Jan 28, 2016

Prior Claim Files

     I wonder if someone could confirm something for me. I've heard that in Social Security disability cases prior claim files, as long as they are electronic, are linked to current electronic claim files in some fashion and are easily available to those adjudicating the new claim. Is this accurate?
     The problem for me is that the prior claim files are not available to attorneys representing claimants. If these files are available to an Administrative Law Judge (ALJ) hearing a case, shouldn't they also be available to the claimant and his or her attorney? I can hear the response, "Well as long as I don't make them an exhibit, what's the problem?" The problem is two-fold. First, how do I, as the claimant's attorney know that you haven't looked at them? It's possible to look at something without making it an exhibit. I'm not implying some impropriety. My impression from things I've heard is that many ALJs believe that if something was made an exhibit at a prior hearing, it remains an exhibit at a hearing on a new claim and is available to the attorney representing the claimant but it isn't. Second, the prior file may include valuable information that would help in the adjudication of the new claim. If ALJs aren't looking at the prior claim files, they should be.
Posted by Charles T. Hall at 20 comments:
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Jan 27, 2016

The CARES Plan

     Social Security's plan for dealing with its hearing backlog has leaked out. It's called CARES, standing for "A Plan For Compassionate And REsponsive Service." Here's another link to the plan, although this second link will expire on January 29.
     The plan is awfully reminiscent of prior plans to deal with the backlog. Here are the elements of this plan as I see it:
  • Assumption that the most important element is better management. Current management is much smarter than the people who used to manage the Office of Disability Adjudication and Review (ODAR). Of course, they were idiots. Look at the backlog! Of course, the new guys are smart. Look at that great graphic on the cover of the report. Anybody who can produce graphics like that must have a great plan.
  • Vague management initiatives. The new management initiatives consist of mere concepts that have little hope of succeeding but the new managers are so much smarter than the old managers that, of course, the new initiatives will work.
  • Unrealistic assumptions about future appropriations. The plan is based upon Social Security getting all the appropriations it desires. However, in the real world, as long as the GOP controls the House of Representatives, the agency's budget may see little improvement. It may be difficult to maintain current staffing levels, much less improve them.
  • The assumption that it is essential that the process be controlled so that allowance rates on disability claims remain at historic lows. Keeping approval rates low is referred to as "quality." If anything, it looks like there will be new initiatives to improve "quality." "Quality" concerns will almost certainly prevent the issuance of many staff attorney decisions.
     What I see here is an unappealing mixture of arrogance, wishful thinking and cowardice. Everyone knows what would help considerably even at current funding levels -- aggressive use of the senior attorney program and encouraging Administrative Law Judges to do on the record reversals in appropriate cases. Social Security management is afraid of offending the GOP by approving more claims so they don't do what they know would work.
     If I sound bitter, it's because I am. I'm out there dealing with the claimants whose lives are being destroyed by the backlogs while Social Security management seems more interested in producing great graphics than in actually doing something about the problem. What's needed is the courage to admit the obvious and do what needs to be done. Instead, we get nonsense like this which only encourages Republican budgetary obstinance. Why give the agency more money when the agency itself is telling you what you want to hear -- that they can manage their way out of the problem? Don't expect Republicans to pay attention to the rosy prediction in CARES that the agency will get more money so it can hire more workers. They will ignore that and demand that Social Security solve its backlogs without additional money while making sure that it's horribly difficult to be approved for disability benefits.
Posted by Charles T. Hall at 51 comments:
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Jan 26, 2016

Finally!

