Baltimore Sun On Vision 2025

     The Baltimore Sun has a piece on Social Security's Vision 2025. It demonstrates the controversies that Social Security faces in making long term plans.

Early Intervention

     Social Security is seeking information for an "early intervention mental health demonstration study." The agency is only giving 17 days to respond to its request for a good deal of information, suggesting that publication of the request is a formality, that Social Security has already identified a contractor.

     I hope this works but I'd be surprised if it does. Mental health problems aren't like appendicitis. They seldom crop up suddenly. If they do, it's usually something like a bad reaction to a prescription medication, a problem that wouldn't result in a person receiving Social Security disability benefits anyway. I have seen no sign that early intervention results in better long term results than late intervention. Less suffering but not less long term disability. You must have been disabled or be predicted to be disabled for at least a year to get Social Security disability. If mental health treatment is going to give you good relief for your psychiatric condition, you're not likely to get on benefits in the first place. In fact, even if you don't get good results from mental health treatment, you're not likely to get on benefits without a lengthy fight.

The "Vision Thing"

     The Social Security Administration has released Vision 2025, the long-awaited statement of how the agency expects to be operating ten years from now. I don't think I've ever read a more vacuous government document. Here's an excerpt from Acting Commissioner Colvin's message on the report to give readers a feel:

As the public moves confidently into the future, we must also change the way we operate. We are compelled to anticipate the social and technical advancements that offer new ways of navigating an ever-changing society. Our challenge is to embrace technological enhancements to achieve efficiency without sacrificing the personalized service for which we are known. Toward this end, we will build a stronger, ever-capable workforce, adopt engaging and contemporary training methods, expand our information and communication technologies, and modernize our operational capabilities. Of course, we must proceed toward this rapidly changing future, mindful of many present day realities. Our budgets will undoubtedly fluctuate, organized interests may express new agendas, social demographics will vary, and executive orders and congressional mandates will continue to affect the way we do business. Yet if we view such possibilities as opportunities, we can focus on creative solutions for meeting these challenges. Regardless of the complexities we might consider in the future, we must never disregard our customers’ expectations for excellence.

     No, it doesn't get specific at some later point in the document. It just stays at this level of advanced meaningless abstraction.
     Let me hasten to say that despite what I've quoted above, neither the Acting Commissioner nor upper management at Social Security is brain dead. They only produce such drivel because they're forced to. Here are the problems they're trying to address:

• The Government Accountability Office (GAO), egged on by some Republicans in Congress, keeps demanding that Social Security produce a "vision" for the future but it's not just any vision they want. For years, they have made relentless demands for a "vision" that does away with person to person service at Social Security because person to person service is just so passe in this age of the internet and so much money could be saved if we just got rid of the old fashioned idea that you should be able to actually talk with someone about your case. 
• The people at GAO have no clue about the complexity of Social Security. As far as they're concerned, it's just retirement benefits. Survivor and disability benefits are nothing more than a footnote. SSI isn't even a footnote as far as they're concerned. Mentally ill people? Let them use their computers! Cognitively impaired people? Surely, someone other than Social Security can help them with their Social Security problems. You can't expect government to do everything!
• Despite egging GAO on with its insane demands that Social Security plan for the elimination of face to face service, individual Republicans in Congress definitely don't want field offices closed in their districts. They believe, in the abstract, that technology can replace personal service but not when it comes to their districts. It goes without saying Democrats don't want field offices closed.
• Social Security management is well aware that doing away with face to face service is unthinkable. The programs they operate are far too complex to function without a field office structure. Not only can that not be done by 2025; it won't be possible by 2125.
• It's impossible to make any meaningful plans for service delivery in 2025 because of budget uncertainty. In fact, it's almost impossible to make meaningful plans for service delivery in 2016 because of budget uncertainty. 
• Even without budgetary uncertainty, who knows what technology will bring us by 2025. Does anyone think that Steve Jobs ever had a ten year plan for what would happen with the iPhone? Anyone who thinks they have a clear view of what will happen with technology in the future shouldn't be working for Social Security because they're delusional.
• Few people in upper management at Social Security now expect to be in upper management at the agency in 2025. They're responsible people but they're bureaucrats. They're mostly concerned with getting by from year to year. GAO's demands for a "vision" for 2025 are laughable, so Social Security produces a laughable "vision."

Sad

     From Social Security:

For 4/28/15, The Social Security Administration Offices at Headquarters are dismissing early as a precautionary measure. Please remain calm and follow all traffic commands. There are no credible threats at this time. Please adhere to the following schedule for an orderly dismissal. 10:30 am WOC Building/Childcare, 11:00 am Wabash/NCC/ Security West, 11:30 am West Building/East Building, 12:00 pm Annex/ RMB, 12:30 pm Altmeyer.

