House investigators: Disability judges too lax in approving state-rejected claims for benefits

By Stephen Ohlemacher

Associated Press

Published: Monday, June 24 2013 3:15 p.m. MDT

In this Friday, Jan. 11, 2013 file photo, the Social Security Administration's main campus is seen in Woodlawn, Md. U.S. House investigators say Social Security is approving state-rejected claims for disability benefits at strikingly high rates for people who might not deserve them. Compounding the problem, the agency often fails to do required follow-up reviews to make sure people still qualify for benefits months or years later.

Patrick Semansky, File, Associated Press

WASHINGTON — Social Security is approving disability benefits at strikingly high rates for people whose claims were rejected by field offices or state agencies, according to House investigators. Compounding the situation, the agency often fails to do required follow-up reviews months or years later to make sure people are still disabled.

Claims for benefits have increased by 25 percent since 2007, pushing the fund that supports the disability program to the brink of insolvency, which could mean reduced benefits. Social Security officials say the primary driver of the increase is demographic, mainly a surge in baby boomers who are more prone to disability as they age but are not quite old enough to qualify for retirement benefits.

The disability program has been swamped by benefit claims since the recession hit a few years ago. Last year, 3.2 million people applied for Social Security Disability or Supplemental Security Income.

In addition, however, management problems "lead to misspending" and add to the financial ills of the program, investigators from the House Oversight and Government Reform Committee say.

"Federal disability claims are often paid to individuals who are not legally entitled to receive them," three senior Republicans on the House committee declared in a March 11 letter to the agency. Among the signers was the committee's chairman, Rep. Darrell Issa of California.

Social Security acknowledges a backlog of 1.3 million overdue follow-up reviews to make sure people still qualify for benefits. But agency officials blame budget cuts for the backlog, saying Congress has denied the funds needed to clear it.

Social Security spokesman Mark Hinkle said the agency follows the strict legal definition of disability when awarding benefits. In order to qualify, a person is supposed to have a disability that prevents him from working and is expected to last at least a year or result in death.

"Even with this very strict standard, there has been growth in the disability program, and the primary reason for this growth is demographics," Hinkle said. He noted that approval rates have declined as applications for benefits have increased.

The most common claimed disability was bone and muscle pain, including lower back pain, followed closely by mental disorders, according to the program's latest annual report.

"Pain cases and mental cases are extremely difficult because — and even more so with mental cases — there's no objective medical evidence," said Randall Frye, a Social Security administrative law judge in Charlotte, N.C. "It's all subjective."

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.

An additional 8.3 million people get Supplemental Security Income, a separately funded disability program for low-income people.

If Congress doesn't act, the trust fund that supports Social Security disability will run out of money in 2016, according to projections by Social Security's trustees. At that point, the system will collect only enough money in payroll taxes to pay 80 percent of benefits, triggering an automatic 20 percent cut in benefits.

Congress could redirect money from Social Security's much bigger retirement program to shore up the disability program, as it did in 1994. But that would worsen the finances of the retirement program, which is facing its own long-term financial problems.

The House oversight subcommittee on entitlements is scheduled to hold the first of several hearings on the disability program Thursday. The hearing will focus on the role of administrative law judges in awarding benefits.

Get The Deseret News Everywhere

Subscribe

Mobile

RSS