Charting the Future of

Social Security’s Disability

Programs:

The Need for

Fundamental Change

Social Security Advisory Board

January 2001
Social Security Advisory Board

An independent, bipartisan Board created by the Congress and appointed by the

President and the Congress to advise the President, the Congress, and the Commissioner of

Social Security on matters related to the Social Security and Supplemental Security Income programs
TABLE OF CONTENTS

EXECUTIVE SUMMARY..............................................................................i

I. THE DISABILITY PROGRAMS

 NEED IN-DEPTH REVIEW......................................................1

II. MAJOR ISSUES NEED TO BE ADDRESSED.............................3

A. Are disability decisions consistent and fair?....................................3

B. Is disability policy being developed coherently

and in accord with the intent of the Congress?..........................5

C. Can today’s administrative structure support

future program needs?..............................................................6

D. Is Social Security’s definition of disability

appropriately aligned with national disability policy?..............9

III. REFORM SHOULD HAVE CLEAR GOALS

 AND OBJECTIVES...............................................................11

IV. THE ELEMENTS OF REFORM

 ARE CHALLENGING............................................................12

A. Strengthen SSA’s capacity to manage............................................12

B. Change the disability adjudication process...................................16

C. Align policy and administrative capacity ................................26

D. Examine ways to improve incentives for

early rehabilitation and employment ................................27

V. CONCLUSION: CONSTRUCTIVE CHANGE AND

 ADDITIONAL RESOURCES ARE REQUIRED ..................29

GLOSSARY....................................................................................................31

THE SOCIAL SECURITY ADVISORY BOARD.....................................33
How the Board Conducted Its Study

Over the last four years the Board has conducted an extensive study of

the Disability Insurance and Supplemental Security Income disability

programs. We have met with thousands of Social Security Administration

and State agency employees in field offices, Disability Determination

Services, hearing offices, and regional offices in all parts of the country. We

have met many times with SSA officials responsible for operations, budget,

policy, systems, hearings and appeals, and other core functions of the agency.

The Board has consulted with union officials, disability advocates, and

outside researchers. We have also conducted public hearings on the disability

programs and service to the public.

The Board has issued three related reports: How SSA’s Disability

Programs Can Be Improved (August 1998), How the Social Security

Administration Can Improve Its Service to the Public (September 1999), and

Disability Decision Making: Data and Materials (January 2001).
EXECUTIVE SUMMARY

The nation’s two primary disability programs – Social Security Disability Insurance (DI) and

Supplemental Security Income (SSI) disability – today provide vital income support for about

10 million individuals. These programs have grown rapidly in recent years to the point where in

fiscal year 2001 they are expected to account for about $90 billion in Federal spending, or nearly

five percent of the Federal budget. In 2001, about two-thirds of the Social Security

Administration’s $7.1 billion administrative budget, nearly $5 billion, is expected to be spent on

disability work. As the baby boomers reach the age of increased likelihood of disability the

growth in these programs will accelerate.

This projected growth threatens to overwhelm a policy and administrative infrastructure that

is already inadequate to meet the needs of the public. Long-standing problems are growing more

acute and new ones are emerging. There are wide variations in decision making between

different regions of the country and different levels of adjudication, raising questions about

whether claimants are being treated consistently and fairly. Major changes have been made in

how disability is being determined. Most of these changes have been made as the result of court

decisions and have never been reviewed by the Congress. The disability administrative structure,

established when the DI program was created nearly 50 years ago, is ill-equipped to handle

today’s massive and complex workload. Many also believe that Social Security’s requirement

that claimants prove they cannot work is inconsistent with the Americans with Disabilities Act

and at odds with the desire of many disabled individuals who want to work but who still need

some financial or medical assistance.

The purpose of this report is to provide the new Administration and the new Congress with a

framework for considering the fundamental changes that need to be made if the disability

programs are to meet the challenges they are facing. Some of these changes would require

Congressional action. Others would require at least the implicit concurrence of the Congress

because they are likely to require additional administrative resources. We believe that, taken

together, these changes would accomplish fundamental reform.

The structural reforms that should be considered include: changing and strengthening SSA’s

administrative structure to improve the agency’s capacity to provide appropriate leadership in

areas of both policy and procedure; reforming the disability adjudication structure, including the

present Federal-State arrangement and the appeals process; and changing the provisions for

judicial review.

The issue of whether present policies provide sufficient assistance and incentive for

employment also needs careful review. Funding should be provided for comprehensive research

on ways to encourage rehabilitation and employment early in a period of disability.

Finally, disability policy and administrative capacity urgently need to be brought into

alignment. Over the last decade and a half SSA has issued numerous regulations and rulings that

require more time and expertise on the part of disability adjudicators than was the case in the

past. Over this same period, workloads have grown substantially and resources have been highly

constrained. Today there is a large gap between policy and administrative feasibility that needs to

be bridged by introducing changes in policy, in institutional arrangements, or in funding – or most

probably, in all of these complex facets of an interwoven process.

i
FACTS ABOUT THE DISABILITY PROGRAMS

SOCIAL SECURITY DISABILITY INSURANCE (DI) is an insurance program that

provides disability benefits based on previous employment covered by Social Security. It is

financed out of Social Security payroll taxes (0.85 percent each for employees and employers).

The cost of the DI program for fiscal year 2001 is estimated at about $60 billion (including

administrative costs).

To be eligible for DI benefits a worker must:

• have a medically determinable physical or mental impairment that has lasted or is

expected to last at least 12 months or result in death and that prevents him/her from

performing any substantial gainful activity (requirements differ for those disabled

because of blindness);

• be fully insured, i.e., have at least one credit for work in employment covered by Social

Security for each year after age 21 and prior to the year he or she becomes disabled; and

• meet a recency of work test, which requires that workers age 31 or older (other than those

disabled by blindness) must have worked in covered employment at least 20 of the 40

calendar quarters ending with the quarter in which the disability began, and that younger

workers have proportionally less recent covered employment.

At the end of calendar year 2000, Social Security Disability Insurance paid:

• benefits to 5.0 million disabled workers;

• family benefits to over 1.6 million spouses and children of disabled workers; and

• an average monthly benefit of $755 to disabled workers.

SUPPLEMENTAL SECURITY INCOME (SSI) is a means-tested income assistance

program for aged, blind, and disabled individuals (regardless of prior workforce participation)

and is funded from general revenues of the Treasury. The SSI disability program is estimated to

cost about $28 billion in fiscal year 2001 (including administrative costs).

To be eligible for Federal SSI disability benefits an individual:

• must, if age 18 or older, meet the Social Security definition of disability, or, if under age

18, have an impairment that results in marked or severe functional limitations;

• cannot have monthly countable income in excess of the current Federal benefit rate ($530

for individuals and $796 for a couple);

• cannot own real or personal property (including cash) in excess of a specified amount

($2,000 for individuals and $3,000 for couples); and

• must meet certain other requirements relating to citizenship, residence, and living

arrangements.

At the end of calendar year 2000, Supplemental Security Income paid:

• benefits to about 4.4 million low income disabled adults and about 0.8 million disabled

children.

ii
I. THE DISABILITY PROGRAMS

NEED IN-DEPTH REVIEW

The nation’s two primary disability

programs – Social Security Disability

Insurance (DI) and Supplemental Security

Income (SSI) disability – are a vital but

complex part of the nation’s social insurance

and welfare systems, requiring vigilant

attention in order to keep their policy and

administrative structures sound and up to date.

Today, more than 135 million American

workers are insured for Disability Insurance

and rely upon this protection in case of serious

illness or accident. About 6.6 million people

are now receiving Disability Insurance

benefits, and nearly 5.2 million disabled and

needy adults and children, many of whom

would otherwise be living in serious poverty,

are receiving SSI disability benefits.

These programs have grown steadily over

the years to the point where in fiscal year 2001

they are expected to account for about $90

billion in Federal spending, or nearly five

percent of the Federal budget. They require a

Chart 1. - DI and SSI

Disability Payments, CY 1960-2009*

(1999 Dollars)

Billions

SSI

As the baby boomers reach the age of

increased likelihood of disability the growth in

these programs will accelerate. The Social

Security Administration’s actuaries project

that between now and 2010 the number of DI

beneficiaries will increase by nearly 50

percent, and the number of SSI disability

beneficiaries will increase by 15 percent.

This projected growth in the number of

disability claimants threatens to overwhelm a

policy and administrative infrastructure that is

already inadequate to meet the needs of the

public.

growing portion of the time and attention of

Social Security Administration (SSA)

employees at all levels. In fiscal year 2001,

about two-thirds of the agency’s $7.1 billion

administrative budget, nearly $5 billion, is

expected to be spent on disability work. In

terms of management time, the disability

programs appear to be even greater than these

numbers suggest.

10

8

6

4

2

0

Millions

Chart 2. - Number of

Disability Beneficiaries*

CY 1960 - 2009

DI

SSI

140

100

120

80

60

40

20

0

historical estimated

historical estimated

1960

1970

1980

1990

2000

2009

Total

DI

1960

1970

1980

1990

2000

2009

1

This projected growth in the number of disability

claimants threatens to overwhelm a policy

and administrative infrastructure that is already

inadequate to meet the needs of the public.

* Excludes administrative costs

*Some individuals receive both SSI and DI benefits.
In recent decades, disability policy has

come to resemble a mosaic, pieced together

in response to court decisions and other

external pressures, rather than the result of a

well thought out concept of how the

programs should be operating. Compounding

the problem, the disability administrative

structure, now nearly a half century old, has

been unable to keep pace with the increasing

demands that have been imposed upon it.

Policy and administrative capacity are

dramatically out of alignment in the sense

that new and binding rules of adjudication

frequently cannot be implemented in a

reasonable manner, particularly in view of the

resources that are currently available.

With the size and projected growth of the

disability programs, it is increasingly urgent

to step back and reexamine how they are

working and whether changes in policies,

resources, and administrative structure need

to be made in order to meet future needs.

