Pandemic-related operational challenges will continue to plague the Social Security Administration, decreasing the predictability and stability of decisions.
Written by Megan Reid, Vice President, Account Management Operations
“What will happen with the Social Security Administration in 2022?”
As we near the close of Q1 2022, we continue to reflect and refresh our thinking pursuant to emerging trends. As a business, we place significant focus on analytics and forecasting as we work to identify trends and anticipate ways to drive favorable claim outcomes. While it is true that nobody has a crystal ball, over the years, the Social Security Administration (SSA)’s historical decision patterns have yielded highly predictable results relative to expected outputs, timing, and the effects of seasonality. Since the onset of the COVID-19 pandemic, however, trends have become less predictable in light of pandemic-related operational challenges.
Initial and Reconsideration claim backlogs will continue to be a pain point
SSA-published data is helpful in painting the picture of what is happening at a macro level. By the end of FY2021, claim backlogs at the State Department of Disability Determination Services (DDS) for Title II Social Security Disability Insurance (SSDI) claims at the Initial and Reconsideration levels were at all-time highs since the onset of the pandemic – nearly 400,000 SSDI applications were awaiting decisions. At that time, Initial Claim decision backlogs were up 16% as compared to one year prior and up 21% at the Reconsideration level. While SSA saw a 5% increase in new SSDI applications in 2021 versus 2020, the total decisions issued only increased by 1% which compounded the growing backlog. Unfortunately, these lower-level claim backlogs have continued to increase in 2022 – up by an additional 3% at the Initial Claim level and 9% at the Reconsideration level through February. The Biden administration is predicting that there could be more than 1 million claims pending at the Initial and Reconsideration levels by the end of the 2023 Fiscal Year.
As we planned for 2022, we knew it would take some time for DDS logjams to begin to clear, so we expected to see similar trending to 2021 in the early part of the year with moderate overall improvement as the year advanced. While we knew that SSA offices were likely to re-open in the coming months, and we had already seen Consultative Examinations increase by mid-year 2021 – both positive signs – the mounting national backlogs continued to be a major consideration in our forecasts. SSA’s own projections were also a key factor. As SSA planned for their upcoming fiscal year they expected a 25% year-over-year increase in new applications and only an 18% increase in the expected decisions issued – both early indicators that national backlogs were likely to grow.
While Initial Claim level decision volumes are close to our 2022 expectations, the same is not true relative to Reconsideration level determinations. With claim backlogs growing at the Reconsideration level, and DDS placing greater emphasis on Initial Claim adjudication, Reconsideration decisions are significantly lagging. Although SSA offices reopening is a strong signal of a return to normalcy, and no doubt SSA will benefit from a broader employee base supporting in office functions, there will also be challenges ahead. SSA is looking to ramp up in-person support by hiring retirees to support an expected influx of work in 400 field offices nationwide. SSA is likely to face a new set of operational challenges as they navigate in-office appointments with COVID restrictions and new hybrid schedules for many of their employees.
National hearing inventory shortfalls will lead to decreased decision volume
In 2021, new hearing receipts were impacted by the slowdown in Reconsideration level activity. Total new hearing filings, for both Supplemental Security Income (SSI) and SSDI claims, were down 7% year-over-year and total overall determinations and awards were down by 20% year-over-year. If we compare FY2021 activity to FY2019, the impact is even more pronounced, with overall determinations down by 45% as compared to 2019. While the decrease in decisions in 2021 suggests that things may be slowing down at the Hearing level, even with decreased incoming volume, it is important to remember the Hearing level is the third step of the adjudicative process. SSA cannot issue decisions at the Hearing level if the claim has yet to be decided at the Reconsideration level. These outputs are a direct result of both decreased new hearing filings and lower starting inventory at a national level. Currently, there are just over 350,000 claimants awaiting hearing decisions. At the end of FY2019 that number was just over 575,000 and back in FY2018 this was over 858,000. A year-over-year comparison of decision output is not meaningful without the context of the existing inventory volume – it drives the result and feeds the decision pipeline.
In November 2021, SSA announced a plan to begin a phased approach to offering in-person hearings for critical cases. This included aged cases, claimants with limited English proficiency, children’s SSI claims, homeless claimants, some veterans, non-disability cases, older claimants, and others facing barriers. In January 2022, SSA officially announced plans to resume in-person hearings more broadly as of June 3rd, and Administrative Law Judges (ALJs) were told they could volunteer to hold in-person hearings beginning on May 4th. At times when they are not scheduled for in-person hearings, ALJs will be able to choose whether they work in their offices or remotely. While we have seen a limited number of our Brown & Brown claimants scheduled for in-person hearings, mostly for claimants who previously opted for an in-person appearance or declined a virtual hearing due to personal preference or specific reasons such as deafness or translation needs, we did not see any significant volume of in-person scheduling requests for ALJs volunteering to hold hearings in May.
As SSA will begin to ramp up scheduling for June and beyond in the coming weeks, we anticipate that the hearings scheduled for future months will likely be a hybrid mix of both in-person and virtual hearings. SSA has continued to mail forms to allow claimants to agree to a virtual hearing, so we take that as a strong sign that telephonic and video hearings will likely be an option for the foreseeable future. SSA faced various challenges in the transition to remote hearings, and there continues to be ongoing, sporadic technical challenges with SSA phone lines or the occasional Microsoft Teams link that results in a postponement. We anticipate that the resumption of in-person hearings will bring with it a new set of challenges for SSA to navigate. SSA offices have stringent restrictions in place, including limiting the time an individual can enter the Hearing Office in advance of their scheduled hearing time. While it is not entirely uncommon for hearings to start late due to a hearing running over time or technical delays – which can occur both virtually and in-person – layering in the complexities of COVID precautions with a tightly controlled entry time may have unintended consequences with miscommunication, confusion, or postponed hearings.
Reflecting and looking ahead
While the last two years have been fraught with various challenges for public and private sector businesses alike, the pandemic has also encouraged a new way of working and collaborating. After many years of resistance to accepting e-signature claimant executed documents, in 2020 SSA began allowing e-signature, enhancing the onboarding experience for our claimants and negating the need to rely heavily upon USPS with its frequent delays. It also streamlines the experience at the Hearing level when the claimant needs to execute updated representation documents.
SSA’s investment in Microsoft Teams has also been a meaningful and positive enhancement. While telephonic hearings were always a tool that SSA had in their toolkit, they were not widely used. The implementation of Microsoft Teams hearings with video connectivity provides a more personal experience and more closely resembles the in-person experience for all parties involved.
We are fully supportive of claimants having more options and a deeper sense of personal control in their SSDI journey. Through challenge and adversity comes opportunity for change and growth – true for individuals and SSA alike.
