Validity Testing Recommended

     From Science Daily:

Broader use of standardized psychological testing for applicants submitting disability claims to the U.S. Social Security Administration (SSA) should improve the accuracy and consistency of disability determinations, says a new report from the Institute of Medicine. Some proponents of mandatory psychological testing, in particular validity testing, for SSA disability applicants argue that it would result in a significant reduction of individuals allowed onto the benefits rolls and a substantial cost savings. The committee that conducted the study and wrote the report said the data necessary to accurately assess the effects on the rolls or calculate financial costs and benefits are limited, and estimates based on available data are subject to considerable error.  ...

Cognitive psychological tests are performance-based and have people answer questions and solve problems as well as they possibly can. Non-cognitive psychological tests are measures of typical behavior -- such as personality, interests, values, and attitudes. Validity tests can be used in conjunction with these standardized psychological tests to assess whether a test-taker is exerting sufficient effort to perform well, responding to the best of his or her capability, or providing an accurate report of his or her symptoms. ...

The committee recommended that under specified conditions, SSA should require standardized, non-cognitive psychological testing for all applicants whose allegation of non-cognitive functional impairment relates to a mental disorder unaccompanied by cognitive complaints or to a disorder with physical symptoms that are disproportionate to the medical findings. Testing should be required when the allegation is based primarily on the applicant's self-reporting of symptoms and is not accompanied by objective medical evidence or longitudinal medical records sufficient to make a disability determination. In addition, the SSA should require standardized cognitive testing be included in the case record for all applicants whose allegation of cognitive impairment is not accompanied by objective medical evidence. ...

Good Planning, GOP

     I think I was the first one to write publicly about this. Here's Mother Jones sounding the same theme:

With Hillary Clinton now officially running for president, progressives are upping the pressure on her to embrace their policy agenda, including the Holy Grail of expanding Social Security benefits. ...

But it's actually Republicans, not progressives, who have essentially guaranteed that Social Security will be a major issue in 2016, setting up a battle that will provide stark contrast between the two parties on the issue ...

Dylan Scott wrote last week, House Republicans passed a little-noticed procedural rule back in January that will ensure a heated debate on the Social Security at the height of the presidential campaign.

As things stand now, in the final three months of 2016, the Social Security Disability Insurance trust fund will run out of money and beneficiaries will see an immediate 20 percent cut in benefits. Luckily, there's an easy fix: Congress can simply reallocate a small amount of payroll tax income from the larger Social Security retirement fund to the disability fund. ...

But just as Republicans in recent years have turned once routine debt-ceiling votes into near-catastrophic showdowns, the Republicans' new procedural rule blocks the House from voting on this simple fix unless they also address the long-term solvency of the program by cutting benefits or raising taxes. Progressives expect House GOPers to use the rule to force through benefits cuts in late 2016.

Or at least that seems to be their plan. But what House Republicans have actually done is set up a battle that will force the two parties and their respective candidates to take a position on whether to expand or cut Social Security benefits in late 2016—just as Americans are picking their next president.

     And, please, if you're a GOP leader, just dismiss this out of hand because it's coming from Mother Jones and because you're sure the public will support your Social Security cuts once you explain that that you're only trying to save Social Security. Everyone knows it's really the Democrats who are recklessly endangering Social Security. Fox News reports this all the time.

I Keep Coming Back To This

     I keep coming back to this since it's such an interesting example of what's been happening at Social Security for the last few years as the agency, seems obsessed with making it harder to get disability benefits. Somebody made a mistake and wrote something sensible in Social Security's policy manual but it could be interpreted as helping claimants in some minor way so it had to be quickly excised but the change couldn't be announced or explained. Here's what I've posted before:

Not too long ago someone told me that this example had been added to Social Security's Program Operations Manual Series (POMS):

A 50-year-old claimant with a high school education and unskilled past relevant work has an RFC [Residual Functional Capacity] for standing/walking 2 hours of an 8-hour day and sitting approximately 6 hours of an 8-hour day. He is able to lift/carry/push/pull 20 pounds occasionally and 10 pounds frequently. This RFC falls between rule 201.12, which has a decision of disabled, and 202.13, which has a decision of not disabled. In this case, use rule 201.12 as a framework for a decision of disabled because the definitions in DI 25001.001 (Medical-Vocational Quick Reference Guide) indicate light work usually requires walking or standing for approximately 6 hours of an 8-hour day. Since the claimant can only walk or stand for 2 hours, he has a significantly reduced capacity to perform light work and a sedentary medical-vocational rule applies as a framework for a determination.

