Telephone Service Disruptions In 2021 And 2022

    From The Social Security Administration’s Telephone Service Disruptions, a report by Social Security's Office of Inspector General (OIG):

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OIG Report On Pandemic Effect On DDS Processing Of Disability Claims

     From a report by Social Security's Office of Inspector General (OIG) on the effects of the pandemic on processing of Social Security disability claims:

While SSA received fewer initial claims during the pandemic, it took the DDSs [Disability Determination Services] longer to process them than the year before. Before the pandemic, DDS’ average processing time for an initial claim was 95.5 days. This increased to 139.4 days and 135.5 days, respectively, during the first and second years of the pandemic. Numerous factors contributed to this:

• CEs - The number of CEs [Consultative Examinations] performed during the pandemic decreased, as SSA suspended in-person CEs for a period of time. Once DDSs resumed in-person CEs, they still had issues scheduling CEs because for example, (1) not all CE providers returned to conducting CEs and (2) claimants refused to attend in-person CEs because of fear of exposure to COVID-19.
• DDS Staffing and Training – About 4,000 DDS employees resigned or retired during the pandemic, but DDSs hired 4,305 employees during this same time. However, it takes a newly hired disability examiner an average of 2 years to become proficient at processing most initial claim workloads.
• Telework and Communication with Claimants – During the pandemic, most DDS employees teleworked, so the DDSs needed to adjust to how they processed certain workloads. SSA provided the DDSs with basic cellular telephones to communicate with claimants, but claimants were wary of answering the calls as the telephones’ caller identification did not show the incoming call was from a state agency.
• Policies and Procedures – During the pandemic, SSA updated policies and procedures on how the DDS should operate. The updates included combined instructions with the field office, which confused some DDS employees about what pertained specifically to DDS processes.

Social Security's Telephone Service Is Terrible

    From The Social Security Administration’s Telephone Service Disruptions, a report by Social Security's Office of Inspector General (OIG):

SSA's telephone systems experienced an increasing number of service disruptions at the end of 2022 as it maintained operations under the temporary Unification platform. From May 2021 through December 2022, 40 telephone service disruptions occurred on the national 800-number and field office systems. The majority of these disruptions occurred from October through December 2022 and involved the 800-number. These disruptions resulted in dropped calls, increased wait times and, in some instances, unavailable automated services. Wait times increased as SSA employees could not take calls during several of the outages. Further, such functionalities as the “estimated wait time” and the “call back assist” features, which callers used to avoid waiting on the telephone to speak with an SSA employee, were no longer available to callers. The rate of unanswered calls for those who opted to speak with an employee during each of the service disruptions ranged from 32 to as high as 80 percent. ...

    I'll pull out some eye-catching charts from this report in coming days.

Direct Express Problems

     The Office of Inspector General (OIG) has issued a report on the Direct Express Debit Card program. Claimants who don't have a financial account into which benefits can be deposited can receive their money through a Comerica Bank debit card. The Comerica deal, which is with the Department of the Treasury, not Social Security, has been criticized because of high fees to benefits recipients and because people complained that they were assigned a debit card without asking for one. The OIG report found that there were some Social recipients complaining about receiving a debit card without asking for one. The OIG report also found that there has been a fair amount of money returned to Social Security by Comerica because of unfinished enrollments and that Social Security has been slow in making sure the claimants involved received their money. OIG found 39 cases where a claimant had been owed over $100,000.

Proposed Regs On Rental Subsidy Execption

     This is the description given for proposed new regulations that the Social Security Administration has sent to the Office of Management and Budget for approval:

We propose expanding the rental subsidy exception beyond the 7 states to which it already applies so that it applies nationwide. Accordingly, our nationwide policy would be that a business arrangement exists when the amount of monthly rent required to be paid equals or exceeds the presumed maximum value or the current market value, whichever is less. We expect that the proposed change would improve service delivery by making our policy uniform throughout the country and reducing administrative burdens for individuals seeking access to the Supplemental Security Income (SSI) program.

    I'm not familiar with this. Could someone explain it? Why is it only in seven states now? How has it worked in those seven states? 

    The only thing available to the public now is this brief description.

    At the rate that proposed regulations have been advancing, it will be two years or more before this could become a final rule and that's assuming there's no change in the party controlling the White House after next year's election

A Good Start

    From a press release:

Senate Finance Committee Chairman Ron Wyden (D-OR), and Senator Bill Cassidy (R-LA), today introduced legislation to remove a Social Security work disincentive for Americans with disabilities. ...