     Pray for everyone's safety and for the future of the city of Baltimore.

     Update: Social Security plans to open its central offices as usual on Wednesday.

Updated Disability Insurance Trust Fund Numbers

     Social Security's Office of Chief Actuary has released the first quarter numbers on the operation of the Disability Insurance Trust Fund. These numbers are crucial because the Chief Actuary's prediction is that the Disability Insurance Trust Fund will run out of money at the end of 2016.

    The Disability Insurance Trust Fund finished the first quarter of 2015 with $54.3 billion in U.S. government bonds. This was down $5.9 billion from the end of 2014. The Disability Insurance Trust Fund had lost $6.4 billion in the first quarter of 2014.

     There's no question that the Disability Insurance Trust Fund is doing somewhat better as time goes along. That's inevitable since the number of people drawing Social Security disability benefits is declining and the economy is growing. However, there's little doubt that the Disability Insurance Trust Fund will run out of money in the not too distant future. Because of the modest improvements in Trust Fund operations, I'd say that, absent some unexpected change, the exhaustion date is likely to be in the first half of 2017, perhaps around the end of the first quarter.

     Benefits do not stop if the Disability Insurance Trust Fund runs of money. There would still be enough income to pay at least 80% of benefits. However, it would be a chaotic situation with benefits reduced by varying amounts each month since trust fund income varies significantly from month to month. Some older beneficiaries would be shifted into retirement benefits since they're entitled to whichever is higher. That would reduce the draw down on the Disability Insurance Trust Fund but be an accounting nightmare.

Student Loan Debts Having Serious Effects On Social Security Recipients

     From The Hill:

A pair of Democratic senators is demanding to know more about the growing number of seniors who are seeing their Social Security benefits slashed to cover student loan debt.

Sens. Claire McCaskill (D-Mo.) and Elizabeth Warren (D-Mass.) sent a letter to the head of the Government Accountability Office (GAO) Thursday, calling for a study on this growing segment of senior Americans. The percentage of households headed by people aged 65 to 74 with student loan debt quadrupled from 2004 to 2010. ...

“Garnishing Social Security benefits defeats the entire point of the program — that’s why we don’t allow banks or credit card companies to do it,” said McCaskill, the top Democrat on the Senate Special Committee on Aging, in a statement. ...

In 2014, the government withheld $161 million in Social Security payments to cover student loan debt that had fallen into default....

Federal Bar Association Newsletter

     The Social Security Law Section of the Federal Bar Association has released its Spring 2015 newsletter. This is the only attorney group with members in private practice as well as members employed by the Social Security Administration.

NADE Newsletter

     The National Association of Disability Examiners (NADE), an organization of personnel involved in making initial and reconsideration determinations on Social Security disability claims, has released its Spring 2015 Newsletter.

More Seemingly Plausible Ideas From House Social Security Subcommittee

     A press release from the House Social Security Subcommittee:

Today, Social Security Subcommittee Chairman Sam Johnson (R-TX) introduced the Improving the Integrity of Disability Evidence Act of 2015. The bill will ensure that the Social Security Administration (SSA) uses medical evidence only from reputable sources when making a disability determination.

“Hardworking American taxpayers expect that honest information is used when making disability determinations,” Chairman Johnson said. “It’s just common sense to say if you can’t participate in Medicare, Social Security can’t consider your medical evidence. Americans want, need, and deserve a fraud-free disability program.”

According to a 2013 report released by the Senate Committee on Homeland Security and Governmental Affairs, some claimant representatives seek out doctors who will provide medical opinions leading to a disability-benefit award without question. The report gives an example of a lawyer who sought out doctors with licensure problems to provide medical opinions to support benefit claims.

The SSA’s regulations already prohibit the agency from purchasing consultative exams from medical providers whose license has been suspended or revoked because of concerns with professional competence or conduct. However, the SSA does not have any similar restrictions on medical opinions provided by a claimant. In addition, to protect beneficiaries and federal health care programs, the Center for Medicare and Medicaid Services is authorized to bar a provider from receiving payment from federal health care programs due to certain actions. By law, doctors who have been convicted of program-related crimes, abused patients, committed health care fraud, or have a felony related to a controlled substance cannot participate in Medicare.

This legislation would prohibit the SSA from considering medical evidence from doctors who are barred from participating in Medicare or who were assessed a civil monetary penalty for submitting false evidence by the SSA.

A similar provision was included in Chairman Johnson’s Stop Disability Fraud Act of 2014 (H.R. 5260) from the 113^th Congress, and in Social Security Subcommittee Ranking Member Xavier Becerra’s recently reintroduced Social Security Fraud and Error Prevention Act of 2015 (H.R. 1419).

