Job Title: Claims Representative
Location: USA
Submitted on: 24-Jul-04
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Social Security Claims Representatives get $58000 a year to open mail
and answer the phone. That sounds great, except that stuff they are
paid
to do just piles up. Medical reviews, reviews of disabled people who
return to work, and overpayment collection actions are piled in boxes,
because Social Security rushes to pay new claims and reinstatements
without clerks.
Most employees were hired when Jimmy Carter got elected, all are
almost age 55, and all count the days until they retire, because Social
Security has fostered an image of immediate service that means it is
the
right of everybody to go to the head of the line. Everybody is
answering
phones. By the time Social Security realizes somebody worked long
enough
to be terminated, the overpayment is in the thousands. Then the person
files for a waiver: he did not understand the reporting, money kept
coming so it must be due, Social Security waited too long to tell him.
Then an Administrative Law Judge, who wears a transparent belt buckle,
so he will not bump into the walls, waives the overpayment. ??Sociable??
Security pours most production resources into new claims and pretty
much
ignores its role as a steward of the public trust. Social Security is
not stopping checks timely when disabled people go back to work, it is
not collecting many overpayments, and it is not asking anyone to be
responsible for their own lives, because it doesn??t want to offend
anybody.
A typical Social Security Office has 1 Manager, 1 Assistant Manager, 1
Operations Supervisor, 1 Management Support Specialist, 1 Systems
Coordinator, 2 Technical Experts, 9 Claims Representatives, 6 Service
Representatives, and no clerks. Seven people GS-12 and higher manage 15
production people who have no clerical support. The management members
print lists of pending claims and ask the 15 production people for
status.
If all the people who ask for status were actually impacting the
status,
there would be no need to ask. Claims Representatives do not need
anybody to do complex work. They know how to do it. They do need
somebody to open the mail and answer the phone.
Some Claims Representatives work on issues involving people already
receiving Social Security disability benefits. Without any clerical
support, they are expected to keep track of all disability
beneficiaries
who have returned to work, interview all persons who are due for
medical
review, coordinate with insurance companies the payments of all of the
people who get workers compensation, determine the need for payment to
a
guardian, and conduct personal conferences with all overpaid people who
ask that they not have to pay back their overpayment. A Claims
Representative may work on about 1500 such cases at one time.
Termination actions are delayed by his reinstatement actions. While he
is reinstating people who quit work, people who started work are
accumulating overpayments that Administrative Law Judges may excuse.
Employees retire at age 55 from a job that pays $28.00 an hour and take
one that pays $9.00 an hour, because they are tired of letting
overpayment cases get older and older, while everybody with a phone is
their boss. They never get to do case reviews that would produce
overpayments and terminations, because they spend most of the week
opening mail and answering phone calls from people who want to report
their job or their workers compensation stopped. They, and management,
expect employees to accommodate each of them first.
SSA is targeting minorities. It advertises with minority advocates but
not in general media. When I retired, the six applicants to replace me
were all Hispanic, Native American, African American, and Asian.
Hours are 8:00 AM to 4:30 PM.
Dress code is business casual.
If President Bush cuts the federal work force without cutting layers of
middle management Social Security managers must learn to say, ??We
haven??t gotten to that yet.?? Social Security employees have two
functions: give people what they want and guard taxpayer money. On
Monday an employee starts working on initial claims to get them
approved
and paid. As the week goes on, he starts responding to the people who
want benefits reinstated because they quit their job. Then he computes
higher benefits for people whose workers compensation stopped or
lowered. Then it??s Friday, and he resolves that next week he is going
to
look at some cessations and overpayments, after he clears next week??s
claims, reinstatements, and recomputations. He always runs out of week
before he gets to stewardship actions.
Social Security has two logistics problems about to mesh with each
other. Over 50% of its work force is poised to retire with no
articulated phase in of replacements at the same time Congress is
requiring it to encourage Disability beneficiaries to go back to work.
Who is going to keep track of people??s work incentives, so their
benefits are stopped timely without overpayments?
Internet page www.ssa.gov/2010, says that Social Security expects 28000
employees to retire and another 10000 to leave by 2010. This is over
50%
of its workforce. Social Security is paying lip service to the problem
but not really doing anything about it.
Social Security does not hire in advance of vacancies and has hired
hardly anybody since the 1970s. In 1974 Social Security hired Claims
Representatives to work the new Supplemental Security Income program.
In
1976 it hired more Claims Representatives, so they would be in place
before Jimmy Carter took office and imposed a federal hiring freeze.
Social Security employees can retire at age 55. The average age of
Social Security employees is 47, but many are 50 or older. In two
offices that I know of, all employees but two and four respectively can
retire within the next three years. In those two offices combined, only
one employee has stayed beyond the age of 55. A manager once retired
with two days of notice.
The public pays Social Security Claims Representatives $58000 a year to
open mail, file mail, associate mail, write names on folders, and
answer
the phone. That sounds great for employees, except that their real work
piles up. Medical reviews, reviews of disabled people who returned to
work, and overpayment collection actions are piled in boxes on top of
file cabinets, because Social Security is rushing to pay new claims and
reinstatements and doing clerical work without clerks.