If an adult has a severe medical condition that began before age 22, they may be eligible for a Social Security benefit called the Disabled Adult Child (DAC) benefit. Their benefits are based on their parent’s Social Security earnings, in the same way that benefits of a child under age 18 would be. However, under current law some of these young adults fear that if they try to work they will lose future DAC benefits, which are often higher than any benefit they may qualify on their own. This fear inhibits the ability of Americans with disabilities to explore their ability to work as they transition to adult life.

The Work Without Worry Act promotes financial security by ensuring that any earnings from work – no matter how much – will not prevent an individual from receiving a Social Security DAC benefit from their parent’s work history if they have an eligible medical condition that began before age 22. ...

This change is estimated to improve the lives of nearly 6,000 individuals with disabilities over the next 10 years and would have no significant effect on the Social Security Trust Funds. ...

     Now, how about we do something about the marriage penalty that cuts off DAC if a recipient marries.

SSI Is A Mess

     Gabrielle Emmanuel has put out a long piece for WBUR on the problems that SSI claimants, particularly children and their parents, face in filing claims, dealing with the Social Security Administration and staying on benefits. 

    SSI is disappearing before our eyes. Social Security lacks the money it needs to administer the program. There's all the money in the world to cut people off benefits but precious little to help people get on the SSI benefits they deserve and to help them stay on those benefits.

Union Complaints About Training

     From Government Executive:

... Rich Couture, president of AFGE Council 215 and the union’s chief negotiator with Social Security management, said a poor “self-taught” training model employed by the agency is leaving new hires unprepared for their duties and already looking for work elsewhere. Council 215 represents Office of Hearing Operations staffers.

“We have folks leaving the agency, because the training stinks,” Couture said. “I’d use another word, but we’re in polite company, but the training is terrible. The mentoring, based on an agency focus group report we just got last week, it looked like it was written by us, saying all the same things [we’ve been saying]. There’s not enough time; there’s not enough accommodation to make sure that it actually works. So instead, our folks are telling us, and they’re telling management when they leave, ‘I feel unsupported, I feel unprepared and I feel set up to fail.’ ” ...

A Sad But Familiar Story

    A television station in Denver presents the now all too familiar story of a disabled person becoming homeless because of delays in processing their Social Security disability claim. Here's a quote from the claimant's attorney:

"We had to re-fax the same paperwork six times over a period of about six months," the attorney explained. "But it's not just the faxing. It's calling, 'Did you receive the fax? No, we haven't received the fax,' Even my staff, when they call into the field office, they will wait on hold for sometimes an hour — if the call is even answered at all."

    This isn't just happening in isolated cases. It happens all the time. How is this acceptable?

Turning 18 Doesn't Make You Healthier

     Mark Betancourt writes for Mother Jones about the problems caused by kicking large numbers of disabled people off SSI when they turn 18. Here's the key quote:

... Youth who lost benefits at 18 were twice as likely to be charged with a crime as they were to hold a job. Compared with those who stayed on SSI, they were 60 percent more likely to be incarcerated. Most were charged with income-generating crimes like theft, fraud, or prostitution. And they didn’t just commit crimes at a higher rate immediately after losing their checks but did so over the ensuing two decades. The study also found that increased spending on policing, adjudication, and incarceration nearly erased any government savings from reduced payouts; the added expenses far outstripped the savings when victims’ costs were included. ...

SSI Child's Disability Disappearing

     National Public Radio has a new piece out about the dramatic decrease in the number of people applying for and receiving Supplemental Security Income for disabled children.

    SSI is disappearing before our eyes, destroyed by antiquated income and resource rules and inadequate resources for the Social Security Administration to do much other than cut people off benefits.

Juneteenth 2023

 

This Won't Get Enacted But It Shows You Where The GOP's Heart Is

     From The New Republic:

Republicans have claimed over and over again that they are not trying to cut Social Security and Medicare. Heck, Joe Biden got them to agree they would not make cuts to the programs in a memorable verbal maneuver during his State of the Union speech earlier this year.

And yet, the Republican Study Committee (of which some three quarters of House Republicans are members of) just released its desired 2024 budget in which the party seeks to, you guessed it, cut Social Security and Medicare. ...

The proposed budget would effectively make cuts to Social Security by increasing the retirement age for future retirees.  The document seeks to assure people that there would only be “modest adjustments,” but does not list what Republicans think the new retirement age should be.

On Medicare, Republicans propose requiring disabled Americans to wait longer before getting benefits and turning Medicare into a “premium support” system, a long-floated Republican idea that essentially turns the government program into a voucher scheme. ...

13% Of Female Employees At Social Security Say They Experienced Sexual Harrassment In 2021

     From Government Executive: 

Social Security Disability Startup

     From Forbes:

Previously, much has been written about the dangers posed by AI and algorithmic decision-making tools in relation to people with disabilities. ...

