Report: Social Security lax on disability claims

[September 13, 2012]  WASHINGTON (AP) -- Social Security is so overwhelmed by disability claims that some officials are awarding benefits without adequately reviewing applications, potentially adding to the program's financial problems as it edges closer to the brink of insolvency, congressional investigators say in a new report.

In more than a quarter of the 300 cases reviewed by congressional staff, decisions to award benefits "failed to properly address insufficient, contradictory or incomplete evidence." In many cases, officials approved disability benefits without citing adequate medical evidence or without explaining the medical basis for the decision, according to the report by the Republican staff of the Senate Permanent Subcommittee on Investigations.

In some cases, it appeared that administrative law judges struggling to reduce backlogs didn't take the time to review all the evidence, the report said. The judges are expected to rule on at least 500 cases a year, with one judge deciding an average of 1,800 cases a year for three straight years, the report said.

"The administrative law judges are not looking at the cases because the pressure from Social Security is to get the cases out," said Sen. Tom Coburn of Oklahoma, the top Republican on the subcommittee. "I think you could flip a coin for anybody that came before the Social Security commission for disability and get it right just as often as the (judges) do."

Social Security has been working for years to reduce a huge backlog of disability claims.

"We share the subcommittee's concern that a small number of judges have failed our expectations with regard to a balanced application of the law, proper documentation, proper hearings and proper judicial conduct," said Social Security spokesman Mark Hinkle. "We have undertaken a vigorous set of quality initiatives since the time most of these cases were filed about five years ago and data indicates that we have made substantial progress."

Hinkle added, "We recognize the need for further improvement and are working hard toward that goal."

Disability claims typically increase in a bad economy because many people who worked despite their disabilities get laid off and apply for benefits. The recent recession was no exception, with a flood of applications straining the disability program's already troubled finances.

Without congressional action, Social Security's disability trust fund will run out of money in 2016, leaving the program unable to pay full benefits, according to the trustees who oversee the program. The trustees have urged Congress to shore up the disability system by reallocating money from the retirement program, just as lawmakers did in 1994. That fix, however, would further weaken the retirement system, which has its own long-term financial problems.

About 11 million people receive disability benefits from Social Security, an increase of more than 23 percent over the past five years. Benefits average a little less than $1,000 a month.

About 8.2 million people receive Supplemental Security Income, a disability program for poor people who don't have substantial work histories. SSI benefits average a little more than $500 a month.

Coburn said he called for the investigation after he learned that a man he had hired to cut down trees in the yard of his home was also collecting Social Security disability. Coburn said he wanted to learn how widespread cheating was in the system, though the report doesn't determine whether undeserving people are getting benefits. Instead, the report is limited to whether officials followed proper procedures.

The subcommittee's staff asked the Social Security Administration to randomly select 100 cases apiece from counties in three states -- Virginia, Alabama and Oklahoma. The cases were limited to those in which benefits were awarded. The investigation was done by both Republican and Democratic staff members. However, subcommittee Chairman Sen. Carl Levin, D-Mich., did not sign off on the final report because he disagreed with some of its recommendations.

The subcommittee released the report ahead of a hearing on the issue scheduled for Thursday morning.

The report acknowledged that the findings may not be representative of the entire country. However, it said, "The same types of issues affected decisions across all three counties, suggesting they may be a factor elsewhere in the nation."

[Associated Press; By STEPHEN OHLEMACHER]

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