[House Hearing, 118 Congress]
[From the U.S. Government Publishing Office]
ONE MILLION CLAIMS AND
GROWING: IMPROVING SOCIAL SECURITY'S
DISABILITY ADJUDICATION PROCESS
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HEARING
BEFORE THE
SUBCOMMITTEE ON SOCIAL SECURITY
OF THE
COMMITTEE ON WAYS AND MEANS
HOUSE OF REPRESENTATIVES
ONE HUNDRED EIGHTEENTH CONGRESS
FIRST SESSION
__________
OCTOBER 26, 2023
__________
Serial No. 118-SS04
__________
Printed for the use of the Committee on Ways and Means
[GRAPHIC NOT AVAILABLE IN TIFF FORMAT]
__________
U.S. GOVERNMENT PUBLISHING OFFICE
55-929 WASHINGTON : 2024
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COMMITTEE ON WAYS AND MEANS
JASON SMITH, Missouri, Chairman
VERN BUCHANAN, Florida RICHARD E. NEAL, Massachusetts
ADRIAN SMITH, Nebraska LLOYD DOGGETT, Texas
MIKE KELLY, Pennsylvania MIKE THOMPSON, California
DAVID SCHWEIKERT, Arizona JOHN B. LARSON, Connecticut
DARIN LaHOOD, Illinois EARL BLUMENAUER, Oregon
BRAD WENSTRUP, Ohio BILL PASCRELL, Jr., New Jersey
JODEY ARRINGTON, Texas DANNY DAVIS, Illinois
DREW FERGUSON, Georgia LINDA SANCHEZ, California
RON ESTES, Kansas BRIAN HIGGINS, New York
LLOYD SMUCKER, Pennsylvania TERRI SEWELL, Alabama
KEVIN HERN, Oklahoma SUZAN DelBENE, Washington
CAROL MILLER, West Virginia JUDY CHU, California
GREG MURPHY, North Carolina GWEN MOORE, Wisconsin
DAVID KUSTOFF, Tennessee DAN KILDEE, Michigan
BRIAN FITZPATRICK, Pennsylvania DON BEYER, Virginia
GREG STEUBE, Florida DWIGHT EVANS, Pennsylvania
CLAUDIA TENNEY, New York BRAD SCHNEIDER, Illinois
MICHELLE FISCHBACH, Minnesota JIMMY PANETTA, California
BLAKE MOORE, Utah
MICHELLE STEEL, California
BETH VAN DUYNE, Texas
RANDY FEENSTRA, Iowa
NICOLE MALLIOTAKIS, New York
MIKE CAREY, Ohio
Mark Roman, Staff Director
Brandon Casey, Minority Chief Counsel
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SUBCOMMITTEE ON SOCIAL SECURITY
DREW FERGUSON, Georgia, Chairman
MIKE CAREY, Ohio JOHN LARSON, Connecticut
DAVID SCHWEIKERT, Arizona BILL PASCRELL, New Jersey
RON ESTES, Kansas LINDA SANCHEZ, California
BLAKE MOORE, Utah BRIAN HIGGINS, New York
RANDY FEENSTRA, Iowa DAN KILDEE, Michigan
GREG STEUBE, Florida
DAVID KUSTOFF, Tennessee
C O N T E N T S
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OPENING STATEMENTS
Page
Hon. Drew Ferguson, Georgia, Chairman............................ 1
Hon. Bill Pascrell, New Jersey, Ranking Member................... 3
Advisory of October 26, 2023 announcing the hearing.............. V
WITNESSES
Linda Kerr-Davis, Acting Assistant Deputy Commissioner of
Operations, Social Security Administration..................... 4
Jacqueline Russell, President, National Council of Disability
Determination Directors........................................ 14
David Camp, Interim CEO, National Organization of Social Security
Claimants' Representatives..................................... 26
Jennifer Burdick, Co-Chair, Consortium for Citizens with
Disabilities Social Security Task Force........................ 38
Mark Warshawsky, Senior Fellow, American Enterprise Institute.... 50
MEMBER QUESTIONS FOR THE RECORD
Member Questions for the Record and Responses from Linda Kerr-
Davis, Acting Assistant Deputy Commissioner of Operations,
Social Security Administration................................. 92
PUBLIC SUBMISSIONS FOR THE RECORD
Public Submissions............................................... 102
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ONE MILLION CLAIMS AND GROWING: IMPROVING SOCIAL SECURITY'S DISABILITY
ADJUDICATION PROCESS
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THURSDAY, OCTOBER 26, 2023
House of Representatives,
Subcommittee on Social Security,
Committee on Ways and Means,
Washington, DC.
The subcommittee met, pursuant to call, at 9:03 a.m. in
Room 2020, Rayburn House Office Building, Hon. Drew Ferguson
[chairman of the subcommittee] presiding.
Chairman FERGUSON. We will call this subcommittee hearing
to order now.
I want to start with my opening statement. We will--
hopefully, by the time we get through that, Mr. Pascrell will
be here, we will move to him, and then go to each of you.
So good morning again. For the first time in history, more
than one million people are waiting on Social Security
Administration to process their initial disability claim. Let
me say that again. That is one million people are now waiting.
On average, claims are taking 220 days to be decided. That is
more than 100 days longer than it was in 2019 and more than 150
days longer than the Social Security Administration--what it
defines as a minimum level of performance.
The real-world consequences for these individuals who are
unable to work and wait for their disability decision are
devastating. Many of these families and many of these
individuals really get hurt by these delays.
To help illustrate what the Social Security
Administration's claim process looks like from a claimant's
perspective, I would like to submit for the record a statement
provided to us by a beneficiary who waited more than a year for
a decision that should have taken months, if not weeks.
Without objection, I would like for this statement to be
entered into the record.
Chairman FERGUSON. She has a very, very severe condition,
and was unable to travel, and she was unable to be here to
testify. But, in place of that, instead of me reading the words
and using that, I would like to play a recording of her
statement as part of this opening statement. So, with that, we
will begin the recording.
Voice. It was a semi-typical day. I was leaning on the
countertop in our hall bathroom, waiting for my two-year-old to
finish going to the toilet. My husband was in the bedroom,
sleeping off the previous night's third shift from his job, but
had his phone on full blast in case I needed help. Suddenly,
the muscles around my ribs cramped, and I could barely get air
in. I pulled out my cell phone and called my husband and said
one quiet word, ``Help.''
As I went to my knees, I thought to myself, I am going to
die on the bathroom floor in front of my two-year-old. At that
moment the Social Security Administration had denied my claim
for disability, stating that I was capable of work. If my
husband hadn't brought my rescue medication, I would have died
that day.
Stiff person syndrome is an exceptionally rare--literally,
one in a million--permanent and progressive autoimmune
neurological condition that the primary symptom is severe
muscle cramps and spasticity. The spasms in me have torn
multiple ligaments, broken multiple ribs, given me multiple
attacks where I cannot breathe, and have left me screaming in
agony more times than I can attempt to count. It also affects
my central nervous system, causing things like seizures and
vision problems. I do my best to complete something productive
each day and be a member of my small family, but most of my
time is spent asleep, either because of sheer exhaustion or the
many medications I have to take each day.
The two primary causes of death from stiff person syndrome
are spontaneous apneic episodes and suicide. Let me repeat
that. I am most likely to die from suffocation or suicide.
It took me weeks to complete the Social Security
application, both because of the breadth of information
required, as well as system errors that would cause entire
pages to empty of data. I received many unclear letters in the
mail. Each time this occurred, I had to call up to confirm that
my application hadn't been lost and that I was still in the
queue to be deemed disabled.
Stiff person syndrome is on the compassionate allowance
list. These are supposed to be the cases where the illness is
so severe that there doesn't need to be a wide assessment of
the validity of disability. However, my case was not treated
this way. My case was denied.
We were living on savings and a very small private
disability insurance payment. Each month, we were calculating
how much longer we had to live before the money ran out. I
emptied my 401(k). We had to pay bills late. We had to delay
some treatments for my autistic son.
Once my case was finally reassessed, my disability claim
was approved and we reached back--we received back pay, but my
lawyer wasn't paid, and now I have to figure out how to address
that issue. I am still awaiting my first monthly payment, but
it has taken 15 months.
This process can be made better for both employees of the
Social Security Administration and claimants by simplifying it.
Chairman FERGUSON. Wow. Words say an awful lot.
I know I almost wish at this point that we had our district
office staffs here to tell story after story after story about
what they deal with.
And, while the Social Security Administration claims it is
working to address the backlog, we are seeing things go in the
wrong direction. We are spending $100 million to fund outreach
efforts aimed at increasing initial disability claims and--
while on their own, disability claims have been declining on
their own.
Let me put this in plain English. If the Social Security
Administration is unable to keep up with the claims that it has
now but is spending hundreds of millions of dollars to get more
claims, it doesn't make sense and it feels like--that those
dollars should be going to address the issue that is at hand.
Over the past 12 years, the Social Security Administration
has invested more than $300 million to obtain an up-to-date
occupational data and to determine whether a claimant can work
a job in today's economy. And, although the SSA has
acknowledged that this data is more useful and more accurate,
they continue to rely on occupational data that is more than 30
years out of date.
These are just a couple of examples of how the SSA is
making life harder for claimants and making more work for
itself. There are many more that we will hear about today, and
I hope that when we are finished with this, we will begin to be
able to figure out better solutions so that we can help these
claimants and help their families. That is what we should be
doing.
Chairman FERGUSON. So, with that, I will yield to my good
friend, the gentleman from New Jersey and ranking member for
this hearing, Mr. Pascrell.
Sir, you are recognized.
Mr. PASCRELL. Thank you, Mr. Chairman. It is good to be
back in the neighborhood.
I am going to say some things now that should not be
misinterpreted as me not wanting to sit down and the rest of
our group wanting to sit down to find solutions to problems.
You will always find us there at your calling. But I think we
have got to make some things clear here.
I look at this hearing as a kind of smokescreen, a cover-up
for the majority's extremist agenda to gut Social Security.
Chapter and verse. The other side, your side, voted over and
over again--and you can't escape that, it either happened or it
didn't happen--to cut the Social Security Administration's
budget. These cuts only make disability delays far longer.
Social Security is one of America's greatest success
stories. Forty percent of seniors, fifty percent of disabled
beneficiaries will live in poverty without Social Security.
Social Security still stands as a monument to decency, dignity,
hardworking Americans after nearly 90 years. Yet, throughout
its storied history it has been under attack. Going back to
1935, it has been the subject of scurrilous attacks and lies
from day one. There is a history here which we all should
appreciate.
Let's not forget a House Republican, Mr. Chairman, brought
our nation to the brink of devastating default with the debt
ceiling debacle. And we are going to go back to that not this
time, but another time. We nearly saw millions of Americans cut
off from Social Security for the first time in history, and we
can't forget that. I am not going to forget it. I know you
won't, either.
And the Republican Study Committee, which represents three
quarters of all the House Republicans, proposed slashing Social
Security benefits by $718 billion over 10 years, which comes to
$70 billion, rather, every year. That is a lot of money.
Far from Social Security saviors, I think the majority
insists on seeking its destruction because they have a better
idea. And we are going to wait for this better idea like we
waited for the peace treaty of Vietnam. Where is it? I can't
ask the guy who talked about it because he is no longer here.
Our nation's retirement system is lurching toward
insolvency. We have got to do something about it. We can do it.
All of us. We can do this. No one party can do this, no one
party. We have a sacred responsibility to address the actual
challenges facing Social Security. Social Security cannot
tackle delays without ensuring that customer service at the
Social Security Administration is fully funded.
We must eliminate the mandatory five-month waiting period
for disability benefits, as my friend John Larson's Social
Security 2100 Act would do.
Enough dishonesty and misdirection. We either sit down, we
either work this out, or Social Security will not be here. You
can't save it. I can't save it. We got to do it together.
Mr. PASCRELL. Thank you, Mr. Chairman.
Chairman FERGUSON. I thank the ranking member. We will
address many of those points throughout this hearing. But
again, the purpose of this is to figure out just one small
section of what the Social Security Administration does, which
is to process disability claims, and how can we do that better,
more cleanly, and help Americans who need this vital service.
So, with that, I will have the pleasure of introducing our
witnesses.
Ms. Linda Kerr-Davis is the acting assistant deputy
commissioner of operations for the Social Security
Administration.
Thank you for being here.
Ms. Jacqueline Russell, president of the National Council
of Disability Determination directors.
Mr. David Camp is the interim CEO for the National
Organization of Social Security Claimants' Representatives.
