The House Social Security Subcommittee has scheduled a hearing for January 24 on minimizing "improper payments and protect taxpayers’ dollars from waste, fraud, and abuse." I think one can read this hearing as an effort to make sure that Social Security's top priority in spending its limited operating funds is cutting people off disability benefits.Maintaining routine operations appears to be of limited interest to committee Republicans.
I don't want to imply that continuing disability reviews or fraud investigations are unimportant. They are important. The problem at the moment is that Social Security is fighting just to keep its doors open.
It sometimes seems to me as if the Republicans on this Subcommittee are intent on confirming my worst suspicions about them.
21 comments:
I agree SSA needs a bigger budget. But in all honesty, any extra funds would be better spent performing more CDRs.
But hey, there's finally some OT!
When an organization is struggling to pay its bills, one of the first things to do is to ensure that expenses are necessary.
Yes, it costs money to review the eligibility of current beneficiaries. However, that cost likely pales in comparison to the outgoing funds being paid to beneficiaries who are no longer disabled.
As an example, even if it takes a week for an SSA employee to determine that a beneficiary is no longer eligible, that cost is MUCH, MUCH, MUCH less than the cost of paying out benefits for several additional years.
You may argue that this is "unfair" or "unkind." However, SSA benefits are meant to cover people who are disabled...they were not designed as welfare (except for child SSI, which is clearly welfare).
Lets not stop at cdrs. Waste can be found at SSA in the form of six figure salaries,unnecessary spending in consultative exams,forms and other supplies.
The budget cant be balanced on the backs of beneficiaries alone otherwise SSA would be a ponzi scheme.
From what I have heard, for every dollar spent on CDR's three dollars are saved. This seems to be a no brainer in my book. Some investigations prior to hearings such as Worker Comp. Insurance companies do would do wonders for the fraud perpetrated by bad acter claimants..
CDRS are only worthwhile if they are targeted to those most likely to improve,such as low birth weight babies and age 18 SSI claims. SSA is simply wasting resources on the majority of CDRS completed. Most are simply continued and if ceased an appeal will be filed and reversal almost inevitable. I have yet to see a long term study to see if cessations actually stay off the rolls after and extended timeframe.
The savings are actually closer to 10:1. And there are other good categories for CDRs, such as many mental impairments (with obvious exceptions such as true mental retardation) as treatment can often be effective in improving functioning; seizures; cardiac or respiratory conditions; fibromyalgia; diabetes; many musculoskeletal problems; any condition where morbid obesity is a significant factor, etc.
Moreover, SSAs budget always contains appropriations for CDRs, but SSA has a habit of not using the money as intended. One of multiple examples of SSA not following Congressional intent.
"[SSDI] overpayments ... have grown from about $860 million in FY 2001 to about $1.4 billion in FY 2010 ... While the agency collected or recovered $839 million in overpayments in FY 2010, DI overpayment debt reached $5.4 billion."
- from the article
"Since 2008, DOD's portfolio of major defense acquisition programs ... has grown to $1.68 trillion. The total acquisition cost of the programs in DOD's 2010 portfolio has increased by $135 billion over the past 2 years, of which $70 billion cannot be attributed to quantity changes."
- http://www.gao.gov/products/GAO-11-233SP
Math hurts republicans' heads.
Why focus on overpayments only?
Rarely do we see the underpayment numbers mentioned. Between 2006-2010 SSA estimated 5.5 billion was over paid and 2.3 billion was UNDER paid,(http://www.ssa.gov/improperpayments/rsdi_programstats.html). If Representative Johnson is so interested in protecting the American tax payers from con artists who are stealing from he system by making sure benefits are paid only to those wo deserve them, perhaps his hearing should also focus ( or at least mention) those taxpayers who became disabled and were underpaid over 2 billion in the last 4 years.
Where is the OT, who has this?
I wonder how much money is spent attempting to keep valid claims from being paid? How much does it cost SSA when their adjudicators fail to follow the law? Is that a figure that they will also investigate?
