A Good Comment

Below is a comment made about the allegation that disability claims dismissed for failure to cooperate had gone up to 30% at one California Disability Determination Service (DDS) office. In one sense, the writer is a little confused. No one is alleging that the number of dismissals went up because of any change at Social Security field offices. The allegation is that changes were made at a DDS office, but that is a quibble. In a larger sense this comment helps explain how what is alleged could happen. Many Social Security claimants need a lot of help. Many of them are frustrating to deal with. It is not easy to say where one should draw the line and say "I've done as much as I should reasonably be expected to do. Either start cooperating or your case is going to get dismissed." When employees are overworked, whether at DDS or a Social Security field office, the line is likely to be drawn at a different place than would be the case if the workloads were more reasonable. As a nation, I think we ought to be encouraging Social Security and DDS employees to go the extra mile and give a lot of help to claimants with cognitive or psychiatric difficulties, but we cannot expect them to do so if they are badly overworked.

Social Security claims reps and service reps are not social workers. Not trained as social workers, not in their job description. And many of the SSI clientele need someone to hold their hands and help them through the process, but some people are just not willing to help themselves. Just this week, I had two cases where the parent had made two appointments to file claims for either two children or themselves and a child. Our appointment calendar is so solidly booked that these appointments were pushed about a month after request. So, our office set aside 3 hours to do what was necessary to file two claims. Both parents cancelled the appointments the same day because they weren't ready after about a month lead time. How much hand holding is SSA supposed to do? The parent is the best source of knowledge, but was unwilling to put forth any effort to file the claim. The parent did not make it a priority and that is just not the fault of SSA. It is very difficult to help people who don't want to do anything to help themselves. I shouldn't care more about the outcome of a claim more than the claimant does. I would really prefer to spend my limited work hours processing claims for people who do manage to complete forms in a reasonable amount of time and who do make a reasonable effort to provide answers to the questions asked.

However, I do believe strongly in due process and applying the regulations without shortcuts and providing assistance as it is needed. To hell with processing time in some claims. But I cannot complete the ADL's on anyone without their assistance. I don't know their lives. They do.

If Astrue truly cared about correcting bad "failure to cooperate" denials, he needs to implement more accountability across the board for technical errors and provide more staff to do the work. Without staff, the backlog will grow. I still think he is using this issue as a bully pulpit to get Schwarzeneggar to back down on his ridiculous furlough of DDS employees. So, I hope he takes a close look at all shortcuts taken by SSA employees. And find a way to properly staff the agency. Automation is not the only answer.

Mental Health Professionals And SSI Benefits For Kids

From a press release:

HealthForumOnline (HFO) announces a new online continuing education (CE/CEU) course, Children's Mental Health Social Security Disability (SSD) Report Writing: A Guide to Enhanced Effectiveness ... This online CE course presents relevant components of commonly alleged Disability impairments for children (Organic Disorders, Mood Disorders, Mental Retardation, Anxiety Disorders, Autistic/PDD, and ADHD) and provides an understanding of how child mental health SSD determinations are made, the instrumental legal decision which established children's right to SSD payments, the associated language and acronyms, the regulations governing mental health disability and how to write effective reports that meet these regulatory standards. ...

HealthForumOnline (HFO), a nationally-approved (APA, ASWB, NBCC, PSNA, CA-BBS) provider of online continuing education (CE) for psychologists, social workers, counselors, nurses and other allied healthcare professionals ...

The online course is the product of Patricia Farrell, Ph.D.

The Human Cost Of Backlogs

The News Journal of Delaware is continuing its series of articles on the hearing backlogs at Social Security. Today's articles are:

• Social Security disability claim denials haunt some Delaware residents to death's door
• Delaware woman fears Social Security disability judge is 'just waiting for me to die'

I wish I could say I was shocked by what I read in this newspaper, but I have many, many clients of my own whose stories are at least as bad as those presented in these articles.

Here is my post on the earlier articles.

Addendum: There is also an editorial.