It has been more than two decades since

either the Congress or the Administration has

reviewed in a comprehensive manner the

question of whether the disability

administrative structure should be

strengthened or changed. Numerous

regulations and rulings affecting how

disability decisions are made have been

2

implemented without the review of policy

makers. The question of whether the

definition of disability should be changed

has not undergone close examination for

more than 30 years.

The reasons for this lack of scrutiny are

not altogether clear, but reflect, at least in

part, the extraordinarily complex and

politically sensitive nature of the disability

programs. Many policy makers and

advocates are concerned that change may

negatively impact some individuals or

groups in unintended ways. Political issues

relating to the roles of the Federal and State

governments have tended to inhibit even the

consideration of enhanced Federal

management of the programs.

But there are problems in the programs

that need to be addressed. Although there

are many capable people working in the

disability system, their efforts will be of little

avail unless they have the tools they need to

administer the program. It is essential for

the new Congress and the new

Administration to conduct an in-depth

review of the disability programs in order to

determine the changes that are required to

better serve both those who are disabled and

the public at large.

Although there are many capable people working

in the disability system, their efforts will be of

little avail unless they have the tools they need to

administer the program. It is essential for the new

Congress and the new Administration to conduct

an in-depth review of the disability programs

in order to determine the changes that are

required to better serve both those who are

disabled and the public at large.
3

Consistency and fairness should be

fundamental goals of the disability

programs. One of the major strengths of the

Social Security retirement program is that

benefits are paid on the basis of objective

rules that treat people consistently and fairly.

A primary reason why the disability

programs do not share the same level of

public confidence as the retirement program

is the perception that determinations of

eligibility for disability are not being made

in a uniform and consistent manner.

The Board has assembled data that show

striking differences in outcomes over time,

among State agencies, and between levels of

adjudication. Allowance and denial rates,

both overall and for specific impairment

categories, vary widely from State to State

and region to region. For example, in fiscal

year 2000 the percentage of DI applicants

whose claims were allowed by a State

agency ranged from a high of 65 percent in

New Hampshire to a low of 31 percent in

Texas, with a national average of 45 percent.

(Chart 3)

Claims denied by State agencies and

appealed to the administrative law judge

(ALJ) hearing level are more likely than not

to be approved at the hearing level. The

percent of cases reversed upon appeal to an

ALJ hearing has varied over the years.

The percentage of decisions at the hearing

level that were favorable for both DI and

SSI claimants stood at 58 percent in 1985,

grew to nearly 72 percent in 1995, fell to

63 percent in 1998, and grew again to

66 percent in 2000. Hearing offices also

vary greatly from State to State in the

percentage of decisions that are decided

favorably for claimants. In 2000, the range

went from 35 percent in the District of

Columbia to 86 percent in Maine, with a

national average of 66 percent. (Chart 4)

For further discussion and examples of differences in

decision making, see the Advisory Board’s January 2001

report, Disability Decision Making: Data and Materials.

A primary reason why the disability programs do

not share the same level of public

confidence as the retirement program is the

perception that determinations of

eligibility for disability are not being made

in a uniform and consistent manner.

Chart 3. - State Agency

Allowance Rates for DI Claims

FY 1980-2000

1980 1985 1990 1995 2000

70

60

50

40

30

20

10

0

Percent

II. MAJOR ISSUES NEED TO BE ADDRESSED

A. Are disability decisions consistent and fair?

High

State

National

Average

Low

State

1

1
4

For many years both Members of

Congress and others who have studied the

disability programs have expressed concern

about variations such as these. Analysts of

the programs have identified many factors

which they believe contribute to

inconsistencies in outcomes, such as

economic and demographic differences

among regions of the country, court

decisions, the fact that the claimant has no

opportunity to meet with the decision maker

until the face-to-face hearing at the ALJ

level, and that the record remains open

throughout the appeals process.

But many who are knowledgeable about

the programs – including disability

...as long as variations in decision making

remain unexplained, the integrity and the

fairness of the disability programs are open

to question. These programs are too

valuable and important to the American

public for this issue not to be addressed.

examiners in the State agencies as well as

administrative law judges – have long believed

that there are also reasons relating to program

policy, procedures, and structure that are

responsible for some if not many of these

inconsistencies. As an example, there is a

widely held belief that the agency’s quality

assurance reviews, which are conducted by

quality assurance units in each region of the

country, are not being conducted in a uniform

manner.

Despite these long-standing concerns, the

agency has no effective mechanism to provide

the information needed to understand the

degree to which the programs’ own policies

and procedures – including their uneven

implementation – are causing inconsistent

outcomes in different regions of the country

and different parts of the disability system.

Given the lack of data, there is no way to

assess the magnitude of the problem. But as

long as variations in decision making remain

unexplained, the integrity and the fairness of

the disability programs are open to question.

These programs are too valuable and important

to the American public for this issue not to be

addressed.

A report completed by The Lewin Group, Inc. and Pugh

Ettinger McCarthy Associates, L.L.C. for the Social Security

Administration in January 2001, titled Evaluation of SSA’s

Disability Quality Assurance (QA) Processes and Development

of QA Options That Will Support the Long-Term Management

of the Disability Program, includes a discussion of programrelated factors that may contribute to differences in decisional

outcomes.

Chart 4. - Percentage of ALJ

Decisions Favorable to Claimants*

FY 1985-2000

High

State

National

Average

Low

State

1985 1990 1995 2000

100

90

80

70

60

50

40

30

20

10

0

Percent

2

2

*Excludes dismissals
5

Chart 5. - State Agency DI Awards

by Basis for Decision

FY 1975-2000

Vocational

considerations

197519801985199019952000

Percent

80

70

60

50

40

30

20

10

0

Percent

Chart 6. - State Agency DI Awards by

Major Cause of Disability

CY 1975-1999

35

30

25

20

15

10

5

0

1975 1985 1995 1999

Mental disorders

Neoplasms (cancer)

 The statutory definition of disability is

broad and was designed to evolve in the light

of subsequent administration and

interpretation. Although Congress has not

changed the law for more than 30 years, the

determination of what constitutes disability has

changed in fundamental ways.

For example, there has been a gradual but

persistent trend away from decisions based on

the medical listings to decisions that

increasingly involve assessment of function.

Since 1983, the percentage of DI claimants

awarded benefits by State agencies on the

basis of meeting or equaling the medical

listings has declined from 82 percent to

58 percent, while the percentage awarded on

the basis of vocational considerations has more

than doubled. (Chart 5)

cases their offices process involve issues

relating to mental impairment.

 There have been other significant

changes. Adjudicators must adhere to more

detailed and intricate rules in weighing the

opinion of treating sources than was the case

in earlier years of the programs. They must

make a finding on the credibility of claimants’

statements about the effect of pain and other

symptoms on their ability to function. The

effect of these and other changes in disability

B. Is disability policy being developed coherently

and in accord with the intent of the Congress?

A growing portion of claims involve

allegations of mental impairment. Mental

impairment has become the largest single

reason for State agency DI awards, growing

from 11 percent in 1980 to 22 percent in 1999.

(Chart 6) Although data are not available,

State agency administrators and examiners

have told the Board that half or more of the

Although Congress has

not changed the law

for more than 30 years,

the determination of

what constitutes

disability has changed in

fundamental ways.

Circulatory system

Musculoskeletal

system

Meets

listing

Equals

listing
6

policy is that disability decision making by

both State agency examiners and

administrative law judges has become

considerably more subjective and complex.

These policy changes have occurred

through changes in regulations and rulings.

A number of the most significant changes

have grown out of court decisions, many of

which have not been appealed. None of

them have been reviewed by the Congress

and there is a question as to whether the

experiencing great stress, with every indication

that the difficulties each is facing will continue

to grow unless changes are made.

As the result of growth in the number of

disability claimants and continued agency

downsizing, field office personnel are no

longer able to provide the kind of assistance

many applicants need to file a properly

documented claim. They lack the time to

explain program rules and procedures so that

applicants can understand whether they may

meet the strict requirements of the Social

Security disability definition and what items of

information they need to document their case.

When the Disability Insurance program was

enacted in 1956, the expectation was that

the program would be relatively small. But

over the last half century, the original FederalState administrative structure has had to

accommodate a dramatic growth in program

size and complexity that it has been

ill-equipped to handle.

C. Can today’s administrative structure support

future program needs?

When the Disability Insurance program

was enacted in 1956, the expectation was that

the program would be relatively small. But

over the last half century, the original

Federal-State administrative structure has had

to accommodate a dramatic growth in

program size and complexity that it has been

ill-equipped to handle. In addition to working

within a fragmented administrative structure,

employees at all levels have been buffeted by

periodic surges in workloads and funding

shortfalls.

At the present time, all parts of the

applications and appeals structure are

agency itself has adequately analyzed them

from the perspective of –

• whether the decisions that are being

made reflect the intent of the Congress,

• whether they will improve consistency

and fairness in decision making

throughout the system, and

• whether they are operationally

sustainable for a program that must

process massive numbers of cases.
7

The State agencies that make disability

determinations on behalf of SSA face even

more difficult challenges. At the same time

that workloads are growing, SSA’s

regulations and rulings are requiring State

agency examiners to make increasingly

complex and subjective decisions. This

means that State agencies should have ever

more expert and experienced staff. Yet these

agencies are bound by State-imposed rules

relating to staff salaries and qualifications.

Too frequently, either because of State

limitations or because of inadequate Federal

funding, the State agencies lack the ability to

hire and retain qualified staff and to provide

the training they need.

Many hearing offices have heavy loads of

appeals and are struggling to keep up with

their workloads. The popular wisdom is that

claimants whose applications are denied by a

State agency need only to pursue their claims

at a hearing with an administrative law judge

and they will likely be awarded benefits. The

data tend to bear this out. About 80 percent of

DI claims and 70 percent of SSI adult

disability claims that are denied by the State

agency at the reconsideration level are

appealed to the hearing level. In 2000, more

than 75 percent of all hearing level decisions

were favorable in the case of DI claimants, and

more than half were favorable in the case of

SSI claimants.

