The Breath Of The Dead

     I remain distressed that Social Security's new Listings for liver disease remains as brutal as ever. One feature of dealing with clients with failing livers is officially called fetor hepaticus. It's sometimes called "breath of the dead." It's an extremely disturbing smell on the breath of some people with failing livers. I wonder whether any of those who drafted these Listings have ever smelled fetor hepaticus. The idea that anyone whose liver disease has progressed to this point can work seems preposterous once you smell it yet such patients are often denied Social Security disability benefits. It's not the smell that disables them. It's just obvious that anyone with that smell isn't long for this world. I can't emphasize too much just how viscerally disturbing fetor hepaticus is. It smells as if the person has already started dying on the inside. Why are patients in this condition being denied?

Presentation On New Occupational Information System

    On March 18, 2023, Charis Clark and Karen Litschgi of the Bureau of Labor Statistics (BLS) gave a presentation to the American Board of Vocational Experts (ABVE) on the Occupational Requirements Survey: Date and Upcoming Changes. By Freedom of Information Act request I have obtained the Powerpoint slide deck they used for the presentation. (I appreciate the Department of Labor's promptness in responding to my request.) I don't see any surprises in it but if you're interested in what's going on with Social Security's effort to have BLS create a new occupational information system for use in determining disability you should take a look. As boring as this may seem, it's vitally important to the future of Social Security disability determination. The seemingly never-ending process to develop a new system deserves close scrutiny. I don't trust Social Security on this. I'm not sure that anyone who knows much about this trusts Social Security.

    Below are links to the original Powerpoint version and to a version that I printed to PDF. If you're using the PDF version, you will see links in the upper left hand corner of the screens leading to notes apparently used by the presenters. Those notes were apparently not visible to the audience. If you use the Powerpoint version, those notes are visible at the bottom of the screen.

• Powerpoint version
• PDF version
  

    Update: You will have to ask permission to receive the file. I will approve these as quickly as I can. If you know of a better way of doing this sort of thing, I'd be interested.

Disability Incidence Rate Down

From What Factors Explain the Drop in Disability Insurance Rolls from 2015 to 2019? by Siyan Liu and Laura D. Quinby for the Center for Retirement Research at Boston College:

 

Average Age Of Disability Applicants Increased Sharply About 10 Years Ago

    From What Factors Explain the Drop in Disability Insurance Rolls from 2015 to 2019? by Siyan Liu and Laura D. Quinby for the Center for Retirement Research at Boston College:

 

Pillersdorf Honored

    The Louisville Courier Journal reports that Ned Pillersdorf is one of four lawyers nationwide who have been honored by the American Bar Association for volunteer legal work. Pillersdorf was instrumental in initiating and directing the legal response to the Eric Conn debacle.

    I think one element of Pillersdorf's work that needs to be especially noted is that he faced indifference, if not hostility, from the Kentucky bar. If this had happened in my state or most other states, I'm sure the bar would have organized a massive response. That didn't happen in Kentucky. Sure, there were some Kentucky attorneys who responded but most who have helped Conn's victims have been from out of state. It takes guts to stick up as Pillersdorf has done.

OHO Caseload Analysis Report

 

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Two Bills Advance

     Yesterday, the House Ways and Means Committee marked up two minor bills that would affect the Social Security Administration in small ways. One would allow minors whose Social Security numbers have been compromised to obtain new Social Security numbers. The other would provide for a single point of contact at Social Security for those whose Social Security numbers have been compromised. I'm sure the first is debatable and the second is pointless without additional funding. 

    I wouldn't bet on either bill advancing in the Senate. If they do, you never know what might get added.

New Digestive And Skin Disorders Listings

     The Social Security Administration will publish final rules to revise its digestive and skin disorders Listings in the Federal Register tomorrow. It runs to 159 pages in the PDF version! (It will be fewer pages in the actual Federal Register since that's three columns of small print.)

    One noticeable part is that they've changed the formula for determining SSA CLD, which has been used to determine whether claimants meet the Listing for chronic liver disease (CLD). It used to be exactly the same as the MELD formula used to determine whether individuals with chronic liver disease can get a liver transplant. Now it's just mathematically the same. I've speculated that the agency used the name "SSA CLD" to obscure the fact that it's literally easier to get a liver transplant than it is to meet the Listing for chronic liver disease. I'll speculate that they're going a step further to further obscure just how impossible it is to meet the Listing. They do note in the materials that a MELD or SSA CLD score that meets the Listing means that the patient has a 19.6% chance of dying in the next three months. They think that's a justification for their standard. I was not under the impression that the definition of disability required a person's condition to be quickly fatal.

    I also note that the new Listings make it impossible for claimants to meet the Listings for hidradenitis suppurtiva. Never heard of hidradenitis suppurtiva? Trust me, you don't want it. It's one of the most commonly disabling skin conditions.  For that matter, it appears that it will now be impossible to meet the Listings for psoriasis. For most people with psoriasis, the disease is annoying and unpleasant but manageable but that's not the case for a small percentage of people with psoriasis.

NPRM On FOIA

     The Social Security Administration posted a Notice of Proposed Rule-Making (NPRM) in the Federal Register today to amend its Freedom of Information Act (FOIA) regulations to make them more consistent with 2016 changes in the FOIA and with recent guidance from the Attorney General.

