The following case histories, all from St. Paul and Ramsey County, Minnesota, and only a few out of many, are of necessity capsulized, and being extremely condensed they do not, of course, reflect the tragic hardships and mental distress often caused by red-tape delays. The case of Mr. B.G. He applied for disability benefits March 1, 1974, and his claim was denied two months later. He applied for reconsideration and went through the required appeals process. Today the case is still pending before the Appeals Council in Washington. Waiting time and delay to date: 18 months. The case of Mr. S.J. He applied for disability benefits on January 17, 1973. Not until more than six months later was the application rejected. He went through the appeals process, but was finally turned down July 31, 1975. Waiting time and delay: 30 months. The case of Ms. C.M. She applied for disability benefits sometime prior to January 29, 1974, when her application was denied. Hearing held by a Hearing Examiner six months after application. Case reviewed by Appeals Council November 21, 1974, and rejected February 3, 1975. Waiting tilme and delay: 12 months. The case of Ms. B.L. She filed for disability benefits in August, 1973, and the application was rejected. She requested reconsideration, but not until January 10, 1975, was the reconsideration denied. Waiting time and delay: 15 months. The case of Mr. W.E. He submitted a Medicare claim for a doctor's bill in April, 1974. The claim was not denied until November, 1974. On January 8, 1975, he requested a hearing and was told at that time that the office had a 10-month backlog. A hearing was finally held August 8, 1975, but to date no decision has been reported. Waiting time and delay: 17 months and still pending. The case of Mr. M.F. He applied for disability benefits on January 3, 1974, and nearly three months later the application was denied. A hearing was held and a favorable decision was handed down March 17, 1975. Waiting time and delay: 14 months. The case of Mr. M.C. This case was already at the appeals level in August, 1974. Applicant was told that the Hearings Board was six to eight months behind, that there were not enough judges, etc. Case still pending. Waiting time and delay: 13 months. The case of Dr. A. The doctor submitted a $50 bill for treatment of a Medicare-covered patient in December, 1973. A check for less than half the amount was sent, lost and payment stopped. On August 7, 1975, she was advised by phone that there would be a continued delay in sending the check. Waiting time and delay: 21 months. The case of Mr. W.R. He originally filed for disability benefits in 1968, was denied and refiled in March, 1974. Case has been kicked around from St. Paul to Baltimore and back to St. Paul. Claim denied and hearing requested. Hearing request still pending today. Waiting time and delay: 17 months The case of Mr. T.D. Following his wife's death in December, 1974, Mr. T.D. applied for a lump sum death benefit. The benefit check was mailed June 14, 1975. Waiting time and delay: six months. The case of Mr. G.A. He filed a disability claim which was denied on December 6, 1974. He requested reconsideration, was again denied, and filed for a hearing. He was advised that there would be at least a six-months wait. Waiting time and delay: more than six months. The case of Ms. H.M. For five years she had been receiving Social Security payments under her deceased husband's account, and then suddenly three months ago the payments stopped. No one in Social Security could explain why. The case of Ms. M.M. She applied for widow's benefits in November, 1974, visited Social Security offices five times. First check was not sent until five months later. These are only a few of the hundreds of cases of red-tape delays, ranging up to an incredible two-and-one-half years, that have victimized my constituents in the last few years. How serious is the problem of delay in the processing of Social Security payments and benefits? Part of the answer is to be found in the current backlog statistics for Minnesota. At present there are 848 cases pending before the Bureau of Hearings and Appeals. That may not sound terribly serious until it is known that of those 848 cases 313 have been pending for six months or longer. And these six-monthold cases take on added significance when it is known that their number is constantly increasing, not decreasing. If the St. Paul experience is typical then the national picture is appalling to contemplate. If St. Paul's backlog is typical-and I have no reason to doubt that it is then there must be tens of thousands of claims and appeals piling up on desks and in filing cabinets waiting