Author Topic: Social Security Administration Rubber-Stamped $400 Billion in Disability Claims  (Read 205 times)

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Offline rangerrebew

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Social Security Administration Rubber-Stamped $400 Billion in Disability Claims

Report: SSA judges approve twice-denied claims at alarmingly high rate

Social Security judges Harry Taylor, Charles Bridges, Gerald Krafsur, and James Burke / AP


BY:  Elizabeth Harrington   
June 10, 2014 4:55 pm

A new report details massive waste in the Social Security Administration’s (SSA) disability programs, revealing how federal judges have rubber-stamped nearly $400 billion in benefit claims, “eroding” credibility in the agency.

The House Committee on Oversight and Government Reform released a report on Tuesday examining administrative law judges (ALJs) who approve disability claims more than 75 percent of the time. The so-called “red-flag” judges approved benefits for 1.3 million people between 2005 and 2013, amounting to $394 billion in lifetime disability payments.

The report takes a closer look at three judges who have approval rates over 90 percent, and accounted for the distribution of $10 billion in benefits alone: Charles Bridges, David Daugherty, and Harry Taylor.

“These ALJs awarded benefits in nearly every decision they made, issued an extremely large number of allowances without holding a hearing, and were subject to numerous complaints from employees within their offices,” the report said.

An ALJ for more than 25 years, Taylor approves almost 94 percent of the disability claims that reach his courtroom, and has been accused of sleeping during hearings he has presided over.

Taylor approved roughly $2.5 billion in benefits between 2005 and 2013 to 8,227 individuals. Sixty-eight percent of those decisions were held without a hearing.

“In addition to multiple allegations of personal misconduct, ALJ Taylor slept at work and during hearings many times,” the report said. “Four years after the first documented allegation that ALJ Taylor was sleeping at work, he was finally disciplined with a 14-day suspension. However, ALJ Taylor continued to violate agency policies, and was recommended for another suspension in April 2013.”

“More than a year later, the recommendation for his suspension is still pending and ALJ Taylor continues to decide a full load of cases,” the report said.

The SSA oversees two disability programs, Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI), which have grown “unsustainably” in recent decades, and now enroll 19.4 million people. The disability trust fund will be depleted by 2016, unless the programs are reformed, according to the Social Security Board of Trustees.

Individuals applying for disability benefits must be denied twice before their case reaches an ALJ.

If an applicant is first denied by their state’s Disability Determination Service (DDS) office, they can appeal to a different reviewer. If denied again, they can appeal to an ALJ.

Judges can have a tremendous impact on the amount of benefits distributed through the programs. Overall, ALJ’s added more than 3.2 million people to federal disability between 2005 and 2013, at a cost of nearly $1 trillion.

“If an ALJ improperly awards disability benefits to just 100 people, they increase the present value of federal spending by $30 million,” the report said.

Furthermore, once approved for disability, individuals “almost never go back to work.” “Less than one percent of those who were on SSDI at the beginning of 2011 have returned to the workforce,” the report said.

ALJ’s are supposed to consider any and all objective medical evidence, statements, information from doctors, and the individual’s own account about their symptoms. However, the House committee found numerous examples of judges not adhering to these standards.

For instance, the majority of decisions made by Charles Bridges, an ALJ in Harrisburg, Pa., were “not supported by substantial evidence and contained no specific findings regarding the claimant’s credibility.”

Bridges approves benefits over 95 percent of the time, costing taxpayers $4.5 billion. He has faced numerous complaints from his employees, though he has never been disciplined and continues to handle a full caseload.

When testifying before the committee on Tuesday, Chairman Darrell Issa (R., Calif.) asked Bridges if he was aware of his high approval rate, and whether that posed any concern. Bridges said “no.”

“You mean that you don’t notice that you’re essentially saying approve, approve, approve?” Issa asked.

“I don’t want to be influenced by that, so I take each case at a time,” Bridges said.

“That’s like saying you don’t want to look at the speed limit signs because you don’t want your speed to be influenced on the highway,” Issa said.

The report noted that Bridges brags about his office’s high amount of dispositions, and that he “awarded a trophy each month to the ALJ with the highest dispositions.”

Former ALJ David Daugherty also was referenced in the report for conducting “sham hearings” and his high number of approvals. Six other ALJs had higher allowance rates despite his approval rate of nearly 99 percent.

Daugherty awarded $2.5 billion in lifetime benefits from 2005 until he was forced to resign in 2011 after the Wall Street Journal exposed his scheme with a Kentucky lawyer to approve fraudulent disability claims. However, Daugherty “continues to collect full federal retirement benefits.”

In a random sample of 128 decisions, Daugherty held only one hearing lasting longer than five minutes. His misconduct was “ignored by SSA management for decades,” the report said.

According to many ALJs cited in the report, the agency “prioritized speed of processing cases over accuracy,” allowing ineligible Americans to receive disability benefits.