Chart 7. - DI and SSI Claims Process:

Steps and Average Processing Time*

FY 2000

SOCIAL SECURITY

ADMINISTRATION

SSA Field Offices**

 DI: 23.2 days

 SSI: 35.5 days

Office of Hearings and

Appeals:

Administrative Law Judges

297 days

Office of Hearings and

Appeals:

Appeals Council

505 days

Disability

Determination Services

Initial Decision ***

DI: 81.5 days

SSI: 84.5 days

Disability

Determination Services

Reconsideration ****

DI: 62.8 days

FEDERAL COURTS

18 months

2

3 4

5 6

* Processing times shown above are additive.

** Field office processing time includes all components of the field office work, including taking the

 claim and processing it after the State agency makes a determination.

*** SSA reports DDS initial processing time by programs; average total processing time (DI and SSI)

 is not available.

  SSA does not have data available for SSI reconsideration processing times.

1

STATE AGENCIES

Claimant starts here
Initial Level

1,988,425

Reconsiderations

584,540

ALJ Dispositions

433,584

Appeals Council

122,780 ** 

Federal Court

Decisions***

12,011

Number Percent

 Total 1,106,344 100.0

 Initial Applications 759,191 68.6

 Reconsiderations 90,805 8.2

 ALJs 253,615 22.9

 Appeals Council ** 1,999 0.2

 Federal Court *** 734 0.1

Number Percent

 Total 1,106,344 100.0

 Initial Applications 759,191 68.6

 Reconsiderations 90,805 8.2

 ALJs 253,615 22.9

 Appeals Council ** 1,999 0.2

 Federal Court *** 734 0.1

Allow

 38%

Remand

22%

Dismiss

2%

Deny

 74%

Remand

48%

Dismiss

6%

Deny

 39%

Dismiss

12%

Deny

 29%

Deny

 84%

Allow

 16%

Allow

59%

Allow

2%

Allow

6%

Deny

 62%

Chart 8. - DI and SSI Disability

Determinations and Appeals*

FY 2000

8

* Data relate to workloads processed (but not necessarily received) in fiscal year

2000, i.e., the cases processed at each adjudicative level may include cases received

at 1 or more of the lower adjudicative levels prior to fiscal year 2000. Not all

denials are appealed to the next level of review.

 ** Includes ALJ decisions not appealed further by the claimant but reviewed by the

Appeals Council on “own motion” authority.

 *** Remands to ALJs by the Appeals Council and Courts result in allowances in about

60 percent of the cases.

Total Allowances
Today, there is far less policy guidance for

the disability system by the Social Security

Administration than was the case in earlier

years.

Prior to 1972, a special office in Baltimore

provided unified policy guidance to all State

agency examiners by reviewing nearly all

State agency decisions. When a Federal

reviewer disagreed with the decision of an

examiner, there was an exchange of views, a

procedure that helped to further define the

policy to be followed by all parts of the

adjudicative system. Appeals to an

administrative law judge were relatively

infrequent in the early years of the program,

reaching 27,000 in 1969, compared to about

490,000 in 2000.

There are currently about 15,000 disability

adjudicators throughout the disability system.

Their qualifications and the rules and

procedures they follow differ, sometimes

dramatically. In some instances, a State

agency adjudicator may be a high school

graduate with relatively limited experience. In

others, the decision may be made by a highlyeducated and well-trained adjudicator with

many years of experience.

Adjudicators may receive vastly different

training and draw upon very different resources.

For example, State agency adjudicators receive

significantly more training on medical listings

than do administrative law judges. As the result

of court decisions, ALJs in some parts of the

country make their decisions only after seeking

the opinion of a vocational expert on whether an

individual can perform work in the national

economy. These experts are not used at the

State agency level. At the hearing level, nearly

all claimants now have an attorney or nonattorney representative. This development has

greatly impacted the appeals process and, if it

should extend to the State agency level, would

have a major impact on the process at that level

as well.

As noted earlier, the disability programs are

expected to continue to grow substantially.

Factors such as those described above raise

questions about how well the administrative

structure will be able to meet the challenge of

this growing workload.

Today, there is far less policy guidance for the

disability system by the Social Security

Administration than was the case in earlier years.

9

D. Is Social Security’s definition of disability

appropriately aligned with national disability policy?

There are many who believe that the

Social Security Act definition of disability,

which requires claimants to prove they cannot

work in order to qualify for benefits, is

inconsistent with the Americans with

Disabilities Act (ADA) and is at odds with the

desire of many disabled individuals who want

to work but who still need some financial or

medical assistance. Recent Ticket to Work

legislation is aimed at helping people who are

already on the disability rolls to return to work

by providing increased services and new

incentives, but does not fully address these

basic inconsistencies.

As the General Accounting Office recently

testified, fundamental weaknesses remain.

These include an eligibility determination
Definitions of Disability

The Social Security Act and the Americans with Disabilities Act (ADA) take substantially

different approaches regarding what is meant by “disability.” The Social Security Act has a

very strict definition that is designed to identify people who are so disabled that they are unable

to work. The ADA has a broader definition designed to prevent discrimination against disabled

people who wish to work.

Social Security Definition: The Social Security Act considers people disabled only if they

have an “inability to engage in any substantial gainful activity by reason of any medically

determinable physical or mental impairment which can be expected to result in death or which

has lasted or can be expected to last for a continuous period of not less than 12 months.” This

disability has to be so severe as to prevent them from doing any “substantial gainful work

which exists in the national economy,” whether a specific job is available or not.

The disability must result from a physical or psychological abnormality that is

“demonstrable by medically acceptable clinical and laboratory diagnostic techniques.”

ADA Definition: The ADA prohibits job discrimination against an individual because of a

disability who could “with or without reasonable accommodation” perform the essential

functions of the job.

A disabled person in the ADA means a person with a physical or mental condition that

“substantially limits” a life activity, that has a record of such a condition, or is “regarded as

having” such a condition.

10

process that concentrates on applicants’

incapacities rather than their capacities, returnto-work services offered only after a lengthy

determination process, and an “all-or-nothing”

benefits structure that characterizes individuals

as incapable of work.

These same points were made at a public

hearing held by the Board on strategies to

encourage employment of the disabled.

Witnesses stressed that programs and services

are much more effective when they address

what people can do rather than what they

cannot do, and that with the many

accommodations that exist today it is possible

to fit many individuals with disabilities into a

satisfying job. Because the nature of work has

changed dramatically in the last few decades

people with disabilities have many more

employment possibilities available to them

than existed in a manufacturing economy. The

Board also heard testimony on the need to

refer individuals for vocational rehabilitation

services immediately upon their first contact

with the agency.

In recent testimony the Consortium of

Citizens with Disabilities questioned whether

the Social Security definition of disability

adequately captures “the spectrum and

continuum of disability today. Does it reflect

the interaction of vocational, environmental,

medical and other factors that can affect the

ability of someone on SSI or SSDI to attain a

level of independence?”

The Ticket to Work legislation enacted last

year authorizes SSA to conduct experiments

and demonstration projects related to

encouraging rehabilitation and employment,

including earlier referral of individuals for

rehabilitation. This demonstration authority

provides the agency with an opportunity to

find ways to bring greater coherence to the

nation’s disability policies.
11

III. REFORM SHOULD HAVE CLEAR

GOALS AND OBJECTIVES

In our August 1998 report on the

disability programs, How SSA’s Disability

Programs Can Be Improved, the Board

recommended ways to strengthen the

disability programs within the present

structure. These recommendations

emphasized the need of the agency to

improve its management of the programs by

providing joint training of all adjudicators;

developing a single presentation of disability

policy that is binding on all decision makers;

providing strong and consistent leadership of

the programs; strengthening the agency’s

disability program policy staff; revising the

quality assurance system; and developing a

computer system capable of supporting all

stages of the disability process.

These changes are necessary regardless

of whether more fundamental changes are

undertaken, and, although it is only a

beginning, we are pleased that SSA has taken

some steps to respond to a number of the

recommendations made in our report.

After two additional years of study of the

disability programs, however, we are

convinced that the issues facing the disability

programs cannot be resolved without making

fundamental changes. In our view, these

changes must be evaluated within the

context of clear goals and objectives which

should include –

• All individuals who are truly disabled

and cannot work should receive

disability benefits.

• Those who can work but need

assistance to do so should receive it.

• Vocational rehabilitation and

employment services should be

readily available, and claimants and

beneficiaries should be helped to take

advantage of them.

• Claimants should be helped to

understand the disability rules and

the determination process.

• The disability system should provide

fair and consistent treatment for all.

• The disability system should ensure

high quality decisions by wellqualified and trained adjudicators.

• The disability system should provide

expeditious processing of claims.

When cases are complex and require

more time, claimants should be

informed so that they will understand

why there is delay.

...we are convinced that the issues facing the

disability programs cannot be resolved without

making fundamental changes. In our view,

these changes must be evaluated within the

context of clear goals and objectives....
IV. THE ELEMENTS OF REFORM

ARE CHALLENGING

In our discussions with employees

throughout SSA’s massive disability structure,

we have heard many expressions of concern

about the agency’s capacity to provide the

strong and coherent management that the size

and complexity of the disability programs

require. In our observation, SSA’s ability to

manage is undermined by three major

shortcomings:

• There is a lack of management

accountability.

• The policy infrastructure is weak.

• The agency lacks a quality management

system that can provide the information

needed to make sound decisions.

Addressing these shortcomings should be

one of the highest priorities of reform.

Provide accountability. – Under the

current administrative structure, nearly every

component of the agency has a role in

administering the disability programs. This

dispersion of functions throughout many

different entities poses a particularly difficult

problem for the disability programs, which

lack the tightly defined policy and

administrative parameters that are typical of

the retirement and survivors programs.

For example, the development of a

redesigned disability computer system may

appropriately rest with the Office of Systems,

but that entity lacks the program knowledge

needed to design a system that takes into

account the relationships between hearing

offices and State disability agencies, or

between State disability agencies and their

parent State agencies.

