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Are Wisconsin's judges too free with Social Security disability?

As Congress struggles to come up with a viable federal budget, it seems as if much of America’s social safety net could be on the line. Throughout much of this year, numerous proposals have been made to reform or cut Social Security disability, including changing how SSDI and SSI benefits are calculated and even reducing those benefits.

In June, several members of the House Oversight and Government Reform Committee issued a statement challenging what one said was a "very, very high rate" of approval of previously-denied Social Security disability claims by the Social Security Administration’s administrative law judges, or ALJs.

Pointing out that the ALJs only hear SSDI and SSI claims that have already been denied by two Social Security Administration field examiners, the committee members contended that the judges should be turning down the majority of those claims. Instead, they assert, some 195 of the SSA’s 1,560 administrative law judges award benefits in 75 percent of the SSD appeals they hear.

Yet, according to current data from the SSA’s Office of Disability Adjudication and Review, nationwide only 46 percent of applicants for SSDI and SSI ever receive benefits. That’s up only 1 percent from an average of 45 percent, according to the SSA, between 2001 and 2010. Also, ALJs approved 50 percent of claims or more in only nine states and Puerto Rico (data from Wyoming was omitted). In Wisconsin, only 34 percent of SSDI and SSI claimants win their appeals before ALJs.

In any case, the committee members’ argument that administrative law judges should logically be turning down the majority of claims because they were previously denied stands reality on its head. In the Social Security disability system, the truth is that the local SSA examiners are inundated with applicants who, while possibly entirely deserving of benefits, are unable, on their first try, to wade through the byzantine SSD rules and provide the rigorous evidence required.

Generally, insufficient medical evidence results in the initial denial, although that doesn’t mean the applicant doesn’t qualify for SSDI or SSI. Their first appeal is a request for reconsideration by another local field examiner -- it’s basically a do-over with the missing evidence now included. Even then, however, applicants often fail to meet one or more of the many, convoluted bureaucratic requirements. The ALJ hearing is often the applicant’s first real chance to have the case fairly heard.

Sources: 

  • Chattanooga Times Free Press, "Inside the world of disability claims," Judy Walton, Sept. 16, 2013
  • Administrative law judge case statistics, all states, Office of Disability Adjudication and Review, DisabilityJudges.com

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