For decades, Social Security reform has been branded the “third rail” of American politics. Although the retirement part of the program remains taboo even when Republicans control all branches of government, the whole program is not off limits to reform.
Social Security Disability Insurance, an oft-overlooked part of the Social Security Administration, is expected to dole out $150 billion to more than 10 million Americans in fiscal year 2019, and a prime candidate for reform.
Despite the noble aim of providing income for Americans with physical and mental limitations, SSDI has morphed into an unaccountable program that fails to serve beneficiaries in true need of assistance. The Making DI Work for All Americans Act of 2018, introduced by Rep. Todd Rokita, R-Ind., would introduce much-needed oversight over the legal system undergirding the system. Additionally, the bill would bring SSDI’s outdated determinations criteria into the 21st century. These critical reforms would restore the program’s promise for millions of disabled Americans, and give taxpayers relief from runaway spending.
Afflictions such as arthritis, colitis, and depression may have little in common with one another, but each on their own can cause serious disruption to work and careers. The unpredictable nature and severity of these ailments prompted former President Dwight Eisenhower to sign the SSDI program into law, originally limiting benefits to workers aged 50 and older.
Successive program expansions made all workers with disabilities eligible, and allowed more “subjective” pain-related ailments to be considered in determinations.
But with this expanded coverage came a glaring weakness that undermined the program’s goals. Applicants twice-denied by trained representatives at the Social Security Administration can appeal to an administrative law judge, or ALJ, with minimal medical training.
For the latest year with complete data (fiscal 2015), these judges granted disability appeals an astounding 53.5 percent of the time – more than half of the claims already denied twice. According to the most recent data, around 5 percent of judges had allowance rates above 80 percent. While its possible that the majority of the twice-denied cases before judges are legitimate, the available evidence suggests otherwise.
A September 2017 audit by the inspector general found that ALJs in their first four years of service had an average allowance rate of 48.7 percent, nearly 5 percent below the average for all ALJs. This least-experienced group also had the highest “agree rate,” a quality measure that demonstrates “the extent to which the Appeals Council concludes the ALJ’s decisions were supported by substantial evidence.”
But as ALJs spend more years in their roles, average quality scores decrease and allowance rates steadily climb. ALJs with more than 14 years of experience had an average allowance rate of more than 57 percent (4.2 percent above average), with the lowest agree rates of any cohort, 6 percent lower than their youngest peers. Quality, then, seems to fall off with age, and higher allowance rates go hand-in-hand with lower quality decisions. This finding is consistent with a 2012 IG report, which found that approval decisions are 40 percent more likely to garner “disagreeable” ratings by SSA’s Office of Disability Adjudication & Review.
SSA deputy commissioner Mark Warshawky and I estimated in 2015 that an overly generous awards process cost taxpayers $72 billion over the 2005-2014 period. While these costs decline in tandem with an decreasing nationwide allowance rate, more work is needed to ensure that taxpayers aren’t getting bilked. H.R. 6532, currently under consideration in the House, would introduce important safeguards for taxpayers and disabled individuals.
The legislation would establish a yearly review of the decisions made by ALJs with higher allowance rates and decision volume than 90 percent of their peers. The bill also paves the way for the updating of five-decade old SSDI determination criteria.
Outdated guidelines allow ALJs flexibility in granting benefits based on fluency in English, shifting the focus away from actual disability to the disadvantage of millions of disabled applicants.
America’s entitlement system has grown bloated and unresponsive to millions of vulnerable Americans in need of assistance. Lawmakers may be wary of reforming “untouchable” programs, but they can and must reorient SSDI to meet the needs of disabled Americans and taxpayers.
Ross Marchand is the director of policy for the Taxpayers Protection Alliance.
