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Social Security Administration Case Study

Introduction

The Social Security Administration (SSA) has unique structural and cultural organization attributes for being both a typical large federal agency and social welfare. While SSA plays a central role in serving millions of people with deserving cases, it has leadership challenges given that it is a top-down bureaucracy and the appointment of its executives is subject to political influence. Therefore, despite being one of the best places employers according to various employees’ surveys, SSA scores lowly on effective leadership. One of the major programs that SSA administers is Disability Insurance (DI) with billions of dollars being spent on disability benefits. The SSA has been experiencing a backlog of cases because processing claims take a long time owing to the many involved issues, such as insufficient resources and the dual factors of technology.

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According to the case study, applying for disability benefits could be long, arduous, and complicated (Cropf et al., 2016). For instance, the process involves intergovernmental bodies with each state having its Disability and Determination Service (DDS) unit, which is tasked with conducting an initial review and referral. It is important to note that each state has different standards for determination from the rest and this lack of uniformity affects both employees and citizens adversely. For a person to qualify for disability benefits, he or she must meet certain requirements. However, due to the involvement of various intergovernmental bodies without standard operating procedures, some flawed referrals are made, especially in cases where states are attempting to pass part of the compensation burden to the federal government. Additionally, the system is prone to fraud with some unprincipled citizens applying and collecting undeserved benefits.

After the initial application for benefits, the process becomes apparent with claims being awarded or denied. Initially, a review of decisions was only made after a claim had been awarded, but with changing times, a review is currently done even after the denial of claims. The client advocacy community has emerged to help applicants with the ever-increasing backlog of disability cases. This community is made up of qualified and experienced advocates to help disabled applicants to navigate the legal processes involved in the Social Security system. These advocates normally charge a fee of 25 percent of the total amount awarded in disability benefits. Additionally, the involved advocates work together with private long-term disability insurance coverage companies. Given that insurance coverage is included in the Social Security disability payments, a private insurer, who is already paying disability benefits to a disabled person, would seek federal benefits to replace or reduce the private insurance payments.

In this case, Vince Rogov sought the help of Mike Lawrence, an advocate, to assist in appealing for denied disability benefits claim. Vince had various medical problems that could qualify him for such benefits. He also had underlying psychiatric issues emanating from his military service in Iraq where he served as a private first class between March 2003 and May 2004. However, despite having compelling evidence that warranted the awarding of disability benefits, Vince had been denied the same severally. Mike was convinced that with competent legal representation, Vince would ultimately get his benefits. However, as Mike researched Vince’s case, he noted that his (Vince’s) mental health problems were aggravated. He (Mike) filed the advocate’s appeal, and the administrative law judge (ALJ) granted a hearing and requested to meet both Mike and Vince.

However, after informing Vince about the meeting, he noted that he would be more than willing to appear for the hearing because it would allow him to shoot and kill everyone involved, including himself. However, the following day he called Mike, apologized for his unwarranted outburst, and promised not to say nor do anything that could cause harm to anyone. Nevertheless, Mike was concerned about Vince’s threats, and even as he walked to the ALJ’s meeting, he was worried about the entire scenario.

Decisions

Various decisions were made in this case with the first one being the several instances when Vince was denied disability benefits, despite having genuine claims based on his physical and mental health problems. In addition, Mike decided to represent Vince and appeal for the review of the resolution to deny Vince his deserved benefits. Similarly, the ALJ decided to grant Mike and Vince a hearing to assess the situation. On his part, Vince decided to threaten to kill everyone involved in the case. Lastly, Mike decided to appear for the scheduled ALJ meeting despite Vince’s threats.

I think some of the decisions made were appropriate while others were not. On the one hand, the resolution to deny Vince his deserved disability benefits was inappropriate because there is enough evidence to support the grounds for the awarding of the same. Similarly, Vince’s decision to threaten Mike was wrong even though he was frustrated by the case’s earlier outcomes. Additionally, he was suffering from mental health problems after his military service in Iran back in 2003. On the other hand, Mike’s decision to represent Vince in the appeals process was appropriate. As an advocate, he is duty-bound to help people like Vince, who have been subjected to the shortcomings of the Social Security system. Finally, the ALJ made the right decision to grant a hearing to Mike’s advocate filing, because as the holder of that office, he or she is required to attend to such cases.

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Solutions

In this case, Vince could have been awarded his disability benefits claims based on his mental health problems. Other people have been awarded these benefits even without as compelling evidence as Vince’s. For instance, attorney Tereasa Rerko “represented a gentleman in his early 50s, with multiple health conditions including Type II Diabetes, Diabetic Neuropathy, obesity, arthritis in his lower back and hips, and sleep apnea” (Quatrini Rafferty, 2020, para. 4). Even though this client has been denied his benefits, after the attorney provided the available evidence, he was approved on the application even without having to attend a hearing. Therefore, Vince could have been awarded his benefits because he had a history of cardiac arrest, hypertension, and back problems. Additionally, he had severe mental health problems, and these conditions were all well documented by physicians at the Veteran’s Administration hospital. If this problem had been addressed in time, the other surrounding tissues such as Vince’s threats would not have arisen.

Conclusion

The SSA has a unique organizational culture and leadership due to the level of political influence involved in appointing its executives. Therefore, it is plagued with inefficiencies that affect its service delivery to citizens. As such, the client advocacy community has evolved to help individuals to secure their disability benefits claims, especially after being denied the same. For instance, Vince was denied his disability benefits, even with sufficient medical reports showing that he was deserving. Mike, out of his obligation to duty, offered to represent Vince, but he (Vince) turned violent and threatened to kill everyone involved in the case. These problems could have been avoided if Vince had been awarded his benefits.

References

Cropf, R. A., Giancola, J. M., & Latinette, C. (2016). Social security administration. In R. Cropf, J. Giancola & K. K. Loutzenhiser (Eds.), The public administration casebook (pp. 10-15). Routledge.

Quatrini Rafferty. (2020). Social Security case examples. Web.

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