Jun 5, 2017

Can We Talk About Real Problems?

      There have been many, many media pieces on the Trump budget proposals that promise big cuts in the number of people drawing Social Security disability benefits. Here's one from CBS and another from Bloomberg.
     The thing that gets me is that the Trump budget proposals on Social Security disability are unlikely to have an effect upon the real world. They mostly rely upon vague proposals to return many disability recipients to the workforce. It's not like this hasn't been tried before. The Social Security Act is littered with work incentive after work incentive to the point that almost no one understands how they all work. Certainly, claimants don't understand. The oldest work incentives date back to the 1960s. Everything has been tried. Nothing worked. Nothing will work. The vast majority of Social Security disability recipients are too sick to work and have no realistic hope of getting better. I doubt that any new work incentive could be passed and if it was, it wouldn't work. However, the news media likes to talk about these proposals because they fit into a narrative that the Trump administration is heartless. It may be but these proposals are more a sign of fecklessness than of heartlessness.
     Meanwhile, almost no one pays attention to Social Security's operating budget. This has an effect on the here and now. The agency is starving for operating funds. As a result, backlogs increase, telephones don't get answered and wait times at Social Security field offices soar. That gets little attention because it's boring but real people are suffering right now. All of this could be improved dramatically by adding another billion dollars to Social Security's operating budget.
     Please, let's pay more attention to the operating budget and Social Security's service delivery problems. They matter. They could be solved so easily.

12 comments:

Anonymous said...

Starved for funds, yes, but also starved for ALJ's willing to do their job.

Decisions per judge per day have steadily dropped from 2.3 to the current 1.8. Yes,m the excuse is the files are bigger and take more time. What transparent nonsense. A Judge is not a doctor and the number of pages in the file has next to nothing to do with how long it takes to decide a case.

Anonymous said...

The ALJ's make their decisions but then it goes to 'writing' which is where the starvation for funds is apparent. There aren't enough writers and none are being hired.

Anonymous said...

11:01,

Are you proposing that ALJs just defer to whatever opinions are in the record? ALJs may not be doctors, but they are responsible for deciding whether a doctor's opinion is supported. To do that, they have to review the record.

As for this comment - "the number of pages in the file has next to nothing to do with how long it takes to decide a case" - I doubt that reps would be willing to give a pass to an ALJ who overlooks an exhibit because the record is too long and he/she has to skip a few pages to keep pace with the 2.3 decision per day quota.

Anonymous said...

To 11:01

There is a difference between knowing what is in the record and studying a file page by page as if it was a sacred text. An ALJ needs to know act the medical problems are and needs to see what treatment has been provided. Once you see that a person had a spinal fusion, how much more of that report does the ALJ have read.

The argument from the ALJ Union Chief is that the cases take longer because the files are thicker. Sorry, just not buying that as anything approaching a reasonable rationale supported by substantial evidence.

Anonymous said...

BRAVO, 1:15PM!

If 11:01AM is an Agency employee, and heaven forbid a Manager, they should be fired immediately, as they are a disgrace to the integrity of the SSA Disabilty Hearings process and the law.

It sickens me to see any Agency employee speak in such a disrespectful manner. What really baffles me is why is it these are the type of employees who move up through the ranks in great numbers, while many of the best and brightest are pushed out the door because individuals like these who become their Managers, cannot stand their success?

Anonymous said...

When I applied for SS Retirement, I began trying to apply online 4 months before my full eligibility date. I could never get "My Social Security" to work. After a few months, I went to the local office, waited an hour, then got it taken care of in 10 minutes.

Perhaps the answer to SSA's operating budget will come when the system is so gummed up that it begins to affect senior citizens attempting to retire. Maybe some congressmen will feel the heat enough to address the problem.

Anonymous said...

How about comments concerning what is said in this post --"The Social Security Act is littered with work incentive after work incentive to the point that almost no one understands how they all work. Certainly, claimants don't understand. The oldest work incentives date back to the 1960s. Everything has been tried. Nothing worked. Nothing will work. The vast majority of Social Security disability recipients are too sick to work and have no realistic hope of getting better. I doubt that any new work incentive could be passed and if it was, it wouldn't work."

