Disability Backlogs Are Cruel

     From the Milwaukee Journal Sentinel (paywall):

A hospital social worker helped Nicholas Johnson fill out dozens of pages of paperwork for Social Security Disability Insurance in September after he woke up from a coma and realized he was paralyzed. ...

Johnson missed two phone calls from the Social Security office while he was in physical therapy. He started the application process over, for a third time, in early January. 

With no income, Johnson can’t pay rent, so he moved in with his grandmother. But her home is too small to accommodate his wheelchair, so family members come over daily to carry him from room to room. ...

Johnson is one of more than 2,000 people in Milwaukee waiting for the Social Security Administration's approval to receive disability benefits, according to the latest data available from the agency. The average wait time is 368 days, leaving many people struggling without adequate housing or money to pay for their basic needs for more than a year. ...

Hope Lloyd is a community living and home supervisor with Independence First who is working with about a dozen people in Milwaukee with spinal cord injuries who haven't been able to get their first disability checks, so they are living in nursing homes or with family. 

"It's not where they belong, but without those expedited payments, they can’t  apply for an apartment because they don't have any income," Lloyd said. "A lot of times, they're the primary breadwinner, so it's just really, really bad." ...

At the state level, the Wisconsin Department of Health Services said a mandated federal update to its computer system in late 2019 further pushed wait times. 

"Wisconsin’s legacy system was superior to the current (federal) system because it included more automatic prompts for examiners that made it easier for them to manage their very high caseloads," said Jennifer Miller, a spokeswoman with DHS. 

Miller said examiners receive specialized training that takes more than two years to become fully proficient.  

"As a result of increased evidence, increased scrutiny, continuously growing case complexity, and a new nationwide case processing system rollout, case production has become more labor-intensive and slower," Miller said. "Adjudicators’ case counts have increased significantly, and the job has become untenable in many states. ...

How Can You Go Wrong With More Agile Scrum Masters?

      From Federal News Network:

The Social Security Administration used the project to modernize its Disability Case Processing System as a proof of concept.

The question then became could SSA replicate the success of DCPS with other legacy, traditional waterfall programs.

Sean Brune, the CIO of SSA, said the answer is a resounding “yes.” The agency is taking the success of the DCPS2 and expanding it through its new IT modernization strategy as a way to guide SSA’s transformation. ...

SSA revamped DCPS2 starting in 2015, and over a 14-month period using DevSecOps to move from a COBOL based, green-screen system that had been in use for more than 25 years. SSA and states use DCPS to determine if claimants are qualified from a medical perspective for a benefit. State and territories process the claims on behalf of SSA using DCPS as a case management and disability determination system.

Brune said the DCPS2 success helped SSA expand their focus on overall IT modernization by further identifying core mission functions, building expertise in modern application development around those core mission functions. ...

“We trained more agile Scrum Masters. ...

     Is DCPS such a big success that it's time to take a victory lap? I don't know because I don't use it. I know that DCPS has been controversial, at least in the past.

NADE Newsletter

     The National Association of Disability Examiners (NADE), a voluntary organization of personnel involved in making initial and reconsideration determinations on Social Security disability claims, has released its most recent newsletter. One thing I noticed is that it says that the Disability Case Processing System (DCPS), a set of software programs, is now "official" even though it has not yet been rolled out at every Disability Determination Service. DCPS has been controversial. I hope   they've got the bugs out of the system.

My Top Eight List

     I've finally gotten around to the sort of list you've seen a lot of in the last couple of weeks -- the most important things that have happened in the Social Security world in the last decade. Below is my list but feel free to post your own list. I came up with eight and didn't want to pad it to make it ten.

1. Constant administrative under-funding of the Social Security Administration accompanied by frequent shutdown threats and occasional actual shutdowns. Agency performance suffered as a result. Service has deteriorated to levels that would have once been thought unimaginable;
2. After the number of Social Security disability claims soared in the 2000-2009 decade, the number of claims started declining in 2010. That decline is continuing. We think we know why claims soared from 2000-2009 -- primarily the aging of the baby boomer population -- but no one has a good handle on why the number of disability claims filed has gone down so much since then or why the decline continues;
3. The Eric Conn debacle which led to a general climate of hostility towards Social Security disability claimants;
4. Social Security went more than six years without a confirmed Social Security Commissioner because Republican Senators wouldn't confirm an Obama nominee and Trump was so slow in nominating anyone;
5. The ongoing story of Social Security's Disability Case Processing System (DCPS) which may or may not ever work;
6. The deal to extend the life of the Social Security Disability Insurance Trust Fund;
7. Social Security's ongoing refusal to deal with the obsolescence of the Dictionary of Occupational Titles;
8. The collapse of Binder and Binder. Yes, I know there's a stub of Binder and Binder left but it's nothing like what it was. A 60 Minutes hit piece hurt Binder and Binder but the bigger problem was that it was based upon a business model that could not succeed at a time when the number of disability claims was going down and it was becoming progressively more difficult to get a claim approved. The ironic thing was that the 60 Minutes hit piece damaged Social Security attorneys generally even though we were appalled by Binder and Binder long before the rest of the world was. At least the original owners sold out to a private equity company -- which I still find astounding -- before the bottom dropped out and have now bought back the stub.

