Jan 29, 2007

Developmental Delay Grant Available

From today's Federal Register -- and, yes, this was posted by the Social Security Administration:
The Social Security Administration requests applications for cooperative agreement funding to support projects that will design and implement effective, replicable, and sustainable models which will increase the number of children (birth to age 5) who receive developmental screening and improve the early identification of children with developmental delays and/or disabilities.
This grant may or may not be a good idea, but why is it coming from the Social Security Administration? Was this a Congressional earmark? I hate to beat a dead horse, but when Social Security cannot answer its telephones and it is routinely taking a year and a half and more for Social Security to schedule hearings for sick, desperately poor Social Security disability claimants, most of whom will be awarded benefits by Administrative Law Judges, does it make any sense for Social Security to spend money on something that is so far away from the agency's core function that it sounds like a project for the National Institutes of Health, if anyone?

Jan 28, 2007

New Commission Proposed

Medical News Today reports on a new proposal in Congress:
Sens. Dianne Feinstein (D-Calif.) and Pete Domenici (R-N.M.) on Monday introduced a bill to establish a permanent, bipartisan commission that would provide recommendations to maintain the future solvency of Medicare and Social Security, CQ Today reports (Wayne/George, CQ Today, 1/22). The 15-member commission -- which would include seven Republicans, seven Democrats and one independent -- would have to provide recommendations to Congress within one year and subsequently every five years. Under the legislation, the recommendations would have to be reported by House and Senate committees within 60 days or be directly discharged to the House or Senate floor.

Jan 27, 2007

Unum Sells Genex

The Associated Press reports that UnumProvident, the nation's largest writer of long term disability (LTD) insurance, has sold Genex, a subsidiary, to a private equity firm. Genex has been involved in case management and medical cost containment in LTD and workers compensation. The case management services have included representing disability claimants before the Social Security Administration. Writers of LTD insurance have a huge interest in obtaining Social Security disability benefits for their insureds since LTD policies offset the Social Security disability benefits. UnumProvident reported only a "small net gain" on the sale.

The sale might free Genex to seek the business of individual Social Security disability claimants who need representation, basically entering the retail market for Social Security representation, rather than relying upon the wholesale business provided by LTD carriers, although there is no sign of such an intent or that Genex could be successful in this should they chose to try it. The sale certainly opens the possibility for dramatic change in the market for LTD carrier representation in Social Security disability claims.

Jan 26, 2007

ALJ Erving Torres Alleged To Misuse Handicapped Parking Space

From the St. Petersburg Times:

TAMPA - Each day, administrative law judge Elving L. Torres decides whether people are disabled enough to receive Social Security benefits.

Sometimes he puts himself in the shoes of people who appear before him: He parks his luxury import car in the handicapped spaces outside the building where he works.

A handicapped parking placard appears on the dashboard of his silver Mercedes-Benz AMG coupe. But it was issued to an 86-year-old woman from Bradenton, according to state motor vehicle records. ...

Through a receptionist, Torres declined to speak to a reporter who inquired about his handicapped placard, referring questions to the Social Security Administration's regional office in Atlanta. He declined to answer questions a second time as he approached his car in the parking lot Wednesday.

"I work for a federal agency," Torres said. "I can't speak to you without approval," he said, adding that he would speak if he received permission. ...

Request For Help On Micronesia Issue

Has anyone investigated the issue of whether immigrants from Micronesia allowed into the United States under the Compact of Free Association Act of 1985 are eligible for SSI? These immigrants stand in a unique position under United States law. Their status under Title XVI of the Social Security Act is difficult to determine, at least for me. If you have information on this subject, I would appreciate an e-mail to charles[at]charleshallfirm.com.

Federal Times On Confirmation Hearing

The Federal Times has an article up on the confirmation hearing on Michael Astrue's nomination to become the next Social Security Commissioner.

Jan 25, 2007

"Fatness" And Early Retirement

The Michigan Retirement Research Center has published a study on the relationship between "fatness" as they call it and early retirement. I do not understand why they chose to call it "fatness" rather than "obesity", but their findings are interesting nevertheless. Here is their abstract of the study:
Theoretical models argue that poor health will contribute to early exit from the labor market and the decision to take early Social Security retirement benefits (Old-Age or OA benefits). However, most empirical estimates of the causal importance of health on the decision to take early OA benefits have been forced to rely on global measures such as self-rated work limitations or self-rated health. We contribute to the empirical literature by using a more objective measure of health, fatness, to predict early receipt of OA benefits. We do so by estimating the causal impact of fatness within an empirical model using the method of instrumental variables, and testing the robustness of our findings using the most common measure of fatness in the social science literature – body mass index – with what is a more theoretically appropriate measure of fatness – total body fat and percent body fat. Overall, our conclusion is that fatness and obesity are strong predictors of early receipt of OA benefits.

