"With No Human Intervention"

From a recent presolicitation notice posted by the Social Security Administration:

The Social Security Administration (SSA) intends to award a sole source contract under the authority of Federal Acquisition Regulation (FAR) 13.5 to Beth Israel Deaconess Medical Center (BIDMC), 330 Brookline Avenue, Boston, Massachusetts 02215. The contract will require BIDMC to jointly develop specifications for a standardized request for medical evidence and response, and an associated implementation guide based on standards approved by the Health Information Technology Standards Panel (HITSP) and other widely used industry standards. The contract period will be approximately nine months.

The objective of the project will be to evaluate the feasibility, technical alternatives, and potential value of leveraging electronic communication along with structured clinical information with healthcare providers for the disability claims process. A standardized process and associated implementation guides will be developed to leverage provider-based Electronic Health Records (EHR) to generate responses to electronic requests from SSA with no human intervention using standard electronic transactions transmitting structured clinical information, which could result in quicker decisions on disability claims.

New Changes In Digestive Listings?

The Office of Management and Budget (OMB) must approve all federal regulations. OMB's website has a list of regulatory proposals it has received. Here is one that was just posted:

AGENCY: SSA	RIN: 0960-AG65
TITLE: Revised Medical Criteria for Evaluating Functional Limitations Due to Digestive Disorders
STAGE: Prerule	ECONOMICALLY SIGNIFICANT: No
RECEIVED DATE: 11/29/2007	LEGAL DEADLINE: None

Social Security just published new final digestive system listings, effective on December 18. Apparently, the agency already wishes to revise the new listings.

The Poverty Caused By Social Security Delays

Every year newspapers publish stories about people suffering from financial distress during the Christmas season and every year some of these stories are about individuals who have had or are having difficulty getting on Social Security disability benefits. Here are some excerpts from a recent story in the Buffalo News:

Hardworking people who live from paycheck to paycheck face an enormous risk. If something happens that prevents them from working, the consequences can be devastating.

“You see everything you worked for disappear,” Kathleen Clark said. “You fall so far behind in your bills, you just hope they don’t cut the heat off to your house.”

Clark, 49, and her 45-year-old husband, Al, both worked for a living. He was a baker at the market on Niagara Falls Boulevard for many years. She worked in a restaurant. They have two sons, James, 22, and Patrick, 19. ...

Expenses were high; making ends meet was a tough, but they were coping. They even found a little extra to donate to local food pantries and community kitchens.

Then, in 1999, Al Clark collapsed on the job. Years of unexplained dizzy spells culminated in a massive epileptic seizure. Blow No. 1. He couldn’t work anymore. He applied for Social Security disability. It would take five years before Al Clark received his first disability check. ...

With the costly medication her husband needed to treat his illness, expenses were higher than before and making ends meet was tougher. Now, they were barely coping.

In 2004, Kathleen Clark’s chronic bad back finally gave out and she was diagnosed with a herniated disk. Blow No. 2. She had to give up her job. ...

An operation earlier this year stabilized Kathleen Clark’s spine but left her in excruciating pain, which seven different prescription pills a day fail to ease. She applied for Social Security disability. But, as her husband’s found, it could take years before she receives any payments.

Their son, Patrick, is a senior at Niagara Falls High School. James works in shipping and receiving at a City of Tonawanda sporting goods store, but he’s barely getting by and can’t help with his parents’ bills. The Clarks are overdue on several bills, including more than $200 on the water bill. Monthly expenses run about $1,300. They’re trying to get by on the husband’s $760-a-month disability payment. ...

Thanksgiving and Christmas food baskets from Niagara Community Action’s food pantry on 19th Street will help them through the holiday season.

Major Media Stories Coming

There are major news media stories on Social Security's disability backlogs in the works.

There have been reports over the last month or so that CBS News is doing a story on Social Security's disability backlogs. It has been unclear to me whether the story is for 60 Minutes or for the CBS Evening News.

The New York Times is currently doing a story on the same subject. A New York Times reporter, Eric Eckholm, came to my office on the Tuesday before Thanksgiving. Eckholm and a cameraman visited the homes of several of my firm's clients that day and the next, returning to New York on Thanksgiving morning. My understanding is that Eckholm is interviewing Commissioner Astrue this week. I know that Eckholm has been in contact with a number of other people concerning the story.

I cannot say when either of these stories will run.

Social Security's Not The Only Agency With Disability Problems

From the Raleigh News and Observer:

The Department of Veterans Affairs fell further behind this year in its attempts to give veterans timely decisions on their disability claims, new records show.

The latest numbers are in an annual report the VA prepares for Congress detailing a range of short- and long-term goals for its disability, health and other benefit programs. Overall, the agency either has fallen behind or has made no progress in improving its performance in more than half of what it lists as its key goals.

In the benefits measure the VA has said is "most critical to veterans" -- the speed of processing disability claims -- the agency lost ground for the third year in a row.

Comments On GAO Report

From Thomson Financial News:

"The report makes clear that cutting guaranteed benefits for retirees would have a devastating impact on families with a disabled worker and on survivors," House Ways and Means Committee Chairman Charles Rangel of New York said today. "The American people fully expect that any discussions on the future of Social Security will look to strengthen and preserve, not undercut, Social Security's guaranteed benefits." The top Republican on the committee, Jim McCrery of Louisiana, acknowledged that Social Security benefits vulnerable families, but did not say, as Rangel did, that Social Security reform must maintain the same level of benefits.

"This report provides useful information to policymakers as we thoughtfully and carefully consider all options to strengthen Social Security," McCrery said.

GAO Report On "Reforming" Social Security Disability

The Government Accountability Office (GAO) has issued a report entitled "Social Security Reform: Issues for Disability and Dependent Benefits." To understand the report one must first understand that almost always when people in our nation's capitol use the word "reform" in connection with Social Security, they are talking about cutting benefits. Basically, this report is about ways of "reforming" Social Security disability and dependent benefits by cutting benefits and how the damage that would cause could be mitigated by employing less "reform", that is, by cutting disability and dependent benefits a bit less.

My guess is that this study was ordered by Republicans when they controlled Congress.

No Match Rules Development: What Does It Mean?

From the New York Times:

The Bush administration will suspend its legal defense of a new rule issued in August to punish employers who hire illegal immigrants, conceding a hard-fought opening round in a court battle over a central measure in its strategy to curb illegal according to government papers filed late Friday in federal court.

Instead, the administration plans to revise the rule to try to meet concerns raised by a federal judge and issue it again by late March, hoping to pass court scrutiny on the second try. The rule would have forced employers to fire workers within 90 days if their Social Security information could not be verified. ...

The rule laid out procedures for employers to follow after receiving a notice from the, known as a no-match letter, advising that an employee’s identity information did not match the agency’s records. The employer would have had to fire an employee who could not provide verifiable information within 90 days, or face the risk of prosecution for knowingly hiring illegal immigrants. Those immigrants often present fake Social Security numbers when applying for jobs.