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Paying for cheaters

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Social Security disability assessment lacks oversight

By Merilee Dannemann

The Social Security expert was among friends and in a mood to be candid.
People who are disabled and unable to work, or who believe they are, can apply for Social Security disability benefits of lifetime income and medical coverage through Medicare.
Typically, applicants are turned down on their first try, so they hire a lawyer and go to a hearing.
That’s why you see so many ads on TV for Social Security lawyers.
Social Security judges hear those cases. The claimant, says this expert, usually has an attorney, but there is no opposing counsel for the government.
There is — no lawyer to advance any argument for why this person is not entitled to disability benefits.
It’s not an adversarial process in the usual sense.  The decision lies between the judge and the claimant.
If the judge denies the claim, the claimant’s lawyer can appeal.
But if the judge approves the claim, there is no party on the other side to say this was a bad decision.
There will be no appeal, hence no additional delays or extra costs to the system, so it’s easier to approve than to deny.
Judges are under pressure, says this expert, not to decide cases a certain way, that would be unethical, but  to dispose  of cases quickly because a huge backlog exists.   
This is familiar ground, a public relations concern for any public agency.
A backlog can be counted by the number of cases backed up or the number of months from filing to hearing.
These numbers  can be reported, whereas the number of pro-claimant versus anti-claimant decisions is not tracked and therefore cannot be reported.
If you wanted to claim a Social Security judge was biased, you would not have statistics. But if you want to claim the program is bogged down and inefficient, that’s easy.
This expert said the unofficial expected rate per judge, which nobody official would admit to, is about 500 cases a year.
That’s about four hours per case, including reading the documentation, holding the hearing, making the decision and writing up the decision as notes, which are handed to a lower paid non-lawyer for final write-up.
This is relatively easy if the judge doesn’t bother to read everything, and if the judge decides in favor of the claimant since that means there will be no appeal and therefore no further examination of the decision.
A judge is not supposed to worry his or her pretty little head about the financial consequences of these decisions for the future of the Social Security system, or anything else.
Once again, in government, the pressure of administrative costs trumps the long-term systemic costs. I ask what percentage of cases come from workers’ compensation.
Like most other issues that matter, this is not tracked, but the expert thinks the percentage is pretty high.
This suggests that the New Mexico workers’ compensation system might be turning out large numbers of injured workers who are, or think they are, so permanently damaged they can never work again.
Which is one reason I worry about the quality of medical care in workers’ compensation.
Maybe these workers were that badly hurt by their injuries, or maybe they didn’t get the help they needed to heal, recover and return to normal life.
A disability benefit system can either save a person’s life or ruin it, save his life if he truly is disabled, ruin it if the system creates an excuse for not trying, which fosters another kind of disability.
When that happens, we all pay for it.

Merilee Dannemann
© New Mexico
News Service 2011