New Cancer Listings Coming

All federal agencies much clear new Notices of Proposed Rule-Making (NPRMs) with the Office of Management and Budget (OMB), which is part of the White House before publishing them in the Federal Register for public comment. OMB has just cleared the following item, which should appear in the Federal Register shortly:

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
** COMPLETED: 04/18/2008	COMPLETED ACTION: Consistent without Change

Oh, yes. Malignant neoplastic diseases means cancer.

ODAR Overstaffed? Work Left Undone? SSA Employees Ovepaid?

From the minutes of the March 4, 2008 meeting of the National Council of Social Security Management Associations, an organization of Social Security management personnel, but which has few members from Social Security's Office of Disability Adjudication and Review (ODAR) I would guess (emphasis added):

Welcome and Report on Meeting with Commissioner Astrue (Greg Heineman and Bethany Paradis):

Bethany and Greg met with Commissioner Astrue on March 3rd. The Commissioner expressed his appreciation of the excellent job NCSSMA has done both in terms of making sure Congress is aware of the effects of the SSA budget on our ability to serve the public and in communicating to CO [Central Office] the unfiltered voice of field and TSC [Teleservice Center] management . The March 3rd meeting included a host of individuals including Linda McMahon, Lisa DeSoto, David Foster, Dr. Wells and others. The Commissioner covered various topics while Linda provided support and David Foster asked clarifying questions. The Commissioner was receptive to what Greg and Bethany had to say on the five discussion topics.

As far as actual input of the discussion, the first question dealt with distribution of staff. Because of major interest in Washington on ODAR backlogs, ODAR will actually hire approximately 175 new ALJs, up from the 150 initially recommended. The total optimum number of ALJs is 1250, but ODAR should have about 1175 ALJs by the end of the year. It appears that ODAR is in adequate shape in terms of support staff. Support is currently at about 4.4 employees for every ALJ. The union is advocating for more, but ultimately the result may be 4 employees for every ALJ. Almost half of the support staff needed to pull paper files and organize the material will have less and less paper to handle as the transition is made to electronic files. This will allow for different distribution of support staff among ALJs. ...

In addition, there are high volumes of work that we can’t do because priorities are on clearing integrity workloads. Last year we had 3300 work years of additional workloads; this year 4800 work years of additional workloads. The truth is, we will not be able to do all of this work with current resource levels. We only have enough funding to complete what have been identified as integrity workloads: redeterminations, limited issue cases, medical CDRs, etc. Some errors will never be corrected because of the inability to address approximately 8100 work years of additional workloads. ...

The last staffing replacement rate was1 hire for every 2 losses. This year, all operations components may get 7 hires for every 10 losses. Other components may still only receive 1 hire for every 2 losses. ...

Basically, over the past years, the agency has experienced a net loss of 2 offices per year. The agency will continue to conduct service delivery assessments to look at offices when leases expire. There is no list of offices on the chopping block, but individual office assessments will need to be performed to determine which closures, consolidates, etc. need to be considered. Office closures are very political, which does affect the final outcome. ...

Recently, a new OPM [Office of Personnel Management] guide was published that provides for a significantly lower grade structure for many SSA positions. John Nolan from the Chicago Region is the lead for reviewing the new OPM supervisory guide. All executives have acknowledged the new plan is a problem, although OPM seemed surprised by that concern. A revised draft should be coming out the week of March 10th. NCSSMA past presidents have been tasked with reviewing this. We did not receive a formal response to the five questions raised in our meeting with the Commissioner. We will need to write a formal response and send it to the Commissioner for review.

Iowa Office To Close

From the Quad-City Times:

The Social Security Administration will close its Clinton office effective June 1 and merge it with the Davenport office.

The move should make the local administration of the agencies services more efficient, an agency spokesman said Friday. However, it will be more inconvenient for some residents to travel to Davenport for personal service they currently get in Clinton.

Buffalo News Editorial

From the Buffalo News:

If you paid insurance premiums that ran a little more than 6 percent of your income every week throughout your working life, but had to wait nearly two years to collect when you had a legitimate claim, you might complain to the government.

But when it is the government that is making people wait to collect the disability benefits to which they are entitled — because they paid for them — even members of Congress are left to rage into the storm.