     Let me explain why this seemingly reasonable idea is really bad. First, anyone representing Social Security claimants who seeks out doctors with disciplinary problems to examine their clients and give medical opinions is a fool. The reports will carry little weight. If you've got any sense, it's not worth even thinking about doing. Only one example is cited. Is this enough to justify legislation? Second, and more important, what do you do about the claimant who has the misfortune of having as their treating physician someone who runs into disciplinary problems? The patient isn't the one who has done wrong. They have no way of knowing that their doctor is going to run into disciplinary problems or, for that matter, that they have already run into disciplinary problems. Honestly, do you check on this yourself before seeing a new physician? Going ahead with this proposal would cause some very sick people to be denied even though they're done nothing wrong. A physician who has fraudulently overbilled Medicaid has done something wrong and should be punished but don't punish their innocent patients.

Rising Tide Against Redistributive Government Policies?

     Is there a rising tide of opposition to redistributive government policies, such as Social Security, and is the rising inequality in income and wealth in the United States actually fueling that opposition?

Let Them Eat Cake!

    I see posts from one or more people on this blog saying that it's obvious that Social Security should be approving fewer disability claims since there's so many more sedentary office jobs now than there used to be. I think those who make these posts need to answer an important question. Why do people work at low wage, physically demanding jobs instead of higher paying, sedentary office jobs? To me, the answer to the question is obvious. They can't do the higher paying, sedentary office jobs! If you work in an office this may sounds nuts. Of course, anyone can work in an office. It's not that hard. Really? You may not be giving yourself enough credit. It takes at least a modest degree of intelligence as well as at least a moderate degree of social ability and mental stamina to work in an office. Not everyone has those characteristics. A high percentage of disability claims are filed by people who have the misfortune of having a borderline or low average IQ or who have chronic psychiatric problems. Those folks end up working in low paying, physically demanding jobs because they have no choice. Really, why else would anyone work in such employment if they could find an easier job that pays more? In high school, you didn't hang out with the people with low IQs or chronic psychiatric problems. They were almost invisible to you then and they still are but they exist in large numbers. It doesn't take much to disable them because they never had much to offer an employer other than a strong back and a willingness to work. The whole idea that you can take a person off the factory floor and put them in an office job is, for the most part, a "Let them eat cake" solution to disability.  And, no technological changes in manufacturing and in offices haven't helped. The technological changes have increased the cognitive demands of factory work leaving those with low IQs at a greater disadvantage.And, please, don't tell me that because infants can make iPhones do amazing things that anyone can work. That's just ridiculous.

     

Why Age Matters

     I keep seeing comments posted here saying, basically, that it's an outrage that Social Security pays disability benefits to people it knows can work just because they're over 50. This is based upon the fact that if a person is 50 or older, can no longer do work they've done in the past due to their medical condition and are limited to sedentary work, it may be possible to get Social Security disability benefits based upon the "grid regulations."
     The person or persons posting this miss some important points. To qualify for this treatment, you have to be unable to do any job you've done in the last 15 years and you must lack transferrable skills to sedentary work. But, it's still an outrage that Social Security pays disability benefits to people it knows can work? No, they really can't work. The Social Security Act requires the consideration of age, education and work experience in determining disability. Age has been given a prominent place in the consideration of disability because as people age they become less adaptable. When you're 25, making a transition to some entirely different type of work isn't so difficult. At age 50, it may be impossible. So, no, those people really can't work because they can't realistically make the transition to completely different lines of work. If this makes no sense to you, it's probably because you're younger. Wait a few years. If you're lucky, you'll get older and you'll have no difficulty understanding. There aren't any advances in medicine or rehabilitation or anything else that's likely to change this because it's hard-wired into the human aging process.

Why Would They Trust The Obama Administration On This?

     A press release:

Today, Ways and Means Social Security Subcommittee Chairman Sam Johnson (R-TX) introduced H.R. 1800, the Guiding Responsible and Improved Disability Decisions Act of 2015 (the GRIDD Act). The legislation would require the Social Security Administration (SSA) to update the medical and vocational regulatory guidelines for determining disability, which have not been updated since they went into effect in 1979.

Recently, the Social Security Administration’s Office of the Inspector General (OIG) issued a report highlighting one of the problems with these outdated rules for cases in Puerto Rico. The OIG found that these rules favor claimants who are unable to speak English, even though Spanish is one of the island’s official languages.
 Upon introduction, Chairman Johnson said:

"Hardworking American taxpayers expect Social Security to fairly, consistently and accurately decide who should receive disability benefits. That's why it makes no sense that Social Security uses rules from 1979 to decide if someone should receive benefits today! I've been calling on Social Security to update its rules, and the recent Inspector General report just further makes that case. This legislation sends a clear message to Social Security: It's time to update your rules—and now. This is what Americans want, need, and deserve."