Thank you for being here.
Ms. Jennifer Burdick is co-chair of the Consortium for
Citizens with Disabilities Social Security Task Force.
And lastly, Mr. Mark Warshawsky, a senior fellow for the
American Enterprise Institute.
Thank you all for joining us today. We look forward to your
testimony. We look forward to the back-and-forth. We hope to
learn an awful lot from you today.
With that, Ms. Kerr-Davis, you may begin when you are
ready.
STATEMENT OF LINDA KERR-DAVIS, ACTING ASSISTANT DEPUTY
COMMISSIONER OF OPERATIONS, SOCIAL SECURITY ADMINISTRATION
Ms. KERR-DAVIS. All right. Well, thank you, Committee Chair
Ferguson, Representative Pascrell, and members of the
subcommittee. Thank you for inviting me to discuss our
disability adjudication process and our strategy to reduce wait
times. We appreciate your partnership and--on this important
topic.
I am Linda Kerr-Davis. I am the acting assistant deputy
commissioner of operations at Social Security. Prior to joining
SSA, I worked for the Kansas Disability Determination Services.
Currently, over 15 million people rely on disability
benefits to provide for basic needs like food, shelter, and
medical care. Meanwhile, pending levels and wait times for
determinations on all initial disability claims and disability
reconsiderations are at all-time highs. Pending initial
disability claims have exceeded one million claims. Applicants
are waiting, on average, seven months for a decision. This is
simply not acceptable to you or to us.
The DDSs are experiencing record high employee attrition
and difficulty hiring qualified examiners to replace them. They
have also at times been challenged with reduced access to
medical evidence, which began with the COVID-19 public health
emergency and was compounded by a shortage of consultative
examination providers. In response to this crisis, a team of
SSA experts worked to identify root causes of the backlog,
implement short-term improvements, while also developing a
long-term strategy to resolve the backlog.
Working within the constraints of our current budget, the
strategy involves improvements in four key areas: first,
processing capacity; second, recruitment and retention; third,
business processes and policies; and finally, information
technology.
We are increasing our processing capacity by redirecting
experienced personnel from across the agency to process cases
for the DDSs, starting with claims for the individuals who have
been waiting the longest. We established cadres of SSA
experienced employees and rehired annuitants to help the DDSs
process initial-level claims. Last fiscal year these cadres
completed over 27,000 initial claims in addition to the claims
processed by the DDSs.
We have engaged directly with many states to increase
recruitment and retention of state employees who process
claims. The acting commissioner has contacted governors,
explaining how improved pay and other policies for these
employees will help the citizens of their states, as well as
SSA.
Last fiscal year, the DDSs made progress by hiring about
2,500 full-time staff and ended the year with over 700
additional full-time staff on duty compared to fiscal year
2022.
We are also working on improvements in business processes
and policies. We continue to retrain field office staff to help
make the disability determination easier for the DDSs by paying
close attention to situations in which we can expedite
disability payments.
We have also taken steps to improve our information
technology. We implemented a national case processing system
which replaced 52 independently operated DDS legacy systems.
Today, all DDSs are using a uniform and modern system to
process disability claims efficiently.
The steps we have taken are beginning to show positive
results. In fiscal year 2023, we processed over 90,000 more
initial disability claims than we did in fiscal year 2022. Our
goal of returning to pre-pandemic processing timeframes,
however, is going to take years and will require sufficient and
sustained resources.
Our disability programs provide a vital safety net for your
constituents. With the support of Congress, we have shown that
we can tackle and overcome significant operational challenges
such as the hearings backlog crisis in 2016. We have a strategy
to improve service and reduce the time your constituents must
wait for a disability decision. Similar to our mutual success
with reducing the hearing backlog, improving service for
initial claims will require the support from Congress.
Thank you for your interest in our efforts to improve
service for the American public, and I would be happy to answer
any questions you may have.
[The statement of Ms. Kerr-Davis follows:]
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Chairman FERGUSON. Thank you so much.
Ms. Russell, you are now recognized.
STATEMENT OF JACQUELINE RUSSELL, PRESIDENT, NATIONAL COUNCIL OF
DISABILITY DETERMINATION DIRECTORS
Ms. RUSSELL. Good morning. Thank you, Chairman Ferguson,
Ranking Member Pascrell, and committee members for this
opportunity to share.
My name is Jacqueline Russell, I am the president of the
National Council of Disability Determination Directors. We are
thankful to have membership from every state, and we regularly
seek input from our membership on needs and best practices.
I am proud also to be the director for the North Carolina
Disability Determination Services, and I have submitted written
testimony that has details and data and examples of what I am
going to talk about today. I thank you for reading that.
I am starting our conversation with the strengths of
disability determination agencies, which are in every state,
processing these disability claims. Disability determination
staff are innovative, we are adaptive. We have proven that
through the pandemic, as we found new sources for paper and
were adaptable. We also have reallocated staff to process
disability claims staff from our disability hearings unit,
professional relations office. Everybody is pitching in, and we
are making progress on reducing the backlog.
We have a long way to go, and we need your help with that.
That leads me to just two focuses today that I want to talk
about for areas of need. The first is a strong workforce.
Disability determination staff, we need to be able to hire
on an as-needed basis, in particular when we have losses. At
the Disability Determination Agency, our budget already
includes those personnel costs for staff, and, when we have
doctors or disability examiners that leave, we need to be able
to have consistent, stable hiring authority every year for
those losses. That will help us with our retention.
We also need to have consistent overtime access for all
case types. We are thankful that this week we received overtime
to support continuing disability review cases, and that is
important. We also need consistent overtime for initial and
reconsideration cases so that we maintain this progress that we
have been making on the backlog.
Additionally, I want to share two efficiencies. The first
one is communications. Currently, disability determination
staff, we have two approaches to connect with claimants. The
first is the U.S. Postal Service and the second is by phone.
And, in this day and age, a lot of people don't like to pick up
the phone when you call them. And so it makes it hard for us to
reach our claimants to find out if they are willing to go to a
consultative examination or remind them of the upcoming
appointments or if we need to have information clearer from the
forms that they have submitted.
And I appreciate that the Social Security Administration
has indicated interest in that, and identified that as a need,
as well. There are two barriers to that that I have heard: one
is security of the personal identifiable information, and the
second is funding.
With security, we know that the Veterans Administration is
able to address that with their patients. My father receives a
text message when he has a medical appointment from the
Veterans Administration. So I feel like we can work together to
figure out security.
The second barrier is funding, and I can appreciate that
the Social Security Administration has priorities for funding,
and Congress wants to make sure everyone is a good steward of
their dollars. Disability determination staff and our
claimants, we are in the middle of this, and we really need to
focus on how we find common ground so that we can use our
dollars well to support the people that we serve.
The second efficiency I want to talk about is a decisional
authority. And I appreciated, Chairman Ferguson, what you
shared with the claimant's message, because that is the exact
type of decisional authority that we would like to see happen.
A decisional authority would allow a trained disability
examiner to make a decision on some case types without review
from a medical consultant and psychological consultant. Those
are--would often be a critical or terminal illness. And that
allows us to get the decision to the claimant faster.
Now, we know this can be done with high quality, because
the Office of Inspector General did a study on a past pilot
that showed 97 percent accuracy with this, and so that was high
quality and also an average of 11 days faster processing time.
So we know that a decisional authority would support people
applying for disability benefits to receive that.
North Carolina was a part of that pilot and in 2015 studied
that impact. We were able to process 12.7 percent of our
workload with that decisional efficiency and that was the
equivalent of 12 medical consultants, our hardest to recruit
and retain staff and our highest paid.
In closing, I want to share that we are all here to serve
the public, and I ask that disability determination agencies
receive your support in realizing solutions to these
challenges. I am thankful for the teamwork from associate--from
Acting Commissioner Kijakazi and Associate Commissioner John
Owen, who have listened to our concerns and are taking some
action steps around that.
And I ask for your support, as well, in finding a solution,
obtaining a solution for consistent hiring authority over time;
a decisional efficiency, a decisional authority for disability
examiners; and communications that meet claimants' needs.
I look forward to any questions that you have and our
teamwork to serve the public. Thank you.
[The statement of Ms. Russell follows:]
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Chairman FERGUSON. Thank you, Ms. Russell.
Mr. Camp, you are now recognized.
STATEMENT OF DAVID CAMP, INTERIM CEO, NATIONAL ORGANIZATION OF
SOCIAL SECURITY CLAIMANTS' REPRESENTATIVES
Mr. CAMP. Thank you, Chairman Ferguson, Ranking Member
Pascrell, members of the subcommittee. I am David Camp, CEO of
NOSSCR, and we are the specialized bar association for those
who represent the Social Security claimants.
From 2010 to 2022, Social Security disability claims
declined by 37 percent, and SSI claims are down 49 percent.
With the claims workload cut by more than a third, almost half,
budget and staffing strains alone cannot explain this growing
backlog. The problem is Social Security's policies.
National average processing times are now more than 250
days for each step in Georgia, more than 300 days each in
Florida. Social Security has a minimum acceptable standard of
under 60 days, a standard never met in 40 years. Forty years.
Reconsideration is optional, and Social Security has been
telling this committee about possibly eliminating it since
1984. Social Security recently tested eliminating it in 10
states for 20 years. But this committee has never been provided
with the results, data for or against eliminating it in some
states, everywhere, or nowhere. If there is a data-driven
reason for reconsideration, show us.
To explain the problem from our perspective, here is an
example. A lawyer in Alabama contacted me last week with this
timeline for a case. The claimant filed his claim in July 2021.
He was denied initially and again on reconsideration. This took
645 days, 547 of which were reconsideration. The
reconsideration findings were identical. More than 90 percent
of findings of reconsideration are exact duplicates of those at
initial, often word for word. Word for word, hundreds of days
later.
He filed a request for hearing by a judge this May. He was
scheduled for hearing after his claim had been pending for 832
days. His hearing should have been last week, but there was no
point. He died earlier this month, on day 825 of his claim.
He died from the conditions that he applied with that went
untreated. He sought help from Social Security with 825 days to
live, and Social Security wasted more than 500 days at
reconsideration. He could not live long enough to outlast
Social Security's capacity to delay.
In addition to reconsideration, there are other policies
that require immediate attention, corrections that would add
efficiency and savings right now.
In August, Social Security suddenly stopped accepting faxed
applications. We would like to see Social Security modernized,
so we were shocked that they would leap that far backward.
There is no reason not to honor a faxed application. Now
claimants and representatives fax to mark the date, then mail
what we have faxed, then mail it again until Social Security
acknowledges the mail. This adds an absurd delay to claims, and
it must be corrected.
The front line of communication with claimants is the
representative's office. Yet when we call and manage to get
through, we are only allowed to get an update on one case at a
time. We want to help Social Security manage communications
with claimants, and our role is to speed up the process, but
Social Security imposes barriers. Social Security should allow
representatives to verify entry on a claim electronically and
stop capping our attempts to check online status at 10 cases.
A recent rule change introduced a new problem and a new
slow-down for veterans. Social Security now ignores VA
decisions. A 100 percent disabled veteran is now less likely to
be found disabled in Social Security's process than someone who
hasn't served. This must be stopped immediately.
Electronic signatures are safe and secure, and it is
unnecessary to call to verify them. When Social Security gets
an electronic signature, they make the staff call claimants to
verify. This means personnel are calling out when they could be
handling calls coming in or doing something else productive,
and it slows the process.
Social Security should provide us with the same data
available to claimants in their My Social Security accounts. We
are ready to help a claimant speed up the process and provide
what is needed but often can't at the early stages.
Finally, Social Security must stop using the DOT. Pneumatic
tube operators have been replaced by email. Addressers have
been replaced by the printer. Recently, claimants in Savannah,
Wichita, and Flint have all been turned down, citing these
long-gone jobs. This happens every day in every district. The
Department of Labor already has a working version of a paid-for
replacement. Social Security must switch to using current data
and finally end the embarrassment of the DOT.
Thank you, and NOSSCR looks forward to continuing to work
with the committee and with Social Security.
[The statement of Mr. Camp follows:]
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Chairman FERGUSON. Thank you, Mr. Camp.
Ms. Burdick, you are now recognized.
STATEMENT OF JENNIFER BURDICK, CO-CHAIR, CONSORTIUM FOR
CONSTITUENTS WITH DISABILITIES SOCIAL SECURITY TASK FORCE
Ms. BURDICK. Chairman Ferguson, Ranking Member Pascrell,
and members of the Social Security Subcommittee, thank you for
inviting me to speak today. I am here on behalf of the
Consortium for Constituents with Disabilities, the largest
coalition of national organizations on behalf of people with
disabilities. I have also been a Social Security disability
attorney for the last 10 years.