Something's Missing

Social Security has sent over to the Office of Federal Register a list of new regulations that it has proposed in the past which it is now officially abandoning. This list will appear in the Federal Register tomorrow:

• Supplemental Security Income for the Aged, Blind, and Disabled; Suspensions, Terminations, and Advance Notice of Unfavorable Determination (51 FR 17057, May 8, 1986) (SSA-31P).
• Disability Insurance and Supplemental Security Income; Nonpayment Policy for Consultative Examination Appointments That Are Not Kept (53 FR 39487, October 7, 1988) (SSA-181P).
• Reduction for Receipt of Government Pension (54 FR 51036, December 12, 1989) (SSA-188P).
• Supplemental Security Income for the Aged, Blind, and Disabled (55 FR 33922, August 20, 1990) (SSA-180P).
• Disability Insurance and Supplemental Security Income for the Aged, Blind, and Disabled; Determinations of Disability--Determining State Agency Substantial Failure to Comply with Federal Rules (56 FR 11025, March 14, 1991) (SSA-206P).
• Administrative Review Process; Prehearing and Posthearing Conferences (65 FR 38796, June 22, 2000) (SSA-778P).
• New Disability Claims Process (66 FR 5494, January 19, 2001) (SSA-816P).

I do not see on here the proposal to increase the age categories in the grid regulations by two years. Why is that proposal not listed? In theory that regulations could be adopted without any additional public input and with only 30 days notice. It would require approval of the Office of Management and Budget (OMB), which is part of the White House, which means it is not likely to happen while Barack Obama is President. Does the Commissioner actually think there is some possibility of going ahead with that at some later time?

Update: What would I do without readers to help me? The proposed age regulations were withdrawn earlier.

Dismissing Up To 30% Of Claims On Failure To Cooperate

From reading some of the comments I have received about the allegations that the California and Hawaii Disability Determination Services (DDS) have been looking for ways to get rid of disability claims they are supposed to review, I wonder if some of my readers understand the gravity of what is alleged. The allegation is that up to 30% of disability claims have been dismissed because of the claimants' alleged failure to cooperate.

This is only an allegation. The allegation is only that "one office" in California had the 30% dismissal figure. Still, in my mind, this is a very serious allegation.

Disparities Among ALJs

The full story from The News Journal of Delaware has been posted. Much of it concerns the Hearing Office Chief Administrative Law Judge (HOCALJ) in the Dover hearing office, Judith Showalter, who denies 56% of the cases she hears. The newspaper also looked at the numbers for other Administrative Law Judges (ALJs), noting that "Baltimore judge Louis J. Pucci denied fewer than 1 percent of his cases during those four years [the newspaper examined], while Houston judge Richard J. Abrams denied 93 percent of his cases."

Addendum: The News Journal published nine separate stories. In addition to the one linked above these were:

• A lifetime of hard labor leaves Delaware man's body and mind beaten up
• Delaware woman felt like a 'beggar trying to get something'
• With a family full of suffering, Delaware woman's benefits don't go a long way
• Hopeless situation sends Delaware mom to depths of despair
• Social Security Administration refuses to release information about complaints
• Dual roles of judges a source of tension for Social Security disability benefits
• Who's eligible for Social Security Disability Insurance
• An audio slidshow of five claimants

A Delaware Teaser

From The News Journal of Delaware:

If a serious ailment keeps you from working, your claim for Social Security disability benefits should be handled the same way everywhere, whether it’s decided by an administrative law judge in Dover, Denver or Des Moines. But those who live in Delaware will face tougher judges.

Through a Freedom of Information request, The News Journal examined four years of Social Security disability claim data and found some startling inequities.Read the full story in the Sunday News Journal and at delawareonline.com. You can browse our database of denial rates now.

The database compares hearing offices, not individual Administrative Law Judges. The Dover, Delaware hearing office has one of the lowest allowance rates in the country.

Update: A reader correctly points out that if one clicks on the location of a hearing office in the database, a list of ALJs assigned to that office comes up, showing the rate at which each denies claims.

Some Thoughts On That Press Release

Some thoughts on Social Security Commissioner Michael Astrue's press release about the allegations that state Disability Determination Service (DDS) agencies in California and Hawaii were sending Social Security disability claimants a long tedious form to complete and then denying them if they did not return the form promptly, leading to many illiterate, mentally ill claimants being denied on technical grounds:

• For those reading this blog who may not have dealt directly with Social Security disability claimants, let me make it clear that I think that everyone who has dealt directly with this population would agree that what is alleged is wrong, wrong, wrong. Social Security disability claimants are terribly vulnerable, especially when they are unrepresented, which would be the case here. Deliberately setting traps for confused, poorly educated, mentally ill people would be despicable.
• I have trouble believing that one state DDS would do this without notifying Social Security's regional office in advance. Social Security cannot control personnel matters at a DDS, which means that Social Security cannot prevent a hiring freeze or furlough at a DDS, but Social Security controls just about everything else at a DDS. Just as an example, j.doe@ssa.gov could be the e-mail address of a DDS employee. I would be astonished if two DDS's in one region did this without the advance approval of the regional office. The heads of these state DDS's may be quickly pointing the finger of blame back at Social Security.
  
