PDA’s 2021 Industry Predictions – #4

Social Security’s disability claim backlog will impact claims well into 2022.

Written by Gina Schreiber, SVP, Account Management & Aevo Insurance Services at The Advocator Group

Like many long-term disability carriers, the Social Security Administration (SSA) faced a number of challenges in the adjudication of disability claim applications in 2020. SSA and the state-run Disability Determination Services (DDS) offices that adjudicate SSDI claims at the Initial & Reconsideration levels, had to mobilize quickly to move a largely in-office team and workflow to a remote environment, causing a slowdown in productivity and a growing backlog of pending claims. Further delays were experienced in obtaining medical records from providers in a timely manner and we saw a decreased ability to obtain Consultative Examinations, physical and mental status consultations from contracted medical providers.

While fewer SSDI applications were filed nationally, the delays and productivity issues described above have led to a 28% increase in the number of claims pending decision at the Initial level. As we look ahead into 2021, we anticipate these trends will continue to put pressure on SSA & DDS operations, and we will see on-going delays in Initial decisions. Even if the introduction of the vaccine enables a return to pre-pandemic productivity, it will take some time for SSA & DDS to work through the backlog of claims. At this time, SSA has not announced any plans to change processes or staffing levels to address the backlog. Thus, over the course of 2021, we’ll see the bulk of the backlogged claims decided at the Initial level, and then begin to work their way through to the Reconsideration and Hearing levels. By nature of the protracted appeals process, we will be feeling the effects of this delay well into 2022. 

Meanwhile, SSA’s employee unions have stated they would like Commissioner Saul removed as part of the new Biden administration. From a recent press release: “American Federation of Government Employees (AFGE) and International Federation of Professional and Technical Engineers (IFPTE) joined together today calling for the ouster of Social Security Administration Commissioner Andrew Saul and Deputy Commissioner David Black. The joint effort comes on the heels of last month’s overwhelming votes of no confidence in the SSA leaders by the members of AFGE Council 220, National Council of SSA Field Operations Locals, and IFPTE Judicial Council 1, the Association of Administrative Law Judges (JC1/AALJ).”

The nearest comparable event to the one with the Commissioner of Social Security holding over, or not holding over, into a new Administration was in 2008 after the election of Barack Obama. Then Commissioner Astrue was the first Commissioner confirmed to a fixed term in office, and he had been nominated by a Republican President. Astrue's term extended into Obama's term, however, Astrue stayed in his position. President-Elect Biden has made a number of personnel decisions to date that reflect his desire for a bipartisan approach, so it remains to be seen whether we will see changes in SSA’s leadership in 2021. 

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