     Social Security has announced that its central offices in the Baltimore area will be operating on a normal schedule tomorrow. 
     Among other effects, the three days of closure due to the snowstorm have added to the backlog of people awaiting payment of disability benefits after a favorable decision and to the backlog of people awaiting action from the Appeals Council. 
     Even with the offices reopening, things will not be back to normal if schools remain closed. Employees can't leave their young children at home alone. Perhaps some locals can update us on the school situation.
Posted by Charles T. Hall at 9 comments:
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Rep Payees Remain A Problem

     From a recent report by Social Security's Office of Inspector General (OIG) (footnotes omitted):
A representative payee receives and disburses benefit payments o n a beneficiary’s behalf. Congress granted SSA [Social Security Administration] the authority to appoint representative payees for those beneficiaries whom SSA deems are incapable of managing or directing the management of their benefit payments because they have a mental or physical disability or are a child. A representative payee may be an individual or an organization. ...
SSA procedures prohibit volume individual representative payees from collecting a fee from SSA benefits except in certain circumstances, such as court-ordered fees, including fees for serving as a court-appointed legal guardian. ...
Since 2007 , we have conducted seven in - depth reviews of high-volume individual payees. All these payees had more than 50 beneficiaries in their care at the time of our r eview. In total, these payees served m ore than 1,000 beneficiaries. ...
Because of the extensive level of our review, we identified several recurring findings — including payees collecting unallowable and /or excessive fees. Specifically, we noted that all seven payees collected fees — many in excessive amounts — to compensate for their services, despite SSA policies to the contrary. Yet, of the 43 payees SSA reviewed with 50 or more beneficiaries, SSA only identified 4 as having collected fees. ...
We used the research tool LexisNexis to review the 47 high-volume individual payees. We noted that six payees had prior financial liens and judgments or bankruptcy filings. The mos t recent lien was filed in 2009 , which is the same year that the payee was selected by SSA. According to LexisNexis, this lien was released in 2011. ...
For example, one payee served only as the representative payee for one beneficiary whom the payee charged $1,592 for unallowable fees. In addition, for 34 of 80 beneficiaries, the payee collected extra fees totaling $49,423 above the allowed monthly guardianship fee of $60. This payee also collected large fees , totaling $113,526, from 2 of the 80 beneficiaries....
In September 2015, our Office of Investigations informed us that the Washington County Grand Jury had indicted 1 of the payees in the Seattle Region for 81 criminal counts including criminal mistreatment in the first degree, aggravated theft, and income tax evasion. This payee was included in our population of the 449 payees caring for between 15 and 49 beneficiaries. She had 45 beneficiaries in her care when the investigation was initiated in October 2014. According to available information, the representative payee filed for bankruptcy in 2001, and a Federal tax lien was filed in 2004 before she became a payee for SSA. Given the fiduciary responsibilities of a representative payee, it may be inappropriate to give those responsibilities to an individual who has claimed a personal bankruptcy and/or has a Federal tax lien.
     Before you criticize Social Security, remember that there aren't people lined up wanting to be representative payees. In many cases, it's hard to find any person or entity willing to do the job and, no, there really isn't an alternative to using rep payees. Some people just can't handle their own funds.
Posted by Charles T. Hall at 1 comment:

Central Offices Remain Closed

     Social Security's central offices in the Baltimore area remain closed today due to the severe snowstorm that hit last week.
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Jan 25, 2016

Central Offices Closed

      Social Security has announced that its central offices in the Baltimore area will be closed on Monday due to Friday's snowstorm.
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Jan 24, 2016

Hives And Rashes At New York Field Office

     From the Olean, NY Times Herald:

Those working at the Social Security office in downtown Olean continue to experience the same medical conditions as they did in late September while at work, a union official has reported.

“Employees have the same medical issues — strong outbreaks of hives and respiratory issues,” said Shawn Halloran, executive vice president of The American Federation of Government Employees Local 3342, which represents the dozen Social Security employees at the Olean office. ...

