congress designs a system that provides it with an advantage. In Immigration Hearings, the Government is represented by an attorney. When the Government is a party to a hearing before the Supreme Court, it is represented by the Solicitor General. In any other federal judicial forum where the Government has an interest, the Attorney General will ensure that the Government is adequately represented.

In Social Security Disability hearings the Government is not represented. The Government is not even present. That is probably because the system was designed to give the claimant an advantage. The case is the claimant’s case, to win or to lose. A judge is not needed to collect the medical records and listen to testimony that is not really cross-examined. The presiding officer is forced to accept the claimant’s testimony, no matter how farfetched it may be. The only evidence available to impeach the testimony of the witnesses is the evidence that the claimant provides. This could hardly be considered cross-examination.

 

 See (http://www.amazon.com/SocialNsecurity-ebook/dp/B006VOQIKK)

Frye said he has never awarded benefits just to clear a case faster, and he couldn’t name any judges who have.

‘‘It’s hard for anyone to say a judge is willingly deciding cases incorrectly just to meet the quota,’’ Frye said. ‘‘What they have told us is they are not reviewing all of the evidence, they are not developing the case as they should, and from that I think you can clearly see that the case may not be or could not be correctly decided.’’

The lawsuit says case quotas violate judges’ independence and deny due process rights to applicants.

‘‘Some ALJs respond by tending to grant more claims,’’ the lawsuit says. ‘‘For other ALJs, the quota impedes their ability to render carefully reasoned, impartial decisions based on a fully developed factual record.’’

The lawsuit alleges that ALJs are expected to meet their quotas, regardless of how complicated their cases are, even though many case files exceed 500 pages. ALJs have been disciplined for missing the quota, including receiving formal reprimands and facing removal proceedings, according to the lawsuit.

Nearly 11 million disabled workers, spouses and children get Social Security disability benefits. That’s up from 7.6 million a decade ago. The average monthly benefit for a disabled worker is $1,130.

In 2011, Social Security disability paid about $129 billion in benefits.
(AP)

Judges Must Be Fair And Impartial.

Judge London Steverson, USALJ(Ret.)

All Social Security Administration (SSA) Admin Law Judges must fulfill their duties with fairness and impartiality. Statements and actions by any Judge that displays unfairness, prejudice, partiality, bias, misconduct, or discrimination undermine public trust and confidence in the administrative process. All SSA ALJs perform an essential role in ensuring that our administrative process is fair to claimants by conducting fair and unbiased hearings and issuing decisions for claimants who are dissatisfied with Agency determinations in claims arising under the Social Security Act.

Background: Statements and actions by our adjudicators that display unfairness, prejudice, partiality, bias, misconduct, or discrimination undermine public trust and confidence in our administrative process. Our ALJs perform an essential role in ensuring that our administrative process is fair to claimants by conducting de novo, informal, non-adversarial hearings and issuing decisions for claimants who are dissatisfied with our determinations in claims arising under the Social Security Act. All adjudicators, including our ALJs, must fulfill their duties with fairness and impartiality. We have three separate processes to guard against unfairness in our hearing process: (1) The Appeals Council review process, under which we review hearing decisions in accordance with 20 CFR 404.969, 404.970, 416.1469 and 416.1470, to ensure that ALJs fairly and impartially consider claims for benefits; (2) the Division of Quality Service's ALJ complaint investigation process; and (3) the civil rights investigation process for allegations of discrimination involving unfairness, prejudice, partiality, or bias based on race, color, national origin (including English language ability), religion, sex, sexual orientation, age, disability, or in retaliation for having previously filed a civil rights complaint. These three processes operate separately from one another and have different focuses. Claimants, parties, and the public may avail themselves of any or all three of the processes, as applicable, and all three processes may occur concurrently.


Social Security Ruling, SSR 13-1p; Titles II and XVI: Agency Processes for Addressing Allegations of Unfairness, Prejudice, Partiality, Bias, Misconduct, or Discrimination by Administrative Law Judges (ALJs).