Now, make no mistake, SSDI is vital to the people who
receive it. And I appreciate, Chairman Ferguson, you centering
the claimant's story at the beginning. But I want to spend some
time highlighting how critical this is by sharing a few more of
my clients' stories.
The first is my client, Ms. C. When I met her, she had just
been terminated for her job as a scheduler from a large
hospital where she had worked for 20 years. The thing is, in
her twenties she was the victim of a very violent crime that
triggered mental health symptoms. With the help of a
psychiatrist and a therapist, she was able to continue working
for many years. But then her mental health declined. And,
despite medical leaves with more extensive treatment, she
eventually was terminated.
Now, fortunately, she learned that while working for almost
20 years, she had paid into the Social Security system, earning
insurance not only for retirement but also in case of severe,
work-limiting disabilities. So she applied. But, like 62
percent of claimants, she was denied when she first applied,
and, like 85 percent of people, she was denied a
reconsideration review, which I know we have heard a lot about
today. She eventually was approved, and received $1,400 a
month, which is very close to the average but modest SSDI
benefit of 1,483 a month. But it was enough to keep her in her
home.
Another client, Ms. G, was a long-time hospice nurse, but
she was born with a heart defect which, despite two surgical
repairs, eventually gave her a debilitating heart disease. And,
at 47, she could no longer work and needed a home health aide,
going from being the nurse to being the patient. Like Ms. C,
she applied for SSDI and was eventually approved for $934 a
month, which was a safety net to ensure that she was able to
stay housed and provide food. But like Ms. C, this took a
while, it took 18 months for her to get benefits. The whole
time, she had no income and relied on the help of family.
Now, my first two clients, it took a while for them to get
benefits. But they weren't caught up in the DDS backlog, like
one of my most recent clients, Ms. P. She applied in March
2021. It took her 239 days for the DDS to issue a decision on
her initial application, which is 7 months and 25 days. And
then it took 300 days for her to get a decision on
reconsideration. So she had been waiting for more than 17
months when we were able to even request a hearing before a
judge, which is frustrating because that is where most people
are approved.
And this delay had a serious--is having serious
consequences for her right now. She has no income and, unlike
some of my other clients, she doesn't have family who can help.
So she has been living in shelter in Philadelphia. And because
some of the shelters don't allow her to stay with her children,
she has had to live separately from her children from time to
time, which is adding additional distress.
Now, I highlight these stories because I think they really
showcase the importance of this disability benefit. It does
lift more people out of poverty than any others, but also the
impact of these delays.
Now, SSA is not going to be able to address this backlog
without adequate funding. I know you have heard from the
speakers before that, due to chronic disinvestment, SSI has
been seriously down-staffed, and that has hit DDSs particularly
hard. And this--these staffing losses have come at the same
time that there are new Social Security rules like the all
evidence rule that are making claims bigger than they ever were
before, meaning that there just needs to be more bodies to work
these claims. And this won't happen unless Congress provides
SSA with meaningful, sustained funding consistent with the
President's fiscal year 2024 budget request.
Now, in my written testimony, I have also highlighted a
number of process recommendations that would also assist with
this backlog at the margins, but the one I really want to
highlight and that would have the most significant impact is
eliminating reconsideration review. I know Mr. Camp just talked
about this as well, but this level of review is largely seen as
a rubber stamp.
You know, I am from Pennsylvania. I was one of the states
where we didn't have it for 20 years, and I can't say that it
has helped the process for any of my claimants. And, by
eliminating it, DDS staff could immediately be freed up to
focus on the initial claims and work on this backlog.
Now, I will be very happy to answer questions about this or
other recommendations from CCD. Thank you very much for having
me here today.
[The statement of Ms. Burdick follows:]
[GRAPHICS NOT AVAILABLE IN TIFF FORMAT]
Chairman FERGUSON. Thank you, Ms. Burdick.
Mr. Warshawsky, you are now recognized.
STATEMENT OF MARK WARSHAWSKY, SENIOR FELLOW, AMERICAN
ENTERPRISE INSTITUTE
Mr. WARSHAWSKY. Thank you. Chairman Ferguson, Ranking
Member Pascrell, and members of the subcommittee, I am Mark
Warshawsky, a senior fellow at the American Enterprise
Institute.
From July 2017 through January 2021, I was deputy
commissioner for retirement and disability policy at Social
Security, where I led the development of a revamp of the
medical-vocational rules for eligibility for disability
benefits.
I understand now it is a very difficult time at the agency.
No doubt there are many causes for this sudden and sharp
deterioration in service and employee morale, and that these
causes are both short-term and long-term in nature. But I want
to focus today on a very important, long-term solution to the
service and resource problems at the agency.
The currently needlessly complex and outdated rules and
data that both claimants and the agency use to determine
eligibility for disability benefits have to be simplified,
modernized, and automated. And actually, a fully specified
disability eligibility simplification and modernization
proposal currently exists at the agency waiting to be
published. And really, the question is, where is it?
But first let me give you just a bit of background to
determine eligibility for disability benefits. SSA uses a five-
step evaluation process. Those last two steps constitute the
medical-vocational rules, and they have not changed since 1978.
They largely rely on job requirements data from the Dictionary
of Occupational Titles, the DOT, which was created during the
Great Depression and last partially updated by the Department
of Labor in 1991, and not since.
Among its 14,000 occupations--and I liked Mr. Camp's
example; I have a few others--which are deemed to exist in
significant numbers in the economy, the DOT has a ``phonograph
cartridge assembler'' and a ``web press operator print.'' It
does not have a web designer. Furthermore, it has never
included the mental requirements of work, an increasingly
important factor in the modern work environment, as we have
heard today.
The regulation adopted in 1978 included a fairly
prescriptive vocational grid for step five, which is outdated
and largely inadequate. It is now used only in about 10 percent
of step 5 cases. For the rest, the rules are a framework, but
they rely on a detailed and often very semi-informed analysis
of job requirements and numbers of available jobs in the
economy by SSA vocational specialists and vocational experts,
paid for by SSA. This adds time, and it adds expense.
These rules also dictate a difficult, expensive, and often
inconsistent and arbitrary assessment of the ability to adjust
or transition to new work at older ages. This also takes time,
and it is very, very inefficient.
The grid or the framework--it produces arbitrary and
inequitable results, often related to age, and in my testimony
I give some examples. There are particularly noticeable jumps
in awards at age 50, which the regulations call ``closely
approaching advanced age''--age 55, advanced age--and age 60
demarcations in the current regulations giving considerable and
increasing leniencies in eligibility standards. The natural
increase in disability awards, according to objective
definitions of disability, would be much more gradual with age
without those rules.
And there have been many changes in the American labor
force since the 1970s that really do add weight to the case for
reform. People are working longer, older people are working
longer. There are a lot of new technologies and changes in the
economy that have reduced the physical aspects of jobs. There
is a lot more part-time work than--with substantial pay than
there was in the past. This is not reflected at all in the
current regulations.
A modernized vocational database should replace the
woefully out-of-date data currently in use. As we have heard,
the Bureau of Labor Statistics and its team of nearly 200 field
economists produced in 2019 and 2020 a complete first wave of
detailed occupational requirements, ORS information. Thus far,
ORS has cost the SSA about $300 million, now roughly $42
million a year, to run the survey, and we have not seen its use
yet.
With this new, nationally representative data on work
requirements, policymakers can make sensible policy changes to
the programs. For example, if only entry level work is
considered as step five, the complex and time-consuming
transferability of skills analysis performed at older ages can
be omitted entirely, a significant simplification.
Similarly, the--all this data would be housed in a public
platform called the Vocational Informational Tool, the VIT,
that, combined with the streamlined new regulations, would
simplify and automate the vast majority of claims. When I left
the agency in January 2021, this rule was ready to be
published.
It is--we know that under current rules, some claimants are
being inappropriately denied benefits and others are
inappropriately being awarded benefits. This should not
continue.
Thank you for your invitation to speak, and I am glad to
answer your questions.
[The statement of Mr. Warshawsky follows:]
[GRAPHICS NOT AVAILABLE IN TIFF FORMAT]
Chairman FERGUSON. Thank you sir, and I appreciate it. And
now we will move to the question-and-answer session.
I am--you know, every now and then my dear friend from New
Jersey and I both agree on something. There are a lot of times
I just simply want to look at him and go, ``Bless your heart.''
[Laughter.]
Chairman FERGUSON. But we have found a--something that is
common here, and I am--I was going to jump on it, I am going to
ask my friend to, when it is his turn for questioning, to
address it, and that was, Mr. Camp, your description of the
difference between when a claimant is 100 percent disabled by
the VA and they are not by the Social Security Administration.
We are going to dive into that a little bit later.
But a couple of things that stood out to me in the
testimony. Ms. Davis, just an observation. You went through a
list of things that, you know, that you were looking to do to
improve, and you said, ``And finally, IT,'' or finally,
technology. I certainly don't mean to sound like I am preaching
to you, but I would start with IT and not make it the final
thing that you have got to go to.
We have heard time and time again from the Administration
that it is all about personnel and increased money for that
personnel. I certainly understand that it takes--it does take
people, but I think there has to be a renewed interest--not a
renewed interest, there has to be laser focus on the
implementation of proper technology. I just think that you
cannot--no business in America, no government agency can solve
the problems that they have with processing if they don't use
proper technology.
Mr. PASCRELL. Ditto.
Chairman FERGUSON. We found it again, twice in one hearing.
Oh, I don't know what that means. [Laughter.]
Chairman FERGUSON. Yes, exactly. It does have me worried.
But I do--I just make that observation on there.
As I get into my questions here, Ms. Russell, you made a
comment. You said that if you have consistent hiring authority,
you said that would help with retention. I am confused because
you got to hire somebody to fill an open slot. How does that
action help with retention?
You see? I mean, it just looks like you are saying, all
right, we just need to hire more folks so it helps with
retention. Why are they leaving to begin with? Hiring somebody
doesn't seem to address the problem of why they are leaving.
Ms. RUSSELL. Thank you, Chairman Ferguson, for that
question, and it is a great question.
The way that that helps disability determination agencies
is if we have consistent hiring authority to replace our
losses, then we have consistent staff there to process those
claims. When staff leave, their caseloads have to be
reallocated to other staff. So that means we have staff with
increased workloads, which leads to burnout, and then that
leads to attrition because people can only work the amount of
hours that they have in a day. And, when they have a higher
workload, then that leads to pressure for them, which leads for
them to leave.
And the disability determination agency staff, they care so
deeply about this work. I was struck by that when I first
arrived at the DDS. They care so deeply, and they take this
home with them, and they wear this. And so, when they are not
able to turn a decision around in a reasonable timeframe, they
have a lot of guilt associated with that that they are
carrying.
Chairman FERGUSON. All right, thanks for the clarification
on that.
You know, one of the things that I look at, you know, we
have seen, is that, you know--and Mr. Camp, I am going to
address this to you. If we are having trouble meeting the
current caseload, and then you are going to spend hundreds of
millions of dollars trying to go scoop up more people to bring
them into a program that is naturally declining in its initial
applicants, does that seem like a good resource, a good use of
resources?
Mr. CAMP. There are certainly improvements in what we
already are using that need to be taken today. There are
changes that need to be made now with already-paid-for new
programs as to the DOT replacement and processes that are
obviously just available with a policy change.
If you have 90 percent of findings at reconsideration, not
involving any additional effort or work or findings, word for
word the same as they were 300 days earlier in the process,
that should represent an opportunity for some savings, for some
9 out of 10, perhaps, savings at that stage. It is not hard to
find activity at initial and reconsideration that isn't
necessary and that is slowing things down.
There are opportunities for the use of the current staffing
and the current budgetary authority that also involve those of
us on the outside of the program that speak for the claimants,
that speak to the claimants, and that advocate on their behalf.
We will get it done. If you give us the information online, let
us see what is happening on a case. We will get it done. We
will answer the claimants' questions, we will go get that
evidence. We will speed up their process if they let us do it.
And we will do it without an appropriation.
Chairman FERGUSON. Okay. When we talk about updating the
job roles, Mr. Warshawsky, I think you touched on--you talked
about this in your testimony. In your opinion, is there a good
explanation why this has not been done?
Mr. WARSHAWSKY. Chairman, I don't have an explanation. The
agency has been aware of this problem with the out-of-date DOT
for already 20 years. They tried various other data sources,
and they decided already almost 15 years ago to go to the
Bureau of Labor Statistics to sponsor a survey. It took some
time to get that organized, but the data is in, and it was
validated, and it has been published. So it is a mystery to me
why it has not been used.
