Social security was designed to function as a societal safety net, ensuring basic economic provisions for those in need. The benefits review process is thus the safety net’s safety net. The benefits review system is designed to ensure that the truly disabled are not denied the benefits to which they are entitled. However, this secondary safety net is presently torn. Litigation of social security disability benefits cases comprises a significant portion of the federal courts’ dockets. Changes in the policies of the Social Security Administration [hereinafter SSA], both substantive and procedural, have drawn the courts into the thicket of interpreting the law surrounding disability benefits, and ordering the SSA to follow these interpretations, only to see these orders flouted. Within the SSA itself, the complicated benefits review process is subject to political control and conflicting views of the law.
This Note was inspired by the author’s own experience representing a social security disability claimant. The claimant became disabled in 1976 and received disability benefits for seven years. In 1983, the claimant’s benefits were terminated, not because his condition improved, but because the system changed its policy. Since 1983, the claimant has repeatedly sought reinstatement of his benefits. During this time, the federal courts issued numerous decisions interpreting the governing legislation which were ignored by the SSA. Congress also acted to amend the Social Security Act so as to afford claimants a presumption of continuing disability. Yet this claimant neverbenefited from such a presumption.
The claimant was denied full reinstatement on three separate occasions after hearings before Social Security Administrative Law Judges [hereinafter ALJs]. In 1989, some benefits were restored, but, due to a mistake on the part of the AIJ, the claimant received neither back payment for benefits wrongly denied during the prior six year period, nor the full reinstatement of benefits to which he was entitled.
At the time of this author’s involvement in the case, the claimant faced a fourth adversarial hearing before an ALJ, on the issues of full reinstatement and back payment of benefits. By this time, the case had been heard by at least three different ALJs. The appellate body of the SSA had considered the case four times since the initial termination of benefits, and had again remanded it for reconsideration.
The case was remanded to the same ALJ who had wrongfully denied theclaimant full reinstatement of his benefits at a prior hearing. At this most recent hearing, the ALJ threatened to dismiss without cause and wait for an- other remand, a move designed to further punish the claimant. Though the claimant’s benefits were restored, back payment to the date of his wrongful termination was denied. His case continues.
A government founded on the rule of law should not allow a single citizen to suffer what this claimant suffered. Nor should a government deriving its sovereignty from its citizens use their tax money to pay for such flagrantly wasteful acts as the repeated, wrongful denials of benefits to deserving individuals. Such behavior is particularly egregious where both Congress and the federal courts have ordered change.
Yet, this claimant’s plight is by no means unique. According to the SSA’s own estimate, this claimant was one of more than 200,000 disabled people whose benefits were wrongfully terminated. Many claimants do not achieve an appropriate result until they reach the federal courts. Most claimants, however, never manage to reach the federal level, since only approximately seventeen percent of disability claimants have the ability to press their claims this far. The safety net’s safety net has clearly failed.
As the number of claimants increases with the rising age of the population, the importance of an adequate benefits administration system grows. Coincidentally, with the federal government facing unprecedented fiscal constraint, the expense of agency administration and article III judicial review has prompted proposals from the Federal Courts Study Committee to repair the secondary safety net. This Note considers these proposals.
In an initial effort to demonstrate the need for reform, the discussion begins with an overview of the function of social security and the tools for evaluating its efficacy. The determination of eligibility for social security disability benefits, a complicated process, is described in order to shed light on the task that must be performed by an adequate review system. Problems with the current system are highlighted, since they inform an evaluation of proposed solutions.
A discussion of the Federal Courts Study Committee and its recommendations follows. The proposals of both the Committee’s majority and dissent are described and analyzed in detail. This analysis involves consideration of proposed changes at two levels: first, change within the SSA and, second, change of the federal judicial review mechanisms which operate outside of the SSA.
Both the majority and the dissent of the Federal Courts Study Committee Report suggest change within the SSA. Evaluation at this first level requires consideration of the goals of an agency review system, and the probability of the success of each proposed system.
An evaluation at the second level involves examination of the proposalsto reform federal judicial review of Social Security claims. A determination as to which system provides a better institutional review mechanism outside of the SSA relies on the answers to several related questions. Under which article of the Constitution should the primary review body be located? Should this body be a specialized court or is a generalist perspective more valuable? When judicial review is sought, should it begin in the trial courts or should it go immediately to the appellate level? Is federal judicial review adequate if there is only one level of scrutiny, or must there be two?
Finally, conclusions are drawn. Since three systems of review are involved, the current system and the two systems proposed by the Federal Courts Study Committee, the conclusions are twofold. First, the majority’s proposed system envisions a weaker secondary safety net than the present system. The majority’s proposed system eliminates a layer of review, and substitutes a less independent tribunal for the district court. Were the majority proposal the only alternative, the current system would better remain unchanged. The dissent’s proposal describes a system superior to that now in place. Rather than eliminating the advantages of the current system, it builds on them, improving the review bodies and eliminating redundancy where possible. The dissent proposes a secondary safety net which better protects those falling into it.
Roxane Picard∞ This is the second in a series of interviews with legal practitioners who are pursuing social change through their work. This conversation is between Mika Aoyama, a Senior Paralegal Case Handler in the Disability Advocacy Project at the
One way to aid Social Security disability claimants is to enforce the recent articulation of the Treating Physician Rule as a Morgan evidentiary presumption.
The administrative hearing process is a fundamentally unfair system to low-income communities who receive public assistance benefits.
The earned income test for eligibility for social security leads to an inequitable and inefficient distribution of benefits.