Modeling and SSA -- An End To "Grand Plans"

Looking back, there was a significant topic at the confirmation hearing for Mike Astrue to become Commissioner of Social Security that I did not mention in my summary yesterday. That is Astrue's frequent mention of the word "modeling." This is a word that has been seldom mentioned in conversations about Social Security. Of course, Astrue was not referring to anything having to do with fashion. What he was talking about is often referred to as computer modeling or computer simulation. A classic example would be the design of an aircraft wing. The old method of doing this involved creating a mock-up of a proposed wing and putting it in a wind tunnel to see how it would perform. With computer modeling the aircraft wing can be designed on a computer and the computer model of the wing could be tested on the computer without the need for a physical model or a wind tunnel. This is possible because of the development of complex and sophisticated computer programs that allow users to simulate the real world on the computers.

Astrue was talking about "modeling" as a process for producing figures for Congress on what sort of progress Social Security could make in dealing with its backlogs depending upon what level of funding the agency receives from Congress. Perhaps, someone at Social Security has devised a computer program that does "model" their operations. More likely, there is no such computer program, but there is plenty of information about employee productivity that would allow experienced agency personnel to come up with high quality estimates of what could be achieved with various levels of funding. This would be the equivalent of a computer model.

This may sound rather boring, but it is actually an important change of focus. The focus at Social Security over the last dozen years or so has been on "grand plans" which various Commissioners of Social Security promised would yield dramatically improved performance. The first of these grand plans was "Re-engineering" which began in about 1994. Re-engineering got a trial. The trial showed that the plan did not work and "Re-engineering" was abandoned. The second grand plan was "Hearing Process Improvement" or HPI. Trial implementation of HPI began in about 1999. There were early signs that HPI was not working, but in the waning days of the Clinton Administration, Social Security went ahead with full scale implementation of HPI. The result was a disaster, with dramatically worsened performance and vastly increased backlogs. Ignoring the warning signs from "Re-engineering" and HPI, Jo Anne Barnhart, who became Commissioner of Social Security in 2000, launched planning for a third grand plan, which incorporated a technological change -- using paperless scanned files instead of physical files to hold the records concerning a claim for Social Security disability benefits, called EDIB, as well as organizational changes referred to as Disability Service Improvement or DSI. There has been enough implementation of EDIB that it is already clear that it will yield only modest productivity gains at Social Security, at best. DSI is only now starting into implementation -- just as Barnhart leaves her position at Social Security -- so DSI has not had an opportunity to succeed or fail, but there is almost no one who either works at Social Security or who deals with the agency on regular basis who has hope for DSI achieving much.

"Re-engineering", HPI, EDIB and DSI had a huge impact upon Congress' view of Social Security. They created the strong impression that the ever-increasing backlogs at Social Security were the fault of poor organization at Social Security which could be corrected by re-organization, that is that the problems were largely independent of Social Security's budget. It has become increasingly obvious that this approach does not work. Smart people have been trying for decades to re-organize Social Security to get greater productivity and for the most part they have failed. The result of relying upon re-organization instead of budget has been backlogs that can be easily measured and reductions in quality of work produced that are not so easily measured.

In talking about modeling, Astrue appears to be getting away from reliance upon the grand plans that have repeatedly failed Social Security. He is telling Congress that performance at Social Security is tied closely to the agency's operating budget. It is not up to the Commissioner of Social Security to produce a grand plan that magically solves Social Security's problems. It is up to the President and Congress to decide what level of service they are willing to pay for. With modeling, Astrue is going to say, in effect "Here is what you can expect based upon these possible levels for the operating budget you give Social Security. You decide and I'll do the best I can to operate within what you give me. Don't expect me to create a grand plan that pulls a rabbit out of a hat."We can hope that this approach yields a bigger budget for Social Security and better agency performance.

In fairness to Commissioner Barnhart and her predecessors, I should note that the era of grand plans at Social Security corresponds exactly with the era of Republican control of Congress. This may be more than a coincidence. It may be that the grand plans were developed because Republicans in Congress demanded that they be created or because they made it clear that any improvement in service at Social Security could only come from productivity improvement since the agency was not going to get more money, no matter how badly service suffered. Senator Bunning gave an excellent representation of a Republican attitude that may have led to the grand plans, as he vehemently told Astrue that he did not want to hear anything about budget problems at Social Security. He knew that the problem was poor performance at Social Security and he demanded that Astrue do better. Bunning, a Republican, was at one time in the House of Representatives and the Chairman of the House Social Security Subcommittee. Listening to Bunning, it is easy to understand how a Commissioner of Social Security would have felt pressured to come up with a grand plan. Bunning is now in the Senate, his party is no longer in control of Congress and the Ranking Minority Member of the Finance Committee seems to agree that budget is the key to better performance at Social Security, so Bunning's views, while still important, are not controlling.