UNUM Forced To Approve 42% Of Reviewed Claims

Social Security employees may wonder why I post from time to time about goings-on in the world of Long Term Disability (LTD) insurance, provided under employer pension plans. Trust me, there is a big interplay between LTD and Social Security. Many people concerned with Social Security matters, such as attorneys who represent Social Security claimants and interest groups that lobby on Social Security matters, pay a lot of attention to what is going on in the LTD world.

This is from the Insurance Journal:

In a forced self-review, the Chattanooga, Tenn.-based Unum Group agreed to fully or partly reverse 42 percent of previously denied disability claims and paid out $676 million in additional benefits.

The Tennessee Department of Commerce and Insurance said the agreement with the Chattanooga-based insurer involved a review of claims from January 1997 through 2004.

An investigation of complaints about Unum's claims handling led to a $1 million fine in March 2003 after Georgia's insurance commissioner said regulators found a mindset of looking "for every technical legal way to avoid paying a claim.'' ...

Company spokesman Jim Sabourin said the reviews have been based on new standards and do not necessarily mean mistakes were made the first time.

"Essentially we are pleased that the exam process has been concluded and particularly pleased with the results,'' he said. "We have taken a lot of steps over the last couple of years to improve our claims practices and processes.''

Sabourin said the company handles about 400,000 claims a year and pays out about $6 billion in benefits, including $4.3 billion for disability.

He said the review started with the company sending about 300,000 letters to customers. About 70,000 of those "opted in,'' and about 20,000 of those responded and had their claims reviewed.

Sabourin said 41.7 percent of those 20,000 were reversed.

Waiting In Oregon

The Bend, Oregon Bulletin is running a lengthy story about the problems that Social Security disability claimants face. A tiny excerpt:

Massive backlogs have stretched application processing times to years, and even the agency itself has acknowledged that the situation is unacceptable. People who pay into the system through taxes and expect to be able to get benefits if needed are finding that the hurdles to getting those benefits are nearly insurmountable. Many are too sick or too hurt to work, which often leaves them with few resources and little to do but wait.

Iowa Field Office To Remain Open -- Office Closure Plans Not Looking Realistic

A press release:

U.S. Senator Tom Harkin (D-IA) and Representative Bruce Braley (IA-1), announced today that after months of pushing for answers, federal officials finally agreed to keep Clinton’s Social Security Administration (SSA) office open. Harkin and Braley thanked the Social Security Commissioner for responding favorably to the concerns raised by the community and praised Clinton’s City Council for their tireless work that resulted in this big win.

“I am proud to be able to deliver this great news to the people of Clinton. We have fought tooth and nail to ensure that these residents had proper access to their Social Security office,” said Harkin. “The Clinton people’s determination to maintain their community has truly paid off and I look forward to continue working with them as they develop a long term economic redevelopment strategy that will revitalize their area.”

“I’m thrilled the Social Security Administration reversed their decision to close the Clinton office,” Braley said. “The people of Clinton fought hard to keep this office open. After a lot of hard work, our persistence has paid off and we’ve reached a positive end. With baby boomers on the edge of retirement, the demand for Social Security services in Clinton is only going to grow. Keeping the office open will provide Clinton seniors full access to services they need.”

The Clinton SSA Social Security office was set to close by June 1; residents would then have to drive over 40 miles to the Davenport office to address their needs.

The local paper contains this:

In a letter to Harkin and Braley, Linda McMahon, deputy commissioner for Operations at the SSA, said the original decision to close the office came after an assessment of field facilities. After the assessment, the SSA concluded that overall service could be improved by closing the Clinton office and relocating staff to the Davenport SSA office.

“While we believe we have valid reasons for our original decision, which is part of a larger plan to provide the most efficient service we can in the state of Iowa, we understand the concerns that you raised on behalf of your constituents. Consequently, we have determined it is best to maintain the status quo at this time,” McMahon wrote.

Earlier, office closures were averted due to political pressure in Connecticut and North Dakota and now political pressure causes Social Security to back off closing an office in Iowa. It is obvious now that if politicians with enough clout raise enough ruckus that Social Security will back off a field office closure.