House Ways and Means Committee Members co-sponsoring the legislation include Tom Reed (R-NY), Kenny Marchant (R-TX) and Diane Black (R-TN). Other original co-sponsors include Representative Mimi Walters (R-CA).

For more information, click here.

     Here is the entire relevant text of the bill:

As soon as possible after the date of the enactment of this Act, the Commissioner of Social Security shall prescribe rules and regulations that update the medical-vocational guidelines, as set forth in appendix 2 to subpart P of part 404 of title 20, Code of Federal Regulations, used in disability determinations, including full consideration of new employment opportunities made possible by advances in treatment, rehabilitation, and technology and full consideration of the effect of prevalent languages on education.

     If you're sure that passage of this bill would result in fewer people drawing Social Security disability benefits, you don't understand the situation. The number of unskilled jobs has declined dramatically over the last thirty years. Any honest updating of the grid regulations is almost certainly going to result in more disability claims being approved, not fewer. Don't believe me? Read back in this blog about the Occupational Information Development Advisory Panel (OIDAP). There was plenty of tension as Social Security tried to stage manage OIDAP so it could avoid paying more claimants. That didn't work so well. That controversy has gone underground as the responsibility for developing a new Occupational Information System (OIS) has shifted to the Department of Labor but it's going to burst into the open eventually. Pass this bill and you're opening Pandora's box a little sooner.
     This bill is evidence to me that the Subcommittee lacks a Republican Social Security disability policy wonk on its staff.

Nice Idea But It's Not Going To Work

     There's a bill pending before the House Social Security Subcommittee that would require that the Social Security Administration "develop online tools to help beneficiaries assess the impact of earnings on eligibility for and benefit amounts of state and Federal programs." 

     It's a nice idea but I have my doubts that anything developed will be helpful. The problem is that Social Security's work incentives are so incredibly complex that they won't fit easily into an online format. You don't just plug in your earnings for a month to determine the effect upon your benefits. There's far more involved than just how much you earn. Earn $2,000 in the first month you work and there's no effect upon your benefits. Keep working and earn $2,000 a month for twelve months and your benefits probably stop -- and note that I said probably, since there's the separate blind standard, there's the issue of whether it's self-employment which has different standards, there's Impairment Related Work Expenses (IRWE) and there's the question of whether you're performing a made-work or subsidized employment job. Keep working at that some pay rate for a time before stopping and what happens depends upon how long you were working before you stopped. There's no simple way of explaining it because it's quite complex. See the image above from the Subcommittee summary of the bill to get an idea of the complexity. 

     This isn't a partisan issue. I think that virtually everybody familiar with this subject would agree that we need a much simpler system of work incentives. I think that almost all would agree that even with a much simpler system few Social Security disability benefits recipients will return to work. They're too sick.
     The work incentives have gotten so complex because members of Congress over several decades have believed that there must be some way of returning lots of Social Security disability recipients to work. They haven't bothered to study the incentives that already existed. They just kept adding more. Additional incentives or tweaked incentives or better explanation of incentives -- none of it is going to work. The idea that large numbers of disability benefits recipients can ever be forced or enticed to return to work is a fallacy.

A Hypothetical

     Let’s say I’m interviewing a client and ask him or her, “Do you get any exercise? And the client answers, “Yes, I get on my exercise bike for 15 minutes a day.” Does this relate to the disability claim? Is my client obliged to tell this to Social Security? Am I obliged to force my client to tell Social Security such information? 

     If I am obliged to force my client to reveal such things, have I been turned into Social Security's investigative agent? Should I just stop asking my clients any questions? Can a claimant have effective representation if this is the standard?

Do They Even Read Their Own Regs?

     I have no idea why they believe this to be consistent with their own recently adopted regulations but Social Security is now taking the position that claimants are not just under an obligation to inform the agency of evidence that "relates to" their disability claim but to submit such evidence, regardless of the expense or difficulty, and are to be hounded to do so.

How Do You Answer The Question?

     From a section added to Social Security's HALLEX manual last week:

Before closing the hearing, the administrative law judge (ALJ) will remind the claimant that he or she must inform the ALJ about or submit, in its entirety, all evidence known to him or her that relates to whether he or she is blind or disabled. See 20 CFR 404.1512 and 416.912. If the claimant has a representative, then the ALJ will remind the representative that he or she must help the claimant obtain the information that the claimant must submit. See 20 CFR 404.1512, 404.1740, 416.912, and 416.1540. The ALJ must ask the claimant and the representative if they are aware of any additional evidence that relates to whether the claimant is blind or disabled.

