Courts of Appeals Updates

Eric Schnaufer has updated his Schnaufer.com website that gives a comprehensive listing of recent Courts of Appeals decisions, including an 8th Circuit case decided on December 6. You cannot get more up to date than that!

SSAB Agenda

The Social Security Advisory Board has announced a schedule for its meeting on December 7.

Fraud Arrests in GA and SC

There have been multiple arrests in Georgia and South Carolina for fraud on the Social Security Administration under Operation Secure Star, billed as a Homeland Security operation, although, as described, the alleged crimes sound like unrelated cases of garden variety fraud, some of which happened to involve two Mexican nationals. The investigations included Social Security's Office of Inspector General (OIG).

NADE Newsletter

The National Association of Disability Examiners (NADE), an organization of employees of the State Disability Determination Service (DDS) agencies that make initial and reconsideration determinations on Social Security disability claims, has released its Fall 2005 Newsletter. The Newsletter contains a summary of Commissioner Barnhart's speech to a NADE conference in September. There is also a summary of a presentation made at the same conference by Patrick O'Carroll, SSA's Inspector General, that included showing video of several claimants engaged in activities alleged to be inconsistent with statements the claimants had made to SSA. The Newsletter includes comments made by NADE on recent Notices of Proposed Rulemakings (NPRMs), a good deal of information about NADE members' take on AEDIB, Social Security's paperless system of the future, and a NADE position paper favoring the elimination of the 24 month waiting period for Medicare.

New POMS on Medicare Part D Appeals

Social Security has added material to POMS (Program Operations Manual Series) concerning appeals of subsidy determinations under the Medicare Prescription Drug Benefit, also known as Part D of Medicare.

New Requirements For Proof of Age

In response to reports that fraudulent birth records have been used to get Social Security cards, SSA has issued a POMS (Program Operations Manual Series) update to tighten the requirements for proof of age when issuing a Social Security card.

SSA Interprets California Paternity Laws

Here is Social Security's summary of a new legal opinion from SSA's Office of General Counsel published in POMS (Program Operations Manual Series):

Under California law, while SSA is not bound by a posthumous court order of paternity, that court order can be used in conjunction with other statements and evidence to establish paternity under the state's clear and convincing evidence standard in cases where there is no contradictory evidence.

Proposed Regulations on Failure to Cooperate with CDR and Fugitive Felons

The Social Security Administration has published two Notices of Proposed Rulemakings (NPRMs) in the Federal Register. Comments are allowed on each proposal. Neither is effective until SSA reviews and responds to those comments.

One proposal would suspend the Title II benefits of a claimant facing a continuining disability review (CDR) who fails to cooperate. If the claimant later cooperated within a year after the suspension of benefits, benefits would resume. This process should be more favorable for a claimant than the current process whereby a claimant's benefits are not suspended, but cut off entirely for failure to cooperate. Under the current process, a claimant who could not be contacted due to circumstances beyond their control, such as a lengthy hospitalization or who failed repeatedly to attend consultative medical examinations due to lack of transportation, could lose their benefits altogether.

The second proposal would implement the changes to the Social Security Act that added a prohibition on payment of Title II benefits to fugitive felons. The most important part of this is SSA's interpretation of the "good cause" exception. To meet the good cause provision a claimant would have to show all of the following:

• The crime or violating the probation or parole which the warrant is based on was both nonviolent and not drug related and, if for violating probation or parole, the original crime(s) was both nonviolent and not drug-related; and

• The person has neither been convicted of nor pled guilty to another felony crime since the date of the warrant; and

• The law enforcement agency that issued the warrant reports that it will not extradite the person for the charges on the warrant or that it will not take action on the arrest warrant.

If the first two requirements above apply but not the third, we may also find good cause if the following two criteria apply:

• The only existing warrant was issued 10 or more years ago; and

• The person’s medical condition impairs his or her mental capability to resolve the warrant; or he or she is incapable of managing his or her benefits; or he or she is legallyincompetent; or we have appointed arepresentative payee to handle thebenefits; or he or she is residing in a long-term care facility, such as a nursing home or mental treatment/care facility.