Page 80 is interesting: "While reducing fraud in public programs is an inherently worthy goal, the cost savings from these efforts is not substantial. Disability insurance already has many safeguards against fraud and abuse, such as continuing disability reviews (CDRs) and strict eligibility standards. Fraud is not responsible for the system’s funding shortfall. Proposals to further increase program integrity include increasing criminal penalties for fraud and improving Continuing Disability Reviews (CDRs)."
While I may see a skewed sample, for every case of likely fraud I have seen, I have seen at least several people who obviously and clearly disabled from any substantial work and whose claims were turned down. Sometimes that is due to adjudicator error. Sometimes it is because the person is so disabled they are unable to properly document the claim or follow the claims procedures without help.
Come on. The name of the game is delay. Keep them waiting they give up or die off. A few are able to go back to work and should not have been in to begin with but that is a very small percentage. Deny them and see if they are sharp enough to appeal on time. Discourage, discourage, discourage. Hang on to the money. That's why you must have some competent, independent minded ALJs who will reverse the blatantly unsupported denials at the lower levels. Plus, disabled people that have managed to survive for several years of this hardship deserve to be paid.
Yep. Something to keep in mind, the rate of improper payments estimated by the OIG has remained under 1% of recipients for the past 30 years, while the rate of award has been cut in half in the past ten years. Additionally, .6% of that one percent is underpayments, not overpayments, and that .4% overpayment is not 100% fraud but also includes administrative error. I find it unlikely that the rate of fraudsters applying doubled (although the recessions might have caused a slight increase due to employers terminating employees they were previously willing to accommodate, not to mention many going bankrupt entirely).
#3, Granted, the above does not include SSI, just SSDI and concurrent claims. However, given that the ten-year decline in the SSI award and allowance rates has only been from 33.6% to 30.5% and from 49.8% to 42.9%, respectively (https://www.ssa.gov/policy/docs/statcomps/ssi_asr/2015/sect10.pdf), that still would not yield anywhere near the chicken-little proclamation of a 50% decline.
#4, Notwithstanding all of the foregoing, it does not, in any event, logically follow that a decline in the award or allowance rates must be due to some nefarious reason ("pressure to deny," anti-disabled bias, whatever). That assumes facts not in evidence: that the rates at the chosen starting point were somehow pure and pristine and unquestionably accurate and the ideal of what the program should yield. Nobody ever wants to entertain the proposition that perhaps the program was unreasonably generous in the past, only that it is unreasonably stingy now.
Oh, I think 10:49 on February 2, 2017, summed up perfectly what's been going on at ODAR, and in every other type of public benefit program for several years now. I base this on my decades of experience with ODAR. I do not all agree with this thinking, but I cannot deny this philosophy is alive and well at ODAR, e.g., deny, deny; wait and hope they either die or return to work; discourage, discourage, discourage; hang on to the money; and those disabled people who manage to survive and whose cases return on appeal years and years later, will be paid by some independent ALJ who by this point in time, is convinced a disabled person who has managed to survive all this should be paid. This is evil and awful, but it is the prevailing philosophy among ODAR adjudicators
If you believe that, either aren't actively practicing this area of law anymore, never were, or... well, if you practice this area of law and still stand by your comments above, then I have a bridge in Brooklyn I'd like to sell you!
In all seriousness -- SSA has crippling levels of dysfunction, most prevalent in the handling of disability claims. The facts are in evidence and are observable statistically as well as on a case-by-case basis by hundreds of representatives (both attorneys and non-attorneys). Fraud is almost nonexistent, but denials of disabled individuals by even the harshest of standards has ballooned in lock-step with Republican obstructionism in Congress and lack of significant reform with commensurate funding for the Agency.
Ah yes, 233 succinct pages.....
ReplyDeletePage 80 is interesting: "While reducing fraud in public programs is an inherently
ReplyDeleteworthy goal, the cost savings from these efforts is not substantial. Disability
insurance already has many safeguards against fraud and abuse, such as
continuing disability reviews (CDRs) and strict eligibility standards. Fraud
is not responsible for the system’s funding shortfall. Proposals to further
increase program integrity include increasing criminal penalties for fraud and
improving Continuing Disability Reviews (CDRs)."