12

To build a disability system that can meet the challenges of the future will require changes in

policy, procedure, and structure. Below we propose a number of changes that we think policy

makers in the Congress and in the Social Security Administration should consider. Some of them

would require Congressional action. Others would require at least the implicit concurrence of the

Congress because they are likely to require additional administrative resources. We believe they

provide a framework for discussion that could lead to consensus for change. Taken together, they

would accomplish fundamental reform.

A. Strengthen SSA’s capacity to manage

To build a disability system that can meet the challenges

of the future will require changes in policy, procedure,

and structure....we propose a number of changes that we

think policy makers in the Congress and in the Social

Security Administration should consider.

For a description of the responsibilities of 14 SSA staff

components that are involved in the administration of the

disability programs, see the Advisory Board’s report, Disability

Decision Making: Data and Materials, January 2001, p. 119.

3

3
There are a number of ways this could be

achieved. The Commissioner may determine

that, given the importance of the disability

programs, it is the Commissioner who is the

most appropriate person to assume direct

responsibility for coordinating the many

aspects of their operation. If the magnitude of

the Commissioner’s other responsibilities is

deemed too great to make this feasible, the

Commissioner could assign this responsibility

to the Deputy Commissioner. An additional

option would be to appoint another high level

individual, who would report directly to the

Commissioner and would have authority to

make decisions that cut across functional lines,

to manage the programs. Still another option

would be to restructure the agency so that

disability-related functions could be

coordinated more coherently than under the

agency’s present functional organizational

arrangement.

Strengthen the policy infrastructure.

– In recent years, SSA has taken several steps

designed to strengthen the policy base for the

disability programs. In 1994 it promised that it

would develop a single presentation of policy

to guide all adjudicators, a so-called “one

book.” In 1996 it attempted to bring State

agency and ALJ decision making closer

together by issuing nine new policy rulings.

And more recently it has tried to increase its

technical capacity by hiring some additional

staff.

These steps have been well intended, but

problems persist.

For many years there have been too many

voices articulating disability policy.

Adjudicators in State agencies and in SSA’s

quality assurance system are bound by

instructions presented in SSA’s Program

Operations Manual System (the POMS),

13

4

4 For a description of SSA’s initiatives to improve

the disability process, see the Advisory Board’s report,

Disability Decision Making: Data and Materials,

January 2001, p. 105.

The Office of Quality Assurance and

Performance Assessment, which is

organizationally separated from the Office of

Disability, operates the quality assurance

system. In theory, this system simply measures

the extent to which disability decisions follow

agency policy with respect to eligibility and

documentation requirements. In practice, the

quality process has a significant ability to

shape disability policy, including who gets on

the disability rolls, through subtle messages

imparted by tighter or looser reviews, the kinds

of decisions selected for review, or by

increased or decreased sampling rates.

The missions and interests of the many

offices that are involved in disability

administration differ, and no one other than the

Commissioner has the authority to bring them

together. The result too often is dissonance

and stalemate rather than well thought out and

timely action.

We urge the new Commissioner to use the

authority provided in the 1994 independent

agency legislation to organize the agency and

appoint such personnel as the Commissioner

considers appropriate in order to ensure greater

accountability and unified direction for the

disability programs.

Under the current

administrative structure,

nearly every component

of the agency has a

role in administering

the disability

programs....The result

too often is dissonance

and stalemate rather

than well thought out

and timely action.
14

which, according to SSA’s description,

provides the “substance” of the law,

regulations, and rulings issued by the

Commissioner, but does not necessarily follow

their wording. The POMS is supplemented by

other administrative issuances from SSA.

Administrative law judges and the Appeals

Council, on the other hand, are bound only by

the statute, along with regulations and rulings

that have been published in the Federal

Register. They also have their own operating

instructions in a Hearings, Appeals, and

Litigation Law Manual (HALLEX).

We believe a single presentation of policy

for all adjudicators is critical to the objective

of providing consistent and fair decisions for

all claimants and we urge the agency to

proceed with this effort as quickly as possible.

We believe a single

presentation of policy

for all adjudicators is

critical to the objective

of providing consistent

and fair decisions for all

claimants and we urge

the agency to proceed

with this effort as

quickly as possible.

important differences in the perspectives and

needs of adjudicators in both State agencies

and hearing offices. It is also more likely to be

interpreted and implemented uniformly

throughout the disability determination

process.

The development of sound disability

policy requires far greater medical and

vocational expertise than the agency currently

has. Over the years SSA has lost many of its

skilled medical and vocational specialists and

they have not been replaced with sufficient

rapidity. As a result, important medical

listings have not been kept up to date to reflect

advances in medical diagnosis and treatment

and vocational guidelines do not take into

account the changes that have occurred in the

workplace.

Of perhaps even greater concern is the fact

that the Department of Labor’s Dictionary of

Occupational Titles (DOT) is no longer being

updated. This document, which describes the

types of jobs that are available in the national

economy, has long served as a primary tool for

adjudicators in determining whether a claimant

has the capacity to work. SSA currently has no

replacement for the DOT, leaving a critical

policy vacuum at a time when program rules

require more and more decisions to be made

on the basis of vocational factors.

To expedite this process we propose that

the agency combine the knowledge and

experience of employees from both the Office

of Disability and the Office of Hearings and

Appeals, bringing them together into a single

policy unit. If employees from both of these

offices participate in writing the agency’s

policy, it is more likely to take into account the

Without a stronger policy

base, the quality of

disability decision making

cannot be substantially

improved, regardless of

any procedural or

structural changes that

may be made.
Without a stronger policy base, the quality

of disability decision making cannot be

substantially improved, regardless of any

procedural or structural changes that may be

made. This essential foundation must be

provided as quickly as possible.

Establish a new quality management

system. – Much of the information the

agency relies upon at the present time to assess

the accuracy and consistency of decision

making is derived from its quality assurance

system. As a recent outside evaluation of

SSA’s system has pointed out, however, SSA’s

current system is of limited value in analyzing

overall performance and in providing

information that can be used to improve the

quality of decision making. Quality should be a central objective of the

disability programs. To make this an operating

reality within the agency, SSA urgently needs

to develop and implement a new quality

management system that will routinely

produce the comprehensive program

information that policy makers need to guide

disability policy and procedures and to ensure

accuracy and consistency in decision making.

Such a system is essential if the agency is to be

able to detect problems promptly and correct

them appropriately. It is also needed to

evaluate agency initiatives such as process

unification, prototype, and hearings process

improvement.

The quality management system should

incorporate all parts of the disability

determination process. It should ensure high

quality and consistency in all regions of the

country and at all levels of decision making.

The information it provides should be made

available to persons who are concerned with

the disability programs both within and outside

of the agency.

As the baby boomers rapidly enter their

disability-prone years, it becomes ever more

urgent for both policy makers and

administrators to have a clear understanding of

whether the programs are functioning as

intended.

...SSA urgently needs to

develop and implement

a new quality

management system

that will routinely

produce the

comprehensive program

information that policy

makers need to guide

disability policy and

procedures and to

ensure accuracy and

consistency in

decision making.

Lewin, op. cit. 5

15

As the baby boomers

rapidly enter their

disability-prone years, it

becomes ever more urgent

for both policy makers and

administrators to have a

clear understanding of

whether the programs are

functioning as intended.

5
16

Strengthen the Federal-State

arrangement

Although the law gives SSA the basic

responsibility for administering the disability

programs, it requires that disability decisions

be made by State agencies rather than by SSA

itself. The Federal government pays 100

percent of the cost.

Whether the disability decision making

authority should belong to the States or to the

agency has been a subject of debate since the

arrangement was established nearly five

decades ago. Proponents of federalizing the

process have long argued that the Federal-State

administrative structure is inherently difficult

to manage and that federalization of the

responsibilities of the State agencies is

necessary to ensure high quality, uniform

administration throughout the country. They

have questioned the capacity of the States to

carry out Federal policies in an efficient and

uniform way.

The issue of federalizing the disability

determination process needs to be examined in

the light of anticipated future needs of the

disability programs. In the short term we

believe it is necessary to strengthen the present

Federal-State arrangement. Underpinning this

view is the fact that, as evidenced by the

findings in the Board’s previous reports, SSA

currently lacks the administrative and staffing

capacity to take on the significant additional

responsibility that federalization would entail.

Nonetheless, the present arrangement is

inadequate to meet the needs of the programs

B. Change the disability adjudication process

today, and problems need to be addressed as

quickly as possible.

There are wide variances among States in

areas that can have a major impact on the

quality of work that is performed, such as

staff salaries, hiring requirements, training,

and quality assurance procedures. Salary

levels in the highest paying State are two and

a half times greater than in the lowest paying

There are wide variances among States in areas that

can have a major impact on the quality of work that is

performed, such as staff salaries, hiring requirements,

training, and quality assurance procedures.

80

70

60

50

40

30

20

10

0

Dollars in thousands

Tennessee Louisiana

Mississippi

Average

Michigan New York

New Jersey

Rhode Island

S. Dakota Wyoming

Connecticut

Chart 9. - State Agency Average

Examiner Compensation, Low and

High States and National Average*

FY 1999

*Average compensation includes full time pay, full time

overtime pay, part time pay, part time overtime pay, and

 total employee fringe benefits.

7

7

6

6 Chart 7, p. 7 shows the various components involved in

the disability adjudication process.

For a discussion of SSA’s urgent need to improve its

capacity to manage the disability programs, see the Board’s

earlier reports, How SSA’s Disability Programs Can Be

Improved (August 1998) and How the Social Security

Administration Can Improve Its Service to the Public

(September 1999).
State. In addition, State agencies are

sometimes subject to Statewide hiring freezes

that can severely limit their ability to process

claims in a timely way.

A change in the law in 1980 gave SSA the

authority to issue regulations to ensure high

quality performance, but the agency exercised

this authority in a limited way.

The agency’s regulations should be revised

to require States to follow specific Federal

guidelines relating to educational requirements

and salaries for staff, training, carrying out

quality assurance procedures, and other areas

that have a direct impact on the quality of their

employees and their ability to make decisions

that are both of high quality and timely.

Regulations should also ensure that State

hiring freezes will not apply to State agency

disability operations.