“As a result of the agency’s emphasis on high volume adjudications over quality decision-making, the credibility of the disability appeals process has been eroded,” the report said. “Genuinely disabled individuals are harmed from the programs’ explosive growth and face large future benefit cuts as the SSDI trust fund is scheduled for bankruptcy in two years because the program has too many beneficiaries who do not meet the disability programs’ requirements.”

“Moreover, the tens of millions of Americans who pay taxes to finance federal disability programs have seen their hard-earned tax dollars squandered because of the agency mismanagement that potentially has led to hundreds of billions of dollars of improper payments,” the report added.
« Last Edit: June 11, 2014, 07:58:41 AM by rangerrebew »
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More on Judge Taylor, from the Charleston, W.Va. Daily Mail:
Report: Charleston judge “rubber stamped” disability claims
 By Dave Boucher, Capitol Bureau Chief

 A Charleston Social Security judge is accused of rubber stamping more than $2.5 billion in lifetime Social Security benefits since 2005, according to a congressional report released today.Administrative law Judge Harry Taylor reportedly approved 94 percent of the cases presented to him between 2005 and 2013, according to an investigation by Republican members of the House Committee on Oversight and Government Reform.

“He had an overall allowance rate of nearly 94 percent and awarded benefits to nearly 6,000 people without a hearing,” the report states.

The report also accuses Taylor of inappropriate conduct toward female employees and sleeping on the job.

“When ALJ Taylor held hearings, the review found that he never elicited testimony from medical experts,” states the report, citing a formal review from 2011.

“The report found that an ‘overreaching problem’ with the reviewed decisions ‘was a lack of rationale . . . There would be little evaluation of the evidence and no function by function assessment of the claimant’[sic] abilities.’”

Taylor is one of four administrative law judges specifically noted in the report who appeared before the committee Tuesday. While Republicans on the committee argued the cases were emblematic of systemic problems, Democrats said several examples don’t mean an entirely new system is needed.

“Although I support these individual reviews, I strongly oppose the broad condemnation of all administrative law judges,” said Rep. Elijah Cummings, D-Md., the ranking Democrat on the committee.

“The four judges here today are not representative of the 1,500 judges who work at the Social Security Administration. Even they admit that they are outliers.”

Each of the judges who appeared Tuesday had reversed benefit denial decisions made by lower administrators in at least 90 percent of their cases between 2005 and 2013. Taylor was the only judge of the four who appeared Tuesday not in response to a subpoena, said Committee Chairman Darrell Issa, R-Calif.

An administrative law judge in the context of the federal Social Security Disability Insurance Program hears appeals of benefits denied to those applying for benefits. The claimants must have already lost an appeal before a local field office before receiving a ruling from the administrative law judge.

Of the 8,770 people with claims before Taylor between 2005 and 2013, Taylor approved 8,277 cases for benefits, the report states. Taylor acknowledged approving many cases and receiving at least one administrative letter appreciative his speedy turnover of cases.

After asking Taylor about the letter, Issa asked Taylor if his high reversal rate meant the administrator who reviewed the case was wrong almost all the time.

 “That’s a hard question to answer, sir,” Taylor responded. Taylor, a Wheeling native who’s served as an administrative law judge in Charleston since 1988, said he followed a multi-step judgment process in deciding whether a case needs a hearing or whether benefits should be awarded.

“I have always been a person driven to work. With very few hobbies except those of my children, my dedication and attention has always been on my work days, nights, and even weekends,” Taylor said at the end of the four-page statement.

Taylor is also accused of leaving an inappropriate message on a female employee’s voice mail, conducting “sloppy work” and routinely falling asleep during hearings and in his office.

“(An administrative inspector) also recounted numerous other sleeping incidents witnessed by other SSA employees and court officials,” the report states.

“He recounted one employee’s statement that ‘Judge Taylor’s snoring was the subject of discussion/humor among the writers whose offices are nearby’ and that he could ‘be heard snoring just about every other day.’” 

Taylor was eventually suspended for 14 days.Since the suspension Taylor is accused of more inappropriate conduct toward female employees and more sleeping in court, in addition to questionable rulings, the report states.

There is an open investigation by the Social Security Administration, according to the report. A spokeswoman from the administration’s regional office said all requests for comment needed to be submitted via email. No one responded to a Daily Mail emailed request for more information about Taylor.

During the hearing, Taylor denied any inappropriate conduct toward any women. He acknowledged falling asleep at work, but said it was due to a sleep medication that was making him drowsy in the morning.

“ALJ Taylor’s high decision total, high number of decisions without hearings, and excessive allowance rate, combined with his personal misconduct, demonstrate that ALJ Taylor should not be deciding disability cases,” the report states.“However, ALJ Taylor continues to decide a full caseload, and awards benefits to nearly every claimant before him.”

A review of rulings data from judges at the Charleston office shows Taylor routinely heard more cases and approved more cases than other judges. ...

Rest of story
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