Disability Allowance Rates Plummeted After 2000

    From What Factors Explain the Drop in Disability Insurance Rolls from 2015 to 2019? by Siyan Liu and Laura D. Quinby for the Center for Retirement Research at Boston College:

 

Disability Incidence Rate Goes Up -- Until Age 62

    From What Factors Explain the Drop in Disability Insurance Rolls from 2015 to 2019? by Siyan Liu and Laura D. Quinby for the Center for Retirement Research at Boston College:

 

New Awards And Terminations

    From What Factors Explain the Drop in Disability Insurance Rolls from 2015 to 2019? by Siyan Liu and Laura D. Quinby for the Center for Retirement Research at Boston College:

 

Why Are Fewer People Drawing Disability Benefits Now?

     From What Factors Explain the Drop in Disability Insurance Rolls from 2015 to 2019? by Siyan Liu and Laura D. Quinby for the Center for Retirement Research at Boston College:

In 2015, the number of individuals receiving Social Security Disability Insurance (DI) benefits began to drop for the first time in two decades. This drop was caused by a wave of terminations, as beneficiaries aged into the Old-Age and Survivors Insurance (OASI) program, combined with a steep decline in the incidence rate (the number of new DI awards relative to the insured population). ...

The paper found that:

• A strong economy accounted for about half of the drop in the incidence rate.
• Policy changes – specifically the retraining of Administrative Law Judges – also accounted for about half the drop.
• Population aging put slight upward pressure on the incidence rate.
• In terms of the total number on the disability rolls, the impact of aging on terminations far exceeds its impact on new awards.

The policy implications are:

• The time may have come to somewhat rebalance the goals of DI from encouraging labor force participation to protecting vulnerable people.
• Congress may want to consider merging the DI and OASI trust funds. ...

    I'll pull out some interesting charts from this paper over the next few days.

Debt Limit Bill Passes House Of Representatives

     The bill to increase the debt limit passed the House of Representatives yesterday. It would force a slight decrease in "non-defense discretionary" spending. That's only a relatively small portion of federal spending but it includes Social Security's administrative budget. If you consider inflation, which may be around 5% now, agencies affected can expect a significant decrease in operating funds. Exactly how much each agency in the "non-defense discretionary" category receives will be determined in the appropriations process that lies ahead. While we can hope that the Social Security Administration fares better than other agencies, the reality is that it has been disfavored in recent years, receiving less than most other agencies in the "non-defense discretionary" category.

     The projected cut in operating funds for Social Security probably won't be across the board. I am attaching a page from the debt limit bill. My guess is that the language about continuing disability reviews is intended to make sure that the Social Security Administration has more and more to spend on CDRs even though its appropriation otherwise will go down. Does anyone know whether there's more going on?

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Debt Limit Extension Bill Would Apply Food Stamps Work Requirements To Those Applying For Social Security Disability Benefits

    From Pamela Herd writing on Substack:

...  SNAP [commonly known as Food Stamps] is a critical safety valve for people trying to access Social Security Disability programs — for which delays in benefit receipt can extend into years. The expansion in work requirements for this age group [as part of the debt limit extension bill just agreed to by the President and the Speaker of the House] seems innocuous, but they are highly consequential. Even those who dislike work requirements don’t fully understand the ramifications. ...

But wait!  Aren’t disabled people excluded from the work requirements?

Yes, but this is where administrative burdens matter. In order to prove you are disabled, you must become eligible for Social Security Disability, either Social Security Disability Insurance or Supplemental Security Income. But this process takes significant amounts of effort and time. ...

The net result is that it can take years to prove disability in order to access either SSDI or SSI, as well as now prove that you can’t meet the work requirements for SNAP. 

And the wait times have been steadily increasing. Between 2014 and 2022, average wait times rose from 106 days to 183 days. The average beneficiary now waits six months to access their benefit, and *prove* their disability.  ...

Hearing On Identity Fraud

     Last Wednesday the House Social Security Subcommittee held a hearing on the Social Security Administration's role in preventing identity fraud. Below in the witness lineup:

Mr. Sean Brune
Deputy Commissioner for Systems and Chief Information Officer, Social Security Administration
Witness Statement

Ms. Katie Wechsler
Co-Executive Director, Consumer First Coalition
Witness Statement

Ms. Margaret Hayward
Private citizen and mother of three
Witness Statement

Mr. Robert Roach
President, Alliance for Retired Americans
Witness Statement

Mr. Jeffrey Brown
Deputy Assistant Inspector General, Office of Audits, Office of the Inspector General, Social Security Administration
Witness Statement

Memorial Day 2023

 

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NADE Newsletter

      The National Association of Disability Examiners (NADE), an organization of the personnel who make initial and reconsideration determinations on Social Security disability claims, has issued its Spring 2023 newsletter. There’s information about a couple of meetings they’ve had with agency officials.

Good Luck Getting Anyone At Social Security To Answer The Phone Much Less Help You

      Elon Musk’s Social Security number was found among Tesla papers made public by a whistleblower.

Unhappy ALJs

      Some of Social Security’s Administrative Law Judges really don’t like that Washington Post piece on all the federal court remands of their decisions. Take a look at what they have to say.