By Scott B. Elkind, Esq.

The old adage “your not getting any younger” could not be any more true when describing the overall age of the United States population in general. The Social Security Administration’s own statistics reveal that 20% of all persons will become disabled for a year or more before reaching the age of 65. As would be expected, the chances of becoming disabled increase with advancing age and consequential infirmity.

As is well known, the largest segment of the United States population is the “Baby Boomer” generation comprised of persons born from 1946 - 1964. Therefore, the corresponding increase in disability claims has begun and only will continue to grow for the next decade.

The sad news is that neither the affected population segment or the Social Security Administration (SSA) are prepared for this oncoming crushing onset of disability. Most Americans are not prepared to deal with the possibility of becoming disabled. A recent survey by the National Association of Insurance Commissioners found that 56% of U.S. adults would be unable to pay their bills or meet expenses if they became disabled and were unable to work for a year or longer. The survey also found that only 44% of respondents have any long term disability insurance coverage with 71% of those persons receiving long term disability coverage through their group benefit plans from their employers rather than individually purchased coverage. Most people do not realize that most group plan benefits are offset by Social Security benefits rendering coverage illusory in many cases. Even then, the strict ERISA standard of review is applied which makes it difficult to receive benefits in the first place. Even worse this fleeting belief in disability coverage is further compromised by a loss of employment resulting in termination of coverage.

This unpreparedness for the burgeoning disability roll is evident at the Social Security Administration which has continually failed to address its attempt to process ever increasing backlog of disability cases. The Annual SSA Work Plan from the Office of Audit of the Office of the Inspector General for Fiscal Year 2007 states the following that the SSA Office of Disability Adjudication and Review processing 519,359 cases in 2005 with significantly increasing case numbers from 308 cases per day in 2001 to 443 cases per day in 2005. The pending workload as of September 30, 2005 was 708,164 cases up from 392,387 cases on September 30, 2001. Part of the case backlog is due to inefficient administrative law judges (ALJs). SSA acknowledges that federal law prohibits SSA from requiring certain productivity goals from ALJs, noting that the range of productivity goes from 276 to 1,892 cases per year depending on the particular ALJ.

SSA has targeted several areas for increased attention including fraud, disabled individuals hiding self-employment income, continuing disability reviews of disabled children, Ticket to Work and overpayment collection. The reality of these efforts is disconcerting. SSA has successfully prosecuted a total of 1,400 cases from 2003 - 2005 and has identified $12.2M in overpayments for which it has recovered only 10% of this amount. The funding and manpower going into these efforts to collect or retain money should be redirected into processing the increasing backlog for deserving claimants.

Unfortunately, SSA is lagging far behind in completing many internal reviews with the following selected reviews due for completion in 2007:

• Administrative Law Judge Caseload Performance
• Social Security’s Disability Service Improvement Process
• Management’s Use of Workload Status Reports at Hearing Offices
• Recovery of Benefit Overpayments
• SSI Income Recipients Whose Medicare Were Terminated Because of Death

Even worse is that the following internal review are not slated to begin until 2007:

• Aged Cases at the Hearing Level
• Disabilities Classified by SSA as Difficult to Prove
• Proper Classification of Terminally Ill Beneficiaries
• Transfers of Case Workload Among Hearing Offices

If this is not bad enough, SSA has recognized that it has not correctly calculated workers compensation offsets in 110,00 cases and has only completed the review of the first 61,000 so far.

So, where is your tax money going if the funding is not claims are not being processed timely? Here are some examples:

• Software migration at 26 DDS offices at a cost of $18M
• Ongoing development of electronic folder and data management architecture at a cost of $17M
• Maintenance, repair, and rebuilding activities at the Great Lake Program Service Center at a cost of $15M
• Yearly cost of security contracted at $40M
• Case folder services at SSA’s Megasite Folder Storage Facility costing $32M

The message being sent by this is very clear. SSA has little intention of funding any initiatives to address their enormous case backlog which will only increase in years to come. The current case processing time of approximately two years for a claimant to receive benefits will only worsen and result in increasing numbers of deserving disabled claimants suffering while waiting to be awarded benefits. As people who are without money are not politically empowered, their voices will only be heard once the burden caused by their disability comes to rest on their families and communities.

Scott B. Elkind is a Principal with Elkind & Shea, The Disability Benefits Law Firm. His practice focuses exclusively on disability benefits.