I posted about this. Not long after I posted about it, without any announcement of a change, the example disappeared from the POMS section to which I cited. However, you can still see the example on the transmittal sheet, which is available online, which notified the various components of the agency about this and other changes. As long as it's there, it's going to be cited to courts and Administrative Law Judges. So, now, the question is whether the example will disappear from the transmittal sheet? Will the agency pretend that none of this ever happened? I've heard of the concept of a non-person. Can there be a non-thing? Can Social Security permanently erase this from the memory bank?

    And here's an e-mail I received from a reader:

Regarding POMS section DI 25025.015, transmittal sheets disappear from the public site after 60 days, so you might want to save a copy. 

Transmittal sheets and archived POMS sections are maintained on SSA's internal web site indefinitely.

I don't know enough about the disability program to understand why the example was problematical, but the people who maintain the POMS web site were asked to remove the example (and did so) on March 27.  You can see at the bottom of the section, in small type, "Batch Run" and "Rev" dates indicating when it was changed.

I'd prefer you didn't mention my name if you use this information.

New Listings For Children

     Social Security is adopting revised Listings used in determining disability in children for growth disorders and weight loss. This includes one of the more interesting names for a medical condition, "failure to thrive." Children are expected to thrive, that is to rapidly gain weight and height. "Failure to thrive" is an ominous condition and a challenge for a pediatrician's diagnostic skills. When they can't figure out what the specific problem is or how to cure it, disability can result.

Isn't It Nice That They're Checking On Me!

     An elderly relative of mine recently passed away after a brief illness. A few months before he died he was surprised to receive a call from a nurse who had been hired by his last employer's retirement plan. The nurse wanted to come out and check his blood pressure. He thought that it was great that they wanted to check on him. I knew the real reason this was happening. They weren't doing this just to be nice. My elderly relative really hated to go to the doctor and hadn't been to one in several years. Since he had supplemental health insurance benefits through his former employer they knew he hadn't been to a doctor recently. They were checking to make sure he was still alive. I expect that Social Security would have been checked on him eventually for the same reason but he got sick and started using his Medicare and then he died. Social Security checks on people drawing retirement benefits who aren't using Medicare. Social Security's Office of Inspector General (OIG) has issued a report recommending that the agency extend this program to those drawing disability benefits. That makes good sense. However, as always, the agency's ability to undertake such efforts is limited by inadequate staffing caused by an inadequate administrative budget. The inadequate staffing is probably why my elderly relative's employee retirement plan checked to make sure he was alive before Social Security did.

As I Predicted

     As I predicted, at least one media outlet has tried to make a big deal out of 18 sexual predators receiving Social Security benefits. Michael Hiltzik calls them out on trying to puff up such a trivial matter.

This Is Interesting

     Not too long ago someone told me that this example had been added to Social Security's Program Operations Manual Series (POMS):

A 50-year-old claimant with a high school education and unskilled past relevant work has an RFC [Residual Functional Capacity] for standing/walking 2 hours of an 8-hour day and sitting approximately 6 hours of an 8-hour day. He is able to lift/carry/push/pull 20 pounds occasionally and 10 pounds frequently. This RFC falls between rule 201.12, which has a decision of disabled, and 202.13, which has a decision of not disabled. In this case, use rule 201.12 as a framework for a decision of disabled because the definitions in DI 25001.001 (Medical-Vocational Quick Reference Guide) indicate light work usually requires walking or standing for approximately 6 hours of an 8-hour day. Since the claimant can only walk or stand for 2 hours, he has a significantly reduced capacity to perform light work and a sedentary medical-vocational rule applies as a framework for a determination.

