Inherent Delays in the Social Security Claims Process
Why does the Social Security Disability Process Take So Long?
In FY 2010, the Social Security Administration received more than 3.2 million initial disability applications,over 200,000 more applications than in FY 2009. As they issued more initial disability decisions, the number of hearing requests continued to rise. The most significant delays in SSA’s disability determination process are at the hearing level. The average processing time for cases at the hearing level has increased dramatically since 2000, when the average time was 274 days.In FY 2009, the average processing time for disability claims at the hearing level was 491 days, about 16.5 months.SSA received and handled a record number of hearing requests in FY 2010. As a result, SSA ended FY 2010 with just over 700,000 pending hearings – the lowest level in five years, but still a backlog. As of December 2010, SSA cut the average wait time for a hearing decision by nearly one-third from its highest level. Unfortunately, there are cases pending for 775 or more at the hearing level. These cases are supposed to be given priority. SSA’s goal is to achieve an average processing time for hearings of 270 days in FY 2013. In FY 2010, SSA reduced the processing time for hearings to an average of 426 days, 65 days lower than the average time for FY 2009. At its peak in August 2008, it took an average of 18 months for a hearing decision. As of December 2010, it took just over a year.
SSA is committed to improving both the timeliness and quality of hearing decisions and is taking step to aggressively reduce the backlog. However, at present SSA claimants must endure long waits. Patience and representation by experienced counsel pay off.
Why is it taking so long for SSA to pay me benefits after a favorable decision?
Even after waiting many months – or years –and finally receiving a favorable ALJ decision, a claimant may wait months to actually receive the past due benefit payments. SSA’s policy is that disability claimants file applications for both Title II and SSI, even if they eventually will not be eligible for SSI because of their Title II monthly benefit amount. The Social Security Act requires that retroactive Title II benefits are reduced by the amount of SSI that would not have been paid if the Title II benefits had been paid in a timely fashion when due, known as the “windfall offset.” Since 1995, SSA policy requires that the SSI past due benefits are computed and paid to the claimant before the release of the Title II retroactive benefits. This policy ensures that the receipt of the Title II benefits does not jeopardize eligibility for SSI and thus Medicaid during the retroactive period.
SSA’s windfall offset rules require that past due Title II benefits are not paid until the amount of the SSI past due benefits is computed. The gross past due Title II amount is computed by the SSA program service centers (PSCs). However, the local SSA field offices have the job of computing the retroactive SSI benefits, which involves post-entitlement contact with the claimant to determine income and resources, living arrangements, and other non-disability issues that affect SSI eligibility and payment amounts. As a result, it means delay for hands-on time with a claimant. Whether the field office is adequately staffed will affect how promptly (or not promptly) the past due SSI benefit calculation is completed. This amount is communicated back to the PSC, which then applies the windfall offset, computes, and pays to the claimant the retroactive Title II benefits.
Due to communication issues between the offices and other factors, the payment of claims can be significantly delayed. The same types of issues arise when SSA has to deal with the offset for workers’ compensation benefits. In order to assist SSA in the timely processing of your benefits, do not miss your income and resource appointment following your approval of your claim. Be sure to bring with you proof of all income and resources since the awarded onset date. This includes monthly bank account statements, pay stubs from work attempts, copy of any workers’ compensation settlement or payments, proof of other disability payments, proof of spouse’s income, life insurance policies, burial policies, documentation for dependents in your household.