Social Security Appeal Research Articles

Consistency and Administrative Review

Administrative law scholars have long asked whether and how systems of review or appeal can limit the discretion of adjudicators and thereby promote consistency in adjudications. From immigration courts to patent adjudications to restaurant inspections, recent scholarship has documented dramatic inconsistency in administrative decisionmaking. The resulting calls for reform have focused especially on systems of administrative review, with advocacy for quality assurance systems and peer review as supplements to (or replacements for) traditional administrative appeals. Mostly absent from these debates, however, have been empirical studies of the effectiveness of traditional systems of administrative review. This Article proposes a theory of consistency-enhancing, discretion-limiting administrative review, along with a method of evaluating the effectiveness of systems that conduct such review. The theory implies that a traditional system of review can promote consistency at three steps. First, litigants should be more likely to appeal the decisions of judges unfriendly to their claims. Second, appeals judges should disproportionately reverse decisions from such judges. Third, those judges should seek to avoid remands and therefore alter their behavior when a decision of theirs is remanded. Effectiveness at these three steps has observable implications, and I evaluate each step using a previously unreleased database, obtained by Freedom of Information Act request, of nearly 4 million Social Security Administrative Law Judge and Appeals Council decisions from 2010 to 2014. Disparities in ALJs’ allowance rates - their relative generosity in granting benefits - are notoriously large. Using the within-hearing-office variation in these allowance rates as a measure of consistency, I find that the Social Security Appeals Council promotes cross-judge consistency at the first and third stages of appeal, but not at the second. Appeals Council decisions do not, on average, distinguish between the decisions of harsher and more generous ALJs. Interviews suggest that this lack of distinction reflects the Appeals Council’s deference to the substantive findings and conclusions of administrative law judges, combined with little deference to the ALJ’s articulated rationale for a decision. Although such an approach shows respect for the factfinder’s decisions and a commitment to procedural due process - and indeed, the Appeals Council has recently won awards for its effectiveness - such review does not address cross-ALJ consistency in outcomes. I therefore propose that the Social Security Administration broaden the mission of the Appeals Council by de-emphasizing policy compliance and granting full review more often.Stepping back, I compare these results with those of previous research on immigration courts, where the largest problems occur at the first step of review (the selection process): many immigrants are unable to afford lawyers and do not appeal, regardless of the potential merit of their case. For both processes, careful empirical attention to what happens before an appeal is filed and after a decision is reached is critical to institutional design.

The Experience of using the Social Security Appeals Tribunal: Providing Individual Justice across Diversity

The Social Security Appeals Tribunal (‘SSAT’) plays a significant role in the provision of administrative justice in Australia, deciding around 10 000 appeals each year. However there is little published information about its operation, especially as experienced by people who bring appeals. This article reports the results of a survey of SSAT users conducted in 2008. Participants were interviewed up to three times during the progress of their appeals. We found that while the majority of participants reported satisfaction with the SSAT and its processes, a small minority were very dissatisfied, not solely as a result of losing their appeals. We also found that the reasons for appealing were wide-ranging and included the desire for a respectful individual response or explanation that may not have been provided previously. Our analysis suggests that SSAT users value many features of the Tribunal, including multi-member panels, which require maintenance of current funding levels.

The Experience of using the Social Security Appeals Tribunal: Providing Individual Justice across Diversity

The Experience of using the Social Security Appeals Tribunal: Providing Individual Justice across Diversity

Losing appeal? The changing face of redress

This article is, in part, an editorial introduction to the three other articles that will be addressing the commissioned theme of this issue of Benefits, which is concerned with social security appeals and redress. It briefly outlines the context and substance of those articles. In part, however, this article is also an historical and conceptual introduction to the theme as a whole. Although it would seem that impending reforms to the social security appeals system hold out the prospect of a reinvigorated and more independent form of tribunal, this article points to a deeper trend: a trend away from adjudication and appeals and towards forms of redress based on complaints procedures and technical reviews.