We believe the agency has authority under

existing law to issue new regulations in these

areas. If SSA believes it should have new and

more explicit authority, however, it should ask

the Congress to provide it.

Some will argue that attempting to exert

greater Federal authority over the State

agencies will not be effective. However, the

disability programs are national programs and

SSA has an obligation to try to ensure equal

treatment for all claimants wherever they

reside. If any States should decide to withdraw

from the program, then the agency should be

prepared to take over that obligation.

At the same time, SSA also has an

obligation to the State agencies to listen to

their concerns and to ensure that they are

adequately funded to adjudicate the claims of

State residents on a timely basis and in

accordance with the law.

In our observation, the Federal-State

relationship is now stronger and more

cooperative than it was in earlier years. SSA

and the States should work together to enhance

it even more.

In addition, both the Congress and SSA

should review the agency’s present plan to

eliminate the reconsideration step in the

appeals process, a step that the States are

currently performing.

...the disability programs

are national programs and

SSA has an obligation to

try to ensure equal

treatment for all claimants

wherever they reside.

17

In our observation, the

Federal-State relationship

is now stronger and

more cooperative than

it was in earlier years.

SSA and the States

should work together to

enhance it even more.

As part of its disability redesign plan in

1994, SSA proposed to eliminate

reconsideration on the grounds that

streamlining the appeals process would

promote faster decisions and ensure that

claimants do not inappropriately withdraw

from the process on the perception that it is too

difficult or time-consuming to pursue their

appeal rights. SSA is currently “testing” the

elimination of reconsideration in 10 prototype

States. The agency intends to eliminate it

nationwide as one of a number of changes it

plans to make in the disability determination

process.
From the standpoint of claimants,

reconsideration was an important step in the

early years of the disability system. In 1959,

for example, the reversal rate at the

reconsideration level approached 50 percent.

In the 1970s, about one in three claimants who

requested a reconsideration had their claims

approved at that level. Today, the

reconsideration reversal rate stands at

15 percent, and many believe that it has

become merely an unnecessary delaying step

in the adjudicatory process.

It is still unclear what impact the

elimination of reconsideration and other

changes being tested in the 10 prototype States

will have on claimants and on the ALJ process.

If the evaluation does not clearly show that the

prototype changes will produce the hoped-for

results, including significantly fewer appeals

to the ALJ hearing level, SSA should consider

enhancing the current reconsideration step by

offering claimants a face-to-face hearing and

ensuring that it involves a de novo review that

is conducted only by highly trained and

experienced individuals.

Reform the hearing process

The formal right of Social Security

claimants to a hearing was adopted by the

agency in 1940. Initially there were only 12

“referees” around the country to hear appeals.

But with the enactment of the disability

programs the number of appeals began to

increase rapidly. In 2000, SSA’s hearing

offices processed nearly 540,000 appeals,

about 85 percent of which were disability

cases. There are now about 1,000

administrative law judges and 6,800 other

employees to handle the appeals workload.

In addition to becoming a vastly more

massive operation than was originally

envisaged, the hearing has changed in another

fundamental respect. Administrative law

judges have traditionally been required to

balance three roles. They are obligated to

protect the interests of both the claimant and

the government, and to serve as objective

adjudicator. But as attorney and other third

party representation on behalf of claimants has

increasingly become the norm, ALJs are

finding it difficult to maintain the balance.

Nationally, about 80 percent of DI claimants

are now represented by an attorney, a situation

that many believe has made the process too

one-sided.

Finally, in the last 25 years the high

volume of work generated by disability

appeals has prompted SSA to make periodic

efforts to increase ALJ productivity. This

emphasis on productivity, which many ALJs

believe has been insufficiently balanced by an

emphasis on quality, has generated

considerable tension between the agency and

the judges. Many ALJs have viewed SSA’s

efforts to exert management control over

administrative matters as an infringement on

their decisional independence. The

relationship has deteriorated to the point where

the judges recently voted to form a union, with

the view that this was necessary to have their

views taken into account.

As the result of our study of these

developments, we make the following

recommendations.

18

1975 1980 1985 1990 1995 2000

1000

Chart 10. - Number of

Administrative Law Judges

FY 1975-2000

1200

400

600

800

200

0
Improve the SSA-ALJ relationship.–

First, SSA’s relationship with the ALJs needs

to be changed from one of confrontation to

cooperation. Many ALJs throughout the

system strongly resent what they perceive as

the agency’s unwillingness to consult them

about changes that are made and to consider

their views. Many believe that the Office of

Hearings and Appeals is buried too low in the

agency and should be elevated so that the head

of the office would report directly to the

agency leadership. Others believe that there

should be independent status for an

administrative law judge organization.

At the same time, ALJ sensitivity to

measures that might challenge their decisional

independence has led some to reject even the

notion that the agency has an obligation to try

to ensure that hearing decisions are made as

promptly and consistently as possible. There

is an understandable tension between these

objectives, but in our view they are not

irreconcilable. We urge SSA and ALJs to work

together to develop reasonable procedures that

will preserve the decisional independence of

judges while also assuring promptness and

consistency in decision making. We also

recommend consideration of three substantive

changes in the hearing and appeal process.

Have the agency represented at the

hearing. – First, the fact that most claimants

are now represented by an attorney reinforces

the proposition, which has been made several

times in the past, that the agency should be

represented as well.

Unlike a traditional court setting, only one

side is now represented at Social Security’s

ALJ hearings. We think that having an

individual present at the hearing to defend the

agency’s position would help to clarify the

issues and introduce greater consistency and

accountability into the adjudicative system. It

would also help to carry out an effective crossexamination of the claimant. Many ALJs have

told us that they are sometimes reluctant to

...SSA’s relationship with

the ALJs needs to be

changed from one of

confrontation to

cooperation....We urge

SSA and ALJs to work

together to develop

reasonable procedures

that will preserve the

decisional independence

of judges while also

assuring promptness

and consistency in

decision making.

19

As we have met with ALJs throughout the

country we have been impressed by the

thoughtfulness and dedication that many of

them have demonstrated. Most are dedicated

professionals who have much to contribute to

the agency. Their experience and insights

should be valued and taken advantage of much

more frequently and consistently than has been

the case in the past.

...the fact that most

claimants are now

represented by an attorney

reinforces the proposition,

which has been made

several times in the past,

that the agency should be

represented as well.
conduct the kind of cross-examination they

believe should be made because, upon

appeal, the record may make them appear to

have been biased against the claimant.

Consideration should also be given to

allowing the individual who represents the

agency at the hearing to file an appeal of the

ALJ decision.

If the agency is represented at the hearing

there are issues that would have to be

addressed, for example, who would have the

responsibility for performing that function.

Whoever had the responsibility would need

substantially increased resources, at least in

the short run. However, if government

representation resulted in better-reasoned and

justified decisions at the front end of the

process, as many believe would be the case,

then over time the number of appeals should

go down, with savings to both the system and

to claimants. The problem of representation

for claimants who do not have it would also

have to be addressed, but this is an issue that

with a good faith effort should be able to be

worked out.

20

Close the record after the ALJ

hearing. – Second, Congress and SSA should

review again the issue of whether the record

should be fully closed after the ALJ decision.

Following legislation in 1980, SSA issued a

regulation that bars the submission of new

evidence that pertains to a period after the ALJ

hearing decision, but allows new evidence to

be submitted if it relates to the period on or

before the date of the decision.

...if government

representation resulted

in better-reasoned and

justified decisions at the

front end of the process,

as many believe would be

the case, then over time

the number of appeals

should go down, with

savings to both the system

and to claimants.

Leaving the record open means that the

case can change at each level of appeal,

requiring a de novo decision based on a

different record. SSA has no data on the

percentage of cases that are remanded back to

ALJs that involve new evidence, but many

ALJs have told us that in their observation it is

more than half and that it adds substantially to

their workload. They argue that leaving the

record open provides an incentive for

claimants’ representatives to withhold

evidence in order to strengthen an appeal at a

later stage. They also believe that it gives

representatives an incentive to prolong the case

in order to increase their fees. Other ALJs do

not believe that representatives hold back

evidence for these reasons. If evidence is held

back, they maintain, it is because the rules for

presenting evidence are lax and representatives

do not take the time or spend the money to

obtain additional evidence unless required to

do so as a result of an unfavorable hearing

decision.

...Congress and SSA should

review again the issue of

whether the record should

be fully closed after the

ALJ decision.
21

Closing the record would heighten the

need to develop the record as fully as possible

before the decision is made in order to ensure

that claimants are not unfairly penalized.

Closing the record would not preclude filing a

new application.

Consider new rules for claimant

representatives. – Third, we recommend that

consideration be given to establishing a system

of certification for claimant representatives.

Federal rules would regulate the representation

of claimants. Consideration should also be

given to establishing uniform procedures for

claimant representatives to follow, such as

requiring them (absent good cause) to submit

all evidence a specified number of days prior

to the hearing and to certify that the case is

fully developed and ready for a hearing. The

objective would be to provide for a more

orderly and expeditious hearing procedure than

currently exists.

In addition, both the Congress and the

agency should review the issue of the payment

of attorney fees. Many attorneys complain that

the current statutory limit of $4,000 for any

one case is unfair to them. But ALJs and other

hearing office employees believe that the

present law requirement that SSA generally

withhold and pay to the attorney a fee equal to

25 percent of the back payment due to a

claimant is often unfair to claimants whose

representatives fail to carry out their

responsibilities appropriately.

Rationalize the role of the Appeals

Council

When the Social Security Board

established the right to a hearing in 1940, it

established an Appeals Council to handle the

Quality

Assurance and

Other Special

Reviews

 5,360

Chart 11. - Appeals Council

Workload

Fiscal Year 2000

New

Court Cases

 14,363

Court

 Remands

9,813

The Appeals Council performs two basic

functions. First, it performs a “case

correction” function by providing a final step

of appeal within the agency for individuals

whose claims have been denied by an ALJ. In

addition, it has authority to review ALJ

decisions on its own motion. In 2000, the

Council conducted preeffectuation reviews of

about 4,000 allowances. (The percentage of

cases chosen for review has varied over the

years, largely reflecting the volatility of the

Council’s workload.) Second, it reviews cases

that are appealed to the courts to determine

whether the agency should defend them or

whether it should request the court to remand

them to the agency for the purpose of

affirming, reversing, or remanding the ALJ’s

decision.

