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Streamlining Appeals

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Many of the elements in a plan by the U.S. So­cial Security Admin­istration to improve the appeals process for de­cisions on disability ben­efits reflect recommendations put forth by the ABA at recent congressional hearings and in meetings with SSA officials.

Some 13 million Americans and their families depend on benefits provided under the Disability Insurance Ben­efits and Supplemental Security Income programs the SSA administers. The process has been plagued, however, with backlogs and administrative problems that have caused claimants and their families to wait up to three years for their appeals to move through the system.

SSA Commissioner Jo Anne Barn­hart unveiled the plan in September at a House Ways and Means subcommittee hearing.

The ABA has maintained an interest in the disability review process since the House of Delegates approved recommendations for improving the process in 1986. Delays “have a profound effect on public confidence in the agency, on agency staff and, most significantly, on claimants who desperately need the benefits,” said John H. Pickering of Washington, D.C., during congressional testimony. He is commissioner emeritus of the ABA Com­mission on Law and Aging and past chair of the Senior Lawyers Division.

In addition to those entities, groups that have been at the forefront of the ABA’s efforts in this area include the Judicial Division and the Section of Administrative Law and Regulatory Practice.

Pickering said the ABA is particularly supportive of the SSA goal of making a correct decision as early as possible. The ABA maintains that improving the quality of intake and development of evidence early in the process will result in fewer appeals and a reduction in backlogs.

Proposals to streamline appeals are among the elements in the SSA plan that were cited as positive steps by ABA President Dennis W. Archer of Detroit in a follow-up letter sent to Barnhart in December.

The initial claims decision and the first stage of appeals now occur at the state level. The SSA plan would replace reconsideration by a state agency of its initial decision with an independent assessment by a new federal reviewing of­ficial. If that official denies the claim, he or she would send a report to the claimant explaining why the claim should be denied or identifying evidence that would support it on further appeal. If the claimant appeals, a de novo hearing would be held before an administrative law judge, who also would receive the reviewing official’s report.

Quicker Rulings

The SSA plan would allow administrative law judges to issue rulings immediately after hearings and would eliminate the appeals council to which claimants may go for reconsideration of ALJ decisions rejecting claims. In­stead, some decisions would be reviewed by a quality con­trol staff. If this results in disagreement, the claim is submitted to an oversight panel for a final agency determination that could be appealed to federal district court.

The ABA has taken no position on eliminating the appeals council, Archer said, but favors limiting its reviews to clear errors of law or lack of substantive evidence for factual conclusions. Archer said the ABA is particularly pleased that the proposed plan retains the claimant’s right to a nonadversarial hearing before an administrative law judge empowered to issue rulings independently.

Barnhart described the SSA plan as the “first step of a collaborative process.” She has indicated that before regulations are drafted, she will confer with Bush administration officials, Congress, state disability determination services, and interested organizations and advocacy groups, including the ABA.

Rhonda McMillion is editor of Washington Letter, an ABA Governmental Affairs Office publication. This article discusses advocacy efforts by the ABA relating to issues being addressed by Congress and the executive branch of the federal government.

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