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Customer service had been a significant issue at Social Security even before the COVID-19 pandemic forced the agency to close its doors to the public in March of 2020. Now that Social Security has opened offices back up the customer service issue is still a problem with many Social Security offices seeing long lines for service and extremely long wait times for service by phone. Disability advocates are asking Congress to act to improve customer service at Social Security. In testimony from Bethany Lilly, who testified before a House Committee on behalf of the Consortium for Constituents with Disabilities (CCD) Social Security Task Force, Lilly identified three customer service-related issues at Social Security that need to be addressed. Lilly testified how important satisfactory customer service is for people who suffer from disabilities. Many disabled individuals suffer from mental health and intellectual impairments, which can make the disability process even more overwhelming without proper customer service assistance. Lilly also identified the agency’s phone and online services as something that needs to be addressed as online and phone service during, and even before the pandemic, were not acceptable. Other issues Lilly addressed in her testimony include the agency’s need to ensure that Social Security gets back to providing acceptable walk-in service at an Social Security offices around the country without an appointment and urged Congress to address the backlog of cases the agency is dealing with. These are extremely important topics that need to be addressed, but Lilly understood the challenges of improving customer service at Social Security without increased funding. “Since 2010, SSA’s operating budget has fallen 14 percent, with an associated drop in staffing of 13 percent. During the same time period, the number of Social Security beneficiaries has grown by 21 percent,” Lilly testified. The lack of funding and staffing shortages have made the customer service problem even more visible. The fact remains that Social Security benefits are crucial to the survival of millions of people across the country. Lilly testified that the 2021 Annual Statistical Supplement reported that just under 65 million people receive Social Security benefits of some kind, including close to 10 million who receive disability benefits. The benefits that these millions of Americans receive are extremely modest. The average monthly disability payment in 2021 was $1,143 per month. Although benefits are modest, they are also desperately needed by millions of Americans to survive and stay above the poverty level.

Some people may think of Social Security Disability as a permanent disability program, but that is not the case. People, who the agency has found disabled, are not entitled to benefits permanently and those who do receive benefits should be aware that down the road Social Security is likely to issue a redetermination of a case. Social Security does this by looking at updated medical information, which is called a Continuing Disability Review (CDR), but when it comes to the technical aspects of Social Security benefits the agency performs redeterminations to make sure a beneficiary’s living situation, income and resources have not changed significantly, which could create eligibility issues for the beneficiary. This may seem like another way Social Security can take away benefits, and it is, but the agency also has to follow the rules set forth by law and a redetermination can be helpful to a claimant so they don’t face massive overpayment penalties due to income and resources. Below is some valuable information from Social Security about redeterminations. HOW DO WE DO A REDETERMINATION? There are three ways that we do a redetermination: • by telephone • in person; or • by mail. For telephone and in-person interviews, we send a letter telling you that we will call you on a certain date and time, or ask you to come into the local Social Security office for a redetermination. Our staff will fill out the forms during the interview based on information you give them. If you have a representative payee, we will send the appointment letter to your representative payee. If you are unable to keep the scheduled appointment, call us. We will make a new appointment that is more convenient for you. If we do your redetermination by mail, we will send you a redetermination form for you to complete, sign and return. If you have a representative payee, he or she must complete and sign the redetermination form for you. If you need help completing a redetermination form you receive in the mail, call us or visit your local Social Security office. Our staff will help you fill it out. RESPONDING TO THE APPOINTMENT LETTER OR THE REQUEST TO COMPLETE FORMS You have 30 days to: • respond to the appointment letter; • complete and return the form; or • tell us that you cannot keep the appointment or are having trouble filling out the form. WHAT HAPPENS IF YOU DO NOT RESPOND TO THE APPOINTMENT LETTER OR COMPLETE AND RETURN THE FORM? If you do not respond, you may: • have your payments stopped; • be overpaid; or • be underpaid. If you lose SSI eligibility, you may lose Medicaid eligibility based on getting SSI benefits. DOCUMENTS YOU MAY NEED FOR REDETERMINATION • savings account, checking account, or other bank statements; • pay stubs or income tax returns; • proof of other income you receive (pensions, annuities, unemployment compensation, worker’s compensation, etc.); • life insurance policies; • burial contracts; and • household receipts and bills to show your monthly expenses (lease, utilities, etc.).

