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"Endemic To The System"

I have been involved in Social Security disability work for thirty years now and I have never seen anything like the amount of publicity given now to the problems in Social Security disability determination. This is way beyond what happened in the early part of the Reagan Administration, when hundreds of thousands of claimants were being cut off benefits. Before the 2006 election, I could go many days, even weeks between posting links to newspaper articles. Now, it seems that I am posting one or more every day.

From the Times-Herald Record of the Hudson Valley in New York:

Robert Veneziali knows he's sick. Anyone who looks at him knows it too. Anyone, that is, unless he or she works in the Social Security Administration's medical disability review section.

They don't see Robert Veneziali when his legs give way beneath him and his body hits the floor and freezes up and his voice is barely strong enough to cry for help.

The medical reviewers at SSA know Robert Veneziali suffers from rapidly progressing debilitating multiple sclerosis, a disease that sometimes comes in terrifying, months-long waves. When these waves strike him, Veneziali has to deal with vision and memory loss, vertigo and physical numbness. He'll be unable to walk and have trouble swallowing his food. He doesn't dare drive; sometimes walking is a risky proposition. ...

Reluctantly, he filed for disability benefits for him and his kids and his wife, Tracey, who has to work three jobs to keep the family afloat. Social Security doctors turned him down and told him he could be re-examined in another 18 months.

That was too much for his mother, Elaine Veneziali. She got hold of Rep. John Hall. Hall caught wind of a recent CBS news report that contended a "culture of denial" in New York and 13 other states designed to deter people from applying for disability benefits. As a result, Hall has called for a federal investigation into the charge.

Veneziali's treatment was "unconscionable," he said. It could only be worse if it proves to be endemic to the system.

Astrue E-Mail To Staff On Budget

An e-mail from Commissioner Astrue, with my comments bolded and in brackets:

^Commissioner Broadcast

Tuesday, February 05, 2008 2:00 PM

COMMISSIONER'S BROADCAST--02/05/08

A Message To All SSA And DDS Employees

Subject: FY 2008 and FY 2009 Budget News

I am pleased to share several items of good news about the agency’s budget.

First, the President’s Budget for FY 2009, submitted to Congress yesterday, provides $10.46 billion for Social Security’s administrative expenses. That’s a 6 percent increase over FY 2008. [But what about the larger budget that you asked for, but which the President was unwilling to give you. And why is an independent Commissioner of Social Security so eager to praise the President?] If enacted by Congress, this would be the largest increase SSA has received in some time. [Really, you could have had more this year, if the President had not vetoed it.] As you know, Social Security is facing an avalanche of disability and retirement claims at the same time that we must address large backlogs due to years of limited resources. The FY 2009 budget will put us in a better position to handle the onslaught of work we are confronting. [Better position? How? The proposed budget provides for almost no additional personnel.]

I am urging Congress to enact this budget quickly. [Come on, Astrue, you know as well as anyone that Democrats are going to enact whatever budget they feel like -- after Bush leaves office and the budget they enact will probably be larger than what is in the Bush budget.] Over the next couple of weeks, I will be joining Chief of Staff David Foster and staff from the Office of Budget, Finance and Management and the Office of Legislative and Congressional Affairs as we make our case for timely and adequate funding for SSA. [It is a shame you are unwilling to do what you say and actually ask for adequate funding.]

Now here is the good news regarding the current fiscal year. As you may know, for the first time in 15 years, Congress appropriated funding for SSA above the President’s budget. [Which Astrue opposed.] Specifically, Congress provided us with an additional $148 million in FY 2008. As a result of this appropriation, I am able to lift our current hiring freeze and provide some needed hiring flexibility across all SSA components. Each Deputy Commissioner will determine where to direct these critical hires to best address the agency's mission. [But don't expect any hiring binge. We're still going to be losing employees.]