I do not see closing a lot of Social Security field offices as politically realistic.

Democrats And Social Security As A Campaign Issue

Josh Marshall writing for The Hill:

Even if President Bush and his Republican allies wanted to forget about Social Security privatization and pretend everything from last year never happened, it still tells you something about the Democrats’ political acumen and general unseriousness that so many of them are seemingly happy to let them send the whole topic right down the memory hole. ...

[Social Security] is, to put it mildly, a perfect wedge issue — a resonant political issue that Democratic candidates can hit on and hit on and that Republicans are afraid to touch. And of course there’s the extra benefit in that it’s actually an issue of great substance and importance to millions of people in their daily lives, unlike the flag-burning amendment, gay marriage, the campaign to shut down The New York Times and whatever other bogus election-season issues Hill Republicans plan to gin up over the next three months.

For too many Democrats, though, it’s just out of sight out, out of mind. If Republicans are done talking about it, that’s good enough for them.

Social Security And Ancient Sumerian

From Conde Nast Portfolio:

The Defense Department has spent billions to fix its antiquated financial systems. So why does the Pentagon still have no idea where its money goes? ...

To enter the Indianapolis center [where the Department of Defense does much of its financial management] is to pass through a time warp, to a place where the most critical software programs date from the dawn of the computer age. They run on old-style I.B.M. mainframes and rely on Cobol, the ancient Sumerian of computer languages. "This was a bunch of systems patched together," says Greg Bitz, a former director of the center. "I never went home at night without worrying about one of them crashing." Bitz predicts a crisis as older programmers retire. "Try to find somebody today who knows Cobol," he says. ...

Guess what other federal agency is in the same time warp, heavily dependent upon mainframes running COBOL? Social Security.

Senate Finance Committee Schedules Hearing

From the Senate Finance Committee:

More Work, Less Resources: Social Security Field Offices Struggle to Deliver Service to the Public

May 8, 2008, at 10:00 a.m., in 215 Dirksen Senate Office Building

Member Statements:
Max Baucus, MT
Charles Grassley, IA

Witness Statements:

Barbara D. Bovbjerg, Director, Education, Workforce, and Income Security, Government Accountability Office, Washington, D.C.

Linda S. McMahon, Deputy Commissioner for Operations, Social Security Administration, Baltimore, MD

Richard E. Warsinskey, Immediate Past President, National Council of Social Security Management Associations, Washington, D.C.

Witold Skwierczynski, President, National Council of Social Security Administration Field Operations Locals, AFL-CIO, Baltimore, MD

Settlement In Class Action

The Social Security Administration has sent out a notice of settlement in the Kaplan v. Chertoff class action lawsuit. The lawsuit has to do with the seven year limit on receiving Supplemental Security Income (SSI) for non-citizens. The problem has been with non-citizens losing SSI benefits because of long delays in processing applications for naturalization.

Here is part of Social Security's description of the settlement:

The key terms of the settlement agreement provide that any class member may request Expedited Processing from the United States Citizenship and Immigration Service (“USCIS”) for pending applications for naturalization or adjustment of status, or for future applications for naturalization or adjustment of status filed during the pendency of the Settlement Agreement, if six months have elapsed since the filing of the pertinent application without a decision. USCIS will request priority processing of any pending or future security checks and provide the earliest available appointment for applications requiring an appointment. If an Oath of Allegiance is required, USCIS will administer or schedule the Oath at the next available opportunity.

USCIS will also, through identifying information provided by SSA, attempt to identify individuals whose SSI benefits have been terminated or will be terminated in the near future and have pending applications for naturalization or adjustment of status. Where those individuals are positively identified, USCIS will automatically expedite their pending application. The automatic expedites will take place close to the end of the first year of the Settlement Agreement.

