At a hearing today on Social Security Disability Programs, the Permanent Subcommittee on Investigations, Ranking Member U.S. Senator Tom Coburn, M.D. (R-OK) released the findings of an 18-month investigation exposing flawed methods used by the Social Security Administration to award disability benefits. The investigation found that more than a quarter of 300 randomly selected case files were awarded benefits without properly addressing insufficient, contradictory and incomplete evidence.
"The flood of Social Security disability applications over the past few years has tested the agency's resources and personnel. As a result, disabled Americans are waiting longer and longer before receiving the benefits they deserve. Many now wait as long as two years before having their application finalized," said Dr. Coburn.
"Oversight of these programs by Congress, however, is critical to the long-term vitality of this important safety net. Congress and SSA need to ensure that benefits are protected for those who would choose to work, but cannot do so because of their disability. Every person who is wrongfully added to the disability rolls by the agency takes money out of the pockets of the disabled. If Congress fails to ensure the financial sustainability of our nation's disability programs, everyone loses. Taxpayers will bear heavier costs; the Social Security Administration will have to do more with less; and most worrisome, there will be nothing left to give to those who need it most."
1. More than a quarter of 300 randomly selected disability case files were awarded benefits without properly addressing insufficient, contradictory and incomplete evidence. This corroborated an internal 2011 review by SSA that found that administrative law judges (ALJs) got decisions wrong or had significant errors 23-26% of the time in the areas examined by the Subcommittee.
2. Every time benefits are wrongly awarded, the cost to taxpayers is at least $300,000. The average lifetime cost of a disability award is $300,000.
3. A single judge in Oklahoma City, Howard O'Bryan, awarded more than $1.6 billion in lifetime benefits in just three years. He decided more than 5,400 cases from 2007-2009 with an approval rate over 90 percent, most of them held "on-the-record" without hearings.
4. ALJs "cut and paste" images of medical records into favorable award decisions instead of including written analysis. Judge O'Bryan had to be told numerous times to stop.
5. SSA relied on insufficient and contradictory medical evidence at every level in the application process. While the most significant problems were found at the ALJ level, problems were also found with decisions made at the state-based Disability Determination Services (DDS).
6. ALJs often gave most weight to medical records from attorneys and least weight to independent DDS doctors. Attorneys often submitted one or two page forms in which a doctor found a person totally disabled. Some ALJs called these "dead man's reports" and "store bought opinions."
7. ALJs failed to hold proper hearings, preventing them from collecting objective and useful information. Some hearings were less than 5 minutes long; at some hearings a claimant did not speak; and at some hearings questions were asked only by attorneys, with none from ALJs.
8. ALJs admitted late-arriving evidence to override all other medical evidence. Claimant attorneys would submit evidence days -- in some cases hours -- prior to an ALJ hearing. Senior SSA officials said this was strongly discouraged because it too little time was left for analysis.
9. SSA relied heavily on the vocational "grids" to find claimants disabled on their 50th or 55th birthdays. SSA finds claimants disabled using the grids four times more frequently than for meeting medical listings -- a reversal of past practice.
10. SSA uses an outdated Dictionary of Occupational Titles from the 1970's to find jobs. This relic fails, for example, to capture current labor market trends. For example, it does not contain any computer-related jobs a person could do, but includes "sorter," "cuff folder," and "battery stacker."
11. "Drug and Alcohol Abuse" was deemed "not material" in 24 cases in which a claimant was awarded benefits. A 2011 SSA review, however, found that failure to explain why the significance of drug and alcohol abuse was a top reason for errors in ALJ decisions.