Please ensure Javascript is enabled for purposes of website accessibility Increasing wait times and overpayments: Social Security struggles to keep up with workflow - Brown & Brown Absence Services Group

Consistent with results over the past few years, the Social Security Administration (SSA) struggles to keep up with the ever-increasing workflow, particularly regarding disability applications. Earlier this year, we discussed some of the challenges facing the SSA as it operates on a continuing resolution budget. Initial disability claim processing time has increased, average wait times for calls on the national 1-800 number are creeping toward one hour, and more than one million claims are pending at the state-run Disability Determination Services (DDS). As of today, the United States government continues to operate on continuing resolutions. Without a final comprehensive budget, Social Security leaders must contend with hiring and overtime freezes, rendering them unable to make headway in advancing hiring initiatives to tackle the backlog.

By the end of 2023, applicants filing a new disability application waited an average of 220 days (about seven months) for a decision, while those requesting a reconsideration appeal had an even longer average wait of 225 days (about seven and a half months). That means these applicants are waiting more than fifteen months before they even have a chance to request a hearing in front of an Administrative Law Judge, which tends to produce the most favorable outcomes. These long wait times have serious implications for applicants.

The unintended impact of Social Security struggles on SSDI applicants
Social Security Disability benefits provide a source of income and financial stability to some of the most in-need Americans – those whose injury or illness prevents them from working. Increasing wait times and staff being unable to review claims promptly cause delays in receiving a decision and affect applicants in other ways.

An unexpected rise in workforce reentry
With Social Security’s inability to achieve application decision rates consistent with pre-pandemic levels, there has been an increase in applicants returning to work while awaiting a decision. Although many applicants can return to work due to a marked improvement in their health, some feel compelled to do so to cover their essential living expenses, including housing, food and medical care – even without medical clearance. The increase in remote work opportunities, brought on because of the pandemic, has made it easier for some individuals with disabilities to re-enter the workforce in ways they were unable to do before. As wait times remain high, we anticipate seeing more applicants opting to return to work while applying for SSDI.

Overpayments continue to pose problems for beneficiaries
In fiscal year 2022, Social Security made improper payments worth more than $13.6 billion, including $11.1 billion in overpayments to beneficiaries and $2.5 billion in underpayments. This problem has a massive ripple effect on those impacted. The law requires Social Security to recover overpayments from beneficiaries, regardless of the amount. For individuals burdened by rising inflation, receiving an overpayment notice only increases frustration. A symptom of an overworked system, between fiscal year 2022 and 2023, Social Security issued over two million overpayment notices.

Beneficiaries may owe any amount from a few hundred dollars to tens of thousands of dollars and have 30 days to repay it – no matter how big or small. Millions of Americans are struggling with overpayments they cannot repay, many of which may have been avoided had proper staffing and technology been available to support the claim adjudication process.

Social Security employs alternative methods to mitigate challenges
With hiring and overtime freezes in place due to budgetary restrictions, Social Security is unable to use concentrated hiring efforts to reduce backlogs. Under the leadership of Commissioner Martin O’Malley, Social Security has instead employed alternative techniques to help reduce backlogs and mitigate challenges.

Technology
Social Security recently released a system update providing attorney and non-attorney representatives access to their clients’ electronic files to check current claim status and ensure all application requirements are submitted. This is expected to decrease the number of phone calls at both Social Security and the state-level Disability DDS offices, allowing staff members to focus on adjudicating cases instead of answering phones.

Social Security has continued its outreach to engage healthcare providers and encourage their partnership with Health Information Technology (Health IT). Social Security estimates that more than 15 million medical records are requested annually as part of the disability determination process. The hope is that integrating the Health IT program will increase accessibility, efficiency, and decision-making in disability determinations. Health IT would provide Social Security access to electronic requests and receive medical records within minutes or hours instead of the typical weeks or months they must contend with today, reducing the number of claims pending in the backlog. Currently, 246 organizations partner with Health IT and 40,651 participating providers.

Policy
In late 2023, Social Security proposed a rule that would change Past Relevant Work requirements. In the rule, Intermediate Improvement to the Disability Adjudication Process: Including How We Consider Past Work, Social Security proposes reducing the time period to consider when determining whether an applicant’s past work is relevant to the disability determination process. Currently, Social Security must consider fifteen years prior to the date of disability onset but is proposing to reduce the time to five years. This would allow applicants to focus on more recent work responsibilities, provide more accurate and detailed information and reduce the burden of providing past work information that is not readily available.

For the first time under Commissioner Martin O’Malley, Social Security has published a proposed rule to help reduce improper payments to Social Security and Supplemental Security Income (SSI) benefit recipients. The Use of Electronic Payroll Data to Improve Program Administration rule seeks to implement an electronic wage reporting exchange to expedite the wage and employment reporting process.⁠ Through implementing a Payroll Information Exchange, the Social Security Administration aims to streamline wage reporting by obtaining wage and employment information electronically directly from providers to help identify gaps in unreported wages. This would reduce the burden on both employees and beneficiaries to obtain and provide wage information and reduce the number of improper payments issued by the Administration.

What does this mean for applicants?
While Social Security waits for a finalized budget to end hiring and overtime freezes, they must continue employing alternative methods to prevent backlogs and caseloads from worsening. Commissioner O’Malley, who has a track record for using data and analytics to help the government address inefficiencies, previously expressed interest in modernizing how the government works; these tactics are just the first of what will hopefully be many innovative changes. Until budgetary restraints are loosened, significant changes in wait times and caseloads are unlikely. Even so, hope remains for wait time reduction on the heels of continued efforts and the force to drive change.

In the meantime, there are several things those applying for benefits can consider to help themselves navigate this uncertain time at Social Security:

    • Adhere to deadlines. Social Security has specific deadlines for a reason and missing them may be detrimental to your claim. This includes requests to complete supplemental questionnaires, attend a Consultative Examination or appeal a denial. Sticking to these deadlines could mean the difference between an approval or denial.
    • Keep your information current. One key component to being approved for SSDI benefits is that your condition(s) will keep you out of work for at least one year. Proving the duration of your impairment is key, so keep track of any new diagnoses, treating providers or medical examinations. Social Security must be kept informed, so developing a plan to update your claim examiner or representative may be beneficial.
    • Work with an experienced representative. Filing an SSDI claim can be challenging, with many deadlines and milestones to track. Working with an experienced representative like Brown & Brown Absence Services Group can help alleviate some of the stress of applying for benefits and enable you to focus on what matters most — your health and family.

As always, Brown & Brown Absence Services Group will continue monitoring the status of government funding and any impact this may have on Social Security applications; we will report on any significant findings. If you have any questions about the disability process or how these slowdowns may impact your claim, please contact your local Social Security office or reach out to Brown & Brown directly.