While I may see a skewed sample, for every case of likely fraud I have seen, I have seen at least several people who obviously and clearly disabled from any substantial work and whose claims were turned down. Sometimes that is due to adjudicator error. Sometimes it is because the person is so disabled they are unable to properly document the claim or follow the claims procedures without help.
ReplyDeleteCome on. The name of the game is delay. Keep them waiting they give up or die off. A few are able to go back to work and should not have been in to begin with but that is a very small percentage. Deny them and see if they are sharp enough to appeal on time. Discourage, discourage, discourage. Hang on to the money. That's why you must have some competent, independent minded ALJs who will reverse the blatantly unsupported denials at the lower levels. Plus, disabled people that have managed to survive for several years of this hardship deserve to be paid.
ReplyDelete@10:01
ReplyDeleteYep. Something to keep in mind, the rate of improper payments estimated by the OIG has remained under 1% of recipients for the past 30 years, while the rate of award has been cut in half in the past ten years. Additionally, .6% of that one percent is underpayments, not overpayments, and that .4% overpayment is not 100% fraud but also includes administrative error. I find it unlikely that the rate of fraudsters applying doubled (although the recessions might have caused a slight increase due to employers terminating employees they were previously willing to accommodate, not to mention many going bankrupt entirely).
#1, the award rate has NOT "been cut in half the past ten years." It has gone from 43% to 29%, a decline of less than a third.
ReplyDelete#2, calculation of the award rate includes technical denials. The allowance rate has gone from 58% from 51%.
https://www.ssa.gov/policy/docs/statcomps/di_asr/2015/sect04.pdf
#3, Granted, the above does not include SSI, just SSDI and concurrent claims. However, given that the ten-year decline in the SSI award and allowance rates has only been from 33.6% to 30.5% and from 49.8% to 42.9%, respectively (https://www.ssa.gov/policy/docs/statcomps/ssi_asr/2015/sect10.pdf), that still would not yield anywhere near the chicken-little proclamation of a 50% decline.
#4, Notwithstanding all of the foregoing, it does not, in any event, logically follow that a decline in the award or allowance rates must be due to some nefarious reason ("pressure to deny," anti-disabled bias, whatever). That assumes facts not in evidence: that the rates at the chosen starting point were somehow pure and pristine and unquestionably accurate and the ideal of what the program should yield. Nobody ever wants to entertain the proposition that perhaps the program was unreasonably generous in the past, only that it is unreasonably stingy now.
@10:46
ReplyDeleteOh, I think 10:49 on February 2, 2017, summed up perfectly what's been going on at ODAR, and in every other type of public benefit program for several years now. I base this on my decades of experience with ODAR. I do not all agree with this thinking, but I cannot deny this philosophy is alive and well at ODAR, e.g., deny, deny; wait and hope they either die or return to work; discourage, discourage, discourage; hang on to the money; and those disabled people who manage to survive and whose cases return on appeal years and years later, will be paid by some independent ALJ who by this point in time, is convinced a disabled person who has managed to survive all this should be paid. This is evil and awful, but it is the prevailing philosophy among ODAR adjudicators
@10:46 AM,
ReplyDeleteIf you believe that, either aren't actively practicing this area of law anymore, never were, or... well, if you practice this area of law and still stand by your comments above, then I have a bridge in Brooklyn I'd like to sell you!
In all seriousness -- SSA has crippling levels of dysfunction, most prevalent in the handling of disability claims. The facts are in evidence and are observable statistically as well as on a case-by-case basis by hundreds of representatives (both attorneys and non-attorneys). Fraud is almost nonexistent, but denials of disabled individuals by even the harshest of standards has ballooned in lock-step with Republican obstructionism in Congress and lack of significant reform with commensurate funding for the Agency.
@7:11
ReplyDeleteAMEN!