Twenty Years Ago Today

     Twenty years ago today domestic terrorists bombed the Alfred P. Murrah Federal Building in Oklahoma City. One hundred sixty-eight people were killed, including these sixteen Social Security employees:

• Richard A. Allen, Claims Representative 
• Saundra G. Avery, Development Clerk 
• Oleta C. Biddy, Service Representative 
• Carol L. Bowers, Operations Supervisor 
• Sharon L. Chesnut, Claims Representative
  Katherine L Cregan, Service Representative
• Margaret E. Goodson, Claims Representative 
• Ethel L. Griffin, Service Representative 
• Ronald V. Harding, Service Representative 
• Raymond L. Johnson, Senior Community Service Volunteer
• Derwin W. Miller, Claims Representative
• Charlotte A. Thomas, Contact Representative
• Michael G. Thompson, Field Representative
• Robert N. Walker, Jr., Claims Representative 
• Julie M. Welch, Claims Representative 
• William S. Williams, Operations Supervisor

Social Security May Be Central Issue In 2016 Election

     It's now becoming mainstream for Republican presidential candidates to express a desire to cut Social Security. House Republicans seem determined to try to cut Social Security disability benefits, perhaps dramatically. Meanwhile, even though Hilary Clinton has yet to announce a position, it's become mainstream for Democrats to embrace expanding Social Security.

Did They Even Read Their Own Regs?

     I have no idea why they believe this to be consistent with their own recently adopted regulations but Social Security is now taking the position that claimants are not just under an obligation to inform the agency of evidence that "relates to" their disability claim but to submit such evidence, regardless of the expense or difficulty, and are to be hounded to do so.

What Does "Relate To" Mean?

     From a section just added to Social Security's HALLEX Manual:

Last Update: 4/15/15 (Transmittal I-2-139)Before closing the hearing, the administrative law judge (ALJ) will remind the claimant that he or she must inform the ALJ about or submit, in its entirety, all evidence known to him or her that relates to whether he or she is blind or disabled. See 20 CFR 404.1512 and 416.912. If the claimant has a representative, then the ALJ will remind the representative that he or she must help the claimant obtain the information that the claimant must submit. See 20 CFR 404.1512, 404.1740, 416.912, and 416.1540. The ALJ must ask the claimant and the representative if they are aware of any additional evidence that relates to whether the claimant is blind or disabled.

25% Who Try To Use Social Security's Online Sytem Are Unable To Access Their Accounts

     At the end of a boring article about Acting Commissioner Colvin's visit to some Social Security offices in Utah, the Salt Lake Tribune relates a nugget of information. Social Security's online system "is so complicated and security so tight that about 25 percent of users who attempt to log on are not able to successfully access their accounts."

New Hematological Listings

     The Social Security Administration has adopted new Listings for hematological disorders.

USA! USA!

     The Guardian Newspaper of the United Kingdom decided to rank countries on their benefits for the unemployed and disabled. The U.S. came in last, after Russia and South Africa. Here are a couple of excerpts:

The US system of benefits for disabled people could be used as a cautionary tale for anyone who wants to know what happens when state financial support for citizens with physical or mental impairments is paired (sic) down to the minimum. ...

According to the OECD [Organization for Economic Cooperation and Development], SSDI payments average $1,140 per month (£777) and are much less than the benefits paid by most other advanced nations placing the US 30th out of 34 countries in international rankings. The US is also hovering towards the bottom of the league tables (27th) on the percentage of its GDP that goes on disability benefits (just 0.8% in 2009 compared to the UK’s 2.4%  ...

Intellectual Disability Diagnosis Standards Much Tougher In U.S. Than In Canada

     From The Star Phoenix of Saskatoon, Saskatchewan:

If you lived in Niagara Falls, Ont., and got benefits for an intellectual disability, then moved across the Canada-U.S. border to Niagara Falls, N.Y., you wouldn't get them.

Psychologists can use two different yardsticks to determine your IQ, which, in turn, determines whether you are considered to have a disability, which, in turn, determines whether you get a disability cheque in the mail every month.

One yardstick is Canadian, the other American. And research by Dr. Allyson Harrison, who heads the Regional Assessment and Resource Centre at Queen's University in Kingston, Ont., finds that five times more people are diagnosed with a disability when the Canadian yardstick, or standard, is used in tests than when the U.S. standard is used. ...

In a research study, Harrison administered the Wechsler Adult Intelligence Scale, Fourth Edition, (WAIS-IV) test to Ontario university students who had been referred to her by a doctor.

But because of how the test works - it's standardized, like SATs - their answers don't mean anything unless they are measured against a standard derived from test results of people in their own demographic as determined by gender, age and educational level. ...

Of Harrison's sample, 21.2 per cent qualify for disability cheques when they're scored using Canadian standards. Only 4.2 per cent qualify using the American standards. That number - 4.2 per cent - is what you'd expect in the population of college and university students she studied.