Navigating a Social Security disability claim can be a learning experience. There are all sorts of rules Social Security has in place that have to be adhered to and that means it is better to know some basics about the process before applying. Two issues that we will deal with today are temporary disability and the definition of disability according to Social Security. First off, Social Security does not offer any temporary benefits based on a partial or temporary disability. Below is information from Social Security regarding the idea about temporary disability. • This is a strict definition of disability. Social Security pays only for total disability. No benefits are payable for partial disability or for any disability lasting less than twelve months (unless it results in death). • Social Security program rules assume that working families have access to other resources to provide support during periods of short-term disabilities, including workers’ compensation, insurance, savings and investments.Secondly it is wise to learn about Social Security’s definition of being disabled. Below is information from Social Security that explains the agency’s definition of disability. Prior to reading that though, understand that Social Security has rules related to length of disability and specific medical requirements before the agency is willing to identify a person who is disabled and entitled to benefits. Below are the specifics from Social Security regarding the requirements set forth by the agency. • Disability under Social Security is based on the inability to work. • SSA considers an individual disabled if, due to an established medical condition, he or she: – meets or equals one of our medical Listings (criteria that are presumed to preclude work for most people); – can not perform any of his/her work that was done before; or – cannot make an adjustment to other work

A recent analysis was released from the Center for Retirement Research at Boston College that shows Social Security benefits help reduce the gap in retirement benefits between mothers and women who have no children. It is understandable that a mother who works is more than likely going to earn less income than a woman who has no children because a woman’s career may be put on hold when she has children, so it is not surprising to learn that, according to the Center for Retirement Research at Boston College, a mother earns just 37 percent of what childless women earn. Fortunately this income gap is reduced when you look at Social Security benefits as mothers earn about 60 percent of what childless women earn in retirement income. Below is the conclusion of the report issued. Even as women have ramped up their involvement in the labor force, the earnings penalty for mothers remains substantial. Social Security is able to offset a significant amount of the penalty by the time mothers reach retirement through two separate channels: the progressive design of worker benefits and the availability of spousal benefits. While Social Security will continue to play a role in reducing disparities between childless women and mothers in retirement, a motherhood penalty will remain. And factors such as different levels of 401(k) saving are likely to aggravate the disparities. In recent years, though, policymakers seem to be more attuned to the motherhood penalty. In part to address mothers’ short-term loss of earnings, the American Rescue Plan Act temporarily expanded the child tax credit. To address mothers’ retirement income gap, legislators have also proposed the Social Security Caregiver Credit Act, which would give caregivers credit for lost earnings when calculating retirement benefits; this proposal was also part of the Social Security reform plan outlined during President Biden’s campaign.

The Social Security disability process can be confusing for people who have never attempted to apply for benefits. One issue many people are confused about is the types of disability programs that pay people benefits who the agency has determined to be unable to maintain fulltime employment. Social Security disability is not a one-sized program that fits all. Generally there are two different Social Security disability programs, Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). These two programs basically have the same medical rules that a claimant must qualify for before any benefits are due, but both programs have very different technical rules in order to qualify for benefits. There is potential to qualify for both programs, depending on work history and household income, if someone is found disabled, but that will be determined by the Social Security Administration. Below is a description of both programs below and an explanation of how the two programs differ to give an idea of who might be eligible. SSI SSI provides minimum basic financial assistance to older adults and persons with disabilities (regardless of age) with very limited income and resources. Federal SSI benefits from the Social Security Administration are often supplemented by state programs. SSDI SSDI supports individuals who are disabled and have a qualifying work history, either through their own employment or a family member (spouse/parent). The Difference The major difference is that SSI determination is based on age/disability and limited income and resources, whereas SSDI determination is based on disability and work credits. In addition, in most states, an SSI recipient will automatically qualify for health care coverage through Medicaid. A person with SSDI will automatically qualify for Medicare after 24 months of receiving disability payments (individuals with amyotrophic lateral sclerosis [ALS] are eligible for Medicare immediately).

