Satellite Office Closes In Hawaii

     Social Security has announced the closing of its satellite office in Kona, Hawaii. The office had only been open four hours a month. Local residents now face a two hour drive each way to conduct business in person at a Social Security office. The satellite office in Kona had been well used. Locals had complained about long lines and limited places to sit. The local mayor said that closing the satellite office was "obviously a decision made by someone not from Hawaii Island.” The decision to close the satellite office affects not just those who are receiving or want to receive Social Security benefits. It affects those who need a replacement Social Security card so they can get a drivers license.

Dreams Die Hard

     From Paul Krugman writing for the New York Times:

... Since the 1970s, the Republican Party has fallen increasingly under the influence of radical ideologues, whose goal is nothing less than the elimination of the welfare state — that is, the whole legacy of the New Deal and the Great Society. From the beginning, however, these ideologues have had a big problem: The programs they want to kill are very popular. Americans may nod their heads when you attack big government in the abstract, but they strongly support Social Security, Medicare, and even Medicaid. So what’s a radical to do? 

The answer, for a long time, has involved two strategies. One is “starve the beast,” the idea of using tax cuts to reduce government revenue, then using the resulting lack of funds to force cuts in popular social programs. Whenever you see some Republican politician piously denouncing federal red ink, always remember that, for decades, the G.O.P. has seen budget deficits as a feature, not a bug.

Arguably more important in conservative thinking, however, was the notion that the G.O.P. could exploit other sources of strength — white resentment, working-class dislike of social change, tough talk on national security — to build overwhelming political dominance, at which point the dismantling of the welfare state could proceed freely....

O.K., you see the problem: Democrats didn’t go along with the program, and refused to give up. Worse, from the Republican point of view, all of their party’s sources of strength have turned into weaknesses. Democratic dominance among Hispanics has overshadowed Republican dominance among southern whites; women’s rights have trumped the politics of abortion and antigay sentiment; and guess who finally did get Osama bin Laden. 

And look at where we are now in terms of the welfare state: far from killing it, Republicans now have to watch as Mr. Obama implements the biggest expansion of social insurance since the creation of Medicare.

So Republicans have suffered more than an election defeat, they’ve seen the collapse of a decades-long project. And with their grandiose goals now out of reach, they literally have no idea what they want — hence their inability to make specific demands [in the fiscal cliff negotiations].

It’s a dangerous situation. The G.O.P. is lost and rudderless, bitter and angry, but it still controls the House and, therefore, retains the ability to do a lot of harm, as it lashes out in the death throes of the conservative dream. 

AFGE Statement On Arizona Bombing

     From a press release issued by the President of the American Federation of Government Employees (AFGE), the union that represents most Social Security employees:

A recent explosion outside the Social Security Administration office in Casa Grande, Ariz., should be a wakeup call for every agency head that the security and safety of our federal employees should be a top priority.

In this frightening event, a homemade bomb was detonated at the employee entrance to the Social Security office on the morning of Nov. 30. Luckily, no one was injured in the blast, although some employees have developed a cough and one is being examined for possible hearing loss as a result of the explosion.

Employees are understandably shaken and frightened and worried that they are putting their lives in danger simply by showing up for work. This incident is a stark reminder of the difficult and often dangerous environment in which federal employees work.

The office reopened Thursday for the first time following the incident, and employees have been gratified by the outpouring of support and encouragement from visitors.

I want to thank AFGE Local 3694 President Tony Thomas and Council 147 President Katrina Lopez for attending to the needs of the affected employees. I also extend my gratitude to SSA Administrator Michael Astrue and Region 9 Commissioner Bill Zielinski for personally visiting the office and pledging to review security enhancements at all Social Security offices.

We Should Double Social Security Benefits!