Every Candidate Needs To Take A Stand On Social Security

     You may not have noticed or cared but Chris Christie is running for President. As a lower tier candidate, Christie feels a need to be bold. He's decided to demonstrate his boldness by campaigning on cutting Social Security by means testing benefits, cutting the cost of living adjustment and raising the retirement age. Michael Hiltzik, at the LA Times finds Christie's plan offensive. So do I, but I'm also delighted that Christie is raising these issues. It will be good to see other candidates reacting to Christie's ideas. The Republican debates in Iowa and New Hampshire should be interesting. Any plan to cut Social Security turns off about 75% of voters. The 25% who favor Social Security cuts are pretty much the Republican base.

SRRT Jobs Disappearing

     From the Wall Street Journal:

The American labor market and middle class was once built on the routine job–workers showed up at factories and offices, took their places on the assembly line or the paper-pushing chain, did the same task over and over, and then went home.

New research from Henry Siu at the University of British Columbia and Nir Jaimovich from Duke University shows just how much the world of routine work has collapsed. The economists released a paper today, published by the centrist Democratic think tank Third Way, showing that over the course of the last two recessions and recoveries, a period beginning in 2001, the economy’s job growth has come entirely from nonroutine work. ... 

In the late 1980s, routine cognitive jobs were held by about 17% of the population and routine manual jobs by about 16%. Today, that’s declined to about 13.5% and 12%.

     What does this have to do with Social Security? A high percentage of people applying for Social Security disability benefits have low cognitive abilities as well as other physical or mental impairments. Often, these people are denied Social Security disability benefits based up a finding that work involving only "simple, routine, repetitive tasks" or SRRT is available that they can do. The SRRT category is also often used to deny people who have normal cognitive abilities but who have psychiatric problems. I've always thought that questionable since psychiatric problems mostly affect the ability to show up for work, get along with other people and concentrate upon the job at hand, all of which have little to do with the complexity of the work being performed but, rightly or wrongly, SRRT is used as a catchall category for many people with psychiatric problems. However, as this study shows, the SRRT jobs are disappearing. You can't "cure" low cognitive abilities in adults with education or training. It's a fixed limitation. If SRRT jobs are disappearing, Social Security ought to be approving more people limited to SRRT.

Validity Testing Recommended

     From Science Daily:

Broader use of standardized psychological testing for applicants submitting disability claims to the U.S. Social Security Administration (SSA) should improve the accuracy and consistency of disability determinations, says a new report from the Institute of Medicine. Some proponents of mandatory psychological testing, in particular validity testing, for SSA disability applicants argue that it would result in a significant reduction of individuals allowed onto the benefits rolls and a substantial cost savings. The committee that conducted the study and wrote the report said the data necessary to accurately assess the effects on the rolls or calculate financial costs and benefits are limited, and estimates based on available data are subject to considerable error.  ...

Cognitive psychological tests are performance-based and have people answer questions and solve problems as well as they possibly can. Non-cognitive psychological tests are measures of typical behavior -- such as personality, interests, values, and attitudes. Validity tests can be used in conjunction with these standardized psychological tests to assess whether a test-taker is exerting sufficient effort to perform well, responding to the best of his or her capability, or providing an accurate report of his or her symptoms. ...

The committee recommended that under specified conditions, SSA should require standardized, non-cognitive psychological testing for all applicants whose allegation of non-cognitive functional impairment relates to a mental disorder unaccompanied by cognitive complaints or to a disorder with physical symptoms that are disproportionate to the medical findings. Testing should be required when the allegation is based primarily on the applicant's self-reporting of symptoms and is not accompanied by objective medical evidence or longitudinal medical records sufficient to make a disability determination. In addition, the SSA should require standardized cognitive testing be included in the case record for all applicants whose allegation of cognitive impairment is not accompanied by objective medical evidence. ...

Good Planning, GOP

     I think I was the first one to write publicly about this. Here's Mother Jones sounding the same theme:

With Hillary Clinton now officially running for president, progressives are upping the pressure on her to embrace their policy agenda, including the Holy Grail of expanding Social Security benefits. ...

But it's actually Republicans, not progressives, who have essentially guaranteed that Social Security will be a major issue in 2016, setting up a battle that will provide stark contrast between the two parties on the issue ...

Dylan Scott wrote last week, House Republicans passed a little-noticed procedural rule back in January that will ensure a heated debate on the Social Security at the height of the presidential campaign.

As things stand now, in the final three months of 2016, the Social Security Disability Insurance trust fund will run out of money and beneficiaries will see an immediate 20 percent cut in benefits. Luckily, there's an easy fix: Congress can simply reallocate a small amount of payroll tax income from the larger Social Security retirement fund to the disability fund. ...