There are some people who decide to file for Social Security disability benefits without knowing what they might be eligible for if they are found disabled by the Social Security Administration. This is fine to do, but to better understand how and why a person is eligible for a certain amount, or not eligible at all for a type of program, it is going to be helpful prior to filing for benefits to understand some basic things. Below are some of the things claimants may like to know before they decide to apply for disability benefits. PIA The acronym PIA stands for Primary Insurance Amount. This is the monthly amount of benefit a disability claimant is eligible for if they are found disabled by Social Security. The PIA is based on years worth of earnings of the claimant and if found disabled they would be eligible for the PIA amount on a monthly basis. The claimant may also be eligible for backpay, depending on when they are found disabled, and the backpay is calculated at the same monthly amount. DLI A claimant’s Date Last Insured (DLI) is a key date in the disability process to be eligible for Social Security Disability Insurance (SSDI) Benefits. When a worker is paying into Social Security a consistent work history is typically needed to be eligible for SSDI benefits. A worker earns credits to be eligible for SSDI should they become unable to work due to illness or injury and the general rule is that a worker has to have worked at least five out of the last 10 years to have enough work credits to be eligible for SSDI benefits. There are just some simple guidelines to be aware of before applying for Social Security disability benefits. For more understanding of these rules visit the Social Security website at sss.gov.

A year ago, the trustees report on Social Security projected the year, 2034, in which the agency would face insolvency if Congress does not act to shore up the retirement and disability trust funds, but in the trustees most recent financial report released in June 2022 indicates another year of solvency for the combined trust funds that will remain solvent until 2035. This may not seem like earth-shattering news, but any movement to extend the solvency of Social Security’s programs is good news. Additionally, the report indicated that Social Security’s Disability Insurance program is now solvent for the next 75 years on its own when last year’s projections predicted insolvency by 2057. It is important to understand that insolvency in the trust funds does not indicate that Social Security will be totally broke and unable to pay any benefits. The projections, if Congress does not act to change the current situation, indicate that by 2035 the agency will only be able to pay about 80 percent of benefits that are owed. Below is the conclusion of the trustees’ report that explains the health of the trust funds moving forward.  Under the intermediate assumptions, the projected hypothetical combined OASI and DI Trust Fund asset reserves become depleted and unable to pay scheduled benefits in full on a timely basis in 2035. At the time of depletion of these combined reserves, continuing income to the combined trust funds would be sufficient to pay 80 percent of scheduled benefits. The OASI Trust Fund reserves are projected to become depleted in 2034, at which time OASI income would be sufficient to pay 77 percent of OASI scheduled benefits. DI Trust Fund asset reserves are not projected to become depleted during the 75-year period ending in 2096. Lawmakers have a broad continuum of policy options that would close or reduce Social Security’s long-term financing shortfall. Cost estimates for many such policy options are available at www.ssa.gov/OACT/solvency/provisions/. The Trustees recommend that lawmakers address the projected trust fund shortfalls in a timely way in order to phase in necessary changes gradually and give workers and beneficiaries time to adjust to them. Implementing changes sooner rather than later would allow more generations to share in the needed revenue increases or reductions in scheduled benefits. Social Security will play a critical role in the lives of 66 million beneficiaries and 182 million covered workers and their families during 2022. With informed discussion, creative thinking, and timely legislative action, Social Security can continue to protect future generations.

