NADE Position Paper Regarding Certification of Disability Examiners by SSA

Executive Summary

Members of the National Association of Disability Examiners (NADE) have had an opportunity to carefully review the proposal from the Social Security Administration regarding the potential of providing certification of disability examiners in the DDSs. NADE has long advocated the concept of providing certification of disability examiners and has, in fact, done so for the past 25 years. The certification process offered through NADE is based on training and at least three years of progressive experience. An applicant must also be a NADE member.

NADE is preparing to revise its certification criteria to limit it to a period of three years and that anyone certified by the Association would have to apply for re-certification every three years. Applicants for re-certification would have to demonstrate that they have completed a prescribed minimum number of additional training hours beyond those required for their initial certification. This requirement for ongoing training and the need for re-certification will be new to the NADE certification program if it is approved by the membership. We invite SSA to examine NADE’s certification program as a more practical model.

As the professional association representing disability examiners, we do have reservations about the certification proposal outlined in the report from the Chauncey Group. We were extremely disappointed that the Chauncey Group did not contact this Association while they were preparing their study, even though officials at SSA had urged them to do so.

A NADE poll of DDS Administrators in the spring of 2000 found that nearly 90% indicated that a certification program would not make any difference in their ability to hire, promote or otherwise reward any employee who became certified. In the face of such evidence NADE questions the wisdom of SSA investing significant funds in such a program. The Chauncey report admits that there has been no strong support for a certification program and, in fact, declares, perhaps self-servingly, that SSA will encounter major obstacles in implementing any certification plan. The certification proposal is overly ambitious, it is too complex, and there has been little, if any, stakeholder input.

Approximately half of all disability examiners in the nation have less that two years of experience because of retirements and an ever-increasing turnover rate. It is generally accepted that two years of experience is necessary as the very minimum for a disability examiner to gain sufficient program knowledge and work skills to become proficient in their job. It should be alarming to everyone connected with the disability program that so few disability examiners currently have this level of experience. Rather than addressing a need for certification through some sort of standardized testing, we believe that SSA should be addressing the need for experience in the disability program. We believe a certification program, similar to the one offered by NADE, that emphasizes training and experience is a more practical model.

Chauncey is an outside consultant who has a significant personal stake in the project. This fact is made obvious by the report’s conclusion that despite “show stoppers,” including potential lack of peer level support, they believe that certification is feasible. The report’s conclusion in this area is unlikely to resonate with credibility for any of the potential stakeholders.

NADE also questions why the focus has been only on disability examiner certification? Why are other decision-makers excluded? What manner of certification will be required of the personnel in the regional and central offices that review the decisions of the certified disability examiner?

The job of the disability examiner is a highly nuanced medical and legal profession. The Disability Examiner’s job is one that is best characterized as a hands on job requiring telephone skills, writing ability, highly sophisticated interactive capacities, and many other skills – none of which are going to be easily demonstrated in a certification test.

The Chauncey Group admits that their research was limited and, even though they claim it was sufficient, this level of research is certainly laughable to knowledgeable stakeholders and seriously undermines the credibility of the entire report.

In conclusion, NADE asserts that there is no evidence of support for the certification process envisioned by the Chauncey Group. This certification initiative may actually detract from an already diminishing pool of potential job applicants and make the process of attracting and retaining a well-qualified and well-trained staff even more difficult. The certification program envisioned in the Chauncey proposal will remain an exercise far removed from the prerequisites of acquiring and retaining a reliable workforce.

We would invite SSA to examine the certification process offered by NADE and already in place as a meaningful way of achieving their desired purpose at a minimal cost. The certification program offered by NADE recognizes training and experience as the basis for certification and not some meaningless test that accounts for neither. Our certification program recognizes the political realities and practicalities of today’s DDS community. NADE does not have a financial interest in SSA’s pursuit of certification. We will not seek to be the certifying body for a certification program envisioned in the Chauncey proposal.

NADE strongly believes that our Association and representatives from the National Council of Disability Determination Directors (NCDDD) should be included at the discussion tables for all future meetings regarding certification. We believe that SSA, if it pursues the certification initiative, must make a commitment that, it will use certification as a means to require states to offer additional incentives to disability examiners who do become certified. However, we believe that SSA should reconsider its certification push at this time and take a step back on the proposal and await the outcomes of the many factors that may affect the issue but which have not been fully understood at this time.

NADE Position Paper Regarding Certification of Disability Examiners by SSA

June 15, 2001

NADE has long advocated the concept of providing certification of disability examiners. In fact, this Association currently offers such an opportunity to disability examiners and has done so for 25+ years. The certification process offered through NADE currently requires that applicants complete a minimum number of hours of training in the medical, administrative and vocational areas. They must also have shown progressive experience over a period of at least three years. An applicant must also be a NADE member.

