The Disability Dilemma

Published: Jul 31, 2014

Author: Rep. Darrell Issa and Sen. Tom Coburn

For our neighbors, friends, and even family members who can no longer work for medical reasons, the federal Social Security Disability Insurance (SSDI) program is a lifeline. The program is teetering on bankruptcy, which means large benefit cuts for current beneficiaries or a massive taxpayer bailout. We can avoid this unnecessary catastrophe for the disabled and taxpayers with real leadership.

The president has recently nominated Carolyn Colvin to be the next commissioner of the Social Security Administration (SSA). If confirmed, one of her biggest challenges will be to fix this vital safety net.

For years, the finances for the nation’s disability program have been in shambles. In a few short years, the disability program’s trust fund is expected to dry up.

Where Congress and her predecessors have failed, Ms. Colvin must succeed.

We have investigated this important program for several years. The work has largely focused on how SSA approves people for disability benefits.

We learned that about a decade ago the agency created production goals for Administrative Law Judges (ALJs) and hearing offices. These goals were formed without any study or analysis of the amount of time it takes ALJs to properly review evidence, hold hearings and issue appropriate decisions. Although the agency paid extremely close attention to the number of ALJ decisions and placed pressure on ALJs who failed to meet the agency’s arbitrary benchmarks, the agency failed to assess the quality of ALJ decisions in any way.

We found the agency allowed — and even encouraged — hundreds of ALJs to rubber-stamp claimants onto disability to relieve a major backlog of cases. A Senate report found that one-quarter of the ALJ decisions approving benefits were made in error and unsupported by evidence. The agency did the same review and essentially came to the same conclusion.

Cases only reach ALJs after other agency experts deny a claim. Despite this, ALJs reversed the denials in two-thirds of their decisions over the last decade. A House Oversight Committee report documented how ALJs with high allowance rates of 75 percent or more placed more than 1.3 million individuals onto disability at a total lifetime cost of $400 billion between 2005-2013. Every person placed on the program inappropriately means someone who actually needs help may not get it.

Unfortunately, SSA showed little interest in addressing the problems with the program until it was disclosed that a West Virginia Judge, David Daugherty, colluded with a flamboyant Kentucky-based disability attorney, Eric Conn, to approve at least 1,823 people to the disability program based on fraudulent medical evidence.  Signed by doctors with questionable credentials, most of the evidence was exactly the same, despite being submitted for different people. Despite these allegations of fraud, the Justice Department has yet to take action.

After media and congressional pressure, the agency finally began analyzing whether ALJs were issuing decisions that complied with agency rules and policies and were based on a reasoned review of the evidence in claimants’ files.

The Oversight Committee found that these reviews generally show that high allowance ALJs fail to properly determine whether individuals could work, fail to properly utilize medical and other experts and fail to render decisions consistent with the evidence.

While these problems did not begin on Acting Commissioner Carolyn Colvin’s watch, the new leadership at the SSA will need to ensure Congress and the public that they have a plan to ensure the integrity of the disability program for present and future beneficiaries as well as taxpayers.

As the Senate considers Ms. Colvin’s nomination, we trust the lawmakers will dive into the changes necessary to sustain the program for Americans who rely on this important safety net.