• Astrue's press release came out just after 5:00 Eastern time on a Friday afternoon. Social Security does not operate on a 24 hour news cycle like the White House. I think that someone really wanted to get this out before the weekend. My guess is that the reason is that Social Security is getting questions about this from the news media. There may be major news stories on this subject about this coming out this weekend.
• Everyone at Social Security has been under enormous pressure to do something about the backlogs. I have seen many signs that the pressure is out of hand. If what is alleged here happened, in my mind it is a sign that the pressure on Social Security and DDS employees is too much. It is time for Social Security to dial this pressure back before there are multiple scandals.
  

The Commissioner Wants An Investigation

A press release from Social Security:

Michael J. Astrue, Commissioner of Social Security, today asked the agency’s Inspector General to investigate allegations that the states of California and Hawaii have recently implemented practices that deny applicants the right to receive full consideration of their Social Security disability claims.

In a memo to Patrick P. O’Carroll, Inspector General, Social Security Administration, Commissioner Astrue writes, “As you know, Gov. Schwarzenegger has insisted on furloughing California Disability Determination Service (DDS) employees, despite the fact that we fully fund both their salaries and overhead. According to Congressman Robert Filner, the State is attempting to find ways to improperly circumvent the effects of the furlough at the expense of some of the State residents who are in the greatest need.”

At a hearing before the House Ways and Means Subcommittee on Social Security yesterday, Congressman Filner (D-CA) testified that the California DDS is denying the claims of disability applicants who fail to return a 25-page report within 20 days – a practice which has been adopted since the institution of furloughs. He reported that one office had closed 30 percent of its cases due to the applicants’ failure to return the completed form within 20 days. In addition, he testified the California DDS may be manipulating its service numbers by assigning claims to fictional examiners or supervisors. According to the Congressman, this scheme would allow the DDS to hide the fact these cases are not actually being reviewed.

“I am concerned about the State of Hawaii DDS, which is furloughing its DDS employees for as many days as California, and which has made statements about new business efficiencies that closely track statements made by California officials,” Commissioner Astrue writes to the Inspector General. “Accordingly, I ask that you also review that agency to ensure they are also fully adhering to all SSA rules and policies.”

The text of Commissioner’s Astrue’s memo is below:

At yesterday’s hearing before the House Ways and Means Subcommittee on Social Security, I testified about some disturbing practices the State of California has instituted that aggravate, rather than help, in response to its budgetary situation. As you know, Gov. Schwarzenegger has insisted on furloughing California Disability Determination Service (DDS) employees, despite the fact that we fully fund both their salaries and overhead. According to Congressman Robert Filner, the State is attempting to find ways to improperly circumvent the effects of the furlough at the expense of some of the State residents who are in the greatest need.

Congressman Filner indicated that since the furloughs began, the California DDS has begun denying the claims of those disability applicants who fail to return a 25-page report within 20 days. This practice, if true, places applicants in an untenable position because the substantial amount of information required must often be gathered from third parties. If an applicant fails to return complete information within the time set by the State, the DDS deems the applicant to have failed to cooperate and closes the file, thereby depriving that applicant of fair and full consideration.

I am also greatly concerned by Congressman Filner’s report that the California DDS may be manipulating its service numbers by “staging” claims, assigning them to fictional examiners or supervisors, rather than to actual examiners. According to Congressman Filner, this practice would allow the DDS to claim that the cases have been assigned, rather than indicate that they are still in queue, thus minimizing the effects of the furlough.

If true, these practices are, of course, very disturbing. Therefore, I am asking you to undertake a full review of the practices of the California DDS to determine the scope and breadth of any inappropriate practices.

I am also concerned about the State of Hawaii, which is furloughing its DDS employees for as many days as California, and which has made statements about new business efficiencies that closely track statements made by California officials. Accordingly, I ask that you also review that agency to ensure they are fully adhering to all SSA rules and policies.

Thank you for your assistance.

Not So Many Vets At Social Security

The Office of Personnel Management (OPM) has issued a report on the employment of veterans by the U.S. government. Vets comprise 25.5% of the federal civilian workforce but only 9.6% of Social Security's workforce.