Wisconsin Disability Blog

Fireworks by Anna Cervova

Over the past few weeks there have been a couple newspaper articles written about the Wisconsin Social Security disability backlog.  On September 19, the Wisconsin State Journal ran an article with the headline, “People seeking Social Security benefits face huge backlog, long delays“.  The LaCrosse Tribune followed up with an article on September 20 with the headline “Wisconsin’s Social Security disability case backlog among worst in U.S.; new video conferencing expected to help in La Crosse.”  There isn’t much in the articles that isn’t known to folks who follow this blog, but it is interesting to see how the state press is handling the situation.

The Wisconsin State Journal also ran an article about the staffing situation at the Wisconsin Disability Determination Bureau indicating that employees at that state agency – which makes disability determinations at the initial and reconsideration levels – will be subject to mandatory furloughs due to the state budget shortfall. 

Don’t think the backlog problem or the bad press for SSA is limited to Wisconsin.  In the same week, The Detroit News ran this story about the situation in Michigan.

As I have discussed previously, when a claimant in Wisconsin requests a hearing before an Administrative Law Judge,  the wait for the hearing is over well over 18 months.  This long wait is one of the toughest things for my clients to deal with.  The Social Security Administration (SSA) has issued a report documenting the state of the backlog of hearing cases in Wisconsin.  This report is the second quarter update for fiscal year 2009.  It shows that the average processing time in Wisconsin is 618 days – more than 128 days longer than the national average.  To give an idea of the age of some cases pending in Wisconsin consider the following from the report:

We started FY 2009 with 3,322 Wisconsin cases that will be 850 days old or more by the end of the fiscal year. Through March, we cleared 57.80% of these cases.

The report has some interesting graphs showing the average waiting time over time.  It also shows how the current recession has resulted in an increase in the number of hearings requested.  The SSA hopes to have the backlog of cases eliminated by 2013.

According to the information published regularly in the NOSSCR Forum, there has been no improvement over the past nine months on disability case processing times at the Wisconsin or Madison hearing offices.  The figures in the June issue indicate that the processing time for Milwaukee is 679 days, whereas Madison is at 717 days.  In comparison, last November Milwaukee was at 575 days and Madison was at 719 days.    Meanwhile, cases in Northeast Wisconsin and the Fox Valley continue to be shipped out of state to the hearing offices in Oakland (591 days), Santa Barbara (561 days) and Pasadena (473 days), California.

As I mentioned in a previous post, as part of the biennial budget bill, 2008 Wis. Act 28, the legislature has now set limits on the amounts that health care providers can charge for medical records.  Previously, these were set by administrative code section HFS 117.  The new law, which appears to have an effective date of June 30, 2009, creates a new statutory provision (Wis. Stat. § 146.83(1f)(4)) that limits the maximum amount that a health care provider can charge disability claimants appealing a denial of benefits to the amount that SSA reimburses the state DHFS for medical records.  I have been in contact with the folks at the State who order and pay for medical records in disability claims and have been informed that the reimbursement rate is $26.00 per records request.  The rate per page authorized by the new statory provision is $0.35.   Because it is typical for a representative to pass the cost of medical records onto the clients in these cases, this is a big change — one which could save claimants a good deal of money in their efforts to prove their disability claims.  

(Note: The limits on medical records will only apply to medical providers in Wisconsin.)

According to the newest addition of the NOSSCR Forum through the 35th week of 2009, there have been 31,432 disability claims filed in Wisconsin.   In comparison, there were 28,831 claims filed during the same period last year.  The result is a 9% increase in initial disability claims.  The explanation for this is the current economic recession.  When you factor the economy in with the aging baby boomer population, I expect we will continue to see an increase in disability applications.

A huge development relating to Wisconsin disability appeals was squeezed into the state budge bill late last month.  As part of that bill, the legislature changed what health care providers can charge for copies of medical records.  An article about these changes is available at the Wisconsin State Bar website.   As it relates to disability appeals, there are two major provisions:

1.  In cases involving appeals of denials of disability benefits (SSDI or SSI), health care providers may charge no more than the amount that the Social Security Administration reimburses the state copies of patient health care records.  This should result in a decrease in the out-of=pocket costs to disability claimants who are trying to provide medical information to SSA in appealing their denial of benefits.  Unfortunately, I haven’t received an answer from the State yet as to what the SSA reimbursement rate is.  I am working to get that information as quickly as possible and will post it here once it is available. 

2.  Medicaid recipients are now entitled to one free copy of their medical records.  Many disability claimants are on state Medicaid (for instance, if they have children).  They can get a copy of their records to help their disability claim at no cost. 

These changes are part of a revamped Wis. Stat. § 146.83.  These changes apparently were effective as of June 30, 2009.  The changes have not yet been incorporated into the revisor’s version of the statutes.