Historic Backlog Prompts Social Security Administration to Take Action in Winchester, TN

When people apply for Social Security Disability benefits and their claim is denied, they can appeal. The first step is asking for a reconsideration, wherein someone not involved in the initial decision reviews the claim and issues a decision. If that reviewer affirms the initial denial, the next step for the claimant is seeking a hearing conducted by an administrative law judge.

As of May 2016, more than 1 million people were waiting for an ALJ’s ruling on their SSDI case. At no point in the history of the SSDI program have so many people waited so long for a hearing decision. Some claimants have waited 17 months or longer – and that backlog is causing a lot of problems for people who are in dire need of medical and financial support.

How it Reached This Point

Theresa Gruber, deputy commissioner of Disability Adjudication and Review for the Social Security Administration, testified before a Senate committee in May about the scope of the problem.

She said that several consecutive years of budget cuts had left the SSA with inadequate funds to hire the ALJs needed to handle disability benefit reviews. During the same time, more people applied for disability benefits, because a larger percentage of the U.S. population was reaching the age at which adult-onset disabilities begin.

Gruber said that many people waiting on a hearing decision faced serious financial consequences, some either losing their homes or nearly losing their homes, because they had no income. Some claimants became sicker – and some died waiting.

Working Toward a Solution

Gruber said the SSA hopes its new Compassionate and Responsive Services (CARES) initiative will reduce wait times for ALJ decisions from the current average of 540 days to 270 days, by fiscal year 2020. But for people currently waiting for a decision, the CARES initiative promises no immediate relief.

The SSA employs about 1,500 ALJs, but the agency loses more than 100 ALJs each year due to retirement or because they’re transferred to another agency. Finding qualified ALJs to replace those that are leaving has been a challenge for the SSA, but Gruber said the agency aims to employ 1,900 ALJs by the end of FY 2018.

About five percent of all SSDI cases include more than 1,000 pages of medical evidence. These cases can take a lot of time to review – time ALJs don’t have. So the CARES initiative is working to divert these cases to a separate case review pipeline, the new 1000+ Page Case Review initiative.

Senior attorneys will have the task of reviewing the documentation in these cases and providing a summary analysis for the ALJ, hopefully expediting the decision-making process.

What This Means for Applicants

For SSDI applicants, the significant backlog at the ALJ-level of the appeals process means initial applications for disability must be flaw-proof. Getting a claim for benefits approved at the initial stage, or during the formal reconsideration, means  claimants won’t have to pursue an ALJ hearing.

Anyone applying for SSDI should seek the help of an attorney experienced with preparing SSDI applications, to ensure all relevant documentation and medical records are included.

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