Sep 30, 2015

Five New Cooperative Disability Investigation Units

     A press release from Social Security's Office of Inspector General:

The Social Security Administration (SSA) and its Office of the Inspector General (OIG) announced that five new Cooperative Disability Investigations (CDI) Units opened across the country this week. As part of the nationwide CDI Program, the new units will identify and prevent Social Security disability fraud throughout their respective states. The new CDI units opened in Birmingham, Alabama; St. Paul, Minnesota; Raleigh, North Carolina; Charleston, West Virginia; and Milwaukee, Wisconsin.
The CDI Program is one of Social Security’s most successful anti-fraud initiatives, contributing to the integrity of Federal disability programs. CDI brings together personnel from SSA, its OIG, State Disability Determination Services (DDS), and local law enforcement agencies to analyze and investigate suspicious Social Security disability claims, to help resolve questions of fraud before benefits are paid. CDI efforts help disability examiners make informed decisions, ensure payment accuracy, and generate significant taxpayer savings for Federal and State programs.
“For 18 years, CDI has had tremendous success in identifying and preventing disability fraud and abuse,” said Inspector General Patrick P. O’Carroll, Jr. “We’re pleased to partner with Social Security, DDS, and local law enforcement agencies to combat fraud and to promote the integrity of Social Security’s disability programs

There's Social Security Disability As It Really Exists And Social Security Disability As Members Of Congress Imagine It To Be

     Here's some excerpts from an opinion piece written by Senators Manchin (D-WV) and Cotton (R-AR) for Fox News with comments from me in brackets and bolded:
According to the 2015 annual report from the Social Security system’s trustees, the SSDI [Social Security Disability Insurance] trust fund will run out in late 2016. ...
SSDI was established as an insurance program for the “totally and permanently disabled.” [You're putting it in quotes but the phrase "totally and permanently disabled" has never been part of SSDI. Not now. Not ever. Depending upon how you interpret the term "total disability", it can be synonymous with chronic vegetative state. Is that the sort of definition of disability that you'd prefer? Permanence has never been required. However, the one year duration requirement that we have isn't that different from a requirement of permanence, as a practical matter.] ...
Today, nearly 300,000 Arkansans and West Virginians rely on SSDI. In some of our counties, nearly 20% of working-age people receive SSDI benefits. [This might be important enough to your constituents for you to actually learn something about it.]
Many of these individuals are permanently disabled, and we’re committed to protecting this vulnerable population. But we must also dramatically improve the program for the temporarily disabled to help them recover and return to work. [How many temporarily disabled people do you really think receive SSDI? You have to have been or be predicted to be disabled for at least a year to be found disabled. How much ground do you think there is between a year and permanent? In the real world, there's little.]...
We must intervene early. On average, applicants wait more than a year before getting an SSDI eligibility decision. [So, the agency needs more money so it can decide cases quicker? However, Manchin and Cotten are enthuaistic budget hawks who favor endless cuts to the federal budget.] We can use this time to help applicants who are disabled, but have the potential for work activity stay connected to the workforce by providing support services. This can be done through vocational training, supportive employment, health services, incentives for employers, and more. [All of this already exists. What more do you want?]
We also need to shift SSDI from a one-size-fits-all mindset to a smarter approach that differentiates between the permanently disabled and those who, with medical treatment and rehabilitation services, can recover. [We have 50 years of evidence that there is no significant number of people drawing SSDI who have the realistic capacity to return to work on a regular basis, regardless of the assistance they receive.]
While SSA categorizes beneficiaries based on likelihood of medical improvement, there’s no requirement to pursue rehabilitation or medical services to prepare for a return to work. [You're attacking straw men. There's zero evidence that claimants are refusing to pursue vocational rehabilitation. Mostly, they're way too sick to take advantage of it. The idea that a claimant would avoid medical treatment in order to stay on SSDI is bizarre. We have strong evidence that this virtually never happens.] We need to help individuals with temporary disabilities gain access to rehabilitation and recovery services and offer a timeline to re-enter the workforce. [They already have such access. It doesn't work. There's no reason to believe that it will ever work] ...
     I suppose I shouldn't complain. It's better for Manchin and Cotton to concentrate upon worthless ideas than upon dangerous ideas.

Sep 29, 2015

New Mental Listings Coming Next Year?