Chairman FERGUSON. Well, let's go back down to the other
end here. Ms. Davis, since you are in the middle of it----
Ms. KERR-DAVIS. Sure.
Chairman FERGUSON [continuing]. Help us solve this mystery.
Ms. KERR-DAVIS. All right. Well, thank you for the
question.
Chairman FERGUSON. I mean, because--I mean, 20 years is--I
mean, we heard from a group last week talking about--when we
were looking at, you know, dealing with trying to trying to
speed up claims on the beneficiary side, we have got programs
that are--that were authorized eight years ago that still
haven't been implemented.
So same thing. You got great technology. Explain to us why
you all can't get this done.
Ms. KERR-DAVIS. Okay. Thank you, first of all, for the
question.
So, while I have not been directly involved in any of these
policy discussions, I understand that this is a complex, multi-
year plan that we need to move through.
Chairman FERGUSON. Twenty years ain't long enough?
Ms. KERR-DAVIS. Well, that is long enough, yes. We have
been making progress, and we have met our goals for reviewing
and updating the medical criteria and also the occupational
data. And----
Chairman FERGUSON. Ms. Davis, again, I don't--I am not--I
promise I am not trying to be combative.
Ms. KERR-DAVIS. Yes, sure.
Chairman FERGUSON. I am just trying to understand.
So you have met your goals, okay, yet we are 20 years from
implementation. You have met your reviews. Why is there so--I
mean, are those goals published? Can you provide a copy of
those stated goals and how many steps it will take to get this
implemented so that some, you know, some poor individual is not
sitting in front of Congress in 5 more years going, ``Why is it
25 years instead of 20 years?''
Ms. KERR-DAVIS. Yes.
Chairman FERGUSON. Can you provide us those goals, and we
can see the steps of how you all are trying to implement
something that seems like it could be done very quickly?
Ms. KERR-DAVIS. Sure, sure. We are happy to submit that for
the record.
Chairman FERGUSON. Thank you.
Ms. KERR-DAVIS. You know, any changes to our policies have
to be well supported by the evidence and designed to achieve
decisional accuracy. So, while 20 years is a long time, there
have been steps, things going on behind the scenes.
But let me provide a written response for the record so
that you can understand the steps that we have gone through.
[The information follows:]
Chairman FERGUSON. Thank you.
Ms. KERR-DAVIS. Yes.
Chairman FERGUSON. Thank you so much, because 20 years is
an awfully long time----
Ms. KERR-DAVIS. I agree.
Chairman FERGUSON [continuing]. Particularly when you have
someone like Mr. Camp described that simply could not outlast
Social Security to receive a benefit, a very sad story.
Mr. Camp, a quick question and then I will move on to let
others have this. And this is some data that we have on
disability decisions. At the initial level, 38 percent are
allowed, 62 percent are not allowed.
And Ms. Burdick, I am going--I think you touched on this,
as well, so I am going to let you all address this.
When you go into the reconsiderations, 15 percent were
allowed, 85 percent were disallowed, okay? So you have got a
huge chunk over here that are not being allowed. Then, when it
gets to the administrative law judge hearing, it is almost like
this thing flips and goes the other direction, where you have
51 percent that are allowed at that process, 39 percent denied.
So we are going from 85 to 39 at this point. Who is right and
who is wrong? Is the judge right or is Social Security right?
Mr. Camp, I will start with you.
Mr. CAMP. If you compare the attention paid to the claim at
the early stages, to the attention paid to the claim by a judge
with a lawyer in the room, with witnesses called, with all of
the evidence updated, it is 15 minutes to hours. Hours is
better. Fifteen minutes is not enough time to read thousands of
pages of medical records and get anything right.
And some of the time at reconsideration it is not the 15
minutes. If the consultant physician comes in and there is no
new evidence, which is often the case, they are given an agree
button to click. Three hundred, five hundred days later, come
in, you don't even need to spend the full 15 minutes, just
click a button and walk back out. That is not an adjudication
process at all. That is just days waiting, and it is not
service to the claimants.
At the ALJ stage, that does not occur. There are hearings.
The judge looks at the file for hours, has clerks assisting.
The attorneys can do their work. We see all of the exhibits. We
see the statuses change. We see the expert that has been called
to testify. We prepare. We can help the agency get it right at
the ALJ stage. And we are blocked at initial and
reconsideration.
Chairman FERGUSON. Yes, Ms. Burdick, can you--could you
address this--what appears to be a sort of major problem at the
beginning of the process? Could you offer suggestions on how to
improve that for the folks that you represent?
Ms. BURDICK. Absolutely. Well, at the initial claim, you
know, the claim goes--it is a paper claim that goes to the DDS
to adjudicate, and the initial--and as you said, 38 percent of
people are----
Chairman FERGUSON. And now you can't even use faxes, right?
Ms. BURDICK. You can't use faxes.
Chairman FERGUSON. Okay.
Ms. BURDICK. Though you can sometimes be on electronically.
So, if people come to us early, you know, we are helping to get
the evidence, submitting it to the initial adjudicator who is
looking at it.
But there is only so much you can do on a claim when you
are just looking at paper. So the difference between when the
case is at DDS and when it moves on to administrative law judge
is you have a human in the room, and you have--the claimant has
an opportunity to go before that judge and explain how their
combinations of impairments really meet the standard, right?
A lot of people are not just one--don't have just one
problem that makes them disabled. Frequently, you have a lot of
things that come together, right?
And so what is problematic about having this secondary
level of review is, if they can't see it on the paper at the
initial claim, why is another people--another person going to
be able to do that same thing? What you really need is that
different format, where there is a conversation.
But, to help people at the earlier level, having--one of
the things that we think is most important is rejiggering the
current rules to make sure those initial adjudicators are
getting more treating source evidence. It makes common sense
that people's treating providers know the most about them. They
have a history with you, they have talked to you most of the
time.
But frequently we find that, even where people have those
providers, the DDSs aren't doing a good-enough job getting that
evidence. And it is not their fault; the rules aren't well
calibrated. They send two letters, then they rely on these
consultative exams that we discussed or that earlier people
discussed, where a one-time Social Security doctor might talk
to someone for 10 minutes. It just--you know, really focused on
getting treating source data----
Chairman FERGUSON. Okay.
Ms. BURDICK [continuing]. And looking at that would improve
things.
Chairman FERGUSON. All right. Thank you so much for that.
Mr. Pascrell, you are now recognized.
Thank you--let me say this--thank you all for those
thoughtful answers.
Mr. PASCRELL. Thank you, Mr. Chairman, and I want to
continue your last line of questioning. I associate myself with
what you were saying and what you are implying here, because
this is not simply going to be solved by putting more resources
and money.
Remember the IRS debates that we had? We know the cuts that
existed over administrations that were both red and blue. As I
always say, no party is privilege to virtue that I know of.
But, Mr. Camp, your testimony is very interesting when you
talked about veterans. I am almost numb when I talk about
veterans. And I think, in the area which you covered,
eliminating reconsideration, I am even more concerned about a
vet going to get some help from Social Security, SSI,
disability.
And I know from listening to many people that--nothing is
simple, but just having an increase in resources, more money to
do the solution, is not enough. Because if we don't have the
right policies, then we are defeating ourselves by simply
duplicating if we think that just more folks are going to solve
the problem. I want to make that very, very, very clear.
And, you know, you could simply, you know, slide it away by
saying just throwing money at the problem. You have heard that
millions of times. But there is a problem. Money is part of the
solution, but policies probably are a greater part of the
solution. Would you agree?
Mr. CAMP. Yes.
Mr. PASCRELL. I had to get that point across. Besides, your
illustrations are the best.
Mr. CAMP. The actual experiences of real claimants have to
drive this policy. See it from the perspective of a veteran
that went through the VA's disability process already. Lots of
expense, lots of time, lots of filling out forms, going to see
their doctor. They see all of their evidence. Now that same
person with that same evidence and those same conditions goes
to another Federal Government agency and has to repeat the
entire process, and has that second agency say, ``We will not
pay attention to the VA's findings.'' See it from that
veteran's perspective.
Mr. PASCRELL. Right.
Mr. CAMP. That drives the policy decision then, which is
that all adjudicators at Social Security should pay careful
attention and discuss how they have considered the findings of
the VA.
Mr. PASCRELL. I think that is a good model example for a
lot of Federal agencies. These are replicated in most of the
agencies that were mentioned this morning. But I think it is
something we need to dig into. You must have modern technology.
You have got to update your data. It is pretty elemental. I
don't think this is--we are discovering something here. It is
there, and we need to take a look at it.
And I want to ask Linda, Ms. Davis, there was under-funding
for years.
Ms. KERR-DAVIS. Right.
Mr. PASCRELL. I mean, you look at the numbers and you see
the cuts that were made. And that seriously eroded the service
that you can provide to people. I understand that, we all do. I
think, though, that the suggestions of cutting, making more
cuts would simply make it worse. So what would happen to Social
Security's customers, customer service and disability
application backlogs, if your budget was slashed by 30 percent?
Ms. KERR-DAVIS. So, first of all, thank you very much for
the question.
I do have to tell you I am not an expert on budget issues,
but I have been around the program for a long time. You know--
--
Mr. PASCRELL. Neither is the Congress. [Laughter.]
Ms. KERR-DAVIS. Yes, true. But a 30 percent cut would be
completely devastating to SSA. So people who apply for
disability, they would wait at least two months longer than
what they are currently waiting. It would likely impact the
office hours for our field offices.
Even with level funding, level funding from last year, from
fiscal year 2023, it is going to be detrimental to SSA. It is
not sufficient for us to continue to build our DDS workforce or
even maintain it, for that matter. With only level funding we
would expect average wait time for an initial disability claim
to go up, like I said, by two months, and actually double the
average wait time from what they had experienced in 2019, pre-
pandemic.
Mr. PASCRELL. I think what we are looking for----
Chairman FERGUSON. The gentleman's----
Mr. PASCRELL. I am sorry?
Chairman FERGUSON. Timewise, right there. I love listening
to you talk, but we are over by about a minute.
Mr. PASCRELL. You know, I know what the cuts mean. But I
want you to know how we feel.
Ms. KERR-DAVIS. Okay.
Mr. PASCRELL. How I feel, and that is that, even if we
eliminate--even if we can avoid those cuts, we need a lot of
changes in the policy of delivering service.
Ms. KERR-DAVIS. Okay.
Mr. PASCRELL. And that is the point. I think we can sit
down and compromise and get to some final solution, if you
would call it, and I think that is important for us, I really
do.
And thank you for your patience.
Chairman FERGUSON. Thank you. I now yield to the gentleman
from the great state of Ohio, Mr. Carey.
Mr. CAREY. I want to thank my friend, Chairman Ferguson,
and Ranking Member Pascrell for once again hosting a hearing to
discuss the issues that our constituents are facing as it
relates to the Social Security Administration.
As somebody who first read ``Future Shock'' when I was
probably 13 years old, and then ``The Third Wave,'' it just--I
find it very troubling that we are still talking about phone
calls and faxes, and the fact that we don't have government
agencies that are able to communicate with one another.
So I really wish that--and we just can't do it in this
body, but I really wish we could have our constituent aides
sitting up here with us that are dealing with you every single
day, because the calls that we get are just remarkable. So--and
again, faxes, to me, are basically like trying to find an eight
track tape player. So I just kind of think it is a little
outdated.
Listen, I know my office is not alone in hearing from our
constituents over and over again about how hard it is to
actually get a hold of Social Security Administration. I know
my dear friends have talked about the cuts to staffing. Wait
times for the 1-800 number continue to increase, and have
reached upwards of, many times, 30 minutes. Some people get
kicked off, I have heard that several times. They have called,
and they call and they call and they call.
The thing it reminds me of--you know, I just--when you go
for a home loan application and you call any one of the
national--you can get a call right back right away, or you--the
wait time is pretty, you know, pretty easy. And then you get an
email, which seems pretty standard nowadays, right?
It is concerning to me that SSA has done little to act on
the backlog and at times made the problem worse. And I am glad
we are working today to get to the root cause of these issues
and talk through solutions that SSA can implement to process
claims in a timely manner and provide Americans more accurate
decisions.
Really, Mr. Camp, that story about the person waiting, what
was it, 825 days, and then died of the disease or the
affliction that could have been resolved, possibly, if they
would have just had gotten what they needed 500 days before, I
think it is a terrible story.