Officials at Park Centre Development, which owns the building and is headquartered nearby, said those working in offices neighboring the Social Security location have not reported experiencing similar symptoms. ...
An industrial hygienist went through the Social Security office two days after it closed and took samples to determine what caused the reaction.
The inspection did uncover some minor issues, such as exposed insulation in a utility closet and some excess equipment gathering dust. In addition, the inspector recommended the office’s heating and cooling system be adjusted to ensure its vents were functioning properly.
Park Centre had the facility thoroughly cleaned before it reopened Oct. 1.
In the nearly four months since the office reopened, Halloran has received calls almost weekly from office employees reporting the recurrence of hives and rashes. He added that officers with a private firm who provide security at the office have also experienced the same symptoms.
Posted by Charles T. Hall at 3 comments:
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Social Security Sued Over Kentucky Suicides

     From WYMT:
Family members of two people who killed themselves after receiving letters from the Social Security Administration indicating their federal disability benefits were suspended are suing the agency. ...
The SSA in 2015 ordered nearly 1,800 people to attend hearings to determine whether they should continue receiving disability checks. ...
The people being forced to undergo hearings are former clients of Floyd County lawyer Eric C. Conn.
Congressional investigators suspect Conn used fraudulent information to secure the benefits.
Conn has not been charged and has denied any wrongdoing.
Posted by Charles T. Hall at 14 comments:
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Jan 23, 2016

"We Make Every Effort To Deliver World Class Service In Our Field Offices"

     From The Ledger:
Some mornings the lines outside the Lakeland office of the Social Security Administration start forming as early as 6:30. The office doesn't open until 9 a.m. but word has spread among elderly and disabled residents that those first in line have a shorter wait.
So over the next few hours they quietly queue up, among them on a recent day an elderly woman sitting in a wheelchair, a woman leaning on a walker, and a young woman toting an infant in a carrier. An older man with a walker leans his back against the building and grimaces.
There are no benches, no water fountains. Until the doors are unlocked at 9 a.m., there is no access to restrooms. And even then, no signs explain to those in the line outside that they can ask the guard's permission for restroom access. Some days, the guard announces no food or drink are allowed inside "so if you have anything with you, you might as well go put it back in your car."...
 Social Security's data shows the average wait time is only 34 minutes, she said, but [a Social Security spokesperson] had no response to that being the average wait from the time a person gets inside and takes a ticket. ...
Stacia Edwards of Lakeland said she had called the number listed on the door for phone service but “calling is ridiculous. Sometimes you wait an hour. Now they have a thing where they say they will call you back.” When she called, it was a 55-minute wait for a callback so she decided to take her chances by lining up in person. ...
Explaining the Social Security Administration's official position, [a Social Security spokesperson] said, “We make every effort to deliver world class service in our field offices. ...
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Jan 22, 2016

Central Offices Closed By Snowstorm

     Social Security's central offices in the Baltimore area will be closed today due to the snowstorm hitting the Northeast today.
Posted by Charles T. Hall at 15 comments:
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Jan 21, 2016

The Depressing State Of Hearing Backlogs At Social Security


 
Posted by Charles T. Hall at 24 comments:
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Jan 20, 2016

