OHO Caseload Analysis Report

     A statistical report from Social Security on performance at its Office of Hearings Operations:

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Senators Seek Action On Long Covid Disability Claims

     Seven Democratic Senators have written the Commissioner of Social Security asking that something be done about disability claims filed by those suffering from long Covid.

    As I've said before, I'm out there representing Social Security disability claimants. My firm is taking on new cases regularly. I'm only seeing a very few claimants with long Covid. I don't see any more problem with those few cases than with other Social Security disability claims which means there are severe problems.

    The letter  also said that a couple of more general changes should be made:

... SSA should allow appointed representatives to see all exhibits at the initial and reconsideration disability claim stages. ...

SSA should restore the “treating physician rule” so a claimant’s primary care physician or Long COVID specialist can have their medical opinion given the weight it deserves. ...

Senators Seek Answers On AI Usage

     From Government Executive:

... Senate Finance Committee Chairman Ron Wyden, D-Ore., and ranking member Mike Crapo, R-Idaho, sent a letter to Social Security Administration Commissioner Martin O’Malley asking for information about how the agency is complying with the Biden administration’s March policy mandating safeguards for AI use. ...

Wyden and Crapo also warned O’Malley against overly relying on artificial intelligence as he seeks to chart a path out of Social Security’s customer service crisis, spurred primarily by a slow disinvestment in the agency by Congress, leading to the agency having its smallest workforce in 30 years amid the greatest number of beneficiaries in history. ...

New Conditions Added To Compassionate Allowance List

    Social Security is adding some new conditions to its compassionate allowance list of conditions that are supposed to result in having disability claims approved quickly. I think the least uncommon one on the adult list would be "Adult Heart Transplant Wait List – Status Levels 1-4."  Here's a description of what those status levels mean:

• 1 - 3: Most often hospitalized in ICU to support their heart.
• 4: This group is often at home but may need IV medications or VAD [Ventricular Assistive Device] to support their heart.
• 6: This group includes all others who are stable enough to remain home while they wait for a heart.
  

    I think anyone in status level 1-4 would easily meet a Listing anyway so I can't say this means much.

    Also, I've had clients who were on a heart transplant list and I don't recall any mention of a Status Level in their medical records.

Adverse Public Relations Potential No Longer A Hardship -- They Say

    From a recent update to Social Security's POMS (Program Operations Manual Series) manual:

To promote homogeneity between the Dire Need POMS and the Dire Need HALLEX instructions, we have revised the language in the Dire Need POMS. ...

We revised and clarified the definition of dire need. We also deleted language which suggested claimants with adverse public relations potential as hardship situations qualifying as dire need condition.

    I'd be amazed if they don't still scurry to resolve cases which get press attention.

For The Frustrated Social Security Disabilty Claimant

     I continue posting on my firm's separate blog directed at a different audience -- For The Frustrated Social Security Disability Claimant. Take a look at some of the recent posts on that blog.

• Top Five Myths About Social Security

• You Don't Have To Pay Upfront To Hire A Social Security Attorney

• A Poll

• You're Not The Only One Waiting And Waiting

• "What Do They Want Me To Do?"

• N.C. Medicaid Now Covers Weight Loss Drugs

• Who Runs The Show At Social Security?

• What Happens If I Die Before Social Security Finds Me Disabled?

• Field Offices Closed Today

• Is It The End If The Judge Turns Me Down?

In The Field

     Social Security's front line employees often complain that high level agency managers don't understand problems in the field, that no one listens to them. Whatever else you think of him, Martin O'Malley is getting out into the field. I'm attaching some photos posted on Twitter from his recent visit to the Jacksonville, FL field office. 

    By the way, O'Malley seems no more proficient at taking selfies than I am! Also, by the way, note that image of a motorcycle up on the screen in that last photo. I wonder if the employee was asked to get something up on the screen that had no PII. Could it even be an artificial image added later by Photoshop to avoid the PII problem?

 

     

Social Security Lump Sums Create Medicaid Problems

 

    Newsweek reports on a problem associated with Social Security that Social Security policymakers probably aren't aware of. The woman in the story had to fight for years for Social Security disability benefits. Finally, she was approved and paid but immediately lost her Medicaid. For SSI purposes, when she received that lump sum of back benefits, she had six months to spend it but there's no six month grace period for purposes of Medicaid. She became ineligible immediately. 

    There are things you can do to spend this sort of lump sum rapidly that give you lasting improvement in your life while retaining Medicaid or at least minimizing your period of ineligibility. You can pay off debts, repair your home which is probably in disrepair since you've been so poor, you can pay down your mortgage, replace worn out appliances and furniture, purchase new clothes, visit family members you haven't seen in years, etc. Just don't give any of it away! The problem is that most people who receive a large sum of money from Social Security or from some other source, such as an inheritance or personal injury settlement, don't see the problem coming and have no idea how to cope with it when it arrives. Often, they give the money to a relative or friend to hold for them which is much worse that useless.

They Could Do A Much Better Job If They Weren't So Understaffed

     From Challenges in Recovering Supplemental Security Income Overpayments, a report by Social Security's Office of Inspector General (OIG):

... SSA made errors on overpayments for 189 (47 percent) of the 400 sampled SSI recipients because it did not follow policies or use all available tools, to prevent, detect, or recover SSI overpayments. For example, overpayments could have been prevented or detected earlier, but employees made errors when they redetermined SSI eligibility. A redetermination is a review of a recipient or couple’s non-medical eligibility factors (that is, income, resources, and living arrangements) to determine whether the recipient or couple is still eligible for, and receiving, the correct SSI payment amount.

Errors also occurred because employees did not always (1) send recipients complete and accurate due-process notices before they initiated recovery of overpayments; (2) follow policy when they processed waivers of overpayments; or (3) follow policy and use available tools to recover overpayments. When SSA identifies an overpayment, it sends the overpaid person written notification of the overpayment’s cause and amount. Overpayment recovery can begin 60 days after SSA notifies the recipient of the overpayment if they have not requested a waiver of the overpayment collection or a reconsideration of the overpayment facts. If the individual is receiving SSI payments, SSA should begin recovery by withholding from ongoing payments. If the individual is no longer receiving SSI payments, SSA should attempt collection through various means including withholding from ongoing payments to a liable representative payee or spouse, cross-program recovery, referral for external collection through the Department of the Treasury or pursuing recovery from estates.

We estimate SSA did not follow its policies or use all available tools to prevent, detect, or recover SSI overpayments for 1.9 million recipients. For 1.7 million of these recipients, we estimated error amounts totaling over $7 billion. ...

    Not only does Social Security lack the manpower to do what OIG recommends, OIG fails to recognize that most of these SSI overpayments are small so going after all of them using every possible mechanism would not be cost-effective.

$81 Million AI Contract

     From a press release:

Accenture Federal Services has won an $81 million artificial intelligence and machine learning (AI / ML) contract from the Social Security Administration (SSA). The company will deliver end-to-end back office intelligent automation services to transform the way 250 million retiree and survivors’ benefits documents are processed every year. The forms are currently being received and managed via email, mail, and fax.

The Social Security Administration has already successfully deployed an enterprise hyperautomation platform that uses advanced deep learning and computer vision techniques to identify data from the agency’s electronic folder, extract text, transcribe data with the highest level of accuracy, and speed processing through downstream business processes. The platform uses internal enterprise data to intelligently and rapidly keep pace with high demand, expedite decision making, and control costs.

Accenture Federal Services will now take this project to the next level providing the licenses necessary to deliver an end-to-end, Infrastructure as a Software (IaaS) roadmap for intelligent automation installation, testing, and training. ...