Beginning in 1997, the Association began looking at its requirements for certification and began considering whether these requirements were still relevant in the ever increasingly complex and technologically advanced environment that characterizes the Social Security disability program. NADE’s Board of Directors considered a proposal in March of this year to revise the criteria for certification. While the initial criteria would stay basically the same, the Board concluded that the certification offered by the Association should be limited to a period of three years and that anyone certified by the Association would have to apply for re-certification every three years. The Board further concluded that applicants for re-certification must be able to demonstrate that they have completed a prescribed minimum number of additional training hours beyond those required for their initial certification. This requirement for ongoing training and the need for re-certification will be new to the NADE certification program if it is approved by the membership at NADE’s upcoming national conference in October of this year.

We invite SSA to examine the requirements for certification offered by NADE and consider using our program as a more practical model. We believe that our certification program can be implemented by SSA at minimal cost.

NADE had polled DDS Administrators in the spring of 2000 to determine the viability of such a certification process. Nearly 90% of the administrators responded and nearly 90% of those indicated that such a certification program would not make any difference in their ability to hire, promote or otherwise reward any employee who became certified. In the face of such evidence NADE questions the wisdom of SSA investing significant funds in such a program.

The Chauncey report admits that there has been no strong support for a certification program and, in fact, declares, perhaps self-servingly, that SSA will encounter major obstacles in implementing any certification plan. While SSA appears to indicate that the support comes from a recent report issued by the Social Security Advisory Board that recommends disability examiners should be well-qualified and well-trained, NADE believes that it is a mistake to accept this recommendation from the Advisory Board as a call for certification.

The GAO reported to Congress in January, 2001 that SSA was failing in its efforts to improve the disability determination process. The report from the GAO declared that, “The Agency’s slow progress was due in part to the overly ambitious nature of the redesign plan, the complexity of the redesign initiatives and inconsistent stakeholder support and cooperation.” The report further advises SSA to, “Scale back its plan and focus on those few initiatives considered most critical and rethink its approach.” It is NADE’s position that the certification proposal is not a critical initiative and that the concept suffers from those very factors that have plagued other initiatives offered by SSA and addressed in the GAO report. It is overly ambitious, it is too complex, and there has been little, if any, stakeholder input.

Throughout the nationwide DDS community, the salaries of disability examiners do vary widely, from a low of $18,000 per year to as much as $60,000 or more per year. These varying salary levels among the DDSs have a strong impact on who DDSs can hire and who they can retain. Even after DDSs invest huge amounts of funds in training new employees, many still walk out the door for more lucrative jobs. Has SSA developed a strategy as to how employees with such wide variances in salary would be expected to conform to the same certification criteria? It seems unrealistic that SSA would pursue an initiative that would create a stringent certification program and expect it to be widely accepted and utilized.

There are other problems that face the DDS community and the SSA disability program. Like SSA as a whole, the DDSs are faced with an impending wave of retirements within the next few years. This comes at a time when approximately half of all disability examiners in the nation have less that two years of experience because of retirements and an ever-increasing turnover rate. This is evident in NADE’s own certification program that requires at least three years of progressive experience. Our Association has witnessed a decline in the number of applicants for certification, a decline that can be attributed to the overall decline in the number of potential applicants who meet the three-year requirement, a requirement that we are not willing to waive. It is generally accepted that two years of experience is necessary as the very minimum for a disability examiner to gain sufficient program knowledge and work skills to become proficient in their job. It should be alarming to everyone connected with the disability program that so few disability examiners currently have this level of experience. In a recent report from the Lewin Group, it was noted that the disability program was characterized by subjectivity. Allowance rates among even experienced examiners varied greatly from a low of 29% to a high of 53%. Rather than addressing a need for certification through some sort of standardized testing, we believe that SSA should be addressing the need for experience in the disability program. As such, a certification program, similar to the one offered by NADE, that is based on training and experience should prove to be a more practical model.

The proposal from the Chauncey Group would have SSA declare that nearly half of the disability examiners in the nation are only “minimally competent” to do their jobs – the lowest of the projected certification ratings. Is this really the message that SSA desires to convey to the public? SSA has stated it is its goal to increase public confidence in the disability program. We fail to see how this achieves that goal. It is our belief that SSA should look first to address the problems of inadequate and widely varying pay for examiners and the turnover rate in the DDSs as more effective use of their resources.