New Instructions For Attorney-Advisor Decision

     Social Security has issued new instructions for Attorney-Advisor (AA) decisions (also called Senior Attorney decisions) after claimants requests a hearing before an Administrative Law Judge (ALJ). The idea is that clearly meritorious claims would be quickly approved by AAs. The AAs would not deny any claims. If the AA couldn't approve a claim, the claimant would still get an ALJ hearing. The point of the AA decisions is to help reduce the backlog of pending requests for hearings.
     The AA decisions have been around for many years. Since 2010 when Republicans gained control of the House of Representatives there have been few AA decisions. Not coincidentally, the hearing backlog has mushroomed. The AA reviews conducted in recent years seemed to me to be a waste of resources. I would get a call from an AA saying they were reviewing a case. The AA would ask for certain pieces of medical evidence and demand that the evidence be submitted in two weeks or less. That's completely unreasonable. Most medical providers don't respond to requests in that kind of timeframe. When I told an AA that I couldn't get the evidence in within the timeframe they were giving, I was told that the AA couldn't hold onto the case any longer. However, it was often the case that I had already requested, obtained and submitted the records that the AA wanted suggesting that the AAs weren't reviewing the files too closely before calling. It didn't seem to matter what records were submitted or how strong the case was. We wouldn't get any action from the AAs. The AAs seemed to be almost incapable of approving a claim. They were just spinning their wheels. The agency would have been better off if the AAs were drafting decisions for ALJs.
     We'll see how these new instructions are implemented but I see no evidence in them that there will now be large numbers of AA decisions. In past years when there were many AA decisions, cases were selected for AA review based upon profiles of claims likely to be approved by ALJs. The profiles were top secret but it wasn't hard to see the pattern -- mentally ill claimants and older claimants. I though the profiles worked pretty well. I never understood why they were abandoned unless the point was to hold down the number of claims approved by AAs. The new instructions suggest to me that cases will not be selected for review based upon profiles. Here are the selection criteria in the new instructions:
  • New and material evidence is submitted;
  • There is an indication that additional evidence is available;
  • There is a change in the law and regulations; or
  • There is an error in the record or another indication that a fully favorable decision may be warranted.
      I suppose the "another indication that a fully favorable decision may be warranted" language would cover profile selection but I can't think of a reason why they wouldn't say they intend to use profiles. The first two criteria could be used to cover virtually any case with a pending request for hearing. Reviewing virtually all cases wouldn't be a good thing. There's too much effort wasted on cases where the AAs can't or won't issue a favorable decision.
     The instructions suggest that there will be a two level process. One person will hand select a case for AA review and then another will actually do the AA review. That's labor intensive. The instructions carefully forbid an AA from actually reviewing a case that he or she has selected for review, suggesting a process that almost requires that two AAs agree before an AA decision is issued.
     It looks like there won't be that many AAs participating in the process. Only those selected to a national "team" will be allowed to participate. The instructions themselves say the "team" is a "small group."
     After an AA decision is issued there will be four different levels of "quality review" which suggests a deep uneasiness with AA decisions.
     It still looks like the agency thinks that holding down the number of disability claims approved is far more important than dealing with its hearing backlog. I hope to be pleasantly surprised but I'm not expecting much from this. Meanwhile, the hearing backlog continues to grow.

Posted by Charles T. Hall at 33 comments:
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Jan 19, 2016

Miami Psychiatrist Indicted For Social Security Fraud

     From the Miami Herald:
A Miami psychiatrist who became a national symbol of over-prescribing was indicted this week by a federal grand jury for allegedly running a racket that defrauded numerous public programs, including Medicare, Medicaid, the Social Security Administration and U.S. Citizenship and Immigration Services.
The psychiatrist, Dr. Fernando Mendez-Villamil, 48, and three other Miami-Dade residents whom he employed in his Coral Way office, were charged with an elaborate scheme to provide false diagnoses of debilitating psychiatric conditions that allowed numerous people to fraudulently qualify for Social Security disability benefits, Medicare and Medicaid, and to be exempted from testing requirements for becoming naturalized U.S. citizens, according to the grand jury indictment filed in Miami federal court on Thursday....
A third employee, Arnaldo Oscar Jimenez, 57, of Hialeah, also allegedly recruited individuals who wanted to fraudulently obtain Social Security disability benefits....

Read more here: http://www.miamiherald.com/news/health-care/article53792465.html#storylink=cpy

Read more here: http://www.miamiherald.com/news/health-care/article53792465.html#storylink=cpyA third employee, Arnaldo Oscar Jimenez, 57, of Hialeah, also allegedly recruited individuals who wanted to fraudulently obtain Social Security disability benefits.

Read more here: http://www.miamiherald.com/news/health-care/article53792465.html#storylink=cpy
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Jan 17, 2016