So my question--boy, and I am running out of time here--
when SSA evaluates the work history of a disability insurance
applicant, the SSA reviewers reviews whether the claimant can
still have any substantial gainful work performed over the last
15 years, known as a lookback period. SSA recently published a
proposed rule to reduce the lookback period from 15 years to 5
years, right?
Dr. Warshawsky, what are the effects of reducing this level
of scrutiny as it applied to a claimant's work history?
Mr. WARSHAWSKY. Thank you for your question.
You know, very simply, in the proposed regulation the
immediate result is an additional $27 billion in disability
benefits, but that is not related at all to, you know, an
assessment of the person's ability to work, because basically
you have chopped off 10 years of a work history.
And so there really is no justification provided in the
proposed regulation. The data that--and studies that have been
cited in the proposed regulation are misleading and incomplete.
They misrepresent results. And then furthermore, the budget
implications are actually severely under-estimated because it
does not mention the additional cost to Medicare, Medicaid, and
other Federal and state welfare program spending.
And finally, it really--you know, they justify it by saying
that work conditions have changed over time, which they
certainly have, and that is the whole point of getting new
data. But yet they don't cite the data. So it is a very
perplexing and disappointing proposal, really unjustified. I
believe it should be removed.
Mr. CAREY. So when you were at Social Security
Administration, were you considering changes to the look period
before?
Mr. WARSHAWSKY. Yes, in the context of a total reform of
the program. And we did consider reducing it from 15 years to
10, which was justified by the data and by the evidence. But
that is only in context of a much larger reform that modernized
and automated the program. And when--in the context of the
larger change, it was a very small expense, as opposed to $27
billion.
Mr. CAREY. I want to thank you all. And again, I want to
appreciate the chairman and the ranking member for having this
important hearing, and just know that we all do appreciate you.
I know you probably spent many, many hours preparing for this
hearing, and I appreciate all your comments. Thank you very
much.
And Mr. Chairman, I yield back.
Chairman FERGUSON. Thank you, Mr. Carey. Next we go to the
gentlelady from California, Ms. Sanchez.
Ms. SANCHEZ. Thank you, Mr. Chairman and to our ranking
member.
Last week, this subcommittee met to discuss SSA
overpayments, and my Democratic colleagues and I spoke about
the delays in customer service, the lengthy phone wait times,
and the catastrophic effects of proposed Republican cuts to
Social Security.
Yesterday, my Republican colleagues elected speaker Mike
Johnson, the chair of the Republican Study Committee and the
author of the budget proposal cutting and privatizing Social
Security. In addition to his terrible record on issues like
same sex marriage and abortion, Speaker Johnson has advocated
for a reduction in benefits and a 30 percent cut to SSA
funding. And, apparently, my Republican colleagues see that as
a positive attribute. But we know that this isn't the case.
Social Security is a vital program that grants almost nine
million Americans disability benefits.
Although the process for approving disability payments may
be flawed, the solution to the issue is, from what I am hearing
today, not cutting costs. What I have heard today is that we
need some policy changes, and we also need some important
investments in the program.
Ms. Burdick, I heard from several of the witnesses on the
panel today that the hiring and retaining of staff is one of
the biggest challenges to cutting the backlog. In fact, I heard
things like, you know, we need a consistent and stable
workforce to reduce the backlog, we need to hire authority to
prevent burnout and attrition. Those were just some of the
things that were--that I heard today from out of the mouths of
witnesses. Can you tell us how cuts to SSA's customer service
budget impact American people's ability to access their hard-
earned Social Security benefits, including their Social
Security disability benefits?
Ms. BURDICK. Cuts to customer service would be extremely
harmful to people trying to access the system. As you have
already heard, it is very hard to access Social Security right
now. It is hard to get through on the 1-800 number. It can be
challenging to apply for Social Security disability benefits.
Many people who are applying for disability benefits are not
even able to apply online yet. Even if there is a partial
online application, there has to be an interview with the field
office. And, by cutting funding for customer service, that is
going to be even more challenging.
But I want to talk about, like, on the ground. For
claimants who are trying to apply for benefits, this can mean
multiple appointments, multiple phone calls, and we see lots
and lots of people get overwhelmed and drop out of the system
because the thing they are applying for may be a disability
that makes, you know, participating in this kind of process
challenging in the first place, whether it is anxiety or
cognitive limitation or--so I think it would be very harmful if
the customer service were to degrade even further than it is
now.
Ms. SANCHEZ. Thank you, and I want to thank you for your
testimony that focused really on the hardships that people with
disabilities face in trying to apply for and receive those
benefits. And, clearly, those hardships and delays could
potentially be reduced by increasing the resources that SSA
instead of cutting them.
You mentioned that you supported President Biden's request
in the budget. President Biden has requested a $1.4 billion
increase for SSA's operating budget in 2024. However, some of
my colleagues on the other side of the aisle have the opposite
idea. The House Republican Study Committee, a committee that I
will note that every Republican on this subcommittee sits on
and which is chaired by our new speaker, has proposed a $718
billion cut to Social Security over the next 10 years. This
plan is going to cut the funds that most disability insurance
beneficiaries receive and, in some cases, stop those benefits
altogether.
Ms. Burdick, why are Social Security Disability insurance
benefits so important to people with disabilities?
And what would happen to disabled Americans if their
benefits were reduced or even cut off entirely?
Ms. BURDICK. So just to be clear that people who receive
these benefits--as we have talked about, it is not only a long
process, it is a hard process. You need to have a severe
impairment that will last at least a year or be terminal, as
some of the claimants we have talked about.
So everyone who are--who is relying on these benefits has a
severe disability that is making it hard for them to work. They
rely on these benefits for housing. They rely on them to pay
for food. And, if they are cut at all, that would be super
harmful because right now the max benefit is already extremely
modest. For SSDI, it is $1,400 a month, for Social Security, it
is in the $700s. This is already a benefit level that makes it
challenging for people to live in single family homes. Often,
they are double upping.
You know, there is--I frequently talk to claimants who
cannot actually pay for all their bills and have very
complicated practices--``If I pay this much to this one and
this much to this one''--so any cuts would be extremely
harmful.
Ms. SANCHEZ. Thank you for your testimony.
I yield back.
Chairman FERGUSON. I thank the gentlelady. Next, we will go
to the gentleman from Kansas, Mr. Estes.
Mr. ESTES. Well, thank you, Mr. Chairman, and thank you to
all of our witnesses for being here today.
You know, today's hearing reasserts a basic principle of
American life, that government should work for the people. And
that is why we have programs like Social Security Disability
Insurance and SSI to help citizens when they need it most. And
as representatives of the American people, we have been sent to
the nation's capital to ensure that government does serve the
people efficiently and effectively, mindful that it is the
people that fund these government services.
So it is disappointing and frustrating to hear some of the
numbers being shared today. I mean, the Social Security
Administration's failure to deliver these services is--I mean,
almost you could say it is unconscionable. You know, when I
looked at--as I was preparing for this hearing and I looked
up--and basically, I would have to say that the Social Security
Administration is failing in its mission to ``deliver Social
Security services that meet the changing needs of the public.''
And how is it that over the past two decades there has been
a decrease in disability claims--applicants, anyway--yet in
recent years the times have been increasing? And, you know, as
we talked about before, since 2009, wait times for initial
claim decisions have increased by 83 percent to 220 days. I
view it as a travesty that American citizens can't get the
Federal Government to process a valid claim without them having
to jump through hoops or paying an attorney to force the
issue--no offense to the attorneys that are here--that help
solve that problem.
However, instead of focusing on these issues, how do we
make sure the program works better? The SSA, under the
direction of the Biden Administration, has instead prioritized
improving optics on equity initiatives. I say ``optics''
because how does it help any claimant, no matter their race or
background, to wait longer to receive the benefits they have
applied for?
So already $100 million have been spent on these efforts in
the last 3 years, and this year's SSA budget request allocates
another $60 million to continue to boost these so-called equity
efforts without accounting for the necessary process
improvements and modernizations needed to actually service the
wider base of claimants they are hoping to reach. And that is
just one example of how SSA is falling short. We live in a
dynamic and rapidly changing world, and SSA has failed to keep
pace with this change in the workplace.
Ms. Russell, in the past 40 years, we have seen significant
improvements to access and care of these individuals with
disabilities. However, it has been pointed out earlier that SSA
is still using a dictionary of occupational titles from 1977
that was last partially updated over 30 years ago. How does
that outdated data affect an examiner's ability to efficiently
process a claim?
And would you say it takes longer and delays some of the
processing of those claims?
Ms. RUSSELL. Thank you for the question, Congressman Estes.
Yes, it does impact the processing time because the skills
that we are looking to match a claimant to see if they can
return to work in their relevant work history, we are not--it
is hard to find that in the Dictionary of Occupational Titles.
So it does take longer to process. And the jobs that we have
today are not in the Dictionary of Occupational Titles.
You know, we have heard about the jobs that are in the
Dictionary of Occupational Titles, and those skills just don't
translate. So it does make the job harder for our disability
examiners, and we look forward to when that is updated.
Mr. ESTES. Yes. So what do you do in a case of, like, a job
title like a web developer? Obviously, that wasn't here in
1977. I mean, what are your steps that you do, and how do you
sort through addressing their claim or their issue?
Ms. RUSSELL. Well, in brief, the approach is to look at the
job skills that the person had in their position. That is why
the information on the work history is so important. And that
is also why the information needs to be relevant and recent in
the work history, because the job that a person did 15 years
ago, they may not be able to do that job anymore.
But, for example, with your example, web design, we are
looking at the skills that are described for that work, and
then we are looking at skills that are in alignment with that
for other jobs that are in the Dictionary of Occupational
Titles.
Mr. ESTES. All right. Well, thank you. And I was glad to
hear in your remarks you talked about you have the funding to
pay the personnel, you just need to be able to get them hired
so that they can actually be there to do the processing, which,
obviously, is an issue across the country now with our
workforce shortages.
And, Mr. Camp, your story really, I guess, is heart-
rending, to go through that in terms of the issues that--your
individual that you referenced went through. I mean, how does
something like the outdated DOT affect applicants and their
process to go through to get their claims?
Mr. CAMP. To wait hundreds of days only to be told that you
are denied because you should go do a job that even the
claimant knows obviously does not exist is discouraging, deeply
bothersome.
The claimants often stop the process. They leave the claims
process. From initial to reconsideration there is a drop-off.
From reconsideration to the judge stage there is a drop-off of
legitimate claims that may have been approved. Because to be
told after hundreds of days that this agency isn't really there
for you and, frankly, is not taking it seriously, causes
claimants to come out of the process. And that is something
that is not measured but should be.
It is remedied already by Department of Labor. And that
would improve the process, that would make their--the
claimants' experience more reliable, more accurate, better for
all of us.
We want the correct outcome on the cases. If you are
disabled, you should be approved. If you are not disabled, you
should be denied. But it should be something you can rely upon.
And, some of the time, you might want to know what you should
go try to do next. Perhaps there is a job out there where
Social Security could help you get a suggestion----
Mr. ESTES. Right.
Mr. CAMP [continuing]. And then put you in voc rehab and go
do it.
Mr. ESTES. Thank you, and I yield back.
Mr. CAREY [presiding]. I want to thank the gentleman. I do
want to remind all of you we do have a five-minute time limit.
So, if you do see that, I want to make sure that everybody has
the right amount of time.
So the chair now recognizes from the great state of New
York, Mr. Higgins.
Mr. HIGGINS. Thank you, Mr. Chairman.
Well, what is clear here is Social Security has a severe
customer service problem. It is not only inefficient, it is
awful, and it is inhumane. And, truthfully, it is not Social
Security that is not fulfilling its mission; it is Congress
that is not fulfilling its mission to Social Security
beneficiaries.
Ten thousand Americans turn sixty-five every single day.
That is 303,650,000 each and every year. The United States is
thirtieth of 39 countries in how much we pay Social Security
benefits. Mexico pays more Social Security benefits to their
people, Finland pays more Social Security benefits to their
people, and Latvia spends--pays more Social Security benefits
to their people.
Ten thousand Americans die every year waiting for a
disability claim. Every office here, Democrat and Republican,
you have to explain to people that call our office about the
Social Security disability process, and you have to, with a
straight face, tell them that you apply, you go through this
lengthy process--good thing these people are retired in most
cases, because otherwise they wouldn't have time to navigate
through the Social Security bureaucracy--so you have to tell
them to apply for Social Security disability benefits and, by
the way, you are going to be denied, so that is a complete
waste of time. And then that begins another lengthy process.
