More Medicare Premium Deduction Problems

I thought that Social Security and CMS had straightened this out, but the problem goes on and on. This is from the Orange County (CA) Register:

Some Social Security recipients will see their payments reduced next month - in some cases significantly - to correct an error in their Medicare premium deductions, Medicare officials have confirmed.

The government failed to deduct enough to cover their Medicare premiums this year, so the shortfall will be taken out in one lump sum from the Social Security checks that will be sent out next week, said Jeff Nelligan, a spokesman for the Centers for Medicare Services in Washington, D.C.

About 15,000 of the country's 4.9 million Social Security recipients are affected, he said. Letters went out this week to those recipients who will get the additional deduction.

National Academies On Rep Payees

From a press release issued by the National Academies:

Although most people who receive and manage Social Security benefits on behalf of other individuals perform their duties well, the Social Security Administration's "representative payee" program should take steps to better prevent and detect the misuse of funds, says a new report from the National Research Council. Currently the program requires reporting by representative payees, but the process does not appear to be effective at identifying cases in which benefits are misspent. The rate of misuse, although very low, is significantly higher than SSA's official estimate, the report says. It offers a new method to aid the agency in identifying possible misuse, and recommends improved support for representative payees and closer tracking of their performance.

"Though the program is meeting the needs of most beneficiaries, the Social Security Administration is not obtaining the information it needs to detect misuse of benefits and provide the best service possible," said Barbara Bailar, chair of the committee that wrote the report, and former senior vice president for survey research at the University of Chicago's National Opinion Research Center. ...

A national survey conducted as part of the study found that almost 95 percent of beneficiaries are "satisfied" or "very satisfied" with their representative payees. And both representatives and beneficiaries understand representatives' basic responsibilities, which include managing funds to help meet beneficiaries' needs for food, clothing, and shelter. However, many representatives are unaware of SSA's requirement that any unused funds must be placed in a special savings account for beneficiaries. SSA should enforce this requirement and encourage representative payees to conserve funds, the report says. Formal training also should be provided to representatives, along with better long-term support through field staff, toll-free telephone numbers to call for assistance, Web-based information, and other avenues....

SSA should shift from auditing a random sample of representative payees to conducting more targeted audits of those most likely to misspend funds, the report says. In a small in-depth study of a specially identified sample of representatives, the committee found that those with certain characteristics -- for example, those who do not live with the beneficiary, who change residences frequently, or who have a felony conviction – tend to have higher rates of misuse. ...

The study was sponsored by the Social Security Administration.

The entire study can be downloaded for free as a PDF document by registering with the National Academies.

Upcoming Meetings and CLE

• August 9-10, 2007, Retirement Research Consortium Annual Conference (funded by SSA), Washington, DC
• August 10, 2007, Ohio NADE state conference, Columbus, OH
  
• August 24, 2007, Social Security Advisory Board meeting, Washington, DC
  
• August 24, 2007, NC Academy of Trial Lawyers CLE on representation of claimants in federal court, Raleigh, NC
  
• August 31, 2007, Utah Trial Lawyers Association Social Security luncheon, Salt Lake City, UT
• September 7, 2007, Idaho State Bar CLE, teleconference
• September 7, 2007 Michigan NADE State Conference, Traverse City, MI
  
• September 10-15, 2007, International Social Security Association General Assembly, Moscow, Russia
• September 14, 2007, SSI Coalition meeting, Boston, MA
• September 15-20, 2007, NADE National Conference, Sioux Falls, SD
• October 17-20, 2007, NOSSCR CLE, St. Louis, MO
• October 26, 2007, Utah Trial Lawyers Association Social Security luncheon, Salt Lake City, UT
  
• November 16, 2007, SSI Coalition meeting, Boston, MA
• November 16, 2007, Utah Trial Lawyers Association Social Security luncheon, Salt Lake City, UT
• November 30, 2007, Legal Services of New York Legal Support Unit CLE, New York, NY
• December 5, 2007, Tennessee Trial Lawyers Association CLE, Chattanooga, TN
• February 2, 2008 Minnesota Legal Services Coalition CLE, location?
  
• April 8-11, 2008 NADE Regional Conference, Austin, TX
• April 13-16, 2008 NADR Conference, St. Petersberg, FL
  
• April 21-24, 2008, NADE Regional Conference, Los Angeles, CA
  
• May 5-6, 2008 NADE Regional Conference, Madison, WI
• May 13-16 2008, NADE Regional Conference, Birmingham, AL
  
• May 14-18, 2008, NADE Regional Conference, Annapolis, MD
  
• June 4-7, 2008 NOSSCR CLE, Miami, FL
• October 15-18, 2008 NOSSCR CLE, Century City, CA

If you know of others I have not listed, please use the feedback button on the right side of the page to let me know.

Social Security Ruling On Evaluating Visual Field Loss Using Automated Static Threshold Perimetry

Social Security has published Social Security Ruling 07-01p on using automated static threshold perimetry to evaluate visual field loss. It appears to be intended to give Social Security stamp of approval for a new technology. This sort of technical refinement in disability determination may not excite Commissioner Astrue (or me), but it is what is practical and helpful, while automated keyword searches of medical records, as discussed above, are not likely to be either practical or helpful.