Senator Mikulski Brings Home The Bacon

     From the Baltimore Sun:
The Woodlawn headquarters of the Social Security Administration is set to receive a $150 million overhaul to remove dangerous lead paint and asbestos, rip out corroded plumbing and modernize the 10-story building for 21st-century technology. ...
Officials declined requests by The Baltimore Sun to tour the building but outlined plans to update the 250,000-square-foot facility with new elevators, modern office layouts with more open space, and windows and insulation that better regulate the temperature. The building is not open to the public. ...
Design work is beginning, he said. No timetable has been set for the project, and [Chris] Molander [the agency official in charge of facilities] said he could not estimate how long it will take. ...
[Senator Barbara] Mikulski, the ranking Democrat on the Senate Appropriations Committee, told Social Security workers at the recent gathering that they deserve a better work environment than the Altmeyer Building.
"We know it's been lead paint, it's asbestos, electrical circuits are out of date," she said. "We're very concerned about your health, about your safety. A modern social insurance company — which you are — deserves to be in a facility where we can bring in the technology that makes your job more efficient and helps you be more effective."
Molander said the building poses no threat to workers' health or safety. All of the asbestos is contained (most of it is in the ceilings), and the lead paint is not "an overriding concern," he said. If coated properly, he said, the old paint won't cause problems. ...
     Meanwhile, claimants wait two years for hearings.
Posted by Charles T. Hall at 5 comments:
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Jan 16, 2016

Most Of Eric Conn's Former Clients Aren't Taking Advantage Of Free Legal Help

     From WSAZ:
Attorneys representing hundreds of people fighting to keep their federal disability benefits worry those benefits may disappear for most of them if they do not have a lawyer.  
Last year, the Social Security Administration ordered nearly 1,800 people to attend hearings to determine whether they should continue receiving disability checks. Many have already gone through with the hearings and are now waiting on the results. 
The people are former clients of Floyd County lawyer Eric C. Conn. ... 
Thursday night, some of those people gathered in Prestonsburg, where they heard from the legal team trying to help them keep their disability payments. 
The prevailing theme was encouraging disability recipients who have not hired an attorney to represent them at their re-determination hearings to do so. ...
[Ned] Pillersdorf [who is handling a class action lawsuit on the terminations] estimates around 1,000 disability recipients do not have legal representation for their hearings and, as a result of not seeking counsel, will lose their hearings. ... 
"The suicide chatter is way up," Pillersdorf said. "It was especially bad around Christmas. Unfortunately people have got this unfortunate response that suicide is somehow a rational response to losing their benefits. We want to reassure people their lawyers are doing everything they can to help them." ...
     It would be great if the other 1,000 or so former clients of Eric Conn were to seek legal help. The problem is that at this point there wouldn't be nearly enough volunteer attorneys to represent them all. By this point, it's almost too late. Virtually all of these cases are now scheduled for hearings.
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Jan 15, 2016

Beware! Social Security Is Using Docutector!

     From a contracting notice posted by the Social Security Administration:
This is ... notification of the Social Security Administration's (SSA) intent to issue, on a sole-source basis, a firm fixed-price contract to D.R. Myers Distributing Co., Inc. dba Driver's License Guide Company, to renew an electronic resource subscription entitled Docutector.
Docutector is an online document forgery detection database. SSA's Office of Media Management (OMM) will use the Docutector subscription as a visual standard to inspect documents submitted by claimants to detect and investigate fraud.
     I think the last dubious document case I saw at Social Security was a family Bible used to prove date of birth. The questionable entry was written by a ballpoint pen supposedly as a contemporaneous  recording of a birth that happened well before ballpoint pens were invented. Most of my readers have no experience with date of birth determinations, much less the concept of using a family Bible to prove date of birth. To explain, states weren't requiring birth certificates until about 100 years ago. Even after birth certificates were required, for some years there were still plenty of home births where no birth certificate was issued. School records, insurance records, census records and entries in family Bibles were used in these cases to prove date of birth for Social Security purposes. Laboriously gathering documents to make a date of birth determination used to be a significant part of what the Social Security Administration did. That's pretty rare these days, except for some immigrants, because all those folks who lacked birth certificates are now on Social Security benefits or deceased. My point is that fraudulent documents are quite uncommon at Social Security these days.
Posted by Charles T. Hall at 4 comments:
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Jan 14, 2016

Income Inequality Hurting Social Security Trust Funds

     From The Atlantic:


The financial picture for Social Security isn’t as dire as some describe: Without any modifications to its funding, Social Security will generate enough revenue to pay for three-quarters of promised benefits. [There is enough revenue and reserves to pay full benefits until 2034.]