ODAR will be able to replace all of their staff losses this year and hire 175 Administrative Law Judges. [How can I restrain my excitement? In the face of large increases in workload, ODAR will be allowed to keep its staffing level stable.] Our FY 2008 funding also allows me to provide Operations with additional hiring authority to increase the number of Teleservice Representatives in the Teleservice Centers. [But it looks like payment center staff will be cut.]

The agency will continue implementing our Hearings Backlog Reduction Plan. We will use the additional resources to build a firm foundation for the future with automation improvements, fast-track reviews, Administrative Law Judge hiring and other initiatives so that we can significantly reduce waiting times at all steps of the disability process while improving accuracy. The waiting time for a hearing has just dropped below 500 days, even though the oldest cases take the longest. [Dropped below 500 days. What do you mean?] ODAR is doing the right thing for the claimants in tackling this workload, and with these additional resources, I fully expect to see further improvement in processing times by early in the next fiscal year. [But will Astrue be around to see the improvements he predicts?]

Funds for Information Technology Systems will be sufficient to move forward with critical information technology projects, which will help SSA improve the disability programs and prepare for the millions of baby boomers who are beginning to apply for retirement benefits.

For most components, overtime will be provided at FY 2007 actual levels. Operations will be given additional overtime to begin addressing our critical backlogs, so that we can provide better service to the millions of beneficiaries who count on us each and every day. Other expenses, such as training, travel and supplies, will be funded at least at the FY 2007 level. [Funding them at the same level is the same as cutting funding when you factor in inflation.]

As the year progresses, we will be reassessing our staffing and hope to provide some additional hiring authority or overtime. I know that adequate funding is essential to providing the level of service that the American public deserves, and I have great hope that in future years we will be able to build upon the progress we make this year.

I want to thank all of you for your hard work, patience and ingenuity during the tough budget times we have faced in recent years.

Michael J. Astrue
Commissioner

Further SSA Press Statement On Budget

The press statement linked below is only the tip of the iceberg. Social Security has issued a a 198 page Justification of Estimates for Appropriations Committees. Here are a few excerpts:

The Social Security Administration (SSA) is now at a crossroads. Due to the aging of the baby boomers, we are facing an avalanche of retirement and disability claims at the same time that we must address large backlogs due to years of increasing workloads and limited resources. In the past, as SSA offices lost staff, waiting times increased and lines grew longer. Over 50 percent of people who called into field offices received a busy signal. Without sustained, adequate funding, this situation will only worsen. Furthermore, we must attack the disability backlogs, which have dramatically and unacceptably damaged many applicants’ lives. Since fiscal year (FY) 2000, processing times for disability hearings have grown by 200 days, which is an incredible hardship for disabled workers and their families as they cope with the loss of income, and often medical insurance as well, due to a severe disability. The problems and shortfalls we have described above are the result of limited resources, increased demand for our core services and new responsibilities. Adequate funding is critical for FY 2009 and must be sustained in the years ahead. Without it, SSA’s service crisis will deepen at a time when our aging population is increasingly counting on Social Security programs. ...

With the 2009 President’s Budget, we will be able to halt the decline in customer service by restoring staffing losses and investing in needed technology. In FY 2009, SSA plans to reduce the hearing backlog by nearly 70,000 cases, process over 200,000 more retirement and survivors claims, and handle 4 million more 800-number calls compared to FY 2008. Waiting times and processing times should decrease, especially since the increased funding will be in concert with continued productivity improvements. Lastly, the President’s Budget will allow us to process more program integrity work. ...

It is important to note that while the FY 2009 budget will make important strides in core areas, SSA will still have significant growth of backlogs in its less visible work, the work that is done after an individual is approved for benefits.

The document indicates that Social Security will have 60,293 workyears in FY 2009, up from 60,064 in FY 2008, an increase of 229 workyears or .38%. Not 38% or 3.8%, but .38%. How does one cope with an "avalanche" of claims and still make "important strides in core areas" with virtually no staffing increase? The number of workyears predicted for FY 2009, though higher than in FY 2008, would not bring Social Security's workforce back to what it was in FY 2007.