Rewriting the Social Contract? the Ssat, the Aat and the Contracting Out of Employment Services

The way in which the contracting out of employment services has affected the ability of unemployed people to seek merits review of adverse decisions is explored and a brief overview of the debate surrounding the contracting out of government services is provided. This debate often assumes that the retention of administrative review mechanisms will ensure some measure of accountability in a deregulated environment and examining the role of the Social Security Appeals Tribunal (SSAT) and Administrative Appeals Tribunal (AAT) in conducting external merits review challenges these assumptions.

Determining a Relationship in the Nature of Marriage: The Impact of Ruka on the Department of Work and Income's Conjugal Status Policy

In the 1997 case of Ruka v Department of Social Welfare, the Court of Appeal altered the test for determining whether a relationship was "in the nature of marriage" for the purposes of the Social Security Act 1964. In this article, the author analyses the impact of the decision on Department of Work and Incomes practice and on the subsequent decisions of the Social Security Appeal Authority. The author questions whether either Department or Appeal Authority has significantly altered their policy in light of the test adopted by the majority in Ruka. In light of its practical application, the author then critically accesses the test in Ruka and concludes that the general approach favoured by previous decisions of the High Court, and apparently continued by the Department subsequent to Ruka, is preferable.

MAINTAINING THE HALLMARKS… THE SOCIAL SECURITY APPEALS TRIBUNAL COMES OF AGE

This paper examines the practices of the Social Security Appeals Tribunal (‘SSAT’) as the first tier externa! review mechanism in respect of primary decision‐making by the Department of Social Security. In particular the characteristics of the SSAT which set it apart as essentially inquisitorial and non‐adversarial, and the appropriateness of the use of features more usually associated with the formal court process, will be considered. The paper concludes with a discussion of the legislative objectives of the SSAT and the extent of their achievement to date, and suggest that the features which set the SSAT apart from its more formal judicial counterparts need to be maintained as the SSAT becomes more institutionalized within administrative review processes.

Issues in Developing a Social Security Appeals System

The development of social security systems in the West has led to the growth of administrative law provisions by which citizens can appeal against the decisions of officials. This paper discusses a number of issues involved in this development. It locates social security appeals amongst a number of different processes of policy implementation. The paper raises the important question of whether such appeal systems can work in different cultures. In this context, the paper argues that appeals can guarantee the integrity of government action.

Social Security and the Law of Dismissal

The sweeping changes made to social security law following the election of the National Government in 1990 have had major repercussions on employment law. This paper examines the developing law on matters such as the 26 week 'stand down' for workers dismissed for misconduct, in the light of decisions of the Social Security Appeal Authority and the Employment Court and policy guidelines formulated by the Department of Social Welfare and the New Zealand Employment Service.

Reforming judicial review: The impact on homeless persons cases

Abstract The homeless are arguably among the most vulnerable members of our society. Since 1977, when the Housing (Homeless Persons) Act was passed, local housing authorities have been under a range of legal duties towards them. The legal entitlements conferred thereby upon the homeless are contingent upon a variety of statutory tests being satisfied. Those aggrieved by decisions taken by housing authorities may have a variety of means of complaint: to councillors, through internal complaints procedures, to the local government ombudsman. Formal legal challenges can, however, be mounted only by way of application for judicial review By comparison with, for example, social security appeals, which can be triggered by an informal letter at no cost to the appellant, and which are now usually disposed of within three or four months, the homeless will be able to proceed only if they can get legal aid; and if so, may have to wait up to two years for a final decision. Such expense and delay do not seem an appropr...

