Nov 18, 2014

Outreach To The Homeless Looks Successful, But ...

     The abstract of an article in the most recent issue of the Social Security Bulletin (emphasis added): 
This study uses administrative data to evaluate the outcomes of the disability applications submitted to the Social Security Administration (SSA) through the Benefits Entitlement Services Team (B.E.S.T) Demonstration Project and to determine if the project successfully increased access to Supplemental Security Income (SSI) payments and/or Disability Insurance (DI) benefits for individuals experiencing homelessness. B.E.S.T—a unique partnership between the Los Angeles County Department of Health Services, SSA, and the California Disability Determination Services—was a collaborative effort to locate homeless adults and assist them in applying for SSI payments and/or DI benefits. B.E.S.T facilitated the completion of SSI and DI applications, including the compilation of all forms and medical evidence needed to submit the completed applications to SSA. The findings show that B.E.S.T contributed to increased access to disability benefits for applicants. Relative to other disability cases, the B.E.S.T cases had high allowance rates and short processing times.
     The thing that concerns me is the degree of selectivity in the B.E.S.T. program. The article indicates that B.E.S.T. applicants had a 90% rate of success! There's no way of achieving that sort of "success" in this or any other population without being incredibly selective. In a law practice setting, I'd call it wildly overselective. Considering the frequency that homeless claimants are "lost to followup", as physicians put it, B.E.S.T. couldn't have just been insisting on gold plated cases. They must have been demanding platinum plated cases.
     This begs the question of what success means when you're trying to help homeless people.

1 comment:

Anonymous said...

I agree that is remarkably high. Perhaps some lessons can be learned from their experience though. You won't catch me complaining about any efforts to provide better services to the homeless.

I've seen some groups touting high approval rates that only take slam dunk cases, where merely getting the records and sending in claim forms is enough to ensure approval (terminally ill, aged and severely disabled, etc.). Those are easy and take very little effort or skill. The problem is there's plenty of people with legitimate disability claims that require a lot more work.

What do I mean by a lot of work? Detailed social worker assessment with follow-up. Cooperation from the local welfare agencies to get them stable housing, transportation, and medical access (not available in plenty places). Add to that competent advocates with knowledge of the claims processes to help them fill out all forms, get all records, assess and address problems, for all claims involved. Add to that ongoing medical case management that checks up with them regularly. Many homeless need that level of help, but few get it. When they don't get it they often are unable to continue regular treatment, which is a frequent grounds for disability claim denial.