Nov 4, 2006

GAO Report On Medical Improvement

The Government Accountability Office (GAO) has issued a report entitled "Clearer Guidance Could Help SSA Apply The Medical Improvement Standard More Consistently." This is a summary from the report:
Several factors associated with the medical improvement standard (the standard) pose challenges for SSA when assessing whether beneficiaries continue to be eligible for benefits. First, limitations in SSA guidance may result in inconsistent application of the standard. For example, SSA does not clearly define the degree of improvement needed to meet the standard, and the DDS directors GAO surveyed reported that they use different thresholds to assess if medical improvement has occurred. Second, contrary to existing policy, disability examiners in a majority of the DDSs are incorrectly conducting CDRs with the presumption that a beneficiary has a disability rather than with a “neutral” perspective. Other challenges associated with the standard include inadequate documentation of evidence as well as the judgmental nature of medical improvement determinations. All these factors have implications for the consistency of CDR decisions. However, due to data limitations, GAO was unable to determine the extent to which these problems affect decisions to continue or discontinue benefits.
GAO's belief that a medical improvement standard somehow means that there is no presumption that a claimant who has been awarded disability benefits remains disabled is ridiculous on its face and suggests a basic misunderstanding. One can read the Social Security Act and regulations to mean this, but it is a logical absurdity. We definitely have a medical improvement standard and that means there must be specific evidence of medical improvement to justify terminating benefits. This means, in fact, that there is a presumption of continued disability regardless of what the statutes and regulations say, because otherwise there is no medical improvement standard. This is the only way a medical improvement standard could be applied.

Like almost all GAO reports, this one suggests that Social Security give clearer guidance to decision makers and that decisions should be more consistent, but fails to suggest any specific ways in which Social Security could achieve these goals.

Interesting, the report shows that Social Security is performing fewer continuing disability reviews in recent years, but cutting the same or more claimants off benefits for medical improvement.

Nov 2, 2006

New Southeastern Program Service Center Mod Assignments

MOD #

SSN ASSIGNED

PHONE NUMBER

1

0000-0624

(205) 801-3015

2

0625-1249

(205) 801-3025

3

1250-1874

(205) 801-3035

4

1875-2499

(205) 801-3045

5

2500-3124

(205) 801-3055

6

3125-3749

(205) 801-3065

7

3750-4374

(205) 801-3075

8

4375-4999

(205) 801-3085

9

5000-5624

(205) 801-3095

10

5625-6249

(205) 801-3105

11

6250-6874

(205) 801-3115

12

6875-7499

(205) 801-3125

13

7500-8124

(205) 801-3135

14

8125-8749

(205) 801-3145

15

8750-9374

(205) 801-3165

16

9375-9999

(205) 801-3175

Nov 1, 2006

Upcoming Meetings and CLE

If you know of one that I have missed, please e-mail me at charles[at]charleshallfirm.com.

Oct 31, 2006

Astrue Nomination Coming To A Head Before Election?

The Senate Democratic Leader, Harry Reid and the Ranking Democrat on the Senate Finance Committee, Max Baucus, have written Michael Astrue, President Bush's nominee to become the next Commissioner of Social Security. Note two things in the letter that is reproduced below. First, Reid and Baucus are obviously concerned about Astrue being in office during the term of President Bush's successor, whom they hope will be a Democrat. Second, and more interesting, the two Senators are demanding answers to questions on Astrue's views on privatization before the election and make only the most thinly veiled threat to block Astrue's confirmation if he fails to answer before the election. The fate of Astrue's nomination may be determined in the next few days.

October 31, 2006

Dear Mr. Astrue:

Congratulations on your nomination to be the next Commissioner of Social Security. This position is one of the most important in the Federal Government because the Commissioner is responsible for maintaining a program that many Americans depend on for their financial survival. Indeed, if the Social Security program did not exist, more than 50 percent of our seniors would be living in poverty. Therefore, we and the other members of the Congress will examine your qualifications for this position very closely.

Given the importance of the Social Security program, Congress established the Social Security Administration as an independent agency in 1994. One important aspect of the Agency's independence is that the Commissioner serves a six-year term, in contrast to the four-year term for the President. Additionally, a President can only fire the Commissioner of Social Security for willful misconduct. With these two features that make the agency and the Commissioner independent, it is quite possible that a Commissioner could be in office during the term of a President who did not appoint him or her. Thus, Congress clearly contemplated the possibility that a Commissioner may have different views on some issues than the President who is in office at the same time.