[B]rand new tech startup Advocate is not only planning to turn this trend on its head but to achieve this through using a sophisticated mixture of AI and human expertise to address one of the most significant historic pain points afflicting the disability community. Namely, the unbearable delays and complexities involved in navigating America’s burdensome Social Security Disability Insurance system. ...

The fledgling company has just announced $4 million in seed funding to build a technology platform that aims to not only shorten and streamline the process of applying for long-term disability benefits but also provides claimants with a clear view of the strength of their application and chances of success. ...

Advocate CEO Emilie Poteat, an accredited disability benefits advocate herself, has already drafted expert advisors onto the corporate team in the shape of former Commissioner of Social Security, Jo Anne Barnhart and the former Secretary of Veterans Affairs, David Shulkin. ...

At the front end, users of Advocate will encounter an elegant and accessible platform that assists them in optimizing their claim by connecting to, prioritizing and synthesizing electronic health records as well as providing a means of filing the paperwork itself. ...

    Why is it that I have a feeling that Jo Anne Barnhart's involvement is a sign that this endeavor is destined to fail? Of course, there's also the fact that this focuses on the application process. Yes, the application process is a barrier but it pales in comparison with the other barriers in the process, such as the long backlogs and high denial rates. A $4 million AI project isn't going to solve those.

The Breath Of The Dead

     I remain distressed that Social Security's new Listings for liver disease remains as brutal as ever. One feature of dealing with clients with failing livers is officially called fetor hepaticus. It's sometimes called "breath of the dead." It's an extremely disturbing smell on the breath of some people with failing livers. I wonder whether any of those who drafted these Listings have ever smelled fetor hepaticus. The idea that anyone whose liver disease has progressed to this point can work seems preposterous once you smell it yet such patients are often denied Social Security disability benefits. It's not the smell that disables them. It's just obvious that anyone with that smell isn't long for this world. I can't emphasize too much just how viscerally disturbing fetor hepaticus is. It smells as if the person has already started dying on the inside. Why are patients in this condition being denied?

Presentation On New Occupational Information System

    On March 18, 2023, Charis Clark and Karen Litschgi of the Bureau of Labor Statistics (BLS) gave a presentation to the American Board of Vocational Experts (ABVE) on the Occupational Requirements Survey: Date and Upcoming Changes. By Freedom of Information Act request I have obtained the Powerpoint slide deck they used for the presentation. (I appreciate the Department of Labor's promptness in responding to my request.) I don't see any surprises in it but if you're interested in what's going on with Social Security's effort to have BLS create a new occupational information system for use in determining disability you should take a look. As boring as this may seem, it's vitally important to the future of Social Security disability determination. The seemingly never-ending process to develop a new system deserves close scrutiny. I don't trust Social Security on this. I'm not sure that anyone who knows much about this trusts Social Security.

    Below are links to the original Powerpoint version and to a version that I printed to PDF. If you're using the PDF version, you will see links in the upper left hand corner of the screens leading to notes apparently used by the presenters. Those notes were apparently not visible to the audience. If you use the Powerpoint version, those notes are visible at the bottom of the screen.

• Powerpoint version
• PDF version
  

    Update: You will have to ask permission to receive the file. I will approve these as quickly as I can. If you know of a better way of doing this sort of thing, I'd be interested.

Disability Incidence Rate Down

From What Factors Explain the Drop in Disability Insurance Rolls from 2015 to 2019? by Siyan Liu and Laura D. Quinby for the Center for Retirement Research at Boston College:

 

Average Age Of Disability Applicants Increased Sharply About 10 Years Ago

    From What Factors Explain the Drop in Disability Insurance Rolls from 2015 to 2019? by Siyan Liu and Laura D. Quinby for the Center for Retirement Research at Boston College:

 

Pillersdorf Honored

    The Louisville Courier Journal reports that Ned Pillersdorf is one of four lawyers nationwide who have been honored by the American Bar Association for volunteer legal work. Pillersdorf was instrumental in initiating and directing the legal response to the Eric Conn debacle.

    I think one element of Pillersdorf's work that needs to be especially noted is that he faced indifference, if not hostility, from the Kentucky bar. If this had happened in my state or most other states, I'm sure the bar would have organized a massive response. That didn't happen in Kentucky. Sure, there were some Kentucky attorneys who responded but most who have helped Conn's victims have been from out of state. It takes guts to stick up as Pillersdorf has done.

OHO Caseload Analysis Report

 

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Two Bills Advance

     Yesterday, the House Ways and Means Committee marked up two minor bills that would affect the Social Security Administration in small ways. One would allow minors whose Social Security numbers have been compromised to obtain new Social Security numbers. The other would provide for a single point of contact at Social Security for those whose Social Security numbers have been compromised. I'm sure the first is debatable and the second is pointless without additional funding. 