From 2010 to 2023, the Social Security customer service
budget was reduced by 17 percent. Social Security
Administration staff has been reduced in that same 13-year
period by 16 percent. Social Security beneficiaries increased
during that same period of time by 22 percent. Wait times for
disability decisions are at a record time of seven months,
followed by a lengthy appeal process. Hold times, people that
call the 800 number just seeking some kind of direction and
help in a customer service context, are at an all-time high: 40
minutes and 90 minutes at peak times. Hold times for people
calling the 800 number was 14 minutes in 2021, it is now 40
minutes today. We are not moving forward, we are going
backwards.
So, Ms. Kerr-Davis, I mean, you people are just too polite.
You people are too nice. You know, you should be indignant
about what Congress has done to this budget that really serves
our people. Sixty-six million Americans, about one in five
collected Social Security in February of this year.
So the Biden Administration asked Congress for more than
100--or $15 billion, $15 billion for Social Security
Administration operating budget for 2024. And as my colleague,
Ms. Sanchez, said, that is a $1.4 billion increase from 2023.
How much did the Social Security Administration ask the Biden
Administration for?
Ms. KERR-DAVIS. I am sorry, I didn't hear the second part--
--
Mr. HIGGINS. How much did the Social Security
Administration ask the Biden Administration for?
Ms. KERR-DAVIS. So the amount that we need for this fiscal
year to continue to make the progress that we were--had put in
place in fiscal year 2023 is $15.5 billion.
Mr. HIGGINS. Fifteen point five?
Ms. KERR-DAVIS. Mm-hmm.
Mr. HIGGINS. So that is what Social Security submitted to
the Biden Administration's budget director to say, ``This is
what we need.''
Ms. KERR-DAVIS. I will need to verify that was the amount
that we--but I know that is what is in the President's budget.
Mr. HIGGINS. So it is $500 million short.
Ms. KERR-DAVIS. Correct.
Mr. HIGGINS. Okay. So you are asking Congress today to,
when it does its work on the budget, if it ever gets around to
that, that you actually need to address all of these problems
that everybody here is concerned with, Democrat and
Republicans, you need $500 million more.
Ms. KERR-DAVIS. Correct. So for us to continue to make the
progress that we have made--so one thing you need to recognize
is that we serve more beneficiaries than ever before. While
agency and state staffing have been at all-time lows, people
continue to go on to the retirement rolls, and they continue to
apply for disability.
So we urge you to support the President's $15.5 billion so
that we can continue to make the progress that we need. We
realize we are not delivering the service that any of us want.
Mr. HIGGINS. You missed my point. He asked for 15 billion
from Congress for the total Social Security Administration
operating budget in 2024. That is $500 million less than what
you reported to the Administration relative to what you need to
address these problems that we have all cited.
Okay, so you would ask Congress to approve $500 million
more than what the President requested of Congress to get you
to where we all seemingly want you to be.
Ms. KERR-DAVIS. Okay. [Laughter.]
Ms. KERR-DAVIS. So, yes, I see your point. I see your
point.
Mr. HIGGINS. You are way too nice.
Ms. KERR-DAVIS. I----
Mr. HIGGINS. Look, I get it.
Ms. KERR-DAVIS. I am going to need to confirm that, and we
will submit something for the record.
Mr. HIGGINS. Yes, there is----
Ms. KERR-DAVIS. But--yes.
Mr. HIGGINS. Look, there is no more--look, the American
economy is--we are 25 percent of the world's economy. We are
five percent of the world's population. Our $25 trillion
economy is 70 percent consumption. And, if you have 66, $70
[sic] million Social Security beneficiaries in America today,
and that goes up by 10,000 a day offset by deaths, I presume,
then these individuals, they are not saving that money. They
are spending the money that they already saved throughout their
entire lives. So not only is it good for the good that it does
for these individuals, but it is also good for the economy of
America.
Mr. CAREY. Mr. Higgins, thank you. I need to move on.
And, Mr. Chairman, I apologize. I have gone over the last
two people about four minutes. So I just wanted to say----
Chairman FERGUSON. You are fired.
Mr. CAREY. I know. [Laughter.]
Mr. CAREY. I am moving on.
Chairman FERGUSON [presiding]. All right, thank you. I next
recognize the gentleman from the great State of Iowa, Mr.
Feenstra.
Mr. FEENSTRA. Thank you, Chairman Ferguson, and thank you,
Ranking Member.
Obviously, I don't need to relitigate what everybody is
saying, that we have a growing backlog of Social Security
claims and disability decisions. We have a situation, you know,
that is just incredible of backlogs. We rolled back a lot of
things that created efficiencies during the pandemic, and now
we are going back to manual processes.
My question to Ms. Kerr-Davis: What are your solutions? I
mean, where do we go?
I mean, you are hearing from everybody we got problems.
Ms. KERR-DAVIS. Yes.
Mr. FEENSTRA. Give me two minutes, give me a minute here.
What are you going to do about it?
Ms. KERR-DAVIS. Okay, well, we have a plan. We are working
on a plan.
So we didn't get here overnight, right? This is a
convergence of factors that--increased wait times for both
initial and reconsideration claims. So what we saw, recruitment
and retention challenges, Jackie talked about that, changes in
the labor market for disability examiners--attrition rate rose
to a record high of 19.4 percent in fiscal year 2021.
Mr. FEENSTRA. Okay, I want to hear what you are doing about
it.
Ms. KERR-DAVIS. Okay.
Mr. FEENSTRA. I get all the stats. And let me give you a
stat. Initial claim receipts are the lowest they have ever been
since 2002, so we have a dramatically lower claims process--or
receipts than we ever had. So, to me, that is the indicator,
right, of how many people are claiming. And yet that is
dramatically down.
So I am asking--the system is broken, all right? What are
you going to do about it?
Ms. KERR-DAVIS. Okay, so we do. We have some short-term and
long-term steps that we are planning to take.
So, in the short term, we have established cadres. And
these are folks who work at SSA that have prior disability
experience. They are Federal employees where we have taken
them, retrained them if needed, gave them refresher training,
and we have diverted them to focus on the disability workloads,
on the backlogs.
We are also looking at the DDS hiring practices. As I
mentioned in my testimony, the commissioner reached out to
governors about, you know, what they could do to help us with
the recruitment and retention.
We also have longer-range plans that are more customer-
focused on communication policies. Again, you know, people
don't want to be contacted by phone.
Mr. FEENSTRA. Right.
Ms. KERR-DAVIS. We also are improving technology and then
looking at the vocational aspects or the lookback period----
Mr. FEENSTRA. Sure.
Ms. KERR-DAVIS [continuing]. Of what it takes to adjudicate
a disability claim.
Mr. FEENSTRA. Yes.
Ms. KERR-DAVIS. So it is--there is not a silver bullet
here. It is going to be a lot of different factors, but we have
short-term plans, we have longer-term plans.
Mr. FEENSTRA. Right.
Ms. KERR-DAVIS. But to do that we are going to need
sufficient and sustained resources.
Mr. FEENSTRA. Okay. And you have got the resources. I mean,
I look at what--all the money that has come in. And this is my
biggest issue that no one is saying, all right? You had just
had an additional $60 million come in. There is a lot of money
out there.
And here is the problem. If you look over the last decade,
all the money that has gone in to help this out, and we are
still in this problem. And this isn't just today's problem.
This was a 5-years-ago problem, this was a 10-years-ago problem
that we have been talking about this. We are still doing manual
processes. SSA is still using occupational data from 30-plus
years ago.
So I hear what you are saying, but it does not resonate
with me because of the long wait times that are happening. And
it is from administrative law, right? I mean, being an
administrative law judge--not myself, but--you have to wait a
long time before you get there, and then you have to wait
another 60 days or more for the review decision. I mean, the
process is broken.
Ms. KERR-DAVIS. Mm-hmm.
Mr. FEENSTRA. So, Mr. Warshawsky, I mean, help me out here.
Has the appeals counsel process--has that ever been discussed
of how long these wait times are?
Mr. WARSHAWSKY. Well, Congressman, I agree with the gist of
your approach, as this is not a budget problem. This
deterioration is very sudden and very severe. And it has come
basically in the last two to three years. We really never saw
such long wait times at the initial stages before. And really,
there has to be--there is not a budget problem. There is a
management and labor--and maybe it relates to the
reintroduction of the reconsideration there. There is a more
immediate problem here, and it is not related to long-term----
Mr. FEENSTRA. And I agree with you. I mean, I just look at
it, the massive bureaucracy that is out there and that we are
paying for, and yet we are not getting the results. And this
is--the bottom line is why aren't we getting the results?
This is what I am trying to--I mean, in private-sector
business we would figure this out real soon. But here,
obviously, Federal bureaucracy, we just can't get it done.
Thank you, and I yield back.
Chairman FERGUSON. I thank the gentleman. Your line of
questioning and your answer reminded me of something.
Mr. Camp, I believe it was you that pointed out that the--
what is considered an ideal wait time is 60 days, and that has
not been met in 40 years.
Mr. CAMP. Not ever.
Chairman FERGUSON. Thank you. Next, we will go to the
gentleman from Florida.
Mr. Steube, you are now recognized.
Mr. STEUBE. Thank you, Mr. Chairman.
The Social Security disability program is broken. It is
broken in its finances, it is broken in its process, it is
broken in its modernization. The solution to these problems is
not a dollar amount. As we have seen far too often, the Federal
Government throwing money at a problem does not fix the
process. Congress has already given hundreds of millions of
dollars to the Social Security Administration to modernize its
claims process. And, if we here--have heard here today, SSA has
failed completely.
The Dictionary of Occupational Titles, the SSA's list of
jobs, was created more than 40 years ago and last updated in
1977. I wasn't even born the last time it was updated. Some
applicants have been denied disability because Social Security
told them they could perform such jobs as egg processor, dowel
pin inspector, or nut sorter. Yes, I said nut sorter. I mean,
that is probably a good title for leadership in Congress these
days, given what is going on, but--though I know some folks in
the Social Security Administration are denying claims based off
of obscure and antiquated jobs that may not even be available.
I have a gentleman who I know through my men's group who I
have gotten to be very close with who has type 1 diabetes, is
losing sight. He is now, like, medically blind. He has had one
surgery in one eye, can't see in the other eye. He is an Amazon
driver part-time. He obviously can't drive a vehicle because he
is now blind. I encouraged him to go to Social Security
disability because that is why it was created, to help people
in his circumstance, people that were working, now not working
for a medical disability. And just to get the appointment was,
like, 60 days out just to get to the appointment to be able to
then start the process, which then, you know, we are talking
about how long that takes.
We are here today because of the historically high backlog
of cases. Today, over 1 million Americans are waiting an
average of 220 days for the Administration to decide their
initial claim, a more than 83 percent increase since 2019. The
Administration publishes its average hold time for its 1-800
number. Its own data shows that last year the average time
someone waited on hold was 32 minutes. So far this year, it is
up to 36 minutes. It is unacceptable.
The American people simply deserve better customer service
from the government that they fund. Receiving Social Security
benefits should not be an overnight process. There should be a
clear vetting and examination process of claims and not every
claim will be or should be approved. But a timely process to
examine cases is absolutely necessary, and these decisions need
to reach transparent conclusions for the American people to
take the next necessary steps.
In one case earlier this year, Northern California District
Judge Susan Illston wrote that a disability claim denied by
Social Security that ignored key physician records was ``so
vague as to be essentially unreviewable.'' The decision was
reversed by the judge, and ordered SSA to pay benefits to the
claimant, a woman suffering with schizophrenia, depressive
disorder, and delusions.
Mr. Camp, according to your testimony, half of the
processing time at the initial stages of the application is
consumed by the optional second step reconsideration. You note
that the Social Security Administration's minimum acceptable
number of days processing is 60. However,--and you just stated
it to the question of the chairman--current data shows that, in
my state of Florida, reconsideration adds 323 days to the 300
days at the initial stage. It takes 623 days for someone in
Florida to get a disability.
Can you explain why my state of Florida specifically has
such long wait times?
Mr. CAMP. There are several factors that cause the states
to vary. One is that they are administered by separate state
DDS programs with different staff, different management,
different functionality.
Another interesting factor is the extent to which the
successful programs have been implemented in that state. One is
health information technology, modern acquisition of the
records: immediate, affordable, doesn't need to be staffed.
That is a success in Iowa, say, where the processing times are
very, very low because there are two large hospital chains in
Iowa, and that provides hit access for the records, shaves off
many, many days. In Florida, not so much. So there is less use
of technology in Florida, and that slows it down.