adjudication. And with the waiting periods growing longer instead of shorter. The nation's Social Security system is one of the most necessary and invaluable functions of our Federal government. Millions of people depend upon it to preserve them from poverty, hunger and homelessness. Millions depend upon Social Security for medical and hospital care they could not otherwise afford. And our economic system itself depends upon Social Security as one of the major bulwarks against a deepening recession, against social and economic collapse. For those and other reasons Congress must do everything it can possibly do to strengthen Social Security, make it more efficient, and more readily accessible to the American people. We can take a very large step in that direction by eliminating the delays which are responsible for so much heartbreaking hardship, suffering and distress. Mr. BURKE. The committee is adjourned. [Whereupon, at 12:11 p.m., the committee adjourned.] DELAYS IN SOCIAL SECURITY APPEALS FRIDAY, SEPTEMBER 26, 1975 U.S. HOUSE OF REPRESENTATIVES, The subcommittee met at 10 a.m., pursuant to notice, in room 2128, Rayburn House Office Building, Hon. James A. Burke (chairman of the subcommittee) presiding. Mr. BURKE. Today we have a very distinguished panel to discuss some of the complex problems involved in the hearings crisis. We have private practitioners in administrative law, former Government administrators, public interest attorneys, and law school professors who specialize in this difficult area. Each of the panelists will have up to 10 minutes to summarize his statement. I would like to introduce our panel in alphabetical order. Ralph Abascal, Deputy Director, California Rural Legal Assistance, Sacramento, Calif., who has worked closely with State and Federal legislators in addition to his poverty law activities. He is an expert on appeals under the SSI program and is writing a manual on the subject. Robert M. Ball, who is a senior scholar with the Institute of Medicine, is the proverbial "he needs no introduction." During his 30 years with the Social Security Administration-10 as Commissioner—the Ways and Means Committee was his second home. Robert G. Dixon, professor of law, Washington University, has a broad career in teaching and government. He conducted a study of the social security disability and appeals procedure for the Administrative Conference, which he enlarged into a book. Following this, he served as Assistant Attorney General, Office of Legal Counsel, and was the author of the Justice Department opinion of the coverage of SSI under the APA. Richard Keatinge is a private attorney who is a member of the Executive Council of the Administrative Law Section of the American Bar Association, which over the years has taken great interest in the issues now under discussion. However, he is testifying as an individual and not for the ABA. Victor Rosenblum, professor of law at Northwestern University, is also a member of the ABA Administrative Law Section. He has just completed a major study for the Administrative Conference on the ALJ's, with special emphasis on the dispute over the SSI hearing examiners. Wilson M. Matthews was Director of the Office of the Administrative Law Judges, Civil Service Commission, for many years prior to his retirement in 1971. Mr. Charles Dullea followed him in this position. Mr. Matthews, as a consultant to HEW, participated in drafting the regulations on the qualifications and organizational status of the SSI hearing examiners. Edwin Yourman, former Assistant General Counsel of HEW for the social security program, has just finished a major study, under contract to the Social Security Administration, on beneficiary hearings, appeals, and judicial review. A PANEL CONSISTING OF RALPH ABASCAL, DEPUTY DIRECTOR, CALIFORNIA RURAL LEGAL ASSISTANCE, SACRAMENTO, CALIF.; ROBERT M. BALL, NATIONAL ACADEMY OF SCIENCES, INSTITUTE OF MEDICINE, WASHINGTON, D.C.; ROBERT G. DIXON, JR., PROFESSOR OF LAW, WASHINGTON UNIVERSITY, ST. LOUIS, MO.; RICHARD KEATINGE, ATTORNEY, LOS ANGELES, CALIF.; VICTOR G. ROSENBLUM, PROFESSOR OF LAW, NORTHWESTERN UNIVERSITY, EVANSTON, ILL.; EDWIN YOURMAN, ATTORNEY, WASHINGTON, D.C.; AND WILSON M. MATTHEWS, ATTORNEY, ALEXANDRIA, VA. Mr. BURKE. Gentlemen, we welcome you. I believe we will start off with Mr. Ralph Abascal. STATEMENT OF RALPH ABASCAL Mr. ABASCAL. Mr. Chairman and members, I want to thank you for convening this series of hearings today so that we may address ourselves to the problem of very substantial importance to 35 million people, over one-sixth of this Nation's population. The problem, I believe, goes far deeper in the Social Security Administration than just the