How Long Have You Been Suffering From This Delusion?

     Erik Sherman at Forbes Magazine believes that Hillary Clinton may be moving towards privatizing Social Security.

Hildred Appointed To SSAB

     The Speaker of the House of Representatives has appointed Kim Hildred to the Social Security Advisory Board. She had been staff director of the House Social Security Subcommittee.

Social Security Means What It Says -- Until It Becomes Inconvenient

     From Emergency Message 16036 recently issued by Social Security:

A. What is the purpose of this Emergency Message? This emergency message clarifies the following sentence in Social Security Ruling 83-20 – Titles II and XVI: Onset of Disability (SSR 83-20), “At the hearing, the administrative law judge (ALJ) should call on the services of a medical advisor when onset must be inferred.” 

B. What is the background behind this Emergency Message? There has been confusion as to whether the above-quoted sentence in SSR 83-20 imposes a mandatory requirement on an ALJ to call on the services of a medical expert when onset must be inferred. 

C. Does SSR 83-20 impose a mandatory requirement on an ALJ to call on the services of a medical expert when onset must be inferred? No, SSR 83-20 does not impose a mandatory requirement on an ALJ to call on the services of a medical expert when onset must be inferred. 

Instead, the decision to call on the services of a medical expert when onset must be inferred is always at the ALJ’s discretion. 

Direct all questions to your hearing office management chain or the Office of Appellate Operations Executive Director’s office, as appropriate.

Unsuccessful Work Attempt Regulations Improved

     This is Social Security's summary of new rules it recently published in the Federal Register:

The final rules at 20 CFR 404.1574(c), 404.1575(d), 416.974(c), and 416.975(d) remove the additional conditions that we used when we evaluated a work attempt in employment or self-employment that lasted between 3 and 6 months and use the current 3-month standard for all work attempts that are 6 months or less. Under these rules, ordinarily, work you have done will not show that you are able to do substantial gainful activity if, after you worked for a period of 6 months or less, your impairment forced you to stop working or to reduce the amount of work you do so that your earnings from such work fall below the substantial gainful activity earnings level. The new rules at 20 CFR 404.1592c and 416.999a allow a previously entitled individual to request EXR [Expedited Reinstatement] in the same month they stop performing SGA [Substantial Gainful Activity].

     The new rules are effective on November 16, 2016, except for the Expedited Reinstatement changes which are effective on April 17, 2017.

Tiny COLA

     The annual Cost Of Living Adjustment (COLA) for Social Security benefits for this year is only 0.3%. For the average recipient of benefits this is less than $4 a month. For the vast majority of beneficiaries this increase will be completely taken away by the increase in Medicare Part B premiums.

OIG Report On Hearing Backlog Initiatives

     Social Security's Office of Inspector General (OIG) recently issued a report on the agency's numerous and varied attempts to reduce its hearing backlog, none of which is working very well.

OIG Report On PASS Plans

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

PASS [Plan for Achieving Self-Support] is an employment support program designed to help disabled individuals return to work. Congress established the PASS program as part of the original Supplemental Security Income (SSI) legislation in 1972, and the program went into effect in 1974. Congress intended employment support provisions, such as PASS, to provide disabled beneficiaries with the assistance needed to move from benefit dependence to independence. The legislative history also indicates that Congress expressed a “. . . desire to provide every opportunity and encouragement to the blind and disabled to return to gainful employment.” ...

SSA did not have sufficient information to evaluate the success of its PASS program . Nevertheless, the Agency was not effectively managing the program. For example, SSA lacked basic data on PAS S program participation, costs, and outcomes. In addition, SSA had not evaluated the PASS program’s impact on the di sability rolls . Finally, SSA did not routinely monitor the PASS program or conduct quality control reviews.

Internal control weaknesses leave the PASS program vulnerable to misuse . For example, PASS program guidelines were broad and vague . In addition, there were no limits on PASS benefits, such as caps on expenditures, time limits to complete work goals, or restrictions on the number of PASS work goals a disabled individual may have. Further , some individuals exploit ed the program by misusing PASS benefits to obtain items or services that were unrelated to their work goals....