The Washington Post has issued multiple stories regarding Social Security’s Office of Inspector General and that office’s enforcement of fines and penalties levied against beneficiaries as part of the OIG’s anti-fraud program. Now an investigation has been ordered to look into the matter at the OIG. Below is a portion of the Washington Post article that addresses the actions of the OIG’s office where some beneficiaries were ordered to pay back money they were not entitled to or even ordered to pay back more than they received in benefits.  The inflated fees were set in motion during the Trump administration, when attorneys in charge of a little-known anti-fraud program run by the inspector general’s office levied unprecedented fines against Deckman and more than 100 other beneficiaries without due process, according to interviews, documents and sworn testimony before an administrative law judge. In doing so, they disregarded regulations and deviated from how the program had recovered money since its inception in 1995, failing to take into account someone’s financial state, their age, their intentions and level of remorse, among other factors.  The sums demanded by the government stunned those accused of fraud. The unusual penalties were not the only break with how the Civil Monetary Penalty program had previously been conducted: Unlike in the past, the chief counsel also directed staff attorneys to charge those affected as much as twice the money they had received in error, on top of the fines, interviews and court testimony show.  It was reported that an independent watchdog group, the Council of the Inspectors General on Integrity and Efficiency (CIGIE), is currently leading the investigation. The CIGIE is a group that investigates misconduct allegations against inspectors general. Additionally, Acting Social Security Commissioner Kilolo Kijakazi has ordered Social Security’s Inspector General, Gail Ennis, to suspend the anti-fraud program. Details  Details of how devastating the actions of the OIG’s practices were during this increased anti-fraud effort by the OIG can be difficult to gage, but the Washington Post provided some details of how beneficiaries were negatively impacted. Below is one incident the paper identified that raises some serious questions regarding the OIG’s actions during this anti-fraud effort. Four years after her longtime partner died of kidney cancer, federal agents knocked on Gail Deckman’s door outside Chicago and told her she was in trouble: She had kept thousands of dollars in Social Security disability benefits that should have stopped when he died. Deckman told the agents she thought the $1,400 check deposited each month into an account to which she had access was a payment for land her partner had sold in Michigan. She spent the money on rent and clothes and gifts for her grandchildren, she said. The inspector general’s office, which investigates disability fraud and tries to recoup money for the government, ultimately charged her $119,392 — nearly three times what she received in error.

The date in which Social Security considers a Social Security disability claimant disabled and entitled to benefits will determine whether a fully favorable decision is issued or a partially favorable decision. On the initial disability application a claimant will be asked when the claimant became unable to maintain full-time work and typically this will be the alleged onset date for a disability claim. After looking at all available evidence Social Security will either agree with the claimant and issue a fully favorable decision, deny the claimant is disabled or disagree when the claimant become disabled and this is where a partially favorable decision is issued. Once a partially favorable decision is issued the claimant can either accept Social Security’s decision or the claimant can appeal the decision and ask Social Security to re-consider if the claimant became disabled prior to the date Social Security determined. It is extremely important for a claimant to consider their options when determining whether or not to appeal a partially favorable decision because there are risks to appealing such a decision. When an appeal is filed Social Security will reexamine the claim, but also has the ability to change the determination from partially favorable to denied. Remembering that under its own rules, Social Security is only able to pay benefits going back one year prior to the filing of the application, no matter the determined disability date, careful consideration is needed when deciding whether to appeal a partially favorable decision. If a claimant has a representative assisting with a claim it should be the responsibility of the representative to advise the claimant of the appeal options and the risks associated with appealing. If a claimant does not have a representative it would be beneficial for the claimant to research their options related to a partially favorable decision.

The Social Security Disability program is a crucial asset that provides income to disabled workers who are unable to maintain full-time employment due to impairments, but because the process to obtain benefits can be long and drawn out there are many pitfalls that claimants can’t avoid before benefits are approved. The first problem is that many people who apply for Social Security disability have little to no income to survive on because they can’t work. Asking these people to survive for a year or longer, which is how long it can take to obtain benefits, is asking too much. Because many of these people have limited resources many go bankrupt. The Government Accountability Office (GAO) found that 48,000 individuals had to file for bankruptcy while waiting for a final decision on their disability claim between fiscal year 2014 and fiscal year 2015. Even worse than having to file for bankruptcy is that a portion of claimants actually pass away before a final determination is made and they are awarded benefits. The GAO reported that nearly 110,000 claimants died prior to receiving a final decision on their disability claim between fiscal year 2008 and fiscal year 2019. Below is a portion of the GAO report that shows wait times on disability claims remain a problem. As the report indicates, too many claimants have to file for bankruptcy during this process or don’t even survive the outcome to where they would receive benefits. GAO found that most applicants for disability benefits who appealed the Social Security Administration’s (SSA) initial disability determination from fiscal years 2008 through 2019 waited more than 1 year for a final decision on their claim. Median wait times reached 839 days for claims filed in fiscal year 2015, following an increase of applications during the Great Recession.