Beltway Bandit Report On Medical Improvement

     The National Academies of Sciences, Engineering and Medicine has done a study for Social Security of Selected Health Conditions and Likelihood of Improvement with Treatment. The National Academies may sound like a purely scholarly group but it's basically a Beltway Bandit paid large amounts of money to do studies for the federal government. Almost always the studies end up gathering dust.

     I suppose that some at Social Security wanted a hit list of medical conditions whose sufferers could be targeted for continuing disability reviews on the grounds that medical science has improved their conditions. They didn't get that.

     One thing I particularly loathe about this sort of Beltway Bandit report on Social Security disability is that they always begin with a statement about how the authors conceptualize the term "disability". Who the hell cares how you conceptualize the term "disability"? We're dealing with a statutory definition of disability. Social Security has to deal with it. I have to deal with it. So, shut up and deal with it yourselves! No one is interested in this sort of throat clearing.

     This tome goes on with all sorts of amazing irrelevancies such as "During a biopsy, a sample of cells is collected for testing. In most cases, a biopsy is the only way to definitively diagnose cancer (Mayo Clinic, 2019). Methods by which a sample may be collected include ..." followed by a description of biopsy methods. If you're an oncologist or other physician tasked with diagnosing cancer, biopsy methods are really important. If you're a government employees dealing with disability claims, biopsy methods aren't of much importance. Besides, I think that even the lay public already knows that most cancers are diagnosed through biopsies.

     Why put discussions of the conceptualization of the word "disability" and descriptions of biopsy methods in such a report? Well, I guess it makes the report longer. If you're going to charge your customer hundreds of thousands of dollars for a report that doesn't give them what they want -- academic support for a hit list of  claimants to attack with continuing disability reviews -- you'd better make the report at least a few hundred pages long so the customer won't feel cheated.

     I will give the National Academies this. I don't see in this report a recommendation for additional studies. You almost always see that self-serving recommendation in Beltway Bandit studies.

     I'll be happy to give Social Security a hit list of medical conditions where there's a good chance of improvement --  for free:

• Severe trauma. The one year duration requirement in the definition of disability that Social Security must use means that few who have experienced trauma are found disabled but those who are found disabled sometimes do get better after they finish all their surgeries and physical and occupational therapies.
• Metastasized cancer. Most of the time people die from this but those who beat the odds may get better after they finish all their surgeries and radiation and chemotherapy. They may relapse later but they may have an interval during which they can work.
  
• Transplant patients. It takes quite some time to get over a kidney, liver, heart or lung transplant but you can. You probably can't return to work at the moment, though, since you'll be on immunosuppressive drugs and should hardly be leaving your house but in better times you might be able to return to work.
  

     Guess what? Social Security is already going after everyone on my hit list. Most of those  on the list who are cut off don't complain too much because they are better. If my list seems short, it's because of that pesky one year duration requirement in the statutory definition of disability. You see, if you're disabled for at least a year, you're probably never going to get much better. You shouldn't expect to find much medical improvement among Social Security disability claimants.