Rep. Brian Higgins, a Buffalo Democrat, is among the congressmen heard to demand that the Social Security Administration finally make some serious efforts to chip away at the disgraceful backlog of cases of people who can no longer hold down a job and need the benefits to survive. ...

The need ... was disgracefully not addressed when the government hired 135 administrative law judges to hear those appeals but assigned only 10 to the state of New York — and none to Buffalo. ...

Attorneys who handle such cases have long lists of people who went bankrupt, were evicted, even died, while waiting for their appeals to be reviewed.

At least one claimant never got the message that he’d finally won his appeal because he was, at that moment, out in the woods killing himself.

An Oldie But A Goodie On ME Usage

Attorneys who represent claimants before the Social Security Administration and who wonder about how Medical Experts (MEs) are selected for hearings may want to take a look at an old report from GAO (General Accounting Office at that time, now called the Government Accountability Office) entitled "Action Needed to Improve Use of Medical Experts at Hearings." Interesting reading. I think that there may be many instances across the country where the agency is not in compliance with the standards suggested by this report.

Report On Simplifying SSI

The Social Security Administration's Office of Policy has produced a report entitled "Efforts Since 2000 to Simplify the SSI Program: Legislative and Regulatory Changes."

Goodness knows that Supplemental Security Income (SSI) needs simplification. It needs updating even more. The resource limits and earnings allowances are absurd.

Technical Questions On Re-Recons

I am not going to the trouble of trying to explain this so that those not well-versed in Social Security can understand it. People who cannot understand this, would not care anyway.

Can Social Security issue a partially favorable decision on re-recon (or informal remand, if you wish to use the agency's formal terminology)? I have been told that this is not allowed, but take a look at this POMS section, which shows a form for issuing a partially favorable re-recon decision and also look here at this POMS section that was updated in 2002 that refers to partially favorable re-recons. The form, in addition to being impossibly confusing, is clearly quite old, since it refers to the Bureau of Hearings and Appeals, whose name was later changed to the Office of Hearings and Appeals and then to the Office of Disability Adjudication and Review.

If partially favorable decisions can be issued on re-recon, what is the procedure after the partially favorable decision? If partially favorable decisions are not allowed on re-recon, can DDS call the claimant or his or her attorney to ask if they want to agree to accept the partially favorable decision? Should DDS notify ODAR if it feels that a partially favorable decision should be entered, but it is not allowed to do so?

And where are Social Security's updated re-recon instructions? Could they possibly be in an emergency message that is too sensitive to release to the public? That sounds ridiculous, but most emergency messages are being withheld from the public.

NY Times: Fix The Database First

From a New York Times editorial:

Every American who has a job or wants one should be following the debates in Congress over bills to crack down on illegal hiring. Employment verification is one of the few ideas still lurching around the Capitol after last year’s Senate shootout mowed down a forest of immigration reforms. It’s boring and complicated — it’s about databases — but unlike other immigration fixes, it affects every worker and employer in America, native-born or not.

Two House bills — the SAVE Act, sponsored by Heath Shuler, and the New Employee Verification Act, sponsored by Sam Johnson — are designed to squeeze illegal immigrants out of the country by making it impossible for them to find work.

Immigration reform is always tricky, but employment verification is where the details get demonic.

It starts with a flawed database that everyone would have to rely on to get work or change jobs. Think of the “no-fly” list, the database of murky origins with mysterious flaws that you, the passenger, must fix if you are on it and want to fly. These immigration bills seek to take small, badly flawed “no-work” lists and explode them rapidly to a national scale. With an error rate of about 4 percent, millions of citizens could be flagged as ineligible to work, too.

That’s only part of the price. The Congressional Budget Office says the SAVE Act would cost $40 billion over 10 years, adding up lost tax revenue and spending on things like thousands of immigration judges. It is likely to overwhelm the Social Security Administration, which already is swamped with disability benefits and retiring baby boomers. It won’t do much for small businesses that would have to pay to comply.

The problem is not with employment verification itself. Illegal immigrants should not be allowed to work, and any system that is rational and lawful needs to be backed up with a hiring database. The trouble with these bills is that they don’t fix the database errors first, and they are strict enforcement-only measures, uncoupled from any path to legalization for undocumented workers.