...we recommend that consideration be given to

establishing a system of certification for

claimant representatives.

appeals. As noted above, appeals were heard

by a handful of “referees” located around the

country. They were reviewed by a small staff

in the central office. The Appeals Council

evolved into what is now called the Office of

Hearings and Appeals. The office now known

as the Appeals Council is a component within

OHA.

Requests

for Review

106,358
22

In the view of the Board, any proposal for

change in the Appeals Council role should

include an evaluation of how it will impact the

quality of ALJ decisions.

Consider changes in the current

provisions for judicial review

Concerns about national uniformity in

policy and procedure have led many to

consider whether there is a need for changes in

the current provisions for judicial review by

the Federal courts. The courts frequently issue

decisions that vary from district to district and

circuit to circuit, resulting in the application of

different disability policy in different parts of

the country. The number of disability cases

As part of its 1994 disability redesign plan,

SSA proposed to eliminate Appeals Council

review of ALJ denials, thereby allowing

appeals to go directly to the courts. The

Council would continue to review cases that

were appealed to the courts and decide

whether the agency should defend the ALJ’s

decision as the final decision of the

Commissioner. It would continue to seek

remand of cases for the purpose of affirming,

reversing, or remanding the ALJ’s decision and

would conduct own motion reviews of both

ALJ allowances and denials for purposes of

quality assurance.

Several years ago the agency conducted an

initial test of the impact of eliminating Appeals

Council review of ALJ denials. The test

showed that the number of cases that would be

appealed to the courts would likely increase

substantially. Apparently the agency has not

decided to abandon this proposal, however,

because it is currently undertaking a second

round of testing.

We urge both the Congress and the agency

to study carefully the function that the Appeals

Council is currently performing or that it could

potentially perform. The Council has been

subjected to much criticism over the years.

Many believe that the ALJ decision should be

the final decision of the agency and that too

often decisions by the Appeals Council simply

reflect the substitution of the opinion of one

adjudicator for another.

We believe that the case correction

function is important, but how it is conducted

needs to be rethought.

Concerns about national uniformity in policy and

procedure have led many to consider whether there is

a need for changes in the current provisions for

judicial review by the Federal courts.

The Carter Administration proposed to

replace the Appeals Council with a Review

Board. Under this proposal, the evidentiary

record was to be closed after the ALJ hearing,

giving the Board an appellate review role

rather than allowing it to redetermine facts.

We urge both the

Congress and the agency to

study carefully the function

that the Appeals Council is

currently performing

or that it could

potentially perform.
23

Following is a brief example of how court decisions have affected disability policy

and procedures in a substantial way.

Since the early years of the Disability Insurance program a number of judicial

circuits have in varying ways addressed the question of how much weight should be

given to the evidence of the claimant’s treating physician. Several ruled that more

weight should be given than SSA provided in its regulations. Although there was

disagreement among the circuits on this issue, it was not appealed to the Supreme Court.

An important development in this area in recent years was when the 2nd Circuit

through the Schisler case held in 1986 that its case law should be followed within the

Circuit rather than the policy of the agency. The case law held that a treating physician’s

opinion is entitled to controlling weight “unless contradicted by substantial evidence.”

The district court judge in the Schisler case issued a ruling spelling out this case law and

ordered SSA to follow it within the Circuit. In 1991, SSA issued new regulatory

language describing the circumstances in which treating source opinion should be given

controlling weight that largely followed the Schisler rule.

 *For a detailed listing of major court cases affecting the disability programs, see the Advisory Board’s January 2001

 report, Disability Decision Making: Data and Materials, p. 115.

Impact of Court Decisions*

that have been appealed to the Federal courts

has risen substantially over the last decade,

from about 5,600 in fiscal year 1990 to about

14,700 in 2000. It is projected to climb

considerably higher in future years, further

stressing SSA’s Office of the General Counsel,

which has the responsibility to handle these

cases, but has insufficient staff to do so even

with the current workload.

Over the years a number of bills have been

introduced in the Congress that would create

either a Social Security Court or a Social

Security Court of Appeals.

Social Security Court. – Under bills

introduced by Congressmen William Archer,

J. J. Pickle, and James A. Burke, all of whom

served as Chairman of theWays and Means

Social Security Subcommittee, a new Social

Security Court would be created, which for

Social Security purposes would replace the

Federal district courts. There would be a Chief

Judge who would establish uniform court rules

and procedures. Decisions of the Court would

be appealed to a single circuit court, either an

existing one or a new separate circuit court.

The principal argument for the Social

Security Court is that it would provide greater

uniformity in case law throughout the country

and would allow for the more orderly

presentation of issues for resolution by the

Social Security Administration and the

Congress. Those who oppose the court have

argued that retaining the generalist judge of the

present system is necessary to ensure a truly

independent judicial decision.
24

have played a major role in defining the

standards for disability. Whether existing

arrangements for judicial review represent the

best public policy is a legitimate question that

deserves careful study by the Congress and the

Social Security Administration.

Give field offices increased

responsibility for taking disability

claims

The work the field offices are currently

responsible for performing does not include

making disability decisions. However, their

work can have a major impact on the quality of

the decisions that are made at later stages in

the process.

In the early years of the DI program, field

offices played the major role in taking and

developing claims. Because of the many

offices throughout the country, employees in

these offices were able to work on a face-toface basis with claimants. In many offices,

9

The agency is currently testing a new way of handling

disability claims that gives a single individual (who may be

either an SSA or State agency employee) the responsibility both

for fully developing the claim and for determining whether a

claimant is disabled. That individual, who is called a Disability

Claims Manager, is responsible for all contacts with the

claimant.

9

The statutorily-established Commission on

Structural Alternatives for the Federal Courts

of Appeals, chaired by Justice Byron White,

stated in its final report in December 1998 that

Congress should seriously consider proposals

that would place judicial review of Social

Security cases in an Article I court. The

Commission further observed that if Congress

should at some point take this action, it might

want to consider placing exclusive appellate

jurisdiction over the court in the Federal

Circuit. It stated that it would seem

appropriate for the standard of review for

Social Security cases to be the same as for

veterans’ appeals, namely, a limitation of

appellate review to questions of statutory and

constitutional interpretation.

Social Security Court of Appeals. –

Another former Chairman of the Social

Security Subcommittee, Andy Jacobs,

introduced a bill to establish a U.S. Court of

Appeals for the Social Security Circuit. The

purpose of the Court was to provide appeal to

a single court for all Social Security cases

decided in Federal district courts, thereby

eliminating the differing case law that comes

out of the 11 Circuit Courts of Appeal.

Opponents of the bill argued that it would

eliminate the “percolation” of ideas through

the various circuits before review of an issue

might be sought in the Supreme Court.

Few would contest that throughout the

history of the disability programs the courts

Few would contest that throughout the history of the

disability programs the courts have played a major

role in defining the standards for disability. Whether

existing arrangements for judicial review represent

the best public policy is a legitimate question that

deserves careful study by the Congress and the

Social Security Administration.

Commission on Structural Alternatives for the Federal

Courts of Appeals, Final Report, submitted to the President and

the Congress pursuant to P.L. 105-119, December 18, 1998,

p. 74.

8

8
claims representatives specialized in taking

disability claims, developing expertise in

interviewing, describing impairments, and

developing evidence.

Over time, the pressure of high workloads

and limited resources has pushed the agency to

reduce the field office role. In the early 1970s,

the responsibility for developing evidence was

given to the State agencies and the narrative

interview providing observations of the

claimant’s disability was generally replaced by

a checklist approach. More recently, the

practice in field offices is to encourage

claimants to fill out their own forms and mail

them in. Administrators of several State

agencies have told us that now more than half

of the claims they receive are teleclaims. In

these cases, claimants may never be observed

unless their claims are denied by a State

agency and appealed to an administrative law

judge. As SSA relies more and more on taking

claims by telephone and (in the future) by

Internet, the number of claims filed without

any face-to-face contact is expected to grow.

At the same time, there appears to be

recognition within SSA and the State agencies

that better documentation of the claim at intake

leads to speedier and better disability

decisions. Thus, the agency is currently

making special efforts to encourage field

offices in the States where it is implementing

disability prototype to improve the quality of

the disability application. Whether substantial

The responsibility of the field office in taking

disability claims is critical and should be carefully

delineated so that the field office function can be

made more effective....Today, many claimants have

little understanding of what they should do to fully

document their claim. They also have little

understanding of what is required to meet the

strict Social Security definition of disability.

improvement will in fact be achieved and

sustained is open to question, as pressures on

employees to speed up case processing

continue and employees have been given no

incentives to do otherwise.

The responsibility of the field office in

taking disability claims is critical and should

be carefully delineated so that the field office

function can be made more effective. We

believe that more, rather than less, face-to-face

contact with claimants would improve the

disability process. Today, many claimants

have little understanding of what they should

do to fully document their claim. They also

have little understanding of what is required to

meet the strict Social Security definition of

disability. There is no way to know what

impact these factors have on the number and

quality of claims that are filed, but anecdotally

they appear to be significant. We question

whether SSA’s policy of increasing reliance on

self-help and teleclaims is consistent with the

objectives of good service to the public,

decisional quality, and program integrity.

The agency should develop performance

measures to hold field offices accountable for

the quality of the disability claims intake work

they perform. Even more important, the Social

Security Administration should have a

workforce-based budget that provides

sufficient resources to field offices so that they

are able to carry out the functions that are

required.

25
26

Nearly every part of the Social Security

Administration has been affected by the

downsizing and restraint on government hiring

that has occurred over the last two decades.

But for various reasons, the disability

programs in particular have tended to suffer.

Important decisions have been made affecting

the disability determination process without

the careful attention that their importance has

warranted.