     Steven Hill writing in The Atlantic urges that we double Social Security benefits. I know and Hill knows that isn't going to happen but he makes a strong argument that Social Security benefits shouldn't be cut and, if anything, should be increased.
     Only about a third of seniors now have pension income. Defined benefit pensions -- the kind that pay a guaranteed benefit -- have been rapidly disappearing over the last thirty years. Only about 10% of workers are now covered by this type of pension. Sixty-five percent of workers are now covered by defined contribution pensions -- 401(k) type plans --  which have exploded in popularity with employers over the last thirty years. The problem is that:

401(k)s and other defined-contribution plans have turned out to be an unreliable pillar of retirement security, not only because they don't provide as secure a net but because many Americans are pretty lousy at managing their investments. A study by the National Bureau of Economic Research found that more than one-quarter of baby boomer households thought "hardly at all" about retirement and that financial literacy among boomers was "alarmingly low." Half could not do a simple math calculation (divide $2 million by five) and fewer than 20 percent could calculate compound interest.

     Seventy-five percent of Americans nearing retirement have less than $30,000 in their retirement accounts.

     Traditionally, home ownership has provided seniors with a cushion they can rely upon in retirement but during the Great Recession homeowners have lost $8 trillion in home equity. Twenty-eight percent of homeowners are underwater on their mortgages.

     The result is that about half of Americans are at risk of not having sufficient retirement income. 

     Still think the idea of increasing Social Security benefits is no outlandish? Are you really ready for retirement?

Merry Christmas

Merry Christmas?

     Yesterday a legal assistant at my firm made this note in our database "Faxed ______ DO [District Office] re: clt being paid. TC _______ DO. On hold 25 min; they just are not answering their phone." The Legal Assistant was trying to contact that DO regarding a client whose Supplemental Security Income claim was approved by an Administrative Law Judge on October 26. So far the client has received no money. If you're familiar with the way these things are supposed to work, this shouldn't be happening. The benefits should have been paid at least a couple of weeks ago. The client is upset. We're trying to get the District Office moving but we can't get them on the phone and they don't respond to faxes. Why is this happening? It's simple. Lack of an adequate staff at that District Office. People who work at Social Security field offices aren't perfect but they typically like to help people. They get frustrated when the best they can do is to give lousy service.

     If you aren't involved directly with Social Security field offices, the whole subject of Social Security's operating budget must seem so abstract.  A hiring freeze and no overtime at Social Security -- what's the big deal? No one's getting fired. It's a big deal to this lady. She's been approved. She can't get paid. Will her benefits get implemented before Christmas? I wouldn't bet on it. By the way, she's on home oxygen. How many more Christmases will she see?

Alleged Fraud At Social Security Employee Activities Association

     I missed this one earlier. From the Baltimore City Paper:

Sal­va­tore Petti, a 76-year-old Elli­cott City res­i­dent who has been at the cen­ter of a still-simmering dis­pute involv­ing the bocce courts in Baltimore’s Lit­tle Italy neigh­bor­hood (“Bocce Brawl,” Fea­ture, June 22, 2011), has been charged in U.S. Dis­trict Court with fraud for allegedly divert­ing funds from a Social Secu­rity Admin­is­tra­tion employ­ees’ association.

Accord­ing to the charg­ing doc­u­ments, Petti had been trea­surer of the non-profit Employ­ees Activ­i­ties Asso­ci­a­tion (EAA) for more than 40 years until 2010, and for about five years until Dec. 2009, “Petti diverted EAA funds for his own per­sonal use to sup­port his lifestyle, which included spend­ing approx­i­mately $430,000 at the Bor­gata Hotel, Casino, & Spa and $43,000 at the Trop­i­cana Hotel and Casino” in Atlantic City between about March 2005 and August 2010.

Merry Christmas

The Definition Of Disability

     The Social Security disability programs receive much public and press attention but few people who talk about these programs have ever actually read the definition of disability that Congress has passed and that the Social Security Administration must apply. Let's look at the definition of disability that Social Security must apply to adult claims. I'll alternate portions of the definition of disability in bold with my comments. 