     My experience with PASS is that it is ridiculously difficult to get a PASS plan approved. Maybe OIG just wants Social Security to effectively repeal PASS by making it literally impossible to get a plan approved.
     Of course, no matter how PASS is administered it's not going to have a significant effect upon the number of people drawing SSI. It's just part of the Congressional fantasy world where SSI recipients will stream off the disability rolls if we just give them enough encouragement. Hint to Congress: It's really tough to get on SSI disability benefits, so tough that very, very few on the benefits have any realistic hope of ever returning to work no matter what anyone does to help them.

NADE Newsletter

     The National Association of Disability Examiners (NADE), an organization of the personnel who make initial and reconsideration disability determinations for Social Security has issued its most recent newsletter, full of summaries of presentations that Social Security management personnel made at a NADE conference.

One Judge Holds Terminations Of Benefits For Eric Conn Clients Unconstitutional

     A United States District Court judge has held that Social Security's termination of disability benefits for Eric Conn's former clients is unconstitutional. Don't think this is resolved. Two other judges on the same court have upheld the terminations. The issue now heads to the Court of Appeals. Interestingly, the judge who found the terminations to be unconstitutional, Thapur, is on Donald Trump's announced list of possible Supreme Court nominees, not that he's likely to have a chance to use that list.

     I'm sorry to be so late posting this but I've been off the net while traveling.

New Somatoform Listing

     From Social Security's new mental impairment Listings effective January 17, 2017:

12.07 Somatic symptom and related disorders (see 12.00B6), satisfied by A and B

     A. Medical documentation of one or more of the following:

          1. Symptoms of altered voluntary motor or sensory function that are not better explained by another medical or mental disorder;

        2. One or more somatic symptoms that are distressing, with excessive thoughts, feelings, or behaviors related to the symptoms; or

      3. Preoccupation with having or acquiring a serious illness without significant symptoms present.

AND

     B. Extreme limitation of one, or marked limitation of two, of the following areas of mental functioning (see 12.00F):

          1. Understand, remember, or apply information (see 12.00E1).

          2. Interact with others (see 12.00E2).

          3. Concentrate, persist, or maintain pace (see 12.00E3).

          4. Adapt or manage oneself (see 12.00E4).

New Personality Disorder Listing

     From Social Security's new mental impairment Listings effective January 17, 2017:

12.08 Personality and impulse-control disorders (see 12.00B7), satisfied by A and B:

     A. Medical documentation of a pervasive pattern of one or more of the following:

          1. Distrust and suspiciousness of others;

          2. Detachment from social relationships;

          3. Disregard for and violation of the rights of others;

          4. Instability of interpersonal relationships;

          5. Excessive emotionality and attention seeking;

          6. Feelings of inadequacy;

          7. Excessive need to be taken care of;

          8. Preoccupation with perfectionism and orderliness; or

          9. Recurrent, impulsive, aggressive behavioral outbursts.

AND

     B. Extreme limitation of one, or marked limitation of two, of the following areas of mental functioning (see 12.00F):

          1. Understand, remember, or apply information (see 12.00E1).

          2. Interact with others (see 12.00E2).

          3. Concentrate, persist, or maintain pace (see 12.00E3).

          4. Adapt or manage oneself (see 12.00E4).

New Neurodevelopmental Listing

     From Social Security's new mental impairment Listings effective January 17, 2017:

12.11 Neurodevelopmental disorders (see 12.00B9), satisfied by A and B:

     A. Medical documentation of the requirements of paragraph 1, 2, or 3:

          1. One or both of the following:

           a. Frequent distractibility, difficulty sustaining attention, and difficulty organizing tasks; or

            b. Hyperactive and impulsive behavior (for example, difficulty remaining seated, talking excessively, difficulty waiting, appearing restless, or behaving as if being “driven by a motor”).

        2. Significant difficulties learning and using academic skills; or

       3. Recurrent motor movement or vocalization. [So in the original; must be typo. They only had a few years to work on it.]