SUMMARY: In accordance with 20 CFR 402.35(b)(1), the Commissioner of Social Security gives notice of Social Security Ruling, SSR-13-Xp. This Ruling explains the three separate vehicles we have for addressing complaints of unfairness, prejudice, partiality, bias, misconduct, or discrimination by an administrative law judge (ALJ). First, the Ruling describes the procedures that the Office of Disability Adjudication and Review's (ODAR) Appeals Council follows when it receives such allegations in the context of claim adjudication. Next, the Ruling describes how ODAR's Division of Quality Service reviews or investigates such complaints outside of the claim adjudication process to determine whether ODAR should take any administrative or disciplinary action with respect to the ALJ. Finally, the Ruling describes how the public may file with us complaints of discrimination based on race, color, national origin (including English language ability), religion, sex, sexual orientation, age, disability, or in retaliation for having previously filed a civil rights complaint against the agency. This Ruling supersedes our prior Notice of Procedures: Social Security Administration Procedures Concerning Allegations of Bias or Misconduct by Administrative Law Judges, 57 FR 49186 (October 30, 1992).

Through SSRs, we make available to the public precedential decisions relating to the Federal old-age, survivors, disability, supplemental security income, special veterans benefits, and black lung benefits programs. SSRs may be based on determinations or decisions made at all levels of administrative adjudication, Federal court decisions, Commissioner's decisions, opinions of the Office of the General Counsel, or other interpretations of the law and regulations.
Although SSRs do not have the same force and effect as statutes or regulations, they are binding on all of our components. 20 CFR 402.35(b)(1).
This SSR will be in effect until we publish a notice in the Federal Register that rescinds it, or publish a new SSR that replaces or modifies it.

Purpose: This Ruling clarifies the three separate processes we have for addressing allegations of unfairness, prejudice, partiality, bias, misconduct, or discrimination by an ALJ.
Citations (Authority): Sections 205(b), 809(a), and 1631(c) of the Social Security Act, as amended; Regulations No. 4, subpart J, sections 404.940, 404.967, 404.969, and 404.970, Regulations No. 5, subpart A, sections 405.25 and 405.30, and Regulations No. 16, subpart P, sections 416.1440, 416.1440, 416.1467, 416.1469, and 416.1470.

In this Ruling, we explain these three different processes and emphasize that:
1. The Appeals Council has authority under 20 CFR 404.970 and 416.1470 to act when a party is dissatisfied with a hearing decision or dismissal of a hearing request. Even when a party does not request review, the Appeals Council may initiate review under 20 CFR 404.969 and 416.1469. The Appeals Council considers allegations of unfairness, prejudice, partiality, or bias by ALJs under the standards for review in 20 CFR 404.970 and 416.1470. The Appeals Council may also consider objections from a party stating why a new hearing should be held before another ALJ pursuant to 20 CFR 404.940 and 416.1440. In evaluating such allegations, the Appeals Council considers only the evidence contained in the claimant's administrative record. The Appeals Council's process is the only process set forth herein that allows a claimant to obtain a remedy on the claim for benefits.

2. The Division of Quality Service may review and, if warranted, investigate any complaints against an ALJ, including allegations of unfairness, prejudice, partiality, bias, or misconduct. Under this process, the Division of Quality Service evaluates allegations to determine whether it is necessary to recommend administrative or disciplinary action against an ALJ.
3. Individuals who allege discrimination based on their race, color, national origin (including English language ability), religion, sex, sexual orientation, age, disability, or in retaliation for having previously filed a civil rights complaint, may also file a separate discrimination complaint with us using our civil rights complaint process.

Policy Interpretation.
Allegations of Unfairness, Prejudice, Partiality, Bias, or Misconduct Evaluated in the Appeals Council Claims Review Process
The ALJ's decision is subject to Appeals Council review under 20 CFR 404.970 and 416.1470 if the claimant or other party or his or her representative timely requests review of the ALJ's decision. The Appeals Council may also review the ALJ's decision on its own motion under 20 CFR 404.969 and 416.1469.
The Appeals Council will grant a party's request for review and issue a decision or remand a case when:
* There appears to be an abuse of discretion by the ALJ;
* There is an error of law;
* The action, findings or conclusions of the ALJ are not supported by substantial evidence;
* There is a broad policy or procedural issue that may affect the general public interest; or
* There is new and material evidence submitted that relates to the period on or before the ALJ's hearing decision, and review of the case shows that the ALJ's actions, findings or conclusions are contrary to the weight of the evidence currently of record.