 The term “disability” means inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months ... 

     Many things to note here. 

     First, it says "inability to engage in any substantial gainful activity ..." It's not enough to be unable to obtain employment due to illness. You have to be unable to do it whether or not you can get it. 

     It says "any" substantial gainful activity. Generally, it's not enough just to be unable to do what you used to do. 

     That term "substantial gainful activity" is what lawyers call a term of art -- something whose definition takes some spelling out. Social Security has lengthy regulations defining the term.

    What does that term "medically determinable" mean? It's never been clear to Social Security or anyone else but it's always been clear that it takes more than just a claimant saying he or she is disabled. An important example of the problem is pain. How does one determine medically how much pain an individual is in? There is no meter that measures pain. Does that mean that pain cannot be considered because it's not "medically determinable"? It's hard to imagine that Congress intended for Social Security to completely ignore pain. There must be medical proof although exactly how much and of what kind is unclear. You will note as we go along that the subject of pain keeps coming up.

      It says "physical or mental impairment" meaning that psychiatric illness must be considered. If you think that mental illness isn't really real, take it up with Congress but first look around at you own family and friends. Don't you know someone who suffers from serious mental illness. If you don't, count your blessings because you're unusually lucky. Also, be honest with yourself. You don't have any mental problems at all? Seriously? Ever been a bit off your game at work because of an argument with your spouse or because a loved one died or because you were mad about something or nervous about something? Ever had to take a day off work because of something like this? How many more mental problems would it take before you have a persistent problem with working? Are you still completely sure that mental disability could never happen to you? 

     Unless the impairment is expected to result in death, it must be "expected to last for a continuous period of not less than 12 months."  Injuries or illnesses that don't take you out of work for at least a year don't count. Twelve months is a long time to be out of work with no income.

An individual shall be determined to be under a disability only if his physical or mental impairment or impairments are of such severity that he is not only unable to do his previous work but cannot, considering his age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy, regardless of whether such work exists in the immediate area in which he lives, or whether a specific job vacancy exists for him, or whether he would be hired if he applied for work. For purposes of the preceding sentence (with respect to any individual), “work which exists in the national economy” means work which exists in significant numbers either in the region where such individual lives or in several regions of the country. 

      This really nails it down. It specifically says that being unable to do your former work isn't enough. You have to be unable to do just about any other job, even if that job isn't anywhere near you and regardless of whether there is any job vacancy and regardless of whether you would be hired. There's also no point in saying you're disabled because you lack transportation to work. That isn't going to cut it. 

     Social Security must consider your age, education and work experience in determining whether other work exists which you can do. Young people often wonder why age should be considered. The reason is that people become less adaptable as they age. A transition to an entirely different line of work isn't so hard when you're in your 30s but few people in their 60s can manage it. Still don't agree with the consideration of age? Just wait until you're older. You'll understand then. 

     Note one thing the definition of disability doesn't say. It says nothing about the status of the job you used to perform. Let's say you worked in a high status, high wage job in the past but all you can do now is a menial, low-paying job. You're not disabled under the definition of disability in the Social Security Act. Most European countries define disability differently and would say that a person in that situation is disabled. This difference tells you something important about both Europe and the United States.

In determining whether an individual’s physical or mental impairment or impairments are of a sufficient medical severity that such impairment or impairments could be the basis of eligibility under this section, the Commissioner of Social Security shall consider the combined effect of all of the individual’s impairments without regard to whether any such impairment, if considered separately, would be of such severity. If the Commissioner of Social Security does find a medically severe combination of impairments, the combined impact of the impairments shall be considered throughout the disability determination process. 

    This entered the statutes because Social Security was at one time trying to evaluate a claimant's problems one by one without considering how they added up. For instance, if the claimant had a bad right hip and a bad left knee, if neither one was all that severe, then to Social Security they added up to nothing but if you have problems in both legs, you have real problems walking. I know. I'm oversimplifying what Social Security was doing at the time but no one, including Social Security, wanted to defend what the agency was doing at that time. This should tell you that at times Social Security has been extraordinarily callus in applying the definition of disability. 