AND

     B. Extreme limitation of one, or marked limitation of two, of the following areas of mental functioning (see 12.00F):

          1. Understand, remember, or apply information (see 12.00E1).

          2. Interact with others (see 12.00E2).

          3. Concentrate, persist, or maintain pace (see 12.00E3).

         4. Adapt or manage oneself (see 12.00E4).

Errors In Applying WEP

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

SSA [Social Security Administration] needs to improve its controls to ensure WEP [Windfall Elimination Provision] is timely and accurately applied for Federal pensions. We determined WEP should have been applied to 14 of the 250 beneficiaries sampled . We did not identify any beneficiaries for whom GPO should have been applied. Although SSA was aware these 14 beneficiaries had a government pension, the Agency did not reduce their benefit payments for WEP. The 14 beneficiaries received about $372,000 in overpayments. Based on our sample results , we estimate SSA overpaid about $129 million in Old-Age, Survivors and Disability Insurance benefits to about 4,900 beneficiaries.

If There's Another Side To This Story SSA Better Start Telling It

     From KOAT:

On Thursday, Congresswoman Michelle Lujan-Grisham walked into Albuquerque's Social Security Office, just like anyone else who needs help - but she said she didn’t receive a warm welcome and after an hour, was escorted from the building by federal officers. ...

 

The democratic representative was accompanying a 90-year-old woman to an appointment. 

She wanted to stay incognito - to see first-hand how the office is handling requests. In the past, Lujan-Grisham has criticized the local Social Security Administration for not offering a drop-off zone at its new downtown location. 

After an hour wait with the elderly woman, she said they got help but then got an alarming surprise. 

“Two armed officers show up, tap me,” Lujan-Grisham said during an interview with KOAT-TV Friday. “They challenge me about my access, they challenge me about my right to be there.” 

She said she told them like any citizen, she has a right to be there because it’s a public building, but they persisted. 

“They ask me to leave where I am,” Lujan-Grisham said. “They want to escort me and have a conversation with me.” 

After a few more minutes, Lujan-Grisham said the officers booted her from the building.

“It was purposeful, it was deliberate,” Lujan-Grisham said. 

She’s spent the last day trying to get an explanation from the Social Security Administration and from Federal Protective Services, a division of the Department of Homeland Security, with no luck. 

No one from either agency returned phone calls and emails KOAT either on Friday. ...

New Childhood Listings For Depression, Bipolar And Disruptive Mood Dysregulation Disorder

     From Social Security's new mental impairment Listings for children:

112.04 Depressive, bipolar and related disorders (see 112.00B3), for children age 3 to attainment of age 18, satisfied by A and B, or A and C: 

     A. Medical documentation of the requirements of paragraph 1, 2, or 3: 

          1. Depressive disorder, characterized by five or more of the following:

               a. Depressed or irritable mood; 

               b. Diminished interest in almost all activities; 

              c. Appetite disturbance with change in weight (or a failure to achieve an expected weight gain); 

               d. Sleep disturbance; 

               e. Observable psychomotor agitation or retardation; 

               f. Decreased energy; 

               g. Feelings of guilt or worthlessness; 

               h. Difficulty concentrating or thinking; or

              i. Thoughts of death or suicide. 

          2. Bipolar disorder, characterized by three or more of the following: 

               a. Pressured speech; 

               b. Flight of ideas; 

              c. Inflated self-esteem; 

              d. Decreased need for sleep; 

              e. Distractibility; 

            f. Involvement in activities that have a high probability of painful consequences that are not recognized; or

              g. Increase in goal-directed activity or psychomotor agitation. 

         3. Disruptive mood dysregulation disorder, beginning prior to age 10, and all of the following: 

               a. Persistent, significant irritability or anger; 

               b. Frequent, developmentally inconsistent temper outbursts; and 

               c. Frequent aggressive or destructive behavior. 