Future Systems Technology Advisory Panel

Social Security Commissioner Michael Astrue is forming a "Future Systems Technology Advisory Panel." Here is the description of the body:

Panel members will analyze SSA's current technology status and provide independent advice and recommendations for future systems enhancements based on their knowledge of the needs of the Agency and technological advancements. This will serve as a road map for the Agency in determining what future systems technologies may be developed. It will help SSA carry out its statutory mission. Advice and recommendations can relate to SSA's systems in the area of internet applications, customer service, or any other arena that would improve the Agency's ability to serve the American people.

The Panel shall be composed of not more than 12 members, including:

(1) Members of academia and private industry recognized as experts in the area of future computer systems technology;

(2) Members of private industry familiar with the use of computer technology in the fields of customer service, health care, privacy, financial, and document management;

(3) Experts that can speak to the needs of SSA's clientele; and

(4) SSA experts familiar with the Agency's policies, systems, and practices with regard to its mission.

It's Hard To Get On And It Doesn't Pay Much

KIMT in Mason City, Iowa is running a piece about the difficulty of living on Social Security disability benefits -- after a disabled person waits and waits to get approved.

Message From Commissioner

A broadcast e-mail from Commissioner Astrue (emphasis added):

Message To All SSA And DDS Employees

Subject: Ways and Means Hearing

Last week, I testified before the Ways and Means Committee of the U.S House of Representatives, one of our two authorizing committees in the Congress. I want to share with you some highlights of what I shared with lawmakers. You also can see the full testimony at http://www.socialsecurity.gov/legislation/testimony_042308.htm.

We are using the additional $148 million allotted to us this fiscal year to not only replace losses, but to hire additional front-line service personnel, Administrative Law Judges and support staff.

More money alone will not solve all of the service challenges we face. We also must innovate, and we are making great strides on that front as well.

Using alternative forms of authentication, retirees born in this country no longer need to present their birth certificate as proof of age. Eliminating this requirement is already easing the burden for both the claimant and our employees.

Soon we will unveil a new look to our website. In addition, in a few months, we plan on launching an easy-to-use and highly accurate online benefit estimator. In September, we will turn on a simplified retirement application that will make filing over the Internet much easier.

We are testing other concepts that can help our busiest field offices, including kiosk computers in waiting areas and office television monitors that silently inform visitors of the documents they need for each service, as well as a menu of services they can use by phone or computer from their home or office. Our notices also need updating so that we tell people more completely and clearly what they need to provide to us in order to receive the quickest response.

On the disability front, the national rollout of Quick Disability Determinations is allowing thousands of truly disabled applicants to receive both a decision and a benefit check within weeks. A pilot later this year with compassionate allowances should further reduce the number of cases requiring an appeal.

We are embracing technologies like the electronic file, video hearings and the new National Hearing Center, which enables us to shift work away from the busiest hearing offices. I am very excited about an upcoming pilot allowing claimants to attend video hearings at their attorney's office. This could be another win for both the agency and the people we serve.

We continue to make updates to the Listing of Impairments that determine whether someone meets the definition of disability. Some important listings have not been updated in decades. I'm pleased to report that we now have a schedule in place to update all medical listings every five years, and we’re going to try to do even better than that.

A proposal requiring claimant representatives to use iAppeals will eliminate an enormous amount of unnecessary repetitive work in our hearing offices.

Important discussions are under way with the states in New Orleans today over a unified IT system to replace the 54 separate COBOL-based systems currently employed by the various Disability Determination Services. If we can obtain a sufficient degree of consensus, I will ask Congress to fund this critical project in FY 2010.

On October 1, we will be forced to absorb more than $400 million in automatic inflationary increases. These costs, combined with an extended Continuing Resolution, would have devastating consequences for our forward momentum. Timely support of the President's budget is critical to maintaining our progress, and you can be sure that I am personally making our case to as many Members of Congress as possible. Today I have two meetings with Members of the House Appropriations Committee.

Aside from the hearing, I also want to let you know that we are working hard on drafting a new Agency Strategic Plan, which we hope to complete this summer. It should give you a better sense of how we will move forward in a time of rising workloads.

Finally, thanks again to all of you for all you do for the American public. With all the talk of data and technology, I never forget that our foundation is the care and hard work of our employees.

Michael J. Astrue

Commissioner