Social Security Offices have no clerks. They were all promoted to
Claims
Representative or Service Representative over the years. We??re ??saving
money?? by not replacing them. Every Claims Representative answers his
own phone, opens his own mail, writes his own letters, and files every
folder he touches. We are paid $26 to $28 per hour, about what a nurse
earns, to represent the government ?? without much quality review ?? to
determine eligibility, to adjudicate points of law, to make binding
determinations about overpayment liability, to accept compromise
offers,
to set the amount of money that will be collected per month for an
overpayment; and all of that work is waiting for us??after we open the
mail, answer the phone, return our messages, and refill the copier and
printer. I am a GS-11. My coworkers and I want to pay claims AND
prevent overpayments. If I had a GS-5 clerk working for me, I could do
twice as much of what I am paid to do. A GS-11 and a GS-5 would cost
the
taxpayers less than 2 GS-11??s doing the same combined work. I have six
copier-paper boxes full of mail that has not been opened. My office has
6 Social Security Claims Representatives, 5 Supplemental Security
Income
(welfare) Claims Representatives, and 6 Service Representatives who
process Medicare claims and input changes of address. We have a Manager
and 2 Management Support Specialists. Three people are managing 16
production people, 2 of whom are Technical Experts (GS-12) who assume
some management duties like being Officer in Charge when Management are
all on leave at the same time.
Social Security makes poor personnel choices. There are layers of
management in local offices and layers of offices between local offices
and the Regional Commissioners. Some examples of bad personnel
practices
are the Management Support Specialist and the Technical Expert.
When told to reduce the ratio of supervisors to production people,
Social Security created the position Management Support Specialist as a
replacement for the Operations Supervisor so it could say that
supervisory ranks dropped. A Management Support Specialist manages work
loads rather than people. Management Support Specialists supervise by
wearing the stripes of their boss. Management Support Specialists have
no production load but print lists of other people??s work, so they can
prod them to do it more quickly.
Most of us were hired when Jimmy Carter got elected, all are almost
age
55, and all are counting the days until they are retired, because
Social
Security has fostered an image of immediate service that means when
people call to say they quit work or lost their Workers Compensation,
employees devote all of their attention to paying them immediately. It
has become the right of everybody to go to the head of the line.
Millions of disabled people with personality disorders, go back to
work. Some report it; some do not. It does not matter. There is no one
there to catch them or count their work months. Everybody is answering
the phones. By the time Social Security realizes somebody worked long
enough to be terminated, their overpayment is $30000 or $90000. Then
advocacy groups for The Ticket to Work, paid grants by Social Security,
call Social Security to argue that the wages are really a subsidy!
These groups want to get paid for managing the Ticket to Work, so they
argue against terminating the benefits of anybody. Social Security
Managers accept these subsidies allegations as written. Then an
Administrative Law Judge, who wears a transparent belt buckle, so he
will not bump into the walls, waives any overpayment.
Social Security is so paranoid about being ??Sociable?? Security that it
pours all of its production resources into new claims and completely
ignores its role as a steward of the public trust. Social Security is
not stopping checks when disabled people go back to work, and they
almost all do, it is not collecting the resulting overpayments, it is
not realizing that people are being awarded workers compensation that
should be offset from Social Security benefits, and it is not asking
anyone to be responsible for their own lives, because it doesn??t want
to
offend anybody?? and have them call a legislator.
Social Security cannot stop or collect overpayments. Everything is paid
based on a premise of eligibility. Disabled people can work 9 months
with no cessation. After that they get a check for months they earn
less
than $740 and no check for months they earn over $740. Some report
work.
Some don??t. Our service area has 6000 disabled beneficiaries. Twenty-
six
percent of all Social Security disability beneficiaries nationwide are
being paid because of mental or personality disorders. They do not
report a return to work, or they report it but don??t check back in 9
months. When confronted with their earnings records 18 months later,
they do not remember. When told their overpayment, they ask for a
waiver. The only people who repay an overpayment are those naive enough
to do so. When a waiver is sought, collection stops. One Claims
Representative must write a determination about the waiver request. If
he denies it, a second Claims Representative must schedule a personal
conference. If he also denies waiver, the person asks for a hearing
before an Administrative Law Judge. About a year later, he tells the
Administrative Law Judge he didn??t understand the reporting
requirement.
Social Security kept sending the checks, Social Security waited a long
time to tell him about it, and collection of the overpayment would
deprive him of the means to pay for his shelter. The Administrative Law
Judge almost always grants waiver of collection. I ran a list today. My
office has 128 personal conference requests pending. The total of those
128 overpayments is $819,610. That??s an average of $6403.20 per person.
A typical Social Security Office has this ratio: 1 Manager, 1 Assistant
Manager, 1 Operations Supervisor, 1 Management Support Specialist, 1
Systems Coordinator, 2 Technical Experts, 9 Claims Representatives, 6
Service Representatives, and no clerks. Seven people GS-12 and higher
manage or mentor 15 production people without clerical support.
Management spend much of their time printing computer lists of pending
claims and asking production people for status, because an Area
Director
Office, with an Area Director, an Area Administrative Assistant and 2
Management Support Specialists, prints computer lists of pending claims
and asks local Managers for status.
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