Reps. Reed, Larson Ask SSA Inspector General to Analyze Customer Service During COVID-19 Pandemic

WASHINGTON, July 23 -- Rep. Tom Reed, R-New York, issued the following news release:

House Ways and Means Social Security Subcommittee Chairman John B. Larson (CT-01) and Republican Leader Tom Reed (NY-23) sent two letters to the Social Security Administration (SSA) Inspector General Gail S. Ennis asking for a review of SSA's telephone service during the COVID-19 pandemic and SSA's process for obtaining medical evidence for disability claims.

As the COVID-19 pandemic continues, beneficiaries are relying on their Social Security now more than ever. Except in dire need, beneficiaries are unable to access in-person services and are relying instead on telephone services.

In addition, SSA requests millions of medical records each year from healthcare facilities and health professionals across the country to obtain evidence of an individual's medical condition. The medical records request is an important part of the disability process, but the most recent report on this topic from the OIG is from 2001 and does not reflect changes to the process over the past nearly 20 years.

"Social Security benefits are earned by hard-working Americans and we must do everything we can to ensure people are receiving the quality customer service they deserve. These reports will provide important information to make sure Americans are receiving the service they expect and deserve from SSA," said Larson and Reed.

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To: The Honorable Gail S. Ennis, Inspector General, Social Security Administration, 6401 Security Boulevard, Baltimore, MD 21235

Dear Inspector General Ennis:

We write to request the Office of the Inspector General (OIG) to assess the Social Security Administration's (SSA) current process for obtaining medical evidence of record (MER) for disability claims.

Medical evidence is used to determine if an individual's condition is severe enough to be eligible for Social Security Disability Insurance and/or Supplemental Security Income benefits. SSA often obtains medical evidence directly from claimants and SSA is also responsible for making every reasonable effort to help the claimant obtain medical reports from his or her medical sources. SSA requests millions of medical records each year from healthcare facilities and health professionals across the country to obtain evidence of an individual's medical condition.

While an important part of the disability process, the most recent report on this topic from the OIG is from 2001 and does not reflect changes to the process over the past nearly 20 years.

With that in mind, we are interested in understanding the following: 1. What share of MER is obtained directly by SSA from providers compared to from claimants themselves? How has this changed over time?

2. With respect to MER that is obtained directly by SSA:

a. What is SSA's current process for obtaining medical evidence in the form of either electronic medical records (also known as Health IT) or traditional paper records?

b. What is the cost for SSA to obtain MER? How does cost vary by form, type, or state?

c. What is the processing time to receive MER and how does it vary? What challenges does SSA face regarding receiving MER quickly?

d. What challenges does SSA encounter regarding the acceptance of Form 827 authorizing the collection of MER? Do these vary by state or provider?

3. What were the results from SSA's June 2018 Request for Information (RFI) for Social Security Administration's National Medical Evidence Collection, SSA-RFI-18-622?

Specifically, what information did SSA receive as a result of the RFI and what actions did the Agency take (or does the Agency continue to take) based on the responses to the RFI?

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To: The Honorable Gail S. Ennis, Inspector General, Social Security Administration, 6401 Security Boulevard, Baltimore, MD 21235

Dear Inspector General Ennis:

Thank you for the Office of the Inspector General's (OIG's) recent congressional response report, "The Social Security Administration's Telephone Services." The OIG completed this report at Chairman Larson's request, to examine access and wait times for people seeking assistance and problem resolution through the Social Security Administration's (SSA's) telephone services.

We write to ask that the OIG expand on this important report, by reviewing SSA's telephone services during the COVID-19 pandemic.

As highlighted in the OIG's recent report, even before the current crisis the public relied heavily on SSA's telephone services, but often could not access timely information or assistance. In fiscal year 2019, SSA's national 1-800 number and field offices received over 145 million calls - but handled fewer than 2 in 5 of these calls. Callers who did not get a busy signal or give up while on hold waited to speak with an SSA employee for an average of 20 minutes on the 1-800 number and 3 minutes at field offices.

We are particularly concerned about the impact of these substantial barriers and delays on the American people's ability to get their Social Security questions answered and problems solved during the COVID-19 crisis. To protect the health and safety of the public and SSA employees during the pandemic, SSA's Commissioner has appropriately closed SSA field offices to the public, except in certain very limited circumstances. As a result, the telephone is now the primary option for members of the public who need to interact with SSA employees.

Given the critical importance of ensuring strong service to the American people across SSA's telephone services, we are requesting two reports that answer the following questions: 1. Telephone service during COVID-19: A one-month snapshot a. For the month of June 2020:

i. How many calls were made to SSA's national 1-800 number; how many were made, in aggregate, to field offices?

ii. For 1-800-service and local field office telephone service, separately: 1. How many calls were routed to Program Service Centers?

2. How many calls: got a busy signal, were abandoned in menus, were abandoned in the queue, were handled by agents, or were handled by automated services?

3. What was the average speed of answer?

4. What percent of customers were able to resolve their issue on the first call, with no follow-up required?

b. How does SSA's performance on these metrics during June compare to SSA's pre-pandemic performance?

c. How does SSA's performance on these metrics during June compare to the performance of other government agencies and industry during the pandemic, if available?

d. How have changes in SSA workloads, staffing, or other factors, made due to the COVID-19 pandemic, affected SSA's ability to ensure that the 1-800 number and field offices are able assist callers in a timely manner, and that the Program Service Centers are able to achieve priority and critical workloads?

2. Telephone service during COVID-19: A review of fiscal year 2020 a. In fiscal year 2020:

i. How many calls were made to SSA's national 1-800 number; how many were made, in aggregate, to field offices?

ii. For 1-800-service and local field office telephone service, separately: 1. How many calls were routed to Program Service Centers?

2. How many calls: got a busy signal, were abandoned in menus, were abandoned in the queue, were handled by agents, or were handled by automated services?

3. What was the average speed of answer?

4. What percent of customers were able to resolve their issue on the first call, with no follow-up required?

iii. How did these metrics differ for the months before and after SSA implemented agencywide service delivery changes and maximized telework due to the COVID-19 pandemic?

b. How do the fiscal year 2020 metrics compare to SSA's experience and performance for fiscal years 2010 through 2019, and to typical government and industry benchmarks? Please discuss these comparisons separately for the months before and after SSA implemented agencywide service delivery changes and maximized telework due to the COVID-19 pandemic.

c. In fiscal year 2020, how did changes in SSA workloads, staffing, or other factors, made due to the COVID-19 pandemic, affect SSA's ability to ensure that the 1-800 number and field offices were able assist callers in a timely manner, and that the Program Service Centers were able to achieve priority and critical workloads?

d. What steps did SSA take in fiscal year 2020 to strengthen its telephone services and to better track and evaluate callers' experience and satisfaction?

e. Has SSA identified any lessons learned related to new or existing workloads that will remain available to optimize timeliness, customer satisfaction, and effectiveness of telephone services?