Under our regulations, an ALJ must not conduct a hearing if he or she is prejudiced or partial with respect to any party or has any interest in the matter pending for decision. A claimant or other party to the hearing who objects to the ALJ who will conduct the hearing must notify the ALJ at his or her earliest opportunity. The ALJ will then decide whether to proceed with the hearing or to withdraw. If the ALJ does not withdraw, the claimant or other party to the hearing may, after the hearing, present objections to the Appeals Council as to reasons why the hearing decision should be revised or a new hearing should be held before another ALJ.
If, in conjunction with a request for review, the Appeals Council receives an allegation of ALJ unfairness, prejudice, partiality, or bias, the Appeals Council will review the claimant's allegations and hearing decision under the abuse of discretion standard. We will find an abuse of discretion when an ALJ's action is erroneous and without any rational basis, or is clearly not justified under the particular circumstances of the case, such as where there has been an improper exercise, or a failure to exercise, administrative authority. For example, if the record shows that the ALJ failed to conduct a full and fair hearing by refusing to allow the claimant to testify or cross-examine witnesses, we will find that an abuse of discretion has occurred. An abuse of discretion may also occur where there is a failure to follow procedures required by law.

An ALJ also abuses his or her discretion if the evidence in the record shows that the ALJ failed to recuse himself or herself from a case in which he or she was prejudiced or partial with respect to a particular claim or claimant, or had an interest in the matter pending for decision. In this instance, we will remand the case to another ALJ for a new hearing or revise the ALJ's decision pursuant to 20 CFR 404.940 and 416.1440.
--This is a summary of a Federal Register article originally published on the page number listed below--
Notice of Social Security Ruling (SSR).
Citation: "78 FR 6168"
Document Number: "Docket No. SSA 2012-0071"
Federal Register Page Number: "6168"
"Notices"
Copyright:
(c) 2013 Federal Information & News Dispatch, Inc.

Social Security Disability JudgesNeed More Scrutiny

Social Security Disability Program Abuses Cited In Senate Committee Report

by London Steverson on Friday, September 14, 2012 at 9:04pm ·

Senator Tom Coburn, (R-Okla.)

A subcommittee headed by ranking minority member Sen. Tom Coburn, R-Okla., reported findings today on improving benefit award decisions for Social Security disability programs.Decisions by ALJs in Social Security disability appeals are riddled with errors and signs of sloppy judgment, according to the report from the Senate Homeland Security and Government Affairs subcommittee on investigations.
More than a quarter of the decisions reviewed by the committee were based on insufficient and often contradictory evidence, according to the report, a finding that is consistent with the Social Security Administration's own internal reviews.
“In May 2007, Commissioner Michael Astrue told Congress he would end the growing wait time for an ALJ hearing,” Coburn said. “To reduce this wait time the agency encouraged judges, where appropriate, to consider skipping hearings and write decisions ‘on the record.’ 
"I think you could flip a coin for anybody who came before the Social Security commission for disability and get it right just as often as the ALJs (administrative law judges) do," Coburn said.
Coburn said he personally reviewed about 100 of the cases, drawn randomly from counties in Virginia, Alabama and Oklahoma. About 75 percent should not have been approved for benefits, Coburn said. The Oklahoma Republican is a practicing physician.
 “One judge we encountered in our investigation played a big role in this effort,” Coburn said. “Between 2007 and 2009, ALJ Howard O’Bryan, from the Oklahoma City office, single-handedly decided 5,401 cases — almost all of them on the record and without a hearing. His decision rate was nearly four times faster than the average judge’s.  In terms of cost, Judge Howard O’Bryan alone awarded an estimated $1.62 billion in lifetime benefits to claimants in just three years.

 “I was at first astounded that one person could decide 1,800 cases per year – especially since each case is

nearly 500 pages long.  On average, he decided five cases per day, 365 days per year. I soon learned, though, that he could move through them so quickly because the quality of his work left so much to be desired.”

Coburn said the Oklahoma judge cut and pasted electronic images of medical evidence into his findings. There were contradictory opinions and findings in the cases, so much so that the agency asked Judge O’Bryan to improve his decision writing.

“But, instead of reducing his caseload to a manageable level, the agency began shipping him cases from around the nation,” Coburn said. “He told us that at one point he was asked to do 500 cases just from Little Rock, Arkansas — an average judge’s caseload for the an entire year. When he finished those, he was sent cases from Atlanta, Houston, Greenville, Des Moines and Yakima, Washington.
One 87-year-old judge in Oklahoma City, who averaged about 1,800 disability cases per year between 2007 and 2009, approved between 90 and 100 percent of them annually.
Another judge awarded disability benefits after a hearing that lasted only three minutes.
Among the recommendations in the report is that the Social Security Administration have a representative at appeals hearings to ensure evidence indicating a claimant is not disabled is presented.
The subcommittee questioned top ALJs from the Social Security Administration's disability office during a hearing on 13 September 2012.
(Read the full story in http://www.amazon.com/socialNsecurity-Confessions-Social-Security-Judge/dp/1449569757)

The report was prepared by Republicans on the subcommittee. However, its factual findings are supported by subcommittee chairman Sen. Carl Levin, D-Mich., who did not sign on because of concerns about some of the recommendations, according to a Levin aide.