     From a recent report by Social Security's Office of Inspector General (OIG):
...[T]he American Psychiatric Association revised the manual [DSM] used to diagnose and classify mental disorders, which it published in May 2013. However, SSA [Social Security Administration] had not updated the mental medical listing since August 1985. ...
[T]he mental medical listing represents the most used body system, and any proposed changes are usually controversial. SSA issued an NPRM [Notice of Proposed Rule-Making] in August 2010, and it had to address many public comments while considering changes in technology and medicine. SSA’s Office of Disability Policy addressed public comments and circulated the draft to other SSA components for review. According to SSA, these revisions were contentious, and the Office of Disability Policy received and addressed substantive comments then circulated a revised draft for comments. SSA needs to reach consensus among its various components. With all these issues, it has taken the Agency over 5 years to move the mental medical listing update from the NPRM to the final revision. SSA projects that the mental medical listing will be finalized in spring 2016 ...
     Why do I have a feeling that these mental Listings will get pushed back even further?

Sep 28, 2015

BOND Study Offers Further Proof That Work Incentives Don't Work

     There has been a longstanding Congressional wish to encourage those who receive Social Security disability benefits to return to work. Some of this comes from a genuine desire to help the disabled but most of it comes from a desire to reduce the amount spent on disability benefits. This has led to one piece of legislation after another, each one adding a new layer of work incentives. There has been a persistent belief that some tinkering with work incentives will result in more disabled people returning to work. None of this has made a difference. Few Social Security disability recipients return to work. What we have now is a preposterously complex system of work incentives that is difficult for Social Security to administer and impossible for the disabled to understand. Most important, the mess we have now just doesn't work.
     The latest work incentive plan is to dramatically simplify, gradually Social Security disability benefits on account of work earnings from work rather the current systems which allow Social Security disability recipients to work for a significant length of time with no reduction in their benefits until they get to a certain point at which their benefits abruptly terminate (although they're easily restarted). The idea is to implement a slope instead of a cliff. Social Security has been conducting a lengthy study of substituting a benefit offset. The call this the BOND (Benefit Offset National Demonstration) project.
     The agency's Office of Inspector General (OIG) just released a study of the BOND project. Here's an excerpt from the OIG report:
As of January 2015, the BOND project’s total cost was approximately $86.8 million. As of October 2014, only 2,333 (2.7 percent) of the 85,140 BOND project’s participants had used the offset for 1 or more months. Also, Abt [the contractor] reported that the BOND project’s benefit offset did not have a statistically significant impact on average total earnings in 2012 for Stage 1 participants; and the Stage 2 two treatment groups’ average total 2012 earnings increased above the control group by only $279 and $301 (about 8 percent), respectively.
     This is what I expected. The study has been expensive. Few have taken advantage of BOND. It has had no significant effect upon the behavior of Social Security disability benefits recipients.
     The reason why BOND isn't working in the way its supporters envisioned is simple. Social Security disability recipients are quite sick. Few have any capacity to return to work. Those who are unfamiliar with the program visualize claimants getting better and returning to work. However, the one year duration requirement in Social Security's definition of disability means that happens only rarely. If you're sick enough to be disabled for a year or more, it's unlikely that you'll get significantly better at some later time. In fact, it's very likely your medical condition will just get worse as time goes on. Yes, recovery does happen but it's rare. Those who are not familiar with Social Security disability determination also believe that many Social Security disability recipients aren't really that sick. (Why, my barber told me that he heard from his sister that her neighbor got on Social Security disability and there's not a thing wrong with him!) This belief is unshakable. It persists even in those who are disabled themselves and struggling to get on Social Security disability benefits. The truth is that it's ridiculously difficult to get on disability benefits. Many people are incapable of believing this.
     A benefit offset program should be adopted, not because it will induce more disabled people to return to work, but because it will be simpler to implement. We've had one ill-advised work incentive plan after another for decades. They haven't worked and they're not going to work. It's time to stop tinkering.  Have a little consideration for the people who have to administer the program. Simplify.

Sep 27, 2015

Is The Social Security Disability Crisis Over?

      Michael Hiltzik at the Los Angeles Times thinks that the Social Security disability "crisis" is over. I'd say that it's a bit early to say that the political battle is over. For that matter, the political battle over the existence of any form of Social Security is far from over as far as many Republicans are concerned.