As noted earlier, over the last decade and a

half SSA has issued numerous regulations and

rulings that require more time and expertise on

the part of all disability adjudicators than was

the case in the past. Over this same period,

however, workloads have grown substantially

and resources have been constrained. The

result is that disability policy and

administrative capacity are now seriously out

of alignment and threaten to become more so

as the agency moves toward national

implementation of several new initiatives.

Of particular importance are the series of

nine rulings issued by SSA in 1996. They are

commonly referred to as “process unification”

rulings, because they were aimed at bringing

State agency and ALJ decisions closer

together. Despite the good intentions of the

agency, many State agency administrators

claim that some of the rulings are so complex

and difficult that State agency employees

cannot adhere to them without spending

substantially increased time on a large

percentage of the cases they are adjudicating.

In addition, these new rules for adjudicating

C. Align policy and administrative capacity

cases require analytical and writing skills that

many employees do not have.

Because of resource demands,

implementation of the rulings has been

proceeding unevenly. For purposes of quality

assurance measurement, SSA is enforcing

them only in the 10 prototype States. As the

result of court challenges, however, three

additional States are also being required to

implement them, and a number of other States,

concerned about being challenged in court,

have undertaken to implement them as fully as

possible on their own initiative. SSA’s data

show that in most States where prototype is

being implemented backlogs are climbing

dramatically, despite SSA’s efforts to relieve

the State agencies by transferring part of their

workloads to other States or to SSA itself.

As the number of applications grows,

backlogs are growing in other States as well.

In many State agencies heavy workloads are

causing employee stress and staff attrition is a

serious problem. For example, in 2000,

10 States had disability examiner attrition

rates of 21 percent or higher. This is a serious

impediment to public service, given the fact

that most administrators believe that it takes at

least 2 years to fully train a disability

examiner.

The process unification rulings establish

standards for developing cases that some ALJs

believe will prove over time to be difficult for

them to meet as well, potentially increasing

the number of cases remanded from the courts

and causing ALJ workloads to grow.

...disability policy and administrative capacity

are now seriously out of alignment and threaten to

become more so as the agency moves toward national

 implementation of several new initiatives.
27

The agency’s process unification rulings

and the regulations on which they are based

need to be reexamined from the standpoint of

both sound policy and administrative

feasibility. Most State agency administrators

agree that these rulings cannot be implemented

given the resources that are presently

Missouri New Hampshire

Alaska N. Carolina

21 22 24 22

Chart 12. - State Agency

Examiner Annual Attrition Rates,

Average and High Ten States

FY 2000

available. The rulings may create a resource

problem for hearing offices as well.

 Both the new Administration and the new

Congress will share the responsibility of

ensuring that disability policy and

administrative capabilities are properly

aligned. The basic point that needs to be

acknowledged is that today there is a big gap

between policy and administrative feasibility

that needs to be bridged by introducing

changes in policy, in institutional

arrangements, or funding – or most probably,

in all of these complex facets of an interwoven

process.

Finally, as the Board has recommended

previously, the agency should develop a

comprehensive work force plan and base its

appropriations requests on this plan, as

directed by the 1994 independent agency

legislation. We hope that both the

Administration and members of Congress will

approve the Board’s recommendation to

exclude SSA’s administrative budget for

Social Security from the statutory cap that

imposes a limit on the amount of discretionary

government spending.

Kansas

Tennessee

Georgia Indiana

Delaware

35

29 28

26 24

 Average

S. Carolina

13

21

Percent

40

35

30

25

20

15

10

5

0

The basic point that needs to be acknowledged is

that today there is a big gap between policy and

administrative feasibility that needs to be bridged

by introducing changes in policy, in institutional

arrangements, or funding – or most probably, in all

of these complex facets of an interwoven process.

D. Examine ways to improve incentives for early

rehabilitation and employment

The Social Security definition of disability

was written at a time when most of the work

being performed in the national economy

required physical labor. There was little

expectation that severely disabled individuals

would be able to perform any kind of

substantial work.

Over the years the labor market has

changed dramatically, and as passage of the
28

Most experts believe that

the most effective

intervention is to help

disabled individuals

return to work as quickly

as possible. More

comprehensive research

on ways to improve

incentives for

rehabilitation and

employment early

in a period of

disability is needed.

Included as part of this comprehensive

research effort should be a study of whether

providing some type of short-term disability

assistance, combined with rehabilitation and

employment services, would improve

assistance for those who have disabilities

while also relieving pressure on the

permanent disability programs. The studies

that are conducted should include cost-benefit

analyses. Where needed, specific legislative

authority and funding for these studies should

be provided.

possible. More comprehensive research on

ways to improve incentives for rehabilitation

and employment early in a period of disability

is needed. This may include new or different

arrangements for cash or medical benefits or

for rehabilitation and employment services.

The experience of other countries and of both

private and public employers in the United

States should be taken into account.

Americans with Disabilities Act in 1990

clearly showed, the attitude of individuals

who have disabilities has also changed.

Employment for the disabled has become a

major objective of disability advocacy groups

and individuals. The public at large also

appears to support this objective. But there is

growing concern that the present definition of

disability is inconsistent with the objectives

of the ADA.

The issue of whether the present

structure of assistance to the disabled

provides sufficient help and incentive for

employment requires thoughtful review. The

fact that disability claimants currently must

establish that they are unable to perform any

substantial gainful activity in order to qualify

for cash and medical benefits makes it

unlikely that they will be motivated to sign

up for vocational rehabilitation services, at

least until they are awarded disability

benefits, a process that can take up to a year

or even more. The 1999 Ticket to Work

legislation should encourage some

beneficiaries to enter or return to work, but it

is aimed at those who have already been

determined to be disabled and are likely to

have been out of the work force for a

substantial period of time.

Most experts believe that the most

effective intervention is to help disabled

individuals return to work as quickly as

The issue of whether the

present structure of

assistance to the disabled

provides sufficient help

and incentive for

employment requires

thoughtful review.
29

V. CONCLUSION: CONSTRUCTIVE CHANGE

AND ADDITIONAL RESOURCES ARE REQUIRED

Social Security’s disability rolls have grown steadily, and the agency’s actuaries project

continued rapid growth as baby boomers reach the age of increased likelihood of disability. At

the same time, disability policy has been growing more complex, while resources have been

constrained.

All parts of the disability policy and administrative structure are under increasing stress. If

the Social Security Administration is to be able to provide an appropriate level of service to those

who are disabled and to the public, fundamental changes are needed.

Today, the many thousands of SSA and State agency employees who are responsible for

administering the disability programs lack the tools they need to carry out their work. The

disability administrative and policy infrastructure is weak, and resources are inadequate to the

task.

These deficiencies manifest themselves in unfortunate ways. The application and appeals

process is too slow, and there are inconsistencies in decision making among different regions of

the country and different parts of the disability system. Disability policy and process are difficult

for claimants to understand and difficult for adjudicators to implement and to explain. Disability

rules and procedures differ in significant ways from one level of adjudication to another.

The problems with the administrative infrastructure begin at the top, where SSA’s current

organizational structure diffuses responsibility over nearly every component of the agency. They

continue throughout the disability system, where a fragmented and uncoordinated administrative

arrangement makes consistency and fairness in decision making difficult to achieve.

Problems in the area of policy are equally critical. For many years disability policy has

tended to be guided by court decisions and other pressures rather than by a well thought out

concept of how the programs should be operating. Policy is articulated by too many voices, with

no single source of policy to which decision makers can turn for guidance and direction. More

fundamentally, there is concern that disability policy is inconsistent with the objective of many

disabled individuals to participate in the economic mainstream through employment.

In this report we have described changes that we think would make the disability programs

more responsive to the needs of claimants and would provide greater accountability and

transparency for the public. We have also emphasized the need to provide the resources that are

required to provide the public with the high quality of service that it deserves.

We urge the new Administration and the new Congress to undertake a fundamental review of

the disability programs as soon as possible. This review will require the involvement of many

individuals and organizations whose views will be diverse and often conflicting. But discussion

and debate are needed to clarify the issues and to inform policy makers and the public. Resolving

differences and reaching consensus will be difficult, but we strongly believe that major changes

in the disability programs are required if they are to serve the needs of the disabled and the public

at large.
30
31

GLOSSARY

Administrative law judge (ALJ): Administrative law judges in SSA’s Office of Hearings and

Appeals conduct hearings and make decisions on cases that are appealed by individuals whose

claims have been denied by State agencies.

Appeals Council: The organization within SSA’s Office of Hearings and Appeals that makes the

final decision in the administrative review process. When an individual disagrees with the

decision or dismissal of the ALJ, he or she may, within 60 days of receiving the hearing decision,

request that the Appeals Council review the decision. The Appeals Council may deny or dismiss

the request for review, or it may grant the request and either issue a decision or remand (return)

the case to an ALJ. The Appeals Council may also review any ALJ action on its own motion

within 60 days after the ALJ’s action.

Equals listing: A step in the sequential evaluation process. Regulations issued by SSA include a

Listing of Impairments which describes, for each major body system, impairments that are

considered severe enough to prevent a person from doing any substantial gainful activity. A

determination that an impairment is equal in severity to the criteria in the listings is sufficient to

establish that an individual who is not working is disabled within the meaning of the law. (See

sequential evaluation process.)

Hearing: The level following reconsideration in the administrative review process. The hearing

is a de novo procedure at which the claimant and/or the claimant’s representative may appear in

person, submit new evidence, examine the evidence used in making the determination under

review, give testimony, and present and question witnesses. The hearing is on the record but is

informal and non-adversarial.

Hearing office: One of the 138 locations of SSA’s Office of Hearings and Appeals at which

hearings are held.

Hearings Process Improvement initiative: A plan which SSA is implementing in its hearing

offices with the goal of reducing processing time and increasing productivity in the hearings

process through process improvements, group-based accountability, and automation.

Medical listings: A common term for the Listing of Impairments issued by SSA as part of the

regulations on determining disability. The listings describe, for each major body system,

impairments that are considered severe enough to prevent a person from doing any substantial

gainful activity. An impairment that meets or equals the criteria in the listings is sufficient to

establish that an individual who is not working is disabled within the meaning of the law.

