GAO Report Shows Positive Effect of Representation

A Government Accountability Office (GAO) study of hearings-level allowance rates for disability claims showed that “claimants who had representatives, such as an attorney or family member, were allowed benefits at a rate nearly 3 times higher than those without representatives.” The report explains that in part this is due to representatives’ ability to select claims that are likely to be successful. However, the report also quotes SSA officials as stating “that a representative can help the claimant by ensuring that the medical evidence and other records are fully developed and help the claimant present their case at a hearing.” Although NOSSCR and its members already believed in the value of representation, it is helpful to have validation from an official source. The report, entitled “Additional Measures and Evaluation Needed to Enhance Accuracy and Consistency of Hearings Decisions,” was released in January 2018. It studied ALJ decisions made on SSI and SSDI claims between Fiscal Years 2007 and 2015, a time period where requests for hearings increased, peaked, and then declined. During this time period, 77% of claimants at ALJ hearings had attorney representatives and 12% had non-attorney representatives. While it is likely that most representatives were professionals rather than friends or relatives of the claimant, the report does not break down the representative population more specifically. During this time period, the variation among ALJs in award rate shrank slightly and the overall allowance rates decreased significantly. ALJs who joined SSA between 1995 to 1999 and were still at the agency between 2007 and 2015 had higher award rates than newer ALJs. Several factors correlated with allowance rate: older claimants were more likely to be awarded benefits than younger adults (the study excluded child SSI claims) and having a critical case, a college education, and a claim for SSDI rather than SSI also increased the chance of an award. Hearings that included testimony from a medical expert were more likely than the average claim to result in an award of benefits, while vocational expert testimony decreased the chance of an award. Video hearings had an award rate 2.8 percentage points lower than in-person hearings, though the GAO report notes that this may in part be attributable to differences in who opts out of video hearings. However, after controlling for the difference between video and in-person hearings, the study did not find any difference in outcomes between hearings performed at hearing offices versus National Hearing Centers.