GAO: Public SSDI claim help mostly a mystery

January 05, 2015 at 09:33 AM
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The Social Security Administration (SSA) has no good way to track how state and local agencies are using outside Social Security claim advocates to help people apply for SSA benefits.

Investigators at the U.S. Government Accountability Office (GAO), an arm of Congress, present that conclusion in a look at what it found when it studied state and local SSA claimant support programs. Some help people file for Supplemental Security Income (SSI) benefits — benefits that go to very poor people who do not qualify for work-based Social Security benefits — and for Social Security Disability Insurance (SSDI) benefits.

Private disability insurers like to see qualified workers qualify for SSDI benefits quickly, because they may use information about SSDI determinations in their own claim review efforts, and they often subtract part or all of any SSDI benefits payments from the amounts they pay.

Some state and local governments help SSDI benefits applicants, both to improve those applicants' quality of life and, in some cases, to reduce the amounts spent on state and local benefits programs.

The GAO investigators estimate that claim advocates with state or local government contracts might help about 1 percent of the people who file initial SSDI claims, Daniel Bertoni, a GAO director, writes in a report summarizing the investigators' findings.

SSA is starting to collect registration information on the claimant advocates, but it is still working on efforts to integrate that information with systems it could use to look for evidence of fraud or other problems, Bertoni says.

Some SSA officials are talking about giving the advocates direct access to claimants' electronic files in exchange for getting more, better-organized advocate information, Bertoni says.

The GAO investigators looked at the advocacy programs in Hawaii, Minnesota and Westchester County, N.Y., to see how the programs work.

Hawaii, for example, spent $410,957 in fiscal year 2013 on advocates from nonprofit organizations. The advocates helped 342 claimants qualify for benefits. Hawaii paid $900 for an approved claim at the initial level, $1,325 for a reconsideration and $1,650 for an appeal.

Minnesota spent about $2 million on 42 nonprofit organizations and 13 for-profit advocates, and those advocates helped 1,112 people qualify for benefits. Minnesota paid $1,500 at the initial level for people in some state aid programs and $2,500 for homeless people with mental impairments. It paid $2,750 or $2,500 for appeals.

Westchester County spent $380,000 on a contract with one for-profit firm, and that company helped 136 people get benefits. The county paid $3,000 for an approved adult disability claim and $1,500 for help with continuing disability reviews.

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