Another factor that does not appear to have been fully understood in the Chauncey report is the expected change in the nature of the job of disability examiner under the new disability claims process. This new process was expected to begin a national rollout this year but has recently been placed on temporary hold. This process, which SSA has experimented with in ten states under a “prototype” test, radically changes the dynamics of the disability examiner’s job tasks and responsibilities. These changes will severely impact the current workforce and require DDS Administrators to drastically alter the basic concepts under which they have been hiring for years. What impact might these changes be expected to have on the certification proposal, especially when data is not yet available to determine the success or failure of this new process?

The national rollout of the new disability claims process is to be implemented in three stages. During these staged rollouts, and even beyond, the DDSs will be in a state of flux. SSA has also determined that each DDS will be allowed to define its own criteria for examiners to qualify to become a Single Decision Maker (SDM), one of the basic tenets in the new disability claims process. This is disturbing because it allows 50+ definitions of the criteria for SDM to exist. How does this impact on Chauncey’s single “hierarchy taxonomy” from minimal to expert?

The Social Security Advisory Board’s recent report warns that the new administration and the new Congress should, “undertake a fundamental review of the disability programs as soon as possible.” The report describes wildly discrepant disability decisions from one region of the country to another and also describes a basic lack of credibility within SSA for assessing quality. We believe that these problems beg for a resolution prior to SSA attempting to expend funds to push examiner certification.

While the Chauncey Group’s report is presented as a scholarly piece of work, it does contain several specific problems. First is the fact that Chauncey is an outside consultant who has a significant personal stake in the project. This fact is made obvious by the report’s conclusion that despite “show stoppers,” including potential lack of peer level support, they believe that certification is feasible. The report’s conclusion in this area is unlikely to resonate with credibility for any of the potential stakeholders.

NADE also questions why the focus has been only on disability examiner certification? Why not include Administrative Law Judges, or disability hearing officers, or even Field Office personnel in a certification program? What manner of certification will be required of those personnel in the regional and central offices that review the decisions of the certified disability examiner? In its current proposal one can only conclude that non-certified quality assurance reviewers in the regional and central offices will be returning claims to certified disability examiners.

We believe that targeting one element of the disability program not only detracts from credibility but will raise suspicions that the report fails to assuage. This is an important concern since the state and federal disability partnership has allowed the DDSs to implement their own training programs with guidance from SSA’s Central Office. Once a certification process is in place, it brings into serious question the possible dissolution of the partnership and an unprecedented oversight role by SSA’s Central Office. This is a volatile issue that was insufficiently researched or addressed in the Chauncey report.

In February of this year, Mr. Stanford Ross, Chairman of the Social Security Advisory Board, informed the Congress that SSA has an internal culture that, “discourages open discussion and timely identification and resolution of problems and [there is a] weakness in communication between SSA’s headquarters and operations in the field…particularly in the areas of disability and SSI.” We believe that, should the certification initiative be a fait accompli without significant dialogue between stakeholders and SSA, failure will be guaranteed. We offer the following contrast between Chairman Ross’ remarks and the description of the communication that the Chauncey report describes as being so necessary for stakeholder support: “Information should be disseminated as water flows down the face of a pyramid, spreading horizontally as well as vertically [which] helps defuse rumor and begins to build ownership in all concerned.” Chauncey’s academic focus clashes severely with the stark reality of how SSA actually operates.

The job of the disability examiner is a highly nuanced medical and legal profession. From what source does the Chauncey Group derive their conclusion that a certification test would demonstrate the skill sets required to perform the profession at a level deemed to be exemplary of proficient performance? The Disability Examiner’s job is one that is best characterized as a hands on job requiring telephone skills, writing ability, highly sophisticated interactive capacities, and many other skills – none of which are going to be easily demonstrated in a certification test.

The Chauncey Group admits that their research consisted of interviews with a single disability examiner from a DDS involved in the prototype study and a single disability examiner from a non-prototype DDS, and two representatives from the Philadelphia and Atlanta Regional Offices. From these interviews, the Chauncey Group claims it gained, “a clear picture,” of the job’s components, training, continuing education and the difference in competency expected in a disability examiner in a prototype and non-prototype DDS. They also spent ONE DAY meeting to determine the content to be included in the certification test. The claims by the Chauncey Group that this level of research enabled them to gain “a clear picture” of anything is certainly laughable to knowledgeable stakeholders and seriously undermines the credibility of the entire report. To expect that such limited research would provide any such level of understanding would require belief in an unprecedented level of assimilation never before seen in the most highly complex disability program in the country.

The test proposed by the Chauncey Group appears to lean heavily toward political correctness by involving a special blend of equal ethnic and gender representation on the test committees and test protocol. We contend that the disability decision is not a social issue but a cognitive process. If the claimant and taxpayer are foremost in mind, the best qualified should serve on the various committees without ethnic or gender considerations.