The main reason it’ll fall short, though—the reason that that remaining one-quarter of benefits hasn’t yet materialized—is that the method of funding for Social Security was calibrated to an America with much less inequality than the nation currently has.

Since the late ‘70s, most of the growth in workers’ earnings has gone to the people who have made the most money. To be precise, the wages of the top 1 percent of workers have grown 138 percent since 1979, while the wages for the bottom 90 percent grew only 15 percent during that period.
If all of that income growth were taxed evenly, Social Security would have no shortfall. But it’s not taxed evenly: Any dollar that an American earns beyond $118,500 is, under current laws, not subject to Social Security taxes. In other words, someone who makes $118,500 this year is going to pay the same amount in Social Security taxes as someone who makes $4 million this year.

Posted by Charles T. Hall at 11 comments:
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Jan 13, 2016

Will SSA Accept Driver's Licenses From Illinois, Minnesota, Missouri, New Mexico and Washington As ID?

     A vaild ID is required to enter a Social Security hearing room. The REAL ID Act sets forth requirements for acceptable IDs. Generally, people have used their driver's licenses. However, I'm reading that driver's licenses from the states of Illinois, Minnesota, Missouri, New Mexico and Washington are not in compliance with the REAL ID Act requirements and may no longer be used to gain access to federal facilities. I'm getting this from a local newspaper article concerning access to Fort Bragg but I believe this should apply in the same way to access to Social Security hearings. Is there a problem in those states? This could be a big headache for Social Security and claimants from those states.
Posted by Charles T. Hall at 19 comments:
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Same Sex Marriage Battle Continues

     From CNN Money:
Kathy Phelan has been waiting more than a year for her first benefit check from Social Security, caught in a back-and-forth with the agency as it works to keep up with a changing legal landscape for same-sex couples. ...
She last heard from the agency in December and was told it could be another 12 to 18 months before a hearing is scheduled on her case. Her claim was first flatly rejected and she has since appealed.
Phelan isn't the only one stuck in limbo with the Social Security Administration.
 "The process is moving inexplicably slowly," said Susan Sommer, an attorney for Lambda Legal, a non-profit that advocates for LGBT rights. ...
 Over the past two decades, there's been a patchwork of same-sex marriage laws across the country as more and more states made it legal. It wasn't until 2013 when the Supreme Court struck down the Defense of Marriage Act (DOMA) that they could get federal benefits like Social Security as a married couple. But that still left some in the lurch if they were married in a different state than where they lived.
 That's what happened to Phelan. They married legally in Washington state in 2013, but lived in Arizona where same-sex marriage wasn't recognized until the middle of 2014. Since Kaye lost her battle with cancer five months before it was legal in Arizona, Social Security did not treat Phelan as her legal spouse. ...
 Why, exactly, does that impact Phelan's benefit? Because married couples are entitled to a "survivor" benefit if the higher-earning spouse died first.
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Jan 12, 2016

Attorney Fee Payments Continue To Decline

     Social Security has posted its final numbers on fees paid to attorneys and others for representing Social Security claimants in 2015. The total was $1.094 billion. This was down $46 million or 4%, from 2014. Fees are down $335 million, or 23%, from their peak in 2010.
     All attorneys who practice Social Security law face considerable economic pressure. Almost no one is entering this field of practice now. The attorney fee provisions of the Social Security Act were designed to allow claimants to have representation. This right could be effectively eliminated over coming years unless something changes. One important way that the Acting Commissioner of Social Security could assure that claimants don't lose their right to representation is to increase the cap on Social Security attorney fees. It's currently $6,000. The Social Security Act allows the Acting Commissioner to raise this to adjust for inflation but does not require that she do so. If adjusted for inflation, the cap would now be over $7,000. It's past time to raise the cap.
Posted by Charles T. Hall at 34 comments:
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