But just as Republicans in recent years have turned once routine debt-ceiling votes into near-catastrophic showdowns, the Republicans' new procedural rule blocks the House from voting on this simple fix unless they also address the long-term solvency of the program by cutting benefits or raising taxes. Progressives expect House GOPers to use the rule to force through benefits cuts in late 2016.

Or at least that seems to be their plan. But what House Republicans have actually done is set up a battle that will force the two parties and their respective candidates to take a position on whether to expand or cut Social Security benefits in late 2016—just as Americans are picking their next president.

     And, please, if you're a GOP leader, just dismiss this out of hand because it's coming from Mother Jones and because you're sure the public will support your Social Security cuts once you explain that that you're only trying to save Social Security. Everyone knows it's really the Democrats who are recklessly endangering Social Security. Fox News reports this all the time.

I Keep Coming Back To This

     I keep coming back to this since it's such an interesting example of what's been happening at Social Security for the last few years as the agency, seems obsessed with making it harder to get disability benefits. Somebody made a mistake and wrote something sensible in Social Security's policy manual but it could be interpreted as helping claimants in some minor way so it had to be quickly excised but the change couldn't be announced or explained. Here's what I've posted before:

Not too long ago someone told me that this example had been added to Social Security's Program Operations Manual Series (POMS):

A 50-year-old claimant with a high school education and unskilled past relevant work has an RFC [Residual Functional Capacity] for standing/walking 2 hours of an 8-hour day and sitting approximately 6 hours of an 8-hour day. He is able to lift/carry/push/pull 20 pounds occasionally and 10 pounds frequently. This RFC falls between rule 201.12, which has a decision of disabled, and 202.13, which has a decision of not disabled. In this case, use rule 201.12 as a framework for a decision of disabled because the definitions in DI 25001.001 (Medical-Vocational Quick Reference Guide) indicate light work usually requires walking or standing for approximately 6 hours of an 8-hour day. Since the claimant can only walk or stand for 2 hours, he has a significantly reduced capacity to perform light work and a sedentary medical-vocational rule applies as a framework for a determination.

I posted about this. Not long after I posted about it, without any announcement of a change, the example disappeared from the POMS section to which I cited. However, you can still see the example on the transmittal sheet, which is available online, which notified the various components of the agency about this and other changes. As long as it's there, it's going to be cited to courts and Administrative Law Judges. So, now, the question is whether the example will disappear from the transmittal sheet? Will the agency pretend that none of this ever happened? I've heard of the concept of a non-person. Can there be a non-thing? Can Social Security permanently erase this from the memory bank?

    And here's an e-mail I received from a reader:

Regarding POMS section DI 25025.015, transmittal sheets disappear from the public site after 60 days, so you might want to save a copy. 

Transmittal sheets and archived POMS sections are maintained on SSA's internal web site indefinitely.

I don't know enough about the disability program to understand why the example was problematical, but the people who maintain the POMS web site were asked to remove the example (and did so) on March 27.  You can see at the bottom of the section, in small type, "Batch Run" and "Rev" dates indicating when it was changed.

I'd prefer you didn't mention my name if you use this information.

New Listings For Children

     Social Security is adopting revised Listings used in determining disability in children for growth disorders and weight loss. This includes one of the more interesting names for a medical condition, "failure to thrive." Children are expected to thrive, that is to rapidly gain weight and height. "Failure to thrive" is an ominous condition and a challenge for a pediatrician's diagnostic skills. When they can't figure out what the specific problem is or how to cure it, disability can result.

Isn't It Nice That They're Checking On Me!

     An elderly relative of mine recently passed away after a brief illness. A few months before he died he was surprised to receive a call from a nurse who had been hired by his last employer's retirement plan. The nurse wanted to come out and check his blood pressure. He thought that it was great that they wanted to check on him. I knew the real reason this was happening. They weren't doing this just to be nice. My elderly relative really hated to go to the doctor and hadn't been to one in several years. Since he had supplemental health insurance benefits through his former employer they knew he hadn't been to a doctor recently. They were checking to make sure he was still alive. I expect that Social Security would have been checked on him eventually for the same reason but he got sick and started using his Medicare and then he died. Social Security checks on people drawing retirement benefits who aren't using Medicare. Social Security's Office of Inspector General (OIG) has issued a report recommending that the agency extend this program to those drawing disability benefits. That makes good sense. However, as always, the agency's ability to undertake such efforts is limited by inadequate staffing caused by an inadequate administrative budget. The inadequate staffing is probably why my elderly relative's employee retirement plan checked to make sure he was alive before Social Security did.

