The American Association for Disability Policy Reform
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Quality vs. Quantity
When asked, any Social Security disability administrator will tell you that quality is the Administration's first concern. The facts show that is not true:
- Pressure on clerks (examiners) and medical consultants is focused far more on production than on quality. Almost no one gets fired for incompetence. It's easy to get fired (or have a contract not renewed) because of "poor" production.
- The Social Security Administration has known for decades that better community-based investigation of disability applicants would lead to more accurate and timely decisions (details). Nevertheless, sloppy information gathering continues to be the rule.
- The Social Security Administration reassures us that its initial decisions are 96% to 97% accurate.** Administrative law judges then say that about half of those decisions were wrong. Other evidence has shown that the error rate is about 30% overall and, for some groups, is about 50%.
- Within the Social Security Administration, communications are focused far more often on production than on quality.
- Congress has held countless hearings about the long waits for decisions and the "backlog" of cases. Meanwhile, Congress has failed to consider quality.
- In 2001, an independent evaluation of the Administration's quality assurance (QA) programs concluded that "no amount of retooling, refocusing, redesign, tinkering or the simple addition of resources to the existing QA processes will achieve [the Social Security Administration's] quality improvement goals." In addition, the consultants said that "The only way that SSA will achieve its quality objectives for the disability programs is to adopt a broad, modern view of quality management that includes efforts outside of [the Office of Quality Assurance] and the current quality assurance process." Little or no progress has been made in the 20 years since the recommendations were made.
The principal reason that quantity is much more important than quality is that, with no reliable method for determining who is disabled and who is not (in most cases), it is not possible to measure the quality of disability decisions. Until Congress revises the definition of disability, as recommended by the Social Security Advisory Board (details), production will continue to take precedence over quality.
**Data available at https://www.ssa.gov/open/data/disability-determination-services-accuracy.html for 2020 (last checked 7/25/2021). The Social Security Administration uses a definition of "quality" that only requires that certain procedural steps be followed and a reasonable decision made from the often-inadequate data. The accuracy and adequacy of the information used in making decisions is almost never a factor. Although deterioration in the claimant's condition during the wait for a judge's decision is often cited as the reason for the reversal of decisions by administrative law judges, the facts indicate otherwise.
Last updated on 7/25/2021.