A critical issue facing the Social Security program is the challenge of shoring up its long-term finances. Under current law, the Social Security program can be fully financed until 2046, according to information on Congressional Budget Office. After that, the program can pay 79 cents of every dollar of benefits. Clearly, we must make some changes to pay full Social Security benefits in the future. The sooner we make these changes, the more time future workers and beneficiaries will have to adjust their retirement plans.President Bush has proposed a privatization plan that would change the Social Security program dramatically, and this proposal is fully reflected in the proposed Budget he sent to the Congress last February. The proposal has two major elements." President Bush has proposed a privatization plan that would change the Social Security program dramatically, and this proposal is fully reflected in the proposed Budget he sent to the Congress last February. The proposal has two major elements.

The first major element would privatize Social Security by allowing workers to divert a portion of their Social Security payroll taxes into private savings accounts, rather than into the Social Security Trust Fund. We have strong objections to this change. The diversion of payroll taxes into private accounts would worsen -- not improve -- Social Security's long-run solvency problems, thereby leading to benefit cuts, it would increase Federal debt held by the public by $5 trillion during its first twenty years in operation, and it would expose Social Security benefits -- which are the sole or primary source of income for many seniors -- to financial market risks.

The second major element of the President's proposal would further cut Social Security benefits deeply by changing the formula by which initial Social Security benefits of future retirees would be determined. As a result of this change, many middle-class retirees would suffer enormous reductions in their benefits. For example, workers with yearly earnings equivalent to $59,000 today would have their future Social Security benefits reduced by 42 percent. Workers with earnings equivalent to $37,000 would suffer a 28 percent reduction in their future benefits. We think that such huge cuts in benefits are not acceptable.

To adequately evaluate your nomination, it is important for us to know your answers to two questions:

1. What are your views on each major element of President Bush's privatization plan?

2. To what extent will you speak out and take actions to support President Bush's privatization plan in public or in private?

In order for us to proceed expeditiously, please provide your answers no later than Nov. 3.

We look forward to hearing your responses to these two important questions and to working with you to keep the Social Security program strong for future beneficiaries.

Sincerely,

Harry Reid, Senate Democratic Leader

Senator Max Baucus, Ranking Member, Committee on Finance

FASAB And Social Security

Ever heard of the FASAB? Those initials stand for the Federal Accounting Standards Advisory Board. So what could that have to do with Social Security? The Associated Press reports that the FASAB has issued a 150 page report proposing that federal government financial reports show future Social Security benefits as a current unfunded liability, basically to apply accrual accounting to Social Security. Interestingly, Bush Administration appointees to the FASAB have opposed the proposal.

Oct 30, 2006

Social Worker Case Manager Job Advertised

Social Security has now advertised five job openings for "Social Worker (Case Manager)." This is part of the Disability Service Improvement (DSI) experiment. The job appears to be nearly identical to the Nurse Case Manager positions advertised earlier, only the job applicants do not have to be nurses. However, a masters degree in social work is required. One might guess that Social Security had trouble finding enough nurses to fill the positions. Below is the job description:
Provides psychiatric/medical policy, procedural, and technical advice and guidance to DDSs, ROs, ALJs, the DRB, OQP and the national network of experts affiliated with the OMVE on complex issues encountered in making the determination or decision in a disability claim. This technical advice and guidance includes confirming what medical, psychological and vocational expertise is needed as well as verifying the need for additional medical or lay evidence, tests, or a consultative examination. Verifies that the request is in accordance with disability law, regulations, and policy.

Provides expert psychiatric/medical advice and guidance to the DDSs, ROs, ALJs, DRB, OQP and the national network of medical and vocational experts.

Ensures that the disability adjudicators in the DDSs and ROs and the ALJs have requested expertise or development that is needed and appropriate.

Ensures consistency in medical disability determinations by the DDSs, ROs and/or ALJs in accordance with established regulations and national practices.

Determines if beneficiary contact, current psychiatric/medical evidence and/or consultative examinations are required; assists DDSs, ROs, ALJs, DRB and OQP in obtaining appropriate evidence and examinations; and, as necessary, contacts sources (Medical Consultants, national network of experts, etc.) for assistance in interpreting medical evidence and/or determining whether additional evidence is required

Oct 29, 2006

Monthly Statistical Packages Released

Social Security has issued its monthly package of statistics on Title II and Title XVI (SSI) of the Social Security Act.

Oct 28, 2006

Emergency Message On Attorney Registration

Social Security has issued an Emergency Message to its staff on the upcoming requirement that attorneys representing Social Security claimants register with Social Security and provide their Social Security number and direct deposit information. The Emergency Message indicates that training for Social Security staff starts on November 8, 2006. Because of budget problems, SSA does not intend to start issuing 1099s to attorneys until 2009 for calendar year 2008.