     AND 

     B. Extreme limitation of one, or marked limitation of two, of the following areas of mental functioning (see 112.00F): 

          1. Understand, remember, or apply information (see 112.00E1). 

          2. Interact with others (see 112.00E2). 

          3. Concentrate, persist, or maintain pace (see 112.00E3). 

          4. Adapt or manage oneself (see 112.00E4). 

     OR 

     C. Your mental disorder in this listing category is ‘‘serious and persistent;’’ that is, you have a medically documented history of the existence of the disorder over a period of at least 2 years, and there is evidence of both: 

          1. Medical treatment, mental health therapy, psychosocial support(s), or a highly structured setting(s) that is ongoing and that diminishes the symptoms and signs of your mental disorder (see 112.00G2b); and 

          2. Marginal adjustment, that is, you have minimal capacity to adapt to changes in your environment or to demands that are not already part of your daily life (see 112.00G2c).

NRA Does Its Thing

     According to a recent report by Social Security's Office of Inspector General (OIG), the agency received 90,920 comments on the recent Rule-Making proposal to have the agency report the names of individuals who have been assigned a representative payee to the National Instant Criminal Background Check System, where it could be used to prevent individuals from purchasing firearms. The agency must go through all of these comments. I'm sure that the vast majority are nothing more than the repetition of National Rifle Association talking points but it's still a huge number of comments to go through, by far the most in Social Security's history. I can predict that without a lot of pressure from the White House, this one will go on the back burner.

Security Issues With Social Security's Online Systems

     Social Security's Office of Inspector General (OIG) has released only a stub of a report on security in Social Security's online services but it's enough to strongly suggest there are problems. The agency admits that it needs a "higher degree of confidence in users’ asserted identities" and OIG says it is "imperative" that the agency do so "as soon as possible."

The Backlogs Are Horrible

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

As of March 2016, ODAR [Office of Disability Adjudication and Review] had about 1.1 million pending claims awaiting a hearing decision with the average age of 318 days, measured as the time from the date of the hearing request. The volume and age of pending hearing cases has increased since FY [Fiscal Year] 2010.

With respect to the claims awaiting a decision, we found:

• claimants’ average age was 45, and about 6 percent of pending claims involved claimants under age 19;

• about 45 percent of hearing requests nationwide awaited assignment for pre-hearing preparation; and

• approximately 7,400 claimants were deceased.

We found wide variations in workloads by hearing office nationwide. For instance, the average pending cases per ALJ ranged from 502 in the Boston Region to 972 in the New York Region. We also found that the proportion of individuals awaiting a decision in Georgia as related to the number of disability beneficiaries in the State was three times higher than that in Massachusetts.

Click on image to view full size

Click on image to view full size

Are You Kidding Me? A 48% Error Rate?

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

Our objective was to determine whether the Social Security Administration (SSA) correctly completed manual actions to bill for Medicare premiums owed by beneficiaries whose monthly Social Security benefit was less than the monthly Medicare premium. 

When an individual entitled to Medicare Part B receives a monthly Social Security benefit, SSA deducts the monthly Medicare premium from the benefit . However, some individuals’ monthly Social Security benefit is lower than the monthly Medicare premium. SSA must bill these individuals for the remaining amount of the Medicare premium. ...

 SSA incorrectly calculated the Medicare premium owed for 120 (48 percent ) of the beneficiaries we reviewed who had a monthly Social Security benefit lower than their monthly Medicare premium. Based on these results, we project 33,092 beneficiaries paid incorrect amounts totaling almost $21.9 million for Medicare premiums because of SSA’s errors. These errors included miscalculations, erroneous system inputs, and failure to update beneficiary records correctly. As a result, some beneficiaries paid more than the correct amount for Medicare premiums, while others paid less ....

This Is Outrageous

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

We continue to find that SSA [Social Security Administration] needs to improve controls to ensure it pays child beneficiaries’ withheld benefits pending the selection of a representative payee. Based on our random sample, we estimate that SSA did not pay 6,615 beneficiaries approximately $9.2 million in withheld benefits.

Finally, we estimate that SSA only paid 2,423 of the 13,464 beneficiaries we identified during our 2010 audit. This occurred, in part, because SSA did not send letters to 4,233 beneficiaries and pay 214 beneficiaries who were in current pay on another record. ...