The Social Security Administration’s Bureaucracy
The Wonderful World Of Disability
The Social Security Administration’s Bureaucracy
This assignment asks for personal experience in order to provide data in support of the subject, so I see it only fitting to start with my personal experience with the Social Security Administration. Moreover, I wish to relay the the problems of antiquated and unfair practices of a government subsidized agency (bureaucracy), the one that handles disability affairs. A few years ago, I was sent to hospital, told I have kidney failure, and was beyond the point of dialysis. Because of my young age, this came as quite a shock. It wasn’t cancer, it was listed as an unclassifiable kidney disorder. After several weeks in the hospital, my kidneys recovered on their own, just as mysteriously, but a lot of medication that softened my muscle tissue left unable to walk. I remained unable to stand for even short periods of time for over six months. Medicaid was approved for me automatically, but at my age, I had rent and other bills to pay, and had no way to afford them.
Upon being wheeled into the Office of Disability, I was given a number, waited almost 8 hours to be served, and was eventually helped by an extremely impersonal, impatient and loud worker, who had no qualms about violating HIPAA (hhs.gov, 1996); instead of meeting in an office where I could remain seated, my mother had to hold me up to the 4 foot tall counter, when I was asked “why can’t you stand on your own, you look like an able-bodied person who should be able to stand on your own.” After protest from my mother and other neighboring people that could her the lady berating me over my disability, she continued to ask me why I couldn’t find a job sitting down, like she was doing? I began crying hysterically. She typed out and printed a rejection letter that she wanted me to sign, which I refused to do. She leaned forward and said, “you know, disability for people your age is usually only given if they know you’re going to die.” After being unable to recoup my feelings, the lady asked with a stone-cold face if I needed to take another number and regain composure, reminding me that I was an inconvenience to her. We left, completely beguiled and let down by the government.
Today, I’m fine. I can walk again and work, and I can systematically describe the top to bottom way that the social security program works, the division of labor, the (very interesting) rules, and the (even more interesting) ways things are documented (and forgotten or lost). As you’ve already read, the people who work for this bureau are more than adequately desensitized and impersonal.
Let’s break this down, in a very simple way. Once a disability file is claimed, it immediately goes to the commissioner of the Social Security administration, which is operated at the federal level (Wolfe, J and Proszek, L. pp 3-5). The claimant (or caretaker of claimant) furnishes this administration with names of hospitals, doctors, and any other evidence, by means of a federal field office or telecommuting service. Once all evidence is obtained, the information is then kicked back to the state level, where an initial determination is made, (as you will see though, this is a huge misnomer), called the Disability Determination Service. Of the 2,259,000 claimants in 1998, 1,766,000, or 69% were denied benefits. About half of those who were denied filed an appeal with the reconsideration board, of which 87% (730,000) were once again denied. The Social Security Administration has a “handbook” of rules (ssa.gov, 2015), that consists of several hundred pages of mostly non-understandable legal jargon, and somewhere in this handbook, is paperwork (consisting of about 100 pages), that a person usually needs a patient advocate to fill out.
I ran through some of these topics really quickly, so now I’ll give concise answers to the questions in the order they were asked for in the guidelines. There is a clear cut hierarchy flowing from the commissioner at the federal, to a federal field office, then to the state office and a case manager at the local level. The division of labor consists of data and evidence collection and materialization at the federal level, then processing and investigation takes place at the state and local levels. The “initial” determination is made at the state level. The written rules are contained in a virtually unintelligible “handbook” in which a patient advocate or lawyer is needed. Written records and communications began at the federal level, and shared with the state and local levels. As shown in the introduction in this paper, there is a high level of impersonality between the patient and the workers at the lowest levels of this bureaucracy. I was unable to find a comprehensive report of retention rates of these employees.
This bureaucracy is probably efficient on paper. However, on a practical level it is highly dysfunctional. To force a person who is bound in a wheelchair to stand up for an hour, while explaining why their claim is being denied isn’t an outlying case. If one visits consumeraffairs.com, it becomes immediately obvious that this is a common issue. Among hundreds of complaints to this consumer agency, the social security administration was given a rating of two stars, and the as you read through the actual complaints and look at the years they are filed, the pattern is downward, meaning the last 50 reviews are so are 1 star, or “angry.” As is the case with many bureaucracies, there was no sense of compassion or even humanity. I think that’s pretty important, particularly when you are dealing with one of the single most vulnerable demographics in the country. Not to mention, the violations of HIPAA were highly illegal and downright inappropriate. Forcing an invalid to do something that they could not have done had they not had help is borderline inhumane treatment. Extreme restructuring must take place in order to change the outlook of this administration. I’d start by firing the people that don’t know how to treat other people like humans.
Consumers Unified. (2015). Consumer Complaints and Reviews. Consumer Affairs.
retrieved from http://www.consumeraffairs.com/insurance/ssa.html
SSI Administration. (2015). Social Security Program Rules. Social Security Administration.
Retrieved from http://www.ssa.gov/regulations/
U.S. Department of Health and Human Services. (1996/2015). Guidance Materials For
Consumers. Health Information Privacy. retrieved from
Wolfe, J. and Proszek, L. (2003). Social Security Disability, and the Legal Professional.
Thomas Delmar Learning. Print. pp. 3-5.