As I Predicted

     As I predicted, at least one media outlet has tried to make a big deal out of 18 sexual predators receiving Social Security benefits. Michael Hiltzik calls them out on trying to puff up such a trivial matter.

This Is Interesting

     Not too long ago someone told me that this example had been added to Social Security's Program Operations Manual Series (POMS):

A 50-year-old claimant with a high school education and unskilled past relevant work has an RFC [Residual Functional Capacity] for standing/walking 2 hours of an 8-hour day and sitting approximately 6 hours of an 8-hour day. He is able to lift/carry/push/pull 20 pounds occasionally and 10 pounds frequently. This RFC falls between rule 201.12, which has a decision of disabled, and 202.13, which has a decision of not disabled. In this case, use rule 201.12 as a framework for a decision of disabled because the definitions in DI 25001.001 (Medical-Vocational Quick Reference Guide) indicate light work usually requires walking or standing for approximately 6 hours of an 8-hour day. Since the claimant can only walk or stand for 2 hours, he has a significantly reduced capacity to perform light work and a sedentary medical-vocational rule applies as a framework for a determination.

     I posted about this. Not long after I posted about it, without any announcement of a change, the example disappeared from the POMS section to which I cited. However, you can still see the example on the transmittal sheet, which is available online, which notified the various components of the agency about this and other changes. As long as it's there, it's going to be cited to courts and Administrative Law Judges. So, now, the question is whether the example will disappear from the transmittal sheet? Will the agency pretend that none of this ever happened? I've heard of the concept of a non-person. Can there be a non-thing? Can Social Security permanently erase this from the memory bank?

Social Security Pays 18 Sexual Predators

     From a report by Social Security's Office of Inspector General (OIG):

We identified 18 sexual predators who were involuntarily confined in 4 SCCs [Special Commitment Centers] and who improperly received approximately $524,000 in Social Security benefits and/or Supplemental Security Income payments. 

Our review indicated that, after States transferred these sexual predators from prison to an SCC, the individuals contacted SSA to apply for benefits or request resumption of payments that SSA had suspended while they were incarcerated. While benefit suspension provisions continued to apply to these individuals, a mechanism had not been established to ensure SCCs reported inmate information to SSA. Consequently, SSA did not have the information it needed to prevent initiation of payments to these individuals.

     This can easily be sensationalized and probably will be but it's a quite minor issue affecting only a handful of cases. It will be quickly resolved.

Don't Let The Tail Wag The Dog

     Let my explain why Social Security has a rule that allows a few severely disabled people onto benefits, in part, because of their inability to read and write in English, even though they live in Puerto Rico and are able to read and write in Spanish. It's fairly simple. Social Security is a national program. What is the agency supposed to do? Put someone on disability benefits when they're living in New York but cut them off once they move to Puerto Rico? Deny their claim while they're living in Puerto Rico but allow it as soon as they move to New York? It's not only impractical to have different rules for different locations; it's probably unconstitutional. What are you going to say next -- that inability to read and write in English has no effect upon a person's ability to hold down a job? You're not going to be able to do a surveillance system monitor job if you can't communicate in English. You can still be an agricultural laborer or a landscaper but when you get to the point in the grid regulations where ability to communicate in English is an issue, laboring jobs are already off the table because of the claimant's physical impairments. In fact, most jobs are off the table throughout most of the country if you can't communicate in English. So what do you want? A rule that may seem a bit odd when applied to a handful of people in Puerto Rico or a rule that's very unfair when applied across most of the country?

Latching Onto 218 Cases As Basis For Changes Affecting Millions Of Cases

     A press release:

The Social Security Administration's (SSA) Office of the Inspector General (OIG) recently issued a report on the determination of disability claims from applicants who cannot communicate in English. The OIG found at least 218 cases in Puerto Rico where a disability rule was applied to the advantage of a claimant who was unable to communicate in English, even though Spanish is one of the island's official languages.

Chairman Sam Johnson has previously called attention to these "grid rules" as one of the challenges facing the Disability Insurance program. In 2012, the Government Accountability Office released a report requested by Chairman Johnson, which found the SSA relies on an outdated view of disability. In 2014, he introduced H.R. 5260, the Stop Disability Fraud Act of 2014, which would require the SSA to update the grid rules for the first time since they were created in 1979.

In response to the OIG report, Chairman Johnson made the following statement:

"As part of my commitment to the disability community and the American taxpayer, I am looking for ways to make the disability program work better, and updating the grid rules to reflect today's world is one way to do so. It makes absolutely no sense that Social Security has been relying on rules that are over 35 years old to determine if someone should receive benefits. While I am encouraged that Social Security is finally getting around to taking a look at these rules, I will be introducing legislation to make sure they actually do so. The American people expect Social Security to use common sense, not outdated thinking, when determining who should receive disability benefits."