Presenting Officers in Social Security Tribunals: The Theory and Practice of the Curious "Amici"

Most claims for social security benefits in Britain are determined by relatively junior civil servants, known as adjudication officers, who work in the local offices of the Department of Social Security.' Claims for unemployment benefit are decided by adjudication officers working within the Department of Employment, and some benefits (for example, child benefit and family credit) are handled centrally. A dissatisfied claimant has the right of appeal to a social security appeal tribunal, consisting of a chairperson and two lay members, which must then hold an oral hearing of the appeal. A further right of appeal lies to the Social Security Commissioners, and from there to the ordinary courts, but such appeals are restricted to points of law.2 In practice, the vast majority of appeals do not proceed beyond the tribunal stage.3 At the tribunal, the adjudication officer who took the original decision has a right to appear in the guise of a presenting officer.4 The presenting officer who appears before the tribunal need not be the individual adjudication officer responsible for the decision under appeal. For income support cases the functions of initial decision making and any subsequent appeals work are kept separate. The appeal is presented by a specialist appeals officer, whose job involves processing all income support appeals received within a particular local office. Where contributory benefits are concerned (for example, invalidity benefit or unemployment benefit), the handling of appeals, including acting as presenting officer before tribunals, remains the responsibility of the adjudication officer. In either event the presenting officer, like the claimant, has the right at the tribunal to be present and to call and question witnesses.5 Based on recent research, this article analyses the ambiguous and ambivalent role played by presenting officers before social security appeal tribunals. To set our findings in context, it is necessary to outline the fundamental changes in the social security appeals system that the last two decades have witnessed. In 1975 the Bell report catalogued a series of deficiencies in the standards ofjustice attained by supplementary benefit appeal tribunals.6 Bell's recommendations led to a phased programme of reforms in the late 1970s and early 1980s.7 Amongst the most significant of these measures were

Social Security Appeals Tribunals and the Industrial Injury Scheme

Abstract This article deals with the main questions facing a Social Security Appeal Tribunal (S.S.A.T.) when considering entitlement to benefit under the industrial injuries compensation scheme. It gives a basic description of the scheme in an attempt to provide a birds-eye view as to how it operates. It aims to provide guidance not only for tribunal members, but also for claimants and the wide range of advisors now offering assistance in the bringing of such claims. However, it does not deal with those questions which have been exclusively reserved for the medical authorities (e.g. relating to the assessment of disablement). Nor does it consider the few peripheral matters which can only be determined by the Secretary of State. In both of these areas not only are laymen excluded from the decision-making, but also hearings are much less common. There may then be less need for guidance. This article therefore, by examining only those questions faced by S.S.A.T.s, does not seek to deal with other, at times important, issues determined elsewhere.

Income support and part-time training courses

Abstract A case that came before me on appeal recently in a Social Security Appeal Tribunal raises a difficult problem in relation to the entitlement to income support of a person trying to obtain a training qualification by part-time study. The purpose of this note is to demonstrate the problem and to suggest an answer through a possible stretch of one of the regulations; the tribunal indulged in this particular stretching exercise, largely because we thought unanimously that the result otherwise was totally unacceptable. Whether our decision was legally sustainable is another matter.

Australian Social Security Appeals

Early developments in the Australian system of provision for poor people led first to voluntary charitable assistance and then to a more generalized system of social security. A national scheme of old age pensions came in only in 1908; and social assistance schemes, as well as demogrants for defined statuses have gradually spread throughout the Australian Commonwealth. Specific provisions to meet crisis situations remain the responsibility of individual States. There are strong discretionary elements in the whole system. The arrangements for appeals against administrative decisions, and the reviews of these arrangements recently made, are then examined critically.

Social Security Appeals Tribunal

In 1975 the Commonwealth Government established the Social Security Appeals Tribunal, its first attempt at an external review of decision. The Tribunal has offered new avenues of activities for social workers, as members of the Tribunal itself, as advocates before it and as advisers to appellants. This paper examines the need for such a process, the structure and operations of the Tribunal and its possible future. The Social Security Act has created a system which combines statutory direction with many areas of discretionary judgement. A successful review process must bring appropriate expertise to the examination of the decisions being appealed against and strike some balance between speed and informality and a thorough analysis of the issues. It should be sufficiently formal for its operations to be understandable and regular and yet accessible to clients who are amongst the most disadvantaged in the community.

Social security appeals systems: A nine‐nation review

Social security appeals systems: A nine‐nation review