     I posted about this. Not long after I posted about it, without any announcement of a change, the example disappeared from the POMS section to which I cited. However, you can still see the example on the transmittal sheet, which is available online, which notified the various components of the agency about this and other changes. As long as it's there, it's going to be cited to courts and Administrative Law Judges. So, now, the question is whether the example will disappear from the transmittal sheet? Will the agency pretend that none of this ever happened? I've heard of the concept of a non-person. Can there be a non-thing? Can Social Security permanently erase this from the memory bank?

Social Security Pays 18 Sexual Predators

     From a report by Social Security's Office of Inspector General (OIG):

We identified 18 sexual predators who were involuntarily confined in 4 SCCs [Special Commitment Centers] and who improperly received approximately $524,000 in Social Security benefits and/or Supplemental Security Income payments. 

Our review indicated that, after States transferred these sexual predators from prison to an SCC, the individuals contacted SSA to apply for benefits or request resumption of payments that SSA had suspended while they were incarcerated. While benefit suspension provisions continued to apply to these individuals, a mechanism had not been established to ensure SCCs reported inmate information to SSA. Consequently, SSA did not have the information it needed to prevent initiation of payments to these individuals.

     This can easily be sensationalized and probably will be but it's a quite minor issue affecting only a handful of cases. It will be quickly resolved.

Don't Let The Tail Wag The Dog

     Let my explain why Social Security has a rule that allows a few severely disabled people onto benefits, in part, because of their inability to read and write in English, even though they live in Puerto Rico and are able to read and write in Spanish. It's fairly simple. Social Security is a national program. What is the agency supposed to do? Put someone on disability benefits when they're living in New York but cut them off once they move to Puerto Rico? Deny their claim while they're living in Puerto Rico but allow it as soon as they move to New York? It's not only impractical to have different rules for different locations; it's probably unconstitutional. What are you going to say next -- that inability to read and write in English has no effect upon a person's ability to hold down a job? You're not going to be able to do a surveillance system monitor job if you can't communicate in English. You can still be an agricultural laborer or a landscaper but when you get to the point in the grid regulations where ability to communicate in English is an issue, laboring jobs are already off the table because of the claimant's physical impairments. In fact, most jobs are off the table throughout most of the country if you can't communicate in English. So what do you want? A rule that may seem a bit odd when applied to a handful of people in Puerto Rico or a rule that's very unfair when applied across most of the country?

Latching Onto 218 Cases As Basis For Changes Affecting Millions Of Cases

     A press release:

The Social Security Administration's (SSA) Office of the Inspector General (OIG) recently issued a report on the determination of disability claims from applicants who cannot communicate in English. The OIG found at least 218 cases in Puerto Rico where a disability rule was applied to the advantage of a claimant who was unable to communicate in English, even though Spanish is one of the island's official languages.

Chairman Sam Johnson has previously called attention to these "grid rules" as one of the challenges facing the Disability Insurance program. In 2012, the Government Accountability Office released a report requested by Chairman Johnson, which found the SSA relies on an outdated view of disability. In 2014, he introduced H.R. 5260, the Stop Disability Fraud Act of 2014, which would require the SSA to update the grid rules for the first time since they were created in 1979.

In response to the OIG report, Chairman Johnson made the following statement:

"As part of my commitment to the disability community and the American taxpayer, I am looking for ways to make the disability program work better, and updating the grid rules to reflect today's world is one way to do so. It makes absolutely no sense that Social Security has been relying on rules that are over 35 years old to determine if someone should receive benefits. While I am encouraged that Social Security is finally getting around to taking a look at these rules, I will be introducing legislation to make sure they actually do so. The American people expect Social Security to use common sense, not outdated thinking, when determining who should receive disability benefits."