Proposed Rule On "Compassionate Allowances"

The Social Security Administration has published an Advance Notice of Proposed Rule-Making (NPRM) on compassionate allowances. No specific amendment to Social Security's regulations proposed. Here is a key excerpt:

In addition to these methods of identifying compassionate allowances [that Social Security is already using], we are considering the creation of an extensive list of impairments that we can allow quickly with minimal objective medical evidence that is based on clinical signs or laboratory findings or a combination of both. We believe that we could use certain listed impairments, such as those described above, as a starting point for a much longer list of impairments that could be allowed based on established diagnoses alone (supported by objective medical evidence) or based on diagnoses that have reached certain points in their progression that would be considered disabling. We would not limit, however, the compilation of conditions to those already covered by our listing. We would incorporate any conditions that should be allowed quickly with minimal, but sufficient, objective medical evidence. As such, the list of qualifying conditions would be specific and extensive.

Additionally, although we already have some policies and procedures for identifying the most obviously disabled individuals quickly, we are investigating methods for identifying compassionate allowances by perhaps starting with a specific allegation or through the use of a computer system that is able to search key words included in an electronic disability folder. Because the health care industry is capturing more and more clinical information in structured electronic formats using standardized codesets, we also are interested in your ideas about whether and how we can use that information for identifying compassionate allowances.

Many, although by no means all, of the individuals who would qualify for a compassionate allowance will have impairments that are expected to result in death and need immediate decisions on their claims. It is our hope that compassionate allowances will not only bring faster benefits to individuals in need, but that they will also help to quicken the processing time of those claims that must be processed through our existing procedures. ...

Please provide us with any comments and suggestions you have about new standards and identification methods for compassionate allowances.

To believe that this is going to make a significant difference, one has to believe that disability examiners cannot now quickly identify the claims of those who are most seriously ill and get those cases adjudicated quickly. For the most part, I do not believe this to be accurate, nor can I imagine anything coming out of this process that will speed up anything. My opinion is that this comes from a naive view that disability examiners are not so bright and that simple checklists or keyword search programs can speed up their work. I think this greatly underestimates the disability examiners and the complexity of the problem. Social Security has been doing disability determination for 50 years. All the simple ideas were implemented a long time ago. I do not think this idea is coming up from the trenches. It is coming down from the top, from people who have never done disability determination work themselves.

NPR On Social Security Budget And Backlogs

National Public Radio ran a piece yesterday on Social Security's backlogs and its urgent need for a bigger budget. You can listen to it online.

USA Today On Social Security Backlogs

USA Today has an article in today's paper on Social Security's backlogs, which contains some stunning information. Here is an excerpt:

The Social Security Administration faces a record — and rapidly growing — backlog of appeals by people who claim they are too disabled to work. Through June, it had just over 745,000 cases pending, and the wait for a hearing averaged 17 months, also a record.

Claimants in some parts of the country must wait up to 31 months, according to the agency. "People have died waiting for a hearing," Social Security Commissioner Michael Astrue says.

The agency says the backlog doubled in six years and could reach 1 million by 2010.

There is a companion article focusing upon the terrible effects of these backlogs upon individual Social Security disability claimants. These sad stories are too familiar to anyone who has been reading this blog, but read this excerpt which focuses upon the bigger picture:

Now the commissioner of Social Security, Astrue wants to make it easier to file for disability. He's pushing simplified procedures for extreme cases, such as terminal cancer. He's updating and expanding the list of impairments that qualify for disability. He's trying to open a national center to hold electronic hearings, thereby easing backlogs in places such as Atlanta [which has some of the biggest backlogs in the country].

All of that, Astrue says, won't be enough to stop the backlog of appeals from growing because of an aging population. Social Security projects cases to grow about 90,000 annually over the next five years. That means the backlog could hit 1 million in 2010.

"I don't think there is any really easy solution," Astrue says.

The talk of the backlog increasing to one million cases appears to come from Commissioner Astrue, himself! Why would we be facing a threat that the backlog will grow to 1 million in the next three years? I thought that Commissioner Astrue was planning to reduce the backlog. That is what he was telling Congress. Why is Commissioner Astrue discouraging Congress from giving his agency any more money for fiscal year 2008 than President Bush has recommended at the same time that he is warning that his agency is facing an increase in its backlogs? I cannot understand the disconnect between this article and what Astrue has been telling Congress. Is this article a sign that Astrue is now trying to persuade the Office of Management and Budget to recommend a higher fiscal year 2009 budget? Is Astrue finally getting more accurate information about how bleak the future looks for the Social Security Administration? Is he belatedly lobbying for a bigger fiscal year 2008 budget?

By the way, there is a really easy solution to the backlogs. Budget enough money and hire enough personnel. Everything else imaginable has already been tried. Simple "brute force", as Commissioner Astrue himself put it, is the only approach that will work.

An Image From 1948