Valid claims are rarely not paid (though it may take time for sufficient evidence to be established); the problem is that a lot of invalid claims are paid.
@anon at 2:06...if you want to complain that "valid" claims are not paid by SSA due to failure by adjudicators to follow the law, be prepared for scrutiny of the opposite...payment of invalid/fraudulent claims by SSA adjudicators who fail to follow the law.
Yes, those happen. There are MANY ALJ's who find people disabled for MANY other reasons other than an inability to work. Those are much more prevalent (in my experience) than the few that are denied due to "error." Be careful what you wish for. Strict application of the law will result in lower approval of claims, not higher.
Just out of curiousity - what are the MANY other reasons that MANY ALJ's find people disabled for, other than an inability to work?
Any claimant who is 50 or older and is paid because he/she is limited to sedentary (or as of age-55 light) work is not being paid because they are unable to work, but rather is being paid because of assumptions about the ability to find work (which are not supposed to be relevant). This is a misuse/abuse of the Medical-Vocational Guidelines (which were promulgated to make it easier to deny cases where the individual could perform the full range of a particular exertional level without having to obtain VE testimony). Of course SSA has taken no steps to change or clarify the regulations (even efforts to increase the ages for "closely approached advanced age" and "advanced age" are quickly abandoned as soon as NOSSCR whines) because SSA wants to pay claims (especially at the hearing level).
Also, there are numerous instances of ALJs and senior attorney advisors paying cases based on a medical source statement by a doctor that is inconsistent with the overall medical record, including often that doctor's own notes. How do you think former ALJ Daugherty was able to pay over 700 cases in six months and only find one case to deny. He looked for a MSS that equated to disabled and accepted it at face value. Eric Conn, the attorney whose cases Daugherty was directing to himself, has a medical office at his firm and has medical professionals who "perform" exams and fill out MSSs for his clients. Do you really think those are reliable?
Wow, I guess I just didn't realize they were that loose and random with their decision making process - interesting.
That could explain the trend toward a deficit!
Anon 6:24,
Have you heard of the GRIDS? Have you read the OIG review of Senior Attorney cases? Did you know that if a claimant GRIDS out, you cannot use a vocational assessment (via VE) to support a finding of not disabled. There are about 10 ALJs nationwide who may being paying an excess of cases (or who were, as I don't think anyone is doing it too much anymore). There are a legion number of ALJs who don't pay the cases that should be paid under our law and regs. I bet you work for DDS. Who said that?
I agree with comments at 2:06 PM, January 20, 2012
I wrote commentss at 7:41 AM, January 19, 2012
Anon 9:44, I have heard of the GRIDS. I apply them every day in my work at ODAR. However, as my post makes clear, I believe the GRIDS are being misused (i.e., SSA is acting contrary to Congressional intent, as it did when it invented "functional equivalency" for children) and that the age-based presumptions are inappropriate. I have read the OIG review of Senior Attorney cases. If you look at the statistics, there are 92 ALJs who pay 90% or more of their cases. The number is much higher if you look at 80% or even just 85% pay rates. Those judges are paying many undeserving claimants. There are very few judges with low pay rates.
Anon 6:24 1/20/12
Just out of curiosity, how is it possible to determine that a claimant is "undeserving" based on a set of loosly-collected statistics? I am suprised that a DDS employee would show such disrespect to an ALJ, particularly in a public forum.
Unless a single individual had an advanced education in a multitude of medical specialties, as well as a legal education, and had thoroughly examined each case involved in the statistics, as well as the claimant, how could you possibly have an intelligent opinion?
Congressional intent? Oh that's rich. Now I really believe you are from DDS. It really doesn't matter. If you believe that too many claims are being paid, that is what you believe. I don't necessarily disagree with you but I do have a problem when the law and regulations are not applied correctly as they are currently written and based on the evidence of the case. Congressional intent notwithstanding.
Post a Comment