Appropriations Bill Report

     The Social Security portions of the Committee report (Social Security part begins at page 157) on the Fiscal Year 2020 appropriations bill covering the Social Security Administration that has been passed by Congress:

The agreement includes an increase of $100,000,000 for SSA's base administrative expenses for additional hires and resources to improve public service at SSA field offices and direct service operations. 

Continuing Disability Reviews.-The agreement directs SSA to include in its next continuing disability review (CDR) report to Congress an evaluation of its CDR prioritization models and a cost-benefit analysis of how it uses estimated savings in determining which beneficiaries receive a full-medical CDR. Additionally, the agreement requests in the fiscal year 2021 Congressional Justification, the process by which SSA intends to pace its CDR workload to properly manage Limitation on Administrative Expenses funding.  

Disability Case Processing System (DCPS).-SSA is encouraged to engage with States to explore all possible options for modernization of the case processing system, to align with the needs of each State, so long as such options have similar or better functionality as DCPS, similar or lower costs to DCPS, and are consistent with Federal procurement and security standards. SSA should continue to provide regular updates on the effort to upgrade DCPS, including the cost and anticipated timeline of the project, and efforts by SSA to engage stakeholders, including any barriers to implementation.  

Disability Hearings Backlog-The agreement encourages SSA to include comprehensive information in its existing reports to Congress on the specific policies SSA has implemented, or has considered, to streamline the disability determination and adjudication process. When considering or implementing changes, SSA should ensure due process, and that applicants have a full and adequate opportunity to present their claims.  

Field Office Closures.-While SSA's Inspector General reviews decisions to close field offices, the Commissioner is strongly encouraged to take every action possible to maintain operations at the offices under review. SSA is expected to support front line operations. As part of the fiscal year 2021 Congressional Justification, SSA should include a plan to identify opportunities for improved field office operations. Finally, SSA is strongly encouraged to ensure its policies and procedures for closing field offices include at least 120 days advance notice to the public, SSA employees, Congress, and other stakeholders. Such notice should include a rationale for the proposed closure and an evaluation of the effects on the public and SSA operations.  

Mail and Printing Systems.-SSA is encouraged to consider and evaluate modernization of its mail and printing systems and contracts that could result in budgetary savings while improving fraud prevention. The agreement requests a briefing for the Committees within 180 days of enactment of this Act on current mailing and printing systems and contracts, including systems or contracts relating to Social Security Cards, and any ongoing efforts to modernize or otherwise improve such systems.

Medical Vocational Guidelines.-The agreement directs SSA to provide a report to the Committees within 90 days of enactment of this Act on its plan and timetable for updating and modernizing medical vocational guidelines and to engage appropriate Committees of jurisdiction prior to making any changes to such guidelines.  

Telework.-SSA is urged to develop a telework plan for Operations employees as quickly as practicable and to brief the Committees on the status of efforts to reinstate telework within 60 days of enactment of this Act.  

Video Hearings.-The agreement reiterates the language included under this heading in House Report 116-62, and directs SSA to provide an update in the fiscal year 2021 Congressional Justification detailing the extent to which SSA meets best practices outlined by the Administrative Conference of the U.S., and the extent to which SSA video hearings, policies, and practices are accessible to individuals with disabilities.  

Work Incentives Planning and Assistance (WIPA) and Protection and Advocacy for Beneficiaries of Social Security (PABSS).-The agreement includes $23,000,000 for WIPA and $7,000,000 for PABSS. 

     A few comments:

• This is mostly precatory language included in the report rather than language actually included in the bill itself. Nevertheless, it's unwise for any agency to ignore it.
• $100 million is a lot of money but it's nowhere near enough to cover increases in the cost of living. In real dollar terms this is a funding cut.
• Congress can order all the studies it wants but you're never going to be able to cut many people off disability benefits under a medical improvement standard. That's because few of them get better, a fact that many in Congress have trouble understanding but, then, there's a lot they don't understand about Social Security disability benefits.
• If Congress doesn't want field office closures, it ought to appropriate more money to the agency.
• I'm going to guess that some company wants a big printing and mailing contract with Social Security and got language into this report supporting them. That seems inappropriate to me.
• This demonstrates what a foolish decision it was to stop telework. How does it feel to get your hand slapped, Andrew Saul?