Meets listing: A step in the sequential evaluation process. Regulations issued by SSA include a

Listing of Impairments which describes, for each major body system, impairments that are

considered severe enough to prevent a person from doing any substantial gainful activity. An

impairment that meets the criteria in the listings is sufficient to establish that an individual who is

not working is disabled within the meaning of the law. (See sequential evaluation process.)
32

Process unification: An SSA initiative with the objective of fostering similar results on similar

cases at all stages of the administrative review process by the consistent applications of laws,

regulations and rulings. Process unification activities include training, development of a single

presentation of policy and enhancing documentation and explanations at the DDS level.

Prototype: The implementation of elements of a redesigned disability process in 10 States

(known as “prototype States”) in preparation for national implementation. This prototype began

in October, 1999. The elements of the prototype are: elimination of reconsideration; an

expanded role for disability examiners to make decisions without approval of a medical

consultant; the opportunity for a telephone conference with an adjudicator for claimants whose

claims would receive an unfavorable decision; and enhanced rationales for decisions.

Reconsideration: An independent reexamination by State agencies of all evidence on record

related to a case. It is based on the evidence submitted for the initial determination plus any

further evidence and information that the claimant or the claimant’s representative may submit in

connection with the reconsideration. A reconsideration determination is made by a different

disability examiner and physician/psychologist from the ones who made the original

determination.

Sequential evaluation process: The five-step process used in determining whether an individual

meets the definition of disability in the law. A determination at any step that an individual is

disabled or not disabled ends the process. The steps are:

1) Substantial gainful activity — If the claimant is, in fact, continuing to work and that work is

found to be substantial gainful activity the process calls for a finding that he or she is not

disabled.

2) Not severe — If it is determined that the claimant’s medical impairments are not severe, i.e.,

do not significantly limit the ability to perform basic work activities, he or she is not disabled.

3) Listing of Impairments — If the claimant meets the criteria for an impairment listed in the

regulations, or has an impairment or combination of impairments that is medically equivalent, he

or she is to be found disabled.

4) Relevant past work — If a claimant’s impairments do not prevent performance of relevant

work he or she has done in the past, he or she is not disabled.

5) Other work — At this step, if a claimant, considering age, education, and work experience,

cannot do other work which exists in the national economy, he or she is found to be disabled.

State agency: A common term for Disability Determination Services, the State agency which

makes the initial and reconsideration determinations of whether a claimant is disabled or a

beneficiary continues to be disabled within the meaning of the law.
33

Establishment of the Board

In 1994, when the Congress passed legislation establishing the Social Security

Administration as an independent agency, it also created a 7-member bipartisan Advisory Board

to advise the President, the Congress, and the Commissioner of Social Security on matters

relating to the Social Security and Supplemental Security Income (SSI) programs. The

conference report on this legislation passed both Houses of Congress without opposition.

President Clinton signed the Social Security Independence and Program Improvements Act of

1994 into law on August 15, 1994 (P.L. 103-296).

Advisory Board members are appointed to 6-year terms, made up as follows: 3 appointed by

the President (no more than 2 from the same political party); and 2 each (no more than one from

the same political party) by the Speaker of the House (in consultation with the Chairman and

Ranking Minority Member of the Committee on Ways and Means) and by the President pro

tempore of the Senate (in consultation with the Chairman and Ranking Minority member of the

Committee on Finance). Presidential appointees are subject to Senate confirmation. Board

members serve staggered terms.

The Chairman of the Board is appointed by the President for a 4-year term, coincident with

the term of the President, or until the designation of a successor.

Members of the Board

Stanford G . Ross, Chairman

Stanford Ross is a partner in the law firm of Arnold & Porter, Washington, D.C. He has dealt

extensively with public policy issues while serving in the Treasury Department, on the White

House domestic policy staff, as Commissioner of Social Security, and as Public Trustee of the

Social Security and Medicare Trust Funds. He is a Founding Member and a former Director and

President of the National Academy of Social Insurance. He has provided technical assistance on

Social Security and tax issues under the auspices of the International Monetary Fund, World

Bank, and U.S. Treasury Department to various foreign countries. He has taught at the law

schools of Georgetown University, Harvard University, New York University, and the University

of Virginia, and has been a Visiting Fellow at the Hoover Institution, Stanford University. He is

the author of many papers on Social Security and Federal taxation subjects. Term of office:

October 1997 to September 2002.

Jo Anne Barnhart

Jo Anne Barnhart is a political consultant and public policy consultant to State and local

governments on welfare and social services program design, policy, implementation, evaluation,

and legislation. From 1990 to 1993 she served as Assistant Secretary for Children and Families,

Department of Health and Human Services, overseeing more than 65 programs, including Aid to

Families with Dependent Children, the Job Opportunities and Basic Skills Training program,

THE SOCIAL SECURITY ADVISORY BOARD
34

Child Support Enforcement, and various child care programs. Previously, she was Minority Staff

Director for the U.S. Senate Committee on Governmental Affairs, and legislative assistant for

domestic policy issues for Senator William V. Roth. Ms. Barnhart served as Political Director for

the National Republican Senatorial Committee. First term of office: March 1997 to September

1998; current term of office: October 1998 to September 2004.

Martha Keys

Martha Keys served as a U.S. Representative in the 94th and 95th Congresses. She was a

member of the House Ways and Means Committee and its Subcommittees on Health and Public

Assistance and Unemployment Compensation. Ms. Keys also served on the Select Committee on

Welfare Reform. She served in the executive branch as Special Advisor to the Secretary of

Health, Education, and Welfare and as Assistant Secretary of Education. She was a member of

the 1983 National Commission (Greenspan) on Social Security Reform. Martha Keys is

currently consulting on public policy issues. She has held executive positions in the non-profit

sector, lectured widely on public policy in universities, and served on the National Council on

Aging and other Boards. Ms. Keys is the author of Planning for Retirement: Everywoman’s

Legal Guide. First term of office: November 1994 to September 1999; current term of office:

October 1999 to September 2005.

David Podoff

David Podoff is visiting Associate Professor at the Department of Economics and Finance at

the Baruch College of the City University of New York. Recently, he was Minority Staff Director

and Chief Economist for the Senate Committee on Finance. Previously, he also served as the

Committee’s Minority Chief Health and Social Security Counselor and Chief Economist. In

these positions on the Committee he was involved in major legislative debates with respect to the

long-term solvency of Social Security, health care reform, the constitutional amendment to

balance the budget, the debt ceiling, plans to balance the budget, and the accuracy of inflation

measures and other government statistics. Prior to serving with the Finance Committee he was a

Senior Economist with the Joint Economic Committee and directed various research units in the

Social Security Administration’s Office of Research and Statistics. He has taught economics at

the University of Massachusetts and the University of California in Santa Barbara. He received

his Ph.D. in economics from the Massachusetts Institute of Technology and a B.B.A. from the

City University of New York. Term of office: October 2000 to September 2006.

Sylvester J. Schieber

Sylvester Schieber is Director of the Research and Information Center at Watson Wyatt

Worldwide, where he specializes in analysis of public and private retirement policy issues and the

development of special surveys and data files. From 1981 to 1983, Mr. Schieber was the Director

of Research at the Employee Benefit Research Institute. Earlier, he worked for the Social

Security Administration as an economic analyst and as Deputy Director at the Office of Policy

Analysis. Mr. Schieber is the author of numerous journal articles, policy analysis papers, and

several books including: Retirement Income Opportunities in An Aging America: Coverage and

Benefit Entitlement; Social Security: Perspectives on Preserving the System; and The Real Deal:

The History and Future of Social Security. He served on the 1994-1996 Advisory Council on

Social Security. He received his Ph.D. from the University of Notre Dame. Term of office:

January 1998 to September 2003.
Gerald M. Shea*

Gerald M. Shea is currently assistant to the president for Government Affairs at the AFLCIO. He previously held several positions within the AFL-CIO, serving as the director of the

policy office with responsibility for health care and pensions, and also in various executive staff

positions. Before joining the AFL-CIO, Mr. Shea spent 21 years with the Service Employees

International Union as an organizer and local union official in Massachusetts and later on the

national union’s staff. He was a member of the 1994-1996 Advisory Council on Social Security.

Mr. Shea serves as a public representative on the Joint Commission on the Accreditation of

Health Care Organizations, is a founding Board member of the Foundation for Accountability,

Chair of the RxHealth Value Project, and is on the Board of the Forum for Health Care Quality

and Measurement. He is a graduate of Boston College. First term of office: January 1996 to

September 1997; current term of office: October 2000 to September 2004.

* Gerald Shea, who rejoined the Advisory Board on October 24, 2000 and therefore did not

participate in the study or the drafting that preceded the issuance of this report, has decided not to

sign it.

Mark A. Weinberger

Mark A. Weinberger is currently the Director of the U.S. National Tax Practice for Ernst &

Young LLP. Mr. Weinberger has previously served as Chief of Staff and Counsel to the

President’s 1994 Bipartisan Commission on Entitlement and Tax Reform (the Kerrey-Danforth

Commission). He also is a former Commissioner of the National Commission on Retirement

Policy. Mr. Weinberger served as Chief Tax and Budget Counsel to Senator John Danforth, and

also as a tax advisor to the National Commission on Economic Growth and Tax Reform (the

Kemp Commission), which studied fundamental tax reform. Mr. Weinberger has written and

lectured extensively on tax, budget, political and retirement security issues. He graduated from

Emory University; holds a Masters degree in Business Administration and a law degree from

Case Western Reserve University; and has an L.L.M. from Georgetown University Law Center.

Term of office: October 2000 to September 2006.

Members of the Staff

Margaret S. Malone, Staff Director

Michael Brennan

Beverly Rollins

George Schuette

Wayne Sulfridge

Jean Von Ancken

David Warner

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Social Security Advisory Board

400 Virginia Avenue, SW

Suite 625

Washington, D.C. 20024

Tel: (202) 475-7700

Fax: (202) 475-7715

E-mail: info@ssab.gov

www.ssab.gov