Mr. STEUBE. When I have--my district alone is the most
elderly district in the country. So obviously that is also part
of the challenges, too.
If the Social Security Administration eliminates the
reconsideration phase, how do they ensure fraud is not
occurring?
And, furthermore, exactly where would available resources
be reallocated?
Mr. CAMP. If you focus on what is actually done at
reconsideration, you would see that it is not going to catch
anything. If you don't do any work at a step, there is no need
for more than one day for that. If you are merely clicking a
box that says ``agree,'' you haven't read the file, you haven't
caught anything. You haven't caught false statements, you
haven't caught reliable medical opinions. It isn't of any value
to do the same thing again hundreds of days later, 9 times out
of 10. It is just not helpful.
The quality can go up at initial if you take the existing
resources, the existing staff, and give them more capacity to
take a look, a more careful look at initial. All of Social
Security's studies--now, they would need to report more on what
happens with these pilots and all these studies that they have
been doing about the claims process, but all of it reveals that
if you have a DDS only doing initial, they do higher quality
work, they pay more attention, they have more time.
Mr. STEUBE. I just want to--my time is expired, but I want
to thank all the witnesses for being here today.
Chairman FERGUSON. I thank the gentleman from Florida.
Next, we will call on my dear friend, Mr. Kildee from Michigan.
Sir, you are now recognized.
Mr. KILDEE. Thank you, Mr. Chairman, and to you and the
ranking member for holding this really important hearing.
You know, Mr. Chairman, you said something at the outset of
the hearing that I think was precisely on point. This hearing
would be well informed if we had our district staff sitting at
this table testifying, because they have had to become quite
expert in these matters.
I have talked to my district director I can't tell you how
many times, and I still remember the first time when I was
questioning him about a case that had come to my attention,
where there was an initial denial of a disability application.
And he told me--and this is something Mr. Higgins referenced--
he told me, ``Well, everybody gets denied at the first step.''
Now, you know, that sounds kind of glib. And, like, oh,
that is just step one is your denial. That is completely
unacceptable, and I think we all agree with that. That is
completely unacceptable because the folks--and, Mr. Camp, you
made this point with the case you raised--these are not cases
to be processed. These are individual human beings who are
going through the worst experience in their lives and have paid
into a system that denies them without really any substantive
review and then puts them through a process that makes it
really difficult for them to get something that is due to them,
that is a promise that we made to them.
Now, where I think we may find some disagreement is how we
fix the problem. The one thing I will acknowledge is that
simply providing more money without using those resources to
make the system work better doesn't solve the problem. But
there is another thing I know absolutely. Punishing the Social
Security Administration with deep cuts because we are unhappy
with customer service only exacerbates the problem. It doesn't
solve the problem; it exacerbates the problem. In either case,
we have got to do a better job.
And, to the issue of technology that you raised, I don't
think that we are going to get, you know, significant
technological improvements through donations. We are going to
have to acquire. And that is going to mean spending some money.
So I could repeat a lot of the arguments that have been
made, but I do have a particular issue that is tangentially
related to this that has become a bit of a cause for me. And it
is a small matter, but it is a big question for individuals
that I represent. It has to do with a case that came to my
attention, an individual in a nursing home who is dependent on
supplemental income and also quite dependent on the personal
needs allowance.
And, Ms. Burdick, based on your experience, if you could,
help us understand how the fact that what was once a $30
allowance is still a $30 allowance going back to 1987--which is
worth about $12 right now--for people who are living on very
modest means and want to buy a birthday card for their
grandchildren or replace a sweater because the one they have
got is worn out. We have got to do something about this.
Congress needs to act to do something about it. I wonder if you
just might comment on what it is like for a person who is
living on such modest means to have such little support for the
basic elements of a decent life.
Ms. BURDICK. Thank you for the question, Congressman.
I mean, personal needs allowances, as you said, have not
been updated for decades. They are supposed to give people who
are living on benefits and in institutions the money they need
for personal items: toiletries, birthday cards, as you
mentioned. Thirty dollars just doesn't cut it anymore. I think
we all know that. I mean, I think I saw in the train station
today deodorant is $5. It just--it isn't enough, and it needs
to be updated. People really are struggling to get just the
bare essentials.
Mr. KILDEE. I appreciate that, and I don't know if any of
the other panelists would like to comment.
I would ask, you know, Ms. Kerr-Davis, what the effect of a
dramatic cut would be on the reform efforts that you are
initiating right now in terms of the disability process.
Ms. KERR-DAVIS. So, as I mentioned earlier, it would be
devastating.
We made tremendous progress. I know it probably doesn't
feel like it or sound like it, but we did 90,000 more initial
claims in fiscal year 2023 than we did in fiscal year 2022.
And, you know, one thing that I think we all need to be
cognizant is the impact that the pandemic had on the agency. It
disturbed our normal operational flow, it impacted the labor
market. And so, you know, we are seeing the outcome of that and
trying to recover.
But, you know, I feel like the money that is requested in
the President's budget, that $15.5 million, we would put to
good use--make good use of it and continue to make the progress
so that we can return to pre-pandemic pendings and pre-pandemic
processing times.
Mr. KILDEE. I appreciate that.
And thank you so much, Mr. Chairman, for holding this
hearing. I will just finish with this one point.
Additional resources without a plan won't solve the
problem. Additional resources to fund a plan give us a shot.
But I know for certain deep cuts to the program will not make
it better for the people that we serve, no matter what our
circumstances might be back home.
Thank you, Mr. Chairman.
Chairman FERGUSON. I thank the gentleman. And, let me just
say, I--you know, we all agree that this is--you know, we need
action on this.
But I also think it is important, when we talk about the
funding that is there, okay,--and really, I just want to think
about this for one second. SSA has a $2 billion-a-year IT
budget. That is a massive amount of spending. I mean, that is
like--I would probably want to find out, on the number of
customers you serve, or people that you serve on a per capita
basis, how is that $2 billion spent compared to, say, something
in the private sector? I mean, that is a massive--now, let me--
that is a massive budget.
And then also, I think it is important to recognize that
the Administration got a $784 billion bump above fiscal year
2022 spending. And, at the same time, the case levels are going
down, as was highlighted by the gentleman from Florida. So I
am--until SSA can provide some clarity on where they are
spending their money, how they are spending their money--and
the fact I am flat over-hearing that the problem during the
pandemic is still hanging on, we have to move past that.
That can no longer be an excuse for any part of this
Federal Government. We have got to find a way to be innovative
and get past it. We do it in our private businesses. We can no
longer use that as an excuse. The world has moved on from that.
I understand that it had an impact, but I will tell you this. I
think--and I am not trying to beat up on you, because you--as
you have said, this--some of these budgeting items are way
above your head. But, when you got a $2 billion budget, and we
are several years past the pandemic, and you have got a
declining caseload, and ultimately there is a massive failure
to implement new technology, I just think before you come ask
for a bunch more money you got to be held accountable.
We just need answers on how this massive budget is being
spent and why it is not being spent efficiently. Because,
again, if we can have a plan, and we can know how to do this,
then we can probably come to an agreement on how we best spend
that money. But we can't just keep wasting money.
With that--sorry, I will get--I will climb down off of my
soapbox now, and I will now yield time to the gentleman from
Tennessee, Mr. Kustoff.
Mr. KUSTOFF. Thank you, Mr. Chairman, and thank you to the
ranking member. Thank you to the witnesses for appearing today.
Mr. Camp and Ms. Burdick, to both of you, we have talked
about reconsideration. You all have talked about that in your
comments--Ms. Burdick, you, as a practitioner.
So, Mr. Camp, thinking things through, let's assume that--
let's assume it is just eliminated. And obviously, that takes
care of the additional time. So then what?
What process, if any, or what procedure or what next step
would you suggest, or would it just end there after the
decision?
Mr. CAMP. Social Security ran a pilot for 20 years in 10
states to see what that would look like and then ended it a few
years ago. And, gradually, in state by state, there is now new
data for what it looks like to add reconsideration back in. The
results of that pilot, the state-by-state assessment, what
happened to the number of days, what happened to the other
parts of the process, we don't have it. They haven't shown us
the data. We don't have an answer after a 20-year pilot for
this idea that Social Security has floated since 1984 and that
we are discussing today.
There must be data and an answer, and then your question is
addressed.
Mr. KUSTOFF. Right. And you don't have the data. The data
doesn't exist.
So, Ms. Burdick, from the practitioner--and you gave some
real-world examples in your opening testimony--you recommend
the elimination of it.
Ms. BURDICK. Absolutely. And the Social Security Task Force
does, as well.
Mr. KUSTOFF. The people that you represent that come before
an ALJ, what have you--do you think you could explain to them
that that process is eliminated, and that is for their
betterment?
Ms. BURDICK. Absolutely. Well, first of all, I was from a
prototype state, so I had to explain to them after years and
years that, no, please appeal two times before we see a judge,
which is a lot. But I think for most people what makes sense,
what is intuitive is I do one paper application and then, if I
am denied, then I go to a judge. Having two doesn't really make
sense, and it is easier for practitioners to get involved. I am
one of a minority of attorneys that get involved at the initial
and recon level because there isn't a hearing, there isn't an
opportunity to advocate, you are just sending in paper. So I
think it will improve the system.
But, to your other question, there are other process
recommendations that--I know I put them in my testimony--I
think some other people--that could also be implemented at the
initial level that would additionally, I think, help with the
wait time and make things more efficient.
Mr. KUSTOFF. I probably shouldn't ask this, but I will. As
a practitioner, what is your opinion of the ALJs that you
appear before?
Ms. BURDICK. As a practitioner, I think many of the ALJs I
appear before are fair. They--I mean, obviously, everything
varies, but many of them spend hours reviewing claims. Often,
when I show up, they are familiar with the issues at hand and
have good questions for the claimants about how these things
affect their daily lives.
Mr. KUSTOFF. Okay, thank you very--I appreciate the answer.
If I could, to the acting deputy commissioner--and I want
to follow up on something Chairman Ferguson talked about in
terms of the money that has been appropriated for IT, Chairman
Ferguson gave the figure of $2 billion. That is an accurate
figure, isn't it, as far as you know?
Ms. KERR-DAVIS. As far as I know. I would have to confirm
that though.
Mr. KUSTOFF. And, over the last 10 years, according to data
that I have got, the Social Security Administration has spent
over $18 billion on IT. Do you know, is that number correct?
Ms. KERR-DAVIS. I do not know, off the top of my head.
Mr. KUSTOFF. I mean, as a layman, $18 billion over 10 years
for IT seems like a lot, even for an agency of your size. And
we still have these issues.
I do want to go to your written testimony when you talked
about the challenges that you have and the DDSs have in terms
of hiring and retention. And I do not want to sound
insensitive, but I bet almost every employer in my district in
the private sector, small, medium, and large, talks to me about
the same issues. They are offering good jobs, they can't get
people to come in to apply, or they don't have the number of
applicants that they would have pre-pandemic or five years ago.
I guess what I am saying is to suggest to you your agency
is no different from any other employer. Everybody has got
these challenges. And I think that, in terms of hiring and
retention--respectfully to you, to any employer--we have got to
think in different ways and think outside the box about how we
attract applicants and how we retain them.
Ms. KERR-DAVIS. Yes.
Mr. KUSTOFF. Thank you. I yield back.
Chairman FERGUSON. I thank the gentleman. Next, my
colleague and friend, Mr. Evans, from the great state of
Pennsylvania.
You are recognized.
Mr. EVANS. Thank you, Mr. Chairman and Ranking Member.
This opportunity to discuss one of the nation's most
effective anti-poverty programs, Social Security. I want to be
clear. Social Security is earned. If the insurance people pay
for every paid day, it is the bedrock of retirement security
guaranteed for nearly all seniors.
As a result of that question I want to go to Ms. Burdick.
In your testimony, you highlight the story of a client who
had difficulty qualifying for Social Security disabled [sic],
unfortunately, is common for many Americans. Can you speak to
the barriers individuals face when trying to access Social
Security disability benefits, and how Congress can help remove
these benefits [sic]?
Ms. BURDICK. Thank you for the question.
There are a number of barriers, and I think--and, you know,
one of them is, while applying, some--you know, a lot of people
get their health insurance through the acquisition of these
SSDI benefits.
So just from the beginning, you know, it is like with my
first example, with a woman who was terminated before she
applied, she has an additional barrier of not being able to
access health insurance during the application process, which
makes it harder to establish that you have the disability.
