Chairman Bunning, Chairman Shaw and members of the Subcommittees, on behalf of the members of the National Association of Disability Examiners (NADE), thank you for this opportunity to provide testimony. The issues being discussed at this hearing affect all taxpayers and those eligible for benefits. We believe NADE can provide a unique perspective on many of these issues.

NADE is a professional association whose membership includes physicians, psychologists, advocates, attorneys and administrative Law Judges. The majority of our members, however, work in the state Disability Determination Service (DDS) agencies and are directly involved in processing claims for Social Security and Supplemental Security Income (SSI) disability benefits. We are keenly aware of many of the challenges facing Social Security today, perhaps the greatest of which is restoring nd maintaining public confidence.

NADE believes that every individual who applies for Social Security or Supplemental Security Income disability benefits is entitled to a fair, accurate and timely decision. To that end we believe that ongoing, open communication between the state DDSs and Social Security’s Field Offices, and between the state DDSs and the Administrative Law Judges is essential. Improving and maintaining these lines of communication provides a more consistent message to the individual applicant and to the public, and should improve the timeliness of the decision. Our cooperation with SSA’s Redesign initiatives demonstrates our commitment to improving the service provided to SSA’s customers. Many of the Redesign pilot projects have included a greater emphasis on communication between the various components and we believe the results from those pilot projects that placed greater emphasis on communication have demonstrated improved customer service.

We are concerned about the long term solvency of Social Security and support the current emphasis on Continuing Disability Reviews (CDRs). Such reviews provide a message to the public that stewardship of the Trust Fund is being maintained and to the beneficiary that disability benefits are not necessarily permanent. We believe that for these reviews to be meaningful and productive; however, the current medical improvement standard should be revised. A copy of NADE’s Position Paper on this subject is attached to this testimony. While we do not want to preserve the Trust Fund at the expense of the truly disabled, we feel the CDR process can provide a bridge from disability to return to work, from one economic status to an even better one.

NADE has previously voiced its concerns regarding the SSI childhood disability program. We strongly supported those provisions in the 1996 Welfare Reform law which tightened eligibility standards and which specified treatment requirements. As a result of this legislation, many of those children who had been awarded benefits since 1990 had their claims reviewed to determine of they continued to meet the new standard of disability. The very tight timelines for processing these cases may have contributed to the perception of errors being made and cast doubt on the fairness with which the reviews were conducted. While we strongly believe this was not the case, we also believe that public confidence in the disability program must be preserved. We support Commissioner Apfel’s decision to address the perception of error by taking a second look at some of these cases.

NADE is committed to insuring the integrity of, and preserving the public confidence in, the disability program. This requires a nationally uniform, equitable decision making process. While we believe that the cast majority of claims are adjudicated correctly, the outcome of the quality assurance reviews which were performed on the childhood cases demonstrated that SSA’s current quality assurance process is less than effective. Statistical data obtained in this process is often inaccurate, unreliable and can result in invalid conclusions. NADE believes it is time for SSA to develop a new model for the quality assurance process which will produce meaningful information and provide a basis for improvement through identification of problem areas or specific training needs.

SSA has been engaged in a number of Redesign pilot projects since 1993 with the ultimate goal of improving customer service in a cost effective manner. NADE members are committed to providing timely and accurate decisions and we have supported piloting these Redesign initiatives. We believe that SSA should now begin the process of moving forward with those initiatives which have proven effective in providing improved customer service. We also believe that SSA should re-examine those projects that have thus far failed to demonstrate improved customer service in a cost effective manner and decide whether such initiatives should continue to be tested.

Continued, ongoing professional training and development is critical to the success of the disability program in meeting the challenges of the 21st century. As we move further into the information age, the issues surrounding the need for professional training and development become even more critical. NADE has consistently supported efforts to maintain a well trained professional workforce and will continue to do so through our annual state, regional and national training conferences. Only with adequate resources, including adequately trained staff, clear and timely instructions, and systems support, will we be able to meet the workload challenges of the future.

Again, thank you for allowing us this opportunity to provide testimony.