The document predicts a 16% increase in hearings held and a 6% decline in the average processing time for hearings, but gives no meaningful explanation of how this can be achieved with little or no increase in staffing.

A table predicts that Social Security's hearing backlog will decline to under 400,000 cases by 2013. That is still a huge backlog and 2013 is a long time from now and I do not see any realistic plan to achieve such a reduction.

Previously, Astrue and other Social Security officials were talking of getting up to 1,250 Administrative Law Judges (ALJs) in the current fiscal year, but this document talks of achieving this goal in "early 2009."

This document contains fulsome praise for the President's budget proposal, but curiously missing from this lengthy document is a prominent mention of the fact that the President's proposal is lower than what the Social Security Administration is asking for.

SSA Press Release On Budget

The Social Security Administration has just put out this press release:

Statement of Michael J. Astrue, Commissioner of Social Security, Commending the President’s Fiscal Year 2009 Budget Request

By requesting $10.46 billion for Social Security’s administrative expenses, the President has demonstrated with this budget proposal that he supports our efforts to drive down the disability backlog with faster and more accurate decisions. With a six percent increase over our 2008 appropriation, which would be the largest increase this agency has received for some time, we also can significantly improve the service in our field offices and teleservice centers.

I urge Congress to enact this budget proposal, and to do so as soon as possible. Any delays would severely undermine what the President wants to achieve for all Americans with his request for Social Security.

Astrue Schedules Meeting With Disability Advocates

The Capitol Insider published by the Disability Policy Collaboration, says that Social Security Commissioner Michael Astrue has scheduled a meeting with "disability advocates" for Thursday, February 7 to discuss the next steps on the procedural regulations that Astrue proposed and then partially withdrew in the face of enormous criticism from advocacy groups and Congress.

This meeting is significant because of the ambiguity of the partial withdrawal. The partial withdrawal could gut the proposed regulations and leave them pending after President Bush leaves office or the partial withdrawal could mean only a minor modification in the proposal with Astrue charging ahead to complete action on the regulations before the end of the year.

New Regulations Coming

The Social Security Administration must file all new Notices of Prospective Rule-Making (NPRMs) with the Office of Management and Budget (OMB) for approval before having them published in the Federal Register. Here is one that was just filed with OMB:

AGENCY: SSA	RIN: 0960-AG57
TITLE: Revised Medical Criteria for Malignant Neoplastic Diseases (3429P)
STAGE: Proposed Rule	ECONOMICALLY SIGNIFICANT: No
RECEIVED DATE: 02/01/2008	LEGAL DEADLINE: None

Social Security has also received permission from OMB for the publication of new listings for HIV. That should be in the Federal Register shortly.

Demonstrating My Lack Of Budget Knowledge

A reader who knows more about budget matters than than I has pointed out while the Commissioner of Social Security has not released his budget statement, the President's budget does include Commissioner Astrue's budget request for the Social Security Administration for fiscal year 2009. Here it is:

As directed by Section 104 of P.L. 103–296, the Social Security Independence and Program Improvements Act of 1994, the Commissioner of Social Security shall prepare an annual budget for SSA, which shall be submitted by the President to the Congress without revision, together with the President’s request for SSA.

The Commissioner’s budget includes $10,529 million for total administrative discretionary resources in 2009. This represents $10,427 million for SSA administrative expenses and $102 million for the Office of the Inspector General.

This total of $10.529 billion compares to $10.386 billion in the President's budget, a difference of $143 million or 1.4%.

Even though Michael Astrue knew that Congress is ready, indeed eager, to give the Social Security Administration more money than the President, he could hardly bring himself to ask for more than the President. Astrue is certainly not asking for enough money to make a significant difference in the backlogs at Social Security. It is not clear whether he is asking for enough to prevent a further decline in employment at Social Security.