There are examples that disabled folks who followed work incentive procedures were able to succeed in returning to work; however, to what degree these incentives lead to that success is uncertain. Too often they serve to shelter income or resources in regards to SSI (not to really return to work) or enable unrealistic adjustments in duties that promote more of an appearance of success than reality. And for those successes, how many return to disability within a year or two? It is not a black and white situation, but the efforts and the lack of significant success are clear. As in many things in life, a cost/benefit review is needed so we can achieve the best use of staff, funds, and realistic expectations. Folks achieve extraordinary success, but not by throwing money at them or denying the truth (sometimes harsh).

Tim said...

This isn't that complicated! If you really want people to try, remove the risks to them while increasing their potential rewards. This could be done at minimal costs to SSA, while potentially allowing some people to better their circumstances. However, you have to make the "attempt" a longer experiment than 3-9 months. Give them a safety net of 2-5 years, with a return easy if symptoms worsen. Anything less will probably get few takers. If you don't want them to try, keep it complicated and risky for the claimants. However, the Republican plan seems to be to force them off and hope they can work!

Anonymous said...

Medical coverage is much more important to most on SSDI than the check itself. Given continued medical coverage, many would pass the check and do something that would keep a roof over their heads and food on the table. They cannot maintain enough work hours to qualify for benefits with most employers. that is where the problems really begin. Keep them covered for healthcare and prescriptions and you will move them off of payments. Unfortunately that care is more costly than the monthly benefit check.

Tim said...

10:38 AM On the flip side, how much money is spent on doctors, medications, etc. in the attempt to get and keep SSDI/SSI? I take $8000 a month (medicaid) medications in order to be "under treatment" with medications that have a marginal effect, at best. Do they allow me to work? Not a chance! I actually had insurance and a job when the treatments began, but they simply don't really work! I would gladly trade the $7000 medication for a $1500 check!

Anonymous said...

Tim,

Obviously you missed the point, and while I understand the only claim that matters is yours to you, there are 10s of thousands of people in a totally and completely different situation from you. As hard as it is to believe.

One of the many pitfalls of disability is things like the Medicare you are getting now. That Medicaid may go completely away if and when you are awarded SSDI and qualify for Medicare because the amount of your SSDI check will be too much income for Medicaid. Then you will have to choose the best Medicare Part D plan that fits you medication needs. It will be more out of pocket than Medicaid.

The point you seemed to miss, is that for many (note here that "many" does not include Tim) have access to medication, treatment and benefits of Medicare is worth more than the check and many (again "many" totally and completely excludes Tim) would try and work more if it did not risk the benefit of health coverage. The addition of wages, even below SGA may knock someone out of energy assistance, food stamps, rent assistance or other assistance programs. Trapped in a circle of poverty by the rules.

Tim, I suggest that with your back and shoulder issues you contact your local ADRC and CIL. Find out what others are doing in your area for treatment options, physical rehabilitation, vocational rehab/ training, and other opportunities and programs that may be available for you and others in a similar situation. If over age 60 you local AAoA will be of assistance as well. Unfortunately, like SSA staff and representatives, not all CILs, ADRCs, and AAoAs are superstars but even the less super should be able to point you into some areas of assistance. Do not let the conditions define you, define your conditions. I am a lot more than a wheelchair, it is just a tool I use, find tools that work for you!

Anonymous said...

I had a dream. I imagined SSA was an automobile running on empty, stalling out as it pulled into the full-service pump. "I really need some gas," the driver said. Instead of filling up the tank, the attendant looked under the hood, fiddled around a bit, and then suggested rust proofing the tires. "I don't need rust proofing, I just need some gas," the driver repeated. "You car would get better mileage if we put fins on it," said the attendant. "Could you please just get me gas?" asked the driver. "Not until we rust proof your tires and put fins on it," insisted the attendant.