I am currently working on a federal court case in which my client completed 8th grade but believes that she really only has an education at the 3rd or 4th grade level. She claims that the teachers just passed her along to the next grade to get her out of their class. The issue of education arises in Social Security Disability cases as a vocational factor – when Social Security has already determined that you cannot perform your past work but is considering what other kind of work you can do.
Social Security’s method for evaluating education is found in 20 C.F.R. Section 404.1564. They understand that if a long time has passed since you have received your education, the skills and knowledge you obtained may no longer be useful. They will use a person’s numerical grade level to determine educational abilities unless there is evidence to contradict it. So, for example, in my case it will be important to look at the school records and determine whether my client actually passed any of the classes she was taking or was absent or tardy so much such that she was not there and thus could not have learned the material despite the fact that she was passed. Also, it will be important to check if she was in special education classes while she was in school.
Last week the Social Security Administration Office of the Inspector General (“OIG”) issued their Semiannual Report to Congress. It summarizes their auditing activities within the last six months and provides statistics on their investigations.
Does it seem like there are a lot of Continuing Disability Reviews in California? It is because there are. The OIG has a unit called Cooperative Disability Investigations (“CDI”) in which they work with State Disability Determination Services (“DDS”) and local law enforcement to identify and resolve issues of fraud and abuse in continuing disability claims. The OIG received 570 allegations in California alone, more than in any other state. Of those cases, 183 of them were denied. I.e., benefits were terminated. The OIG estimated that this resulted in a $12,505,334 savings to SSA. So interestingly, less than half of them resulted in benefits being terminated but would explain why it seems we are seeing many continuing disability reviews. (See p. 21 of the report.) (It should be noted that these statistics reflect only those allegations that the OIG acted upon. SSA conducts more that are not initiated by OIG.) Continue reading
In a report, The Social Security Administration’s Progress in Reducing the Initial Disability Claims Backlog released on April 28, 2014, the Office of the Inspector General (“OIG”) examined the Social Security Administration’s (“SSA”) efforts to reduce its initial disability claims backlog. The OIG found that the SSA has failed to reduce its backlog to projected goals and recommended that the SSA create new goals and try to implement them.
As background, the SSA in November 2010 released a report on its strategy to reduce initial disability claims. They outlined a four part plan: (1) increase staffing at Disability Determination Services (“DDS”), (2) improve efficiency through automation; (3) expand the use of screening tools to streamline claims likely to be allowed, and (4) refine policies and business processes to expedite cases.