But because of, you know, chronic disinvestment, there have
been customer service problems at SSA which make it harder to
access the agency. Some of the recommendations that we have
had, which I know SSA is working on, and I think will go
farther with more funding, is making sure more of the
applications are online, making sure things are more
accessible, that there are people to call to get help.
It is a very complicated system. And, although some people
get representatives and--in order to help them, there aren't
enough. And I think making sure there are enough claims
representatives to help people navigate, to understand the
problems is really, really important.
But finally, having this additional effort to make sure
that DDSs get it right the first time by really taking extra
steps to make sure they are getting treating source evidence
will help everyone access their benefits more quickly, because
treating doctors are the ones that really know.
Mr. EVANS. In your comments that you just made and what Mr.
Higgins questioned Ms. Davis, and specifically about Congress,
I am not talking about Social Security, our responsibility is
what I am most interested in hearing you talk about, our
responsibility.
Ms. BURDICK. Well, thank you for the clarification, and you
are right.
So one of the things that Congress can do is they can help
rework the statute and the regs to make sure Social Security is
focusing on treating source evidence. There was a rule that
used to prioritize treating source evidence called the treating
physician rule that was eliminated. And that should come back.
Because, if everyone is focusing on the treating doctor, we
will get to the right decision, or Social Security will get to
the right decision earlier, which will really impact things.
But the other thing that Congress can do is funding. Make
sure not only it is one time, but sustained funding so Social
Security can do the work they need to do to make customer
service better and make it easier to access these benefits.
Mr. EVANS. I thank you for your clarity, and I say that to
you because I just joked with Mr. Higgins, and he is from the
great state of New York and Baltimore, he is a Baltimore
Buffalo fan. So he and I have a constant running discussion. So
from his clarity I wanted to make sure we make this connection.
So--and I appreciate it.
Thank you, Mr. Chairman, I yield back.
Chairman FERGUSON. Thank you. Next, we will go to the
gentleman from Utah.
Mr. Moore, you are now recognized.
Mr. MOORE of Utah. Thank you, Chairman. Thank you, Ranking
Member. I appreciate the discussion today.
So I recently had to go to the DMV in Utah, and I am here
to tell you it was the single best experience I have had. Utah
has--I don't know how long it had been since I had been there,
but I had waited a ton before. I pre-made an appointment. I
filled out the electronic information, I showed up, I was
processed within like seven minutes. Over time, you know, the
bad rap that places like that get have embraced technology and
have used it to dramatically improve customer service.
And that is the essence of my question here, and it is
because sometimes the pandemic, in a lot of ways, forced us to
change a little bit. And so my question first--is for you, Ms.
Kerr-Davis.
It is my understanding that faxed application, signed faxed
applications, were accepted during that period and now they are
not being accepted. Is that correct?
Ms. KERR-DAVIS. That is correct.
Mr. MOORE of Utah. Could you just share a little bit of
context on, like, why that is the case?
What are you doing to embrace as much technology as
possible to help alleviate some of the wait times, the burden,
the showing up when you really arbitrarily don't need to always
show up for something?
Just kind of give me some context on that.
Ms. KERR-DAVIS. Of course. Thank you for that question.
So, during the pandemic, we did put in place a number of
flexibilities so that we could continue to serve the public.
And, in some cases, we have ended these flexibilities for a
variety of reasons.
But I want to be clear that we do accept fax applications
as leads, and then we will contact the claimant, schedule an
appointment or complete the application over the phone, and
then have them attest to their signature.
I do want to go back to your comment about the DMV. So I
had a similar experience in Kansas at our DMV, did everything--
you know, went online, got a text, a reminder, went in,
everything, and very quickly. We are in the process of moving
in that direction at SSA. But as you know, we have a lot of
security issues that we have to consider.
Mr. MOORE of Utah. I share a building in my district with
your team, and I totally get the differences that do exist.
Ms. KERR-DAVIS. Yes, yes. So--but that is where part of
that $2 billion went, is modernizing our system and moving in
that direction. It is just going to take us some time to get
there.
Mr. MOORE of Utah. So I appreciate that context. And just
to reiterate, like, there is--it is out there. And I represent
a huge IRS processing facility in Ogden, Utah, as well. And
that is the number-one thing I hear from constituents and from
the folks that I serve that work at that facility is there is a
desire and a need to embrace as much technology as possible
because it is out there, and, you know, we are seeing it
working.
And take for--whatever good examples that can come from,
you know, more bite-size approaches like you can from a state-
level DMV, and I just encourage you to continue to do that. It
is huge. We cannot get into a position of just we got to throw
more money at things. We have to innovate as we are approaching
this.
And that is what I appreciate in Mr. Camp and Mr.
Warshawsky's testimony, particularly--and I will quote this--
``Social Security could improve the decision process for
claimants that would utilize''--and again, quote--``existing
authority appropriations and staffing.'' So it kind of gets to
my point. There are opportunities out here with what already
exists. Let's improve that as much as we possibly can, build on
that, and then reassess what we need with regards to workforce
and everything to solve the--to fit the needs.
Can--you like to share anything else that you would do to
help modernize this process as we think about the next 5 to 10
years and the crucial time for Social Security? Because I do, I
think the next 5 to 10 years is the most important time of this
organization.
Mr. WARSHAWSKY. Well, Mr. Moore, I don't know if you
addressed your question to me----
Mr. MOORE of Utah. Yes.
Mr. WARSHAWSKY [continuing]. But I will say that the
vocational tool, the VIT, which the agency spent $10 million on
that was part of the IT budget, they are not using. And it
depends on the new data, but the data exists. So it is really a
real question, really, as to why this has not been implemented.
And it would reduce times significantly because it would
automate the process. It would be an application of technology
as well as new data that would certainly speed the process, the
adjudication process, significantly.
I will also sort of note that not only are disability
claims declining, but, during the pandemic, the agency didn't
do a lot of work. So it is really a mystery. And, really, I
think the agency needs to explain why this problem has
developed, given that their workload declined so much and it
continues to get worse.
Mr. MOORE of Utah. Mr. Camp, anything to add?
Mr. CAMP. They already have the fax machines in every
office. They already turn them on in the morning. Count it. Let
us actually fax something, and let us save those weeks. Easy.
Mr. MOORE of Utah. Yes. And I would argue that we would be
moving past fax machines, too. So, if it is there, let's take
advantage of it, and let's continue to embrace whatever we can.
I think it is the best tool that we have to continue this, and
I think that is something that has to go across the board.
So, Chairman, I am done with my time. Thank you.
Chairman FERGUSON. Thank you, Mr. Moore. I do think it is
just a sad state of affairs when we are talking about whether
or not we should cut on a fax machine. We might as well strap
these notes onto carrier pigeons and send them, as well.
With that we will move to the gentleman from the
Commonwealth of Virginia.
Mr. Beyer, you are now recognized.
Mr. BEYER. Mr. Chairman, thank you very much and thank you
to the ranking member for holding this. As all the Members of
Congress, I hear lots and lots of negative feedback on our
constituent service. It is a really consistent thing, and I
share our frustration.
I am a huge fan of process management. Rather than just
throwing money at things, taking the pieces apart and trying to
look at each section of it. So an obvious question--and not to
be repetitive, but I would love to get the answer--as best you
can, Ms. Kerr-Davis, why haven't we eliminated reconsideration?
We have 20-year projects, all the groups think this is the
right thing to do. Why do we cling to it?
Ms. KERR-DAVIS. So we did test it, as you know, we--someone
on the panel mentioned here.
There are thousands of people who receive benefits--are
allowed at the reconsideration level. It is--actually
streamlines the process. It is--costs less money to process a
claim at the reconsideration level. But certainly, if that is
something you are interested in exploring, we are happy to work
with you on the technical aspects of that.
Mr. BEYER. Are you aware of any legislative attempt at the
congressional level to eliminate reconsideration?
Ms. KERR-DAVIS. No, I am not, not currently.
Mr. BEYER. Okay, Ms. Burdick, same line of thought on
process management. The treating physician rule. Again, I would
love to know why did they get away from that?
Is there a sense that you can't trust the physicians that
are treating these people because they are their friends and
they are from their communities?
Is there a really valid reason why the treating physician
rule shouldn't be in place?
Ms. BURDICK. The task force would endorse getting--
restoring the treating physician rule. And I will say when they
eliminated it none of the reasons that were put forth we found
were very compelling. I mean, because when it comes down to it,
it just--there doesn't seem to be any reason why you wouldn't
try, first and foremost, to get the treating provider to weigh
in on a person's claim.
Mr. BEYER. They are the ones who know them best.
Ms. BURDICK. They do.
Mr. BEYER. Their health.
Ms. BURDICK. And without that, there is this reliance on
Social Security consultative examinations, which are there for
a reason, but this is a one-time doctor, usually doesn't have
any of the specialties of the person who is talking to them. It
just isn't--the evidence created isn't as persuasive, it takes
time, it costs money, and it would just be so much more
efficient to go to the source in every case.
Mr. BEYER. Thank you.
Mr. Camp, Dr. Warshawsky suggested that because the
attorneys get paid on the total amount due there is an
incentive to postpone it as long as possible. How do you react
to that, as an attorney representing these folks?
Mr. CAMP. It isn't our real world. We get hired to obtain
the appropriate outcome, but as fast as possible. Every client
that retains an attorney is expecting us to make the agency
perform better services--to go faster, primarily. We are the
ones on the phone with the clients every day. We are the ones
that are frustrated in being blocked in speeding up the cases.
It is our job to make the claim go faster, and that is--would
be an unacceptable failure to serve your client, which is not
something professionals do if they expect to last.
Mr. BEYER. Okay, thank you.
Dr. Warshawsky, to roll up, let me quote you: ``The
currently needlessly complex and outdated rules that both
claimants and agency use to determine eligibility for
disability benefits have to be simplified, modernized, and
automated.'' Is there anyone charged with doing this? Who owns
that charge?
Mr. WARSHAWSKY. When I was at Social Security, I was in
charge, and the regulation was written. In fact, it was ready
to go literally days before the change of administration.
So it is there, and it was an agency-wide--in fact, even a
government-wide effort. So it involved people from the Office
of Management and Budget, they were extensively involved. The
entire agency, people in operations, people in the actuaries
office, people in the hearings office, the budget office, it
was a total agency effort.
My very rough estimate is that it cost $100 million in
terms of people time to do that, in addition to the expenditure
of $300 million for the data. And it stopped. It is sort of
inexplicable.
Mr. BEYER. And what would the savings be if implemented?
Mr. WARSHAWSKY. Well, I can't speak to that in terms of--it
would be--it would definitely speed things up because it would
be automated. And that is really--and it would be relying on
current data. So that would provide much more accuracy at the
initial level and in the claims. I think it would be a vast
improvement.
Mr. BEYER. Thank you.
Mr. Chairman, I yield back just with the question that once
again there may be a window for legislative initiative here,
too.
Chairman FERGUSON. I thank the gentleman, wholeheartedly
agree with you.
I am going to ask for unanimous consent to enter into the
record the fiscal year 2022 disability decision data. This came
from SSA's budget document. The ranking member and I have been
looking at this.
The reason I think this is so important is it speaks to the
reconsideration process, and how many initial-level claims then
get bumped to that, and then how many are stuck in that
regulatory purgatory that then ultimately go to the
administrative law judge and get corrected. I think this
document highlights very much a very, very broken system.
So without objection, I would like this submitted.
[The information follows:]
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Mr. PASCRELL. Chairman, I want to just mention one thing.
We are so anxious to move into an automation world. For the
last 60 years we have been so anxious to do that. And yet the
process of tracing a gun, the numbers, we still don't automate
it. So that is what takes so long to trace a weapon and to find
out about a perpetrator. So when we talk about automation, we
are talking also, obviously, about the heart of policy, whether
we want to do it and find the reasons to, or not to do it and
keep our heads in the sand. So I just wanted to add that.
Automation is very important to modern living.
And I would suggest, Mr. Chairman, since the subject came
up, we don't know the result of the pandemic, particularly with
our own children. That is for another day. Thank you.
Chairman FERGUSON. Thank you, and I appreciate your embrace
of technology.
This comes from a good friend who every now and then will
whip out his flip phone next to me. [Laughter.]
Chairman FERGUSON. So, with that, again, I would like to
thank the witnesses for being here today. Thank you for your
time, your candid answers.
Please be advised that members have two weeks to submit
written questions to be answered later in writing. Those
questions and your answers will be made part of the formal
hearing record.
With that, the subcommittee stands adjourned.
[Whereupon, at 11:11 a.m., the subcommittee was adjourned.]
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