    I wouldn't bet on either bill advancing in the Senate. If they do, you never know what might get added.

New Digestive And Skin Disorders Listings

     The Social Security Administration will publish final rules to revise its digestive and skin disorders Listings in the Federal Register tomorrow. It runs to 159 pages in the PDF version! (It will be fewer pages in the actual Federal Register since that's three columns of small print.)

    One noticeable part is that they've changed the formula for determining SSA CLD, which has been used to determine whether claimants meet the Listing for chronic liver disease (CLD). It used to be exactly the same as the MELD formula used to determine whether individuals with chronic liver disease can get a liver transplant. Now it's just mathematically the same. I've speculated that the agency used the name "SSA CLD" to obscure the fact that it's literally easier to get a liver transplant than it is to meet the Listing for chronic liver disease. I'll speculate that they're going a step further to further obscure just how impossible it is to meet the Listing. They do note in the materials that a MELD or SSA CLD score that meets the Listing means that the patient has a 19.6% chance of dying in the next three months. They think that's a justification for their standard. I was not under the impression that the definition of disability required a person's condition to be quickly fatal.

    I also note that the new Listings make it impossible for claimants to meet the Listings for hidradenitis suppurtiva. Never heard of hidradenitis suppurtiva? Trust me, you don't want it. It's one of the most commonly disabling skin conditions.  For that matter, it appears that it will now be impossible to meet the Listings for psoriasis. For most people with psoriasis, the disease is annoying and unpleasant but manageable but that's not the case for a small percentage of people with psoriasis.

NPRM On FOIA

     The Social Security Administration posted a Notice of Proposed Rule-Making (NPRM) in the Federal Register today to amend its Freedom of Information Act (FOIA) regulations to make them more consistent with 2016 changes in the FOIA and with recent guidance from the Attorney General.

Disability Allowance Rates Plummeted After 2000

    From What Factors Explain the Drop in Disability Insurance Rolls from 2015 to 2019? by Siyan Liu and Laura D. Quinby for the Center for Retirement Research at Boston College:

 

Disability Incidence Rate Goes Up -- Until Age 62

    From What Factors Explain the Drop in Disability Insurance Rolls from 2015 to 2019? by Siyan Liu and Laura D. Quinby for the Center for Retirement Research at Boston College:

 

New Awards And Terminations

    From What Factors Explain the Drop in Disability Insurance Rolls from 2015 to 2019? by Siyan Liu and Laura D. Quinby for the Center for Retirement Research at Boston College:

 

Why Are Fewer People Drawing Disability Benefits Now?

     From What Factors Explain the Drop in Disability Insurance Rolls from 2015 to 2019? by Siyan Liu and Laura D. Quinby for the Center for Retirement Research at Boston College:

In 2015, the number of individuals receiving Social Security Disability Insurance (DI) benefits began to drop for the first time in two decades. This drop was caused by a wave of terminations, as beneficiaries aged into the Old-Age and Survivors Insurance (OASI) program, combined with a steep decline in the incidence rate (the number of new DI awards relative to the insured population). ...

The paper found that:

• A strong economy accounted for about half of the drop in the incidence rate.
• Policy changes – specifically the retraining of Administrative Law Judges – also accounted for about half the drop.
• Population aging put slight upward pressure on the incidence rate.
• In terms of the total number on the disability rolls, the impact of aging on terminations far exceeds its impact on new awards.

The policy implications are:

• The time may have come to somewhat rebalance the goals of DI from encouraging labor force participation to protecting vulnerable people.
• Congress may want to consider merging the DI and OASI trust funds. ...

    I'll pull out some interesting charts from this paper over the next few days.

Debt Limit Bill Passes House Of Representatives

     The bill to increase the debt limit passed the House of Representatives yesterday. It would force a slight decrease in "non-defense discretionary" spending. That's only a relatively small portion of federal spending but it includes Social Security's administrative budget. If you consider inflation, which may be around 5% now, agencies affected can expect a significant decrease in operating funds. Exactly how much each agency in the "non-defense discretionary" category receives will be determined in the appropriations process that lies ahead. While we can hope that the Social Security Administration fares better than other agencies, the reality is that it has been disfavored in recent years, receiving less than most other agencies in the "non-defense discretionary" category.

     The projected cut in operating funds for Social Security probably won't be across the board. I am attaching a page from the debt limit bill. My guess is that the language about continuing disability reviews is intended to make sure that the Social Security Administration has more and more to spend on CDRs even though its appropriation otherwise will go down. Does anyone know whether there's more going on?

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