The purpose of certification, announced by SSA, is to allegedly increase public confidence in the job of the Disability Examiner (equally lacking from the report is the documentation of support from the public that certification will accomplish this purpose). Yet, SSA has announced that it will hold harmless any current employee who cannot pass the test. This idea is faulty and defeats the proclaimed purpose of certification. If there is to be a valid certification, should current employees who cannot do the job really be grandfathered in? Will SSA admit that the certification test is flawed and does not address all the skills required to do the job?

SSA has announced that the test, when developed, would be piloted by six disability examiners picked by SSA. This is an incredible underestimation of an instrument that will be applied to thousands of individuals. Given the extensive problems that SSA has seen with its pilot programs over the past few years, it would appear to the knowledgeable observer that SSA should be willing to design a much more expansive test and a more realistic pilot.

In conclusion, NADE asserts that there is no evidence of support for the certification process envisioned by the Chauncey Group. Disability examiners are currently so overwhelmed by SSA’s constant hubris of policy and program initiatives that there is actually little support from the examiner staff for a certification initiative, especially one that requires testing when there is no tangible benefit to be gained. This certification initiative may actually detract from an already diminishing pool of potential job applicants and make the process of attracting and retaining a well-qualified and well-trained staff even more difficult.

Disability examiners desire policy clarification, program consistency, and the tools and resources necessary to do their jobs. In return, they ask for a salary commensurate with their skills and the tasks they are expected to perform. We believe that these are the productive short-term goals upon which SSA should direct its efforts and resources. Until these goals are achieved, the certification program envisioned in the Chauncey proposal will remain an exercise far removed from the prerequisites of acquiring and retaining a reliable workforce. Until the program perimeters come into sharper focus and actual job duties and performance achieve acceptable consistency on both a state and regional basis, the certification initiative is unlikely to have a positive impact and certainly will not bring any enhancement to the disability program.

We would invite SSA to examine the certification process offered by NADE and already in place as a meaningful way of achieving their desired purpose at a minimal cost. It is our opinion that disability examiners who see themselves as professionals and demonstrate their professionalism by maintaining membership in their professional association, do have current access to professional certification through their professional association. The certification program offered by NADE recognizes training and experience as the basis for certification and not some meaningless test that accounts for neither. Our certification program recognizes the political realities and practicalities of today’s DDS community.

NADE believes that certification should be pursued from an entirely professional point of view. This can be successfully achieved as we have demonstrated over the past quarter of a century.

Unlike the Chauncey Group, NADE does not have a financial interest in SSA’s pursuit of certification. We will not seek to be the certifying body for such a certification program envisioned in the Chauncey proposal. However, we do believe in the practicality and usefulness of our own certification program and we encourage SSA to consider our program as a more practical model and one that will more effectively achieve the stated purpose of certification. However, NADE will not provide certification to non-members.

NADE strongly believes that our Association and representatives from the National Council of Disability Determination Directors (NCDDD) should be included at the discussion tables for all future meetings regarding certification. The fact that this was not done earlier certainly added to the credibility problems that we have with the Chauncey proposal. We believe that it will be critical that NADE and NCDDD be involved from this point forward in any and all discussions on this issue.

SSA has allowed the Chauncey Group to proceed with additional work on other deliverables that were outlined in the proposal. We strongly believe that SSA must make a commitment that it will use certification as a means to offer additional incentives to disability examiners if it intends to pursue certification as envisioned in the Chauncey proposal. Specifically, SSA must make a definite commitment that certification will be used as means of enhancing the pay and other means of recognition of disability examiners throughout the country. In view of the previous study conducted by NADE that found that a vast majority of DDS Administrators are powerless to use certification as a means to enhance the pay levels of their employees, we fail to see how SSA will be able use certification as a means to accomplish this goal.

Congress has heeded the recommendation of the Social Security Advisory Board and has begun to take a closer look at the disability program. Already, the Social Security Subcommittee has held several hearings this year on issues pertaining to the Social Security disability program. Additional hearings are expected and the committee is expected to take a top-to-bottom review of the program. SSA has, meanwhile, put a hold on the national rollout of the new disability claims process (prototype) while it further examines the costs and benefits of this new process. In consideration of these factors, we believe that SSA should reconsider its certification push and take a step back on the proposal and await the outcomes of these other factors.

NADE is appreciative of this opportunity to offer these comments.

Questions concerning NADE’s position on this matter may be directed to:

Jeffrey H. Price
NADE President
Post Office Box 243
Raleigh, NC 27602
1-800-443-9359 ext. 6056
fax (919) 662-3581