hearings backlog. This backlog is a symptom of a much deeper problem. My testimony will focus upon urging you to propose specific time limits in the application appeals process because such standards will force, I think like a catalyst, the adoption of more efficient procedures at deeper levels as well as causing expansion of personnel to meet such time limits. I have a few brief comments on a few of the procedural reforms that have been proposed by others. Preliminarily, I will offer a brief comment on the issue of the applicability of the Administrative Procedure Act to the SSI program. I think it is, indeed, unfortunate, that this issue of applicability to the APA has consumed so much energy and so much time of HEW, the Civil Service Commission, the Attorney General, the staff of this committee, its chairman, its members, and the witnesses in these hearings. It is unfortunate because it consumed so much energy and thought that should have been directed to the principal problem; that is, the backlog and delays in hearings and the consequences of that. The issue has been decided incorrectly, I would suggest. I would agree with an analysis just recently published in an article in the Northwestern University Law Review, entitled "Social Security Hearings for the Disabled: Who Decides, Trial Examiners or Ad ministrative Law Judges." I believe that an analysis of the statute and a review of its legislative history, as well as sound policy considerations, all point to the conclusion of applicability. I think the only argument in opposition appears to be the egocentric concerns of the existing corps of non-HEW administrative law judges to assure that the prestige of their titles will not be tarnished by an expansion of their ranks. The issue has been decided, and all Congress can do now is reaffirm its original intention, as is done in H.R. 8911, the bill recently reported to the full committee by the Public Assistance Subcommittee. This will not forestall the very real possibility that the decisions of SSI hearing examiners rendered prior to enactment of H.R. 8911 will be held invalid by the courts. However, prompt enactment of the measure would diminish the impact of such a ruling. There is one aspect of H.R. 8911 that I believe is quite ill advised. The measure provides authority to the Secretary to appoint temporary hearing examiners until 1978. It appears from the bill such individuals would not be under the control of the Civil Service Commission. Thus, the degree of independence that they will have is much less than administrative law judges. I think, in order to assure the reality and appearance of justice, that incorporation of 5 U.S.C. 5362 and 7521 into the provision in H.R. 8911 would achieve such independence, but I would defer to somebody more familiar with Civil Service Commission law. I think the important thing is to insure the greatest degree of independence. The real problem right now, as well as for the past 15 years, that the administrative process from initial application to final adjudication consumes an inordinate and unconscionable amount of time. While the delay has been bad enough in the past, the data developed by the committee's staff reveals that it is now worse than it has ever been and if nothing is done now, it will get even worse. I do not mean to be facetious or unduly macabre, but delay all too frequently means the "exhaustion of administrative remedies" and results in the attrition of the claimant. I think we should never lose sight of the fact that delayed payment of benefits for eligible claimants will very often cause considerable psychological anguish that contributes to the obvious and disastrous consequences to the claimants' abilty to survive. If the individual is forced to work to survive, the disabling condition is often made worse, perhaps precluding the possibility of subsequent restoration of earning capacity. If the condition precludes work, and he or she has little or no income, as is always the case in SSI, the claimant is forced to live with whatever general assistance which may be available. That is the only alternative, an alternative that is often not too generous. In my State, California, the amount of general assistance paid in several counties is a maximum of $2 per month. In San Francisco, a city where the cost of living is amongst the highest in the Nation, it is a generous $78.50 per month. I think that emphasizes the necessity of prompt action on appeals, particularly given the percentage of reversals that exist throughout the entire appeals process. Professor Dixon, Mr. Yourman, and others have made several proposals to reduce the delay. Regardless of the details and relative |