Breaking up the backlog

In field offices where the Social Security Administration is accepting

disability claims electronically, case workers have complained that a computerized intake system meant to save time has done the opposite. It has added 18 to 20 minutes on average to the time needed to handle each new case.

The time anomaly has caused claims representatives to schedule fewer appointments in a day, said Ron Buffaloe, district manager in SSA's Salisbury, N.C., office. Still, he said, the system's potential for cutting case-processing times overall by a third or more makes him willing to put up with the new demands. "It hurts right now," he said. "But we understand we're part of a bigger process."

SSA has had ups and downs with its new disability claims-processing system, as congressional auditors cited in a recent report. For each new case, an electronic folder is created to hold letters, health records and medical images pertaining to that case. However, claims examiners have complained about the poor quality of some scanned images in the electronic folders.

Despite a number of such problems and advice from the General Accounting Office to proceed cautiously, SSA officials said they will stick with an accelerated schedule for expanding electronic disability claims processing nationwide. It is SSA's second attempt in recent years to eliminate the mailing of thick case folders back and forth between offices. Last year, SSA Commissioner Jo Anne Barnhart told lawmakers that she hoped that by using electronic folders the department could eliminate its entire claims backlog — 625,000 cases — in five years. Doing so is a top priority, she said.

Although still not fully integrated, SSA's automated disability claims-processing system offers many new capabilities. One is a Web-based application that lets citizens use the Internet to file a disability claim. "Just like retirees can do today and file for retirement, we wanted our disabled population to be able to do the same thing," said Bill Gray, SSA's deputy commissioner for systems.

But the system still lacks features, such as a secure means for attorneys to go online to check the status of their clients' claims. "If the U.S. Courts can [create such a system, SSA] should be able to do it," said Marcia Margolius, a private attorney in Cleveland who is past president of the National Association of Social Security Claimants' Representatives.

The state-run offices that decide who qualifies for disability benefits had to prepare to use the new claims-processing system. Officials bought iSeries servers from IBM Corp. to replace obsolete Wang processor hardware and then rewrote their critical software applications to run on the new hardware.

In a 10-year period, SSA will spend about $1 billion on the new system, Gray said. But it will save the department about $1.5 billion, he said, a net savings of $500 million. Substantial savings will come from eliminating postage costs and clerical salaries, he said.

This is not the first time SSA has tried to go paperless. In 1992, the department began a large project to redesign and automate claims processing. But that work was suspended in 1999 after nearly seven years. A year later, agency officials revived the plan, with modifications. Then, in 2002, the commissioner approved an accelerated schedule to complete installing the new system by June 2005.

In a report released March 26, GAO auditors questioned that schedule and the agency's cost estimate. SSA agreed to review the assumptions on which its cost/benefit analysis was based, but it rejected other advice from the auditors.

The GAO report criticized the agency for starting a nationwide rollout of electronic disability claims processing before it had thoroughly integrated and tested the component pieces. SSA officials dismissed that criticism and others, including the suggestion that they should seek more feedback from caseworkers and physicians about how the new system should work.

SSA's answer to GAO was a polite but dismissive letter that said, "We've given thorough consideration to a wide variety of views, but we have had to make difficult choices and move on."

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Using IT to tackle the disability claims backlog

The Social Security Administration has developed the following components for automating the processing of disability claims.

Document management architecture. SSA officials will be able to capture, store, index, distribute and protect medical evidence about citizens who apply for disability benefits.

Self-service Internet application. Citizens will be able to file disability claims via the Internet.

Electronic disability collection system. SSA field employees will collect information from citizens with disability claims and store the information in electronic case folders.

Systems migration and electronic folder interface software. State officials who make the initial decisions on disability claims will enhance their existing case-processing systems and gain access to electronic case folders.

Case-processing management. SSA's hearings and appeals officers will manage their cases electronically and gain access to electronic case folders.

Source: General Accounting Office

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