FINDINGS OF FACT:
A subcommittee headed by ranking minority member Sen. Tom Coburn, R-Okla., reported findings today on improving benefit award decisions for Social Security disability programs.
Based upon its review of the 300 disability case files, the report finds:
 •Low Quality Decisions.  The investigation’s review of 300 disability case files found more than a quarter of agency decisions failed to properly address insufficient, contradictory, or incomplete evidence.  This corroborates a 2011 internal review.
• Insufficient and Contradictory Medical Evidence.  In many cases, at the initial and appellate levels of review, the state-based Disability Determination Services examiners and SSA Administrative Law Judges  issued decisions approving disability benefits without citing adequate, objective medical evidence to support the finding or at times without explaining contradictory evidence. 
 • Poor Hearing Practices.  There were perfunctory hearings lasting less than 10 minutes, misused testimony provided by vocational or medical experts, and a failure to elicit testimony to resolve conflicting information.
• Late Evidence.   Some case files showed disability applicants submitted medical evidence immediately before or on the day of a hearing or after the hearing’s conclusion. 
• Inconsistent Use of Consultative Examinations.  In many cases, consultative examinations submitted on behalf of either SSA or a claimant were either summarily dismissed or heavily relied upon, with little to no explanation.
 • Misuse of Medical Listings.  In many case files, opinions failed to demonstrate how a claimant met each of the required criteria in the SSA’s Medical Listing of Impairments to qualify under “Step Three” in the application process. Awards at Step Three are determined to be severe enough to qualify an applicant for benefits. 
• Reliance on Medical-Vocational Guidelines.  The majority of disability awards reviewed by the Subcommittee  utilized SSA medical-vocational grid rules.  A recent SSA analysis found that benefit awards were made under these grid rules at a rate of 4 to 1, compared to awards made due to a claimant’s meeting a medical listing.  At times, decisions resulted from a claimant’s representative and the Administrative Law Judge negotiating an award of benefits by changing the disability onset date to the claimant’s 50th or 55th birthday. 
• Outdated Job List.  Some case files showed examiners and ALJs relied on the Department of Labor’s outdated Dictionary of Occupational Titles, to identify jobs open to claimants with limited disabilities.  The last major  revision to the DOT occurred in 1977.

RECOMMENDATIONS:
The report makes the following recommendations: 
• Require Government Representative at Administrative Law Judge Hearings. Including a government representative at the ALJ Level is a recommendation of the Association of Administrative Law Judges and the Social Security Advisory Board. Congress should designate funds for such a program. 
• Strengthen Quality Review Process.  The review process initiated by the Quality Division of the Office of Appellate Operations should be expanded and strengthened by conducting more reviews and developing metrics to measure the quality of disability decisions, and the information made available to Congress.
• Close the Evidentiary Record. To eliminate confusion, inefficiencies, and abuses, the evidentiary record should close one week prior to a hearing, with exceptions allowed only for significant new evidence.
• Strengthen Use of Medical Listings.  Provide additional training to ALJs on the use of SSA Medical Listings, and direct ALJ decisions to identify how a claimant meets each required element of a listing, citing objective medical evidence.
 • Expedite Updated Job List.  Move more quickly to ensure the Occupational Information System can serve as a usable replacement for the Dictionary of Occupational Titles to identify jobs that claimants with limited disabilities can perform in the national economy.  
 • Focused Training for ALJs.  The Office of Appellate Operations, Quality Division, should provide training to all ALJs regarding adequate articulation in opinions of determinations that involve obesity and drug and alcohol abuse.
• Strengthen Consultative Examinations.  Because many disability claimants do not have sufficient funds to obtain detailed medical evidence of their conditions, SSA should determine how to improve the usefulness of agency-funded Consultative Examinations, including requiring an explanation of any significant disparity.
 • Reform the Medical-Vocational Guidelines.  The medical-vocational guidelines should be reviewed to determine if reforms are needed.