Federal Employee Wins Additional Compensation After Being Denied by OWCP

I am pleased to announce another victory for a federal worker who was previously delayed and denied in receiving his injury benefits from the US DOL OWCP. A postal worker, his knee gave out on him while performing his job duties. Surgical repair of the knee was required. After he was treated and released we submitted a claim for 7% permanent impairment of the left knee to the OWCP. The OWCP, after much stalling, had their own in-house doctor give a rating of only 2% to the knee. The OWCP doctor never examined or met the claimant. We appealed this decision to the Employees Compensation Appeals Board (ECAB) arguing that a report of a non-examining doctor should have no weight or preference over that of our examining doctor's report. The ECAB totally agreed with our argument. Not only did the ECAB agree, but the ECAB further ordered that the US DOL OWCP pay an additional award to the claimant over what we had originally requested: up to 9% impairment to the knee. ECAB 2004-2167

Jim Linehan 

Social Security: Cure Thyself?

The simple truth is that the SSA is an extremely large government bureaucracy. And in that bureaucracy, as with most bureaucracies, the left hand rarely knows what the right hand is doing with your money.

According to the SSA itself the performance of the SSA was well below par in 2004. For example, with ever increasing funding the SSA's goal in 2004 was to process 538,000 disability hearings in the country. Yet the SSA reports it failed to do this and was only able to process 497,397 disability hearings.

As another example, the SSA set a goal to reduce the amount of time it took for your disability claim to be processed. The goal was to have the process not exceed 377 days. Again, despite additional funds, personnel, etc., the SSA failed and the actual time it took for the SSA to process a disability claim in 2004 increased to over 390 days. Just four years ago, in 2000, with fewer personnel, funding, etc, the SSA time to process a disability claim was almost 100 days faster.

In 2004, the SSA set a goal to have only 582,000 disability claims waiting, on hold, to be processed. Again the SSA failed in its goal and reported by year end that over 624,650 initial disability claims remained waiting to be processed by the SSA.

In 2004 the SSA set a goal to reduce to 586,000 the number of disability claims waiting on a hearing before a judge. Again the SSA failed to meet its goal and by year end the SSA reported that more than 635, 600 claims were still waiting on a hearing before a judge.

In response to this dismal performance, the SSA is new seeking to implement a new disability claims processing method. The Deputy Commissioner Martin Gerry has acknowledged that within the SSA there is "no communication" between the initial disability claim processors and the final disability decision maker. In other words, the SSA personnel who are making the decision on your initial disability claim have "no communication" with the SSA personnel (including the SSA Judges) who later issue the final decision on your disability claim. This fact is
Readily illustrated in that of the disability claimants initially denied by the SSA administration, up to 70% of those denials are later overturned on appellate review due to findings of poor decision making by the SSA examiners, including the SSA judges.

Adding to the communications failures within the SSA is an ongoing very hostile climate that has developed between the Association of Administrative Law Judges who hold the SSA hearings, and the SSA itself. This in-fighting is due to a current proposal to reduce or even fully eliminate the current disability hearings and administrative judges and create instead an independent Social Security Court.

This again bodes badly for social security claimants as administrative law judges may face coercion from the SSA to make claims decision that favor the SSA, simply in order to insure the judges own job survival.

Is the SSA in dire trouble and in need of privatizing as proposed by President Bush? Or is the SSA functioning fine and in no need of reform as argued by the Congress?

Perhaps the real answer is best summarized by a policy analyst for the SSA working on the new claims processing model: "We are hemorrhaging and have no idea how to stop the bleeding."

Until and unless the President and the Congress each acknowledge that the real problems with the SSA may be within the SSA administration itself, rather than privatizing or throwing more money at the SSA, the SSA may very well bleed to death on its own.