An individual shall not be considered to be disabled ... if alcoholism or drug addiction would (but for this subparagraph) be a contributing factor material to the Commissioner’s determination that the individual is disabled 

     You still think that Social Security is awarding benefits to people because they are alcoholics or drug addicts? It's very clear in the statute that they aren't supposed to do this and they don't. However, note that this doesn't forbid paying disability benefits to alcoholics or drug addicts as long as their substance abuse isn't "a contributing factor material" to finding the person disabled. Do you want to deny disability benefits to someone who is dying of cancer because they drink too much? Something like 20-25% of the adult population of this country has a substance abuse problem. You can't just deny all their disability claims automatically. Well, I guess you could take a "go die in the gutter" approach to substance abusers. Some people might wish that the statute said that, but it doesn't. If it did, it would be extremely harsh and punitive.

For purposes of this subsection, a “physical or mental impairment” is an impairment that results from anatomical, physiological, or psychological abnormalities which are demonstrable by medically acceptable clinical and laboratory diagnostic techniques. 

     Again, there is the emphasis on medical evidence of disability. The problem is that there are no "medically acceptable clinical and laboratory diagnostic techniques" that measure pain or fatigue much less the severity of symptoms associated with mental illness. Congress thought that physicians could tell how sick a person is apart from anything the patient says. Most of the time, though, it's just not possible. A physician has to ask a patient about their symptoms and make informed judgments. There is a tension in the definition of disability that comes from the inability of Congress to accept the obvious -- physicians have a luxury that veterinarians do not have -- talking with their patients. It's just part of medicine. 

An individual shall not be considered to be under a disability unless he furnishes such medical and other evidence of the existence thereof as the Commissioner of Social Security may require. An individual’s statement as to pain or other symptoms shall not alone be conclusive evidence of disability as defined in this section; there must be medical signs and findings, established by medically acceptable clinical or laboratory diagnostic techniques, which show the existence of a medical impairment that results from anatomical, physiological, or psychological abnormalities which could reasonably be expected to produce the pain or other symptoms alleged and which, when considered with all evidence required to be furnished under this paragraph (including statements of the individual or his physician as to the intensity and persistence of such pain or other symptoms which may reasonably be accepted as consistent with the medical signs and findings), would lead to a conclusion that the individual is under a disability. Objective medical evidence of pain or other symptoms established by medically acceptable clinical or laboratory techniques (for example, deteriorating nerve or muscle tissue) must be considered in reaching a conclusion as to whether the individual is under a disability. 

      This is the same thing as above at greater length. Congress wants Social Security to consider pain but Congress wants Social Security to do the impossible -- use an objective medical test to measure pain. Saying the same thing at greater length doesn't resolve the tension in the definition of disability.

Fee Payment Numbers

     Social Security has released updated numbers on payments of fees to attorneys and others for representing Social Security claimants. These payments come out of the past due benefits of the claimants involved. A portion of the fees is withheld as a user fee to reimburse Social Security for the paperwork involved. Generally, the attorney is paid at the same time as the claimant involved. These numbers give some idea of how quickly or slowly that Social Security is able to pay claimants after a favorable decision.

Month/Year	Volume	Amount
Jan-12	29,926	89,749,312.99
Feb-12	43,946	134,207,416.10
Mar-12	47,376	139,571,577.57
Apr-12	38,239	113,225,483.07
May-12	37,648	112,446,283.39
June-12	43,816	128,559,225.66
July-12	33,342	97,458,955.82
Aug-12	41,441	119,484,061.59
Sept-12	38,393	115,676,630.23
Oct-12	29,646	84,612,068.75
Nov-12	37,384	110,226,459.65