Jul 8, 2008

The Twenty-Four Month Waiting Period For Medicare

A person who is approved for Disability Insurance Benefits under Title II of the Social Security Act faces two waiting periods. First, there is a five month waiting period until cash benefits begin. This works out to be more than a six month waiting period in fact, since the five months must be full months and because benefits for a month are not paid until after the month has ended. If you become disabled on July 2 2008, you cannot count July as one of the five months. The date of first entitlement to cash benefits would be January 2009, but the check for January 2009 would not arrive until well into February, 2009. Your waiting period in this example would be almost seven months.

The second waiting period is for Medicare. This is a 24 month waiting period after the entitlement to cash benefits begins. Thus, the claimant who became disabled on July 2, 2008 would not become eligible for Medicare until January 2011.

My clients often ask why they have to endure these waiting periods. What is the rationale behind it? They crave some logic to explain these long waits. The only answer I can give them is that it saves money. There is no other explanation. There is no logic.

Both waiting periods are controversial. There have recently been rumblings about eliminating them.

Someone at Social Security decided to do a study to see how many of those people enduring that 24 month waiting period were covered by Medicaid. (Remember, Medicaid is the poverty program and Medicare is the non-poverty program. If you are on SSI, you are categorically eligible for Medicaid. Got that?) My guess is that someone, perhaps the Commissioner, perhaps someone in the White House, perhaps someone in Congress, was looking for ammunition to fight off a push to end the 24 month waiting period. If that was the goal, it looks like the statistical study will not help. The study is presented in a confusing format, but it looks like only 11% of those in the 24 month waiting period for Medicare are on SSI and thus categorically eligible for Medicaid. Of the other 89%, undoubtedly some are covered by health care insurance provided to them at no cost by their former employer and others are able to come up with the money to keep paying their health care insurance premiums. Others are eligible to receive care from the Department of Veterans Affairs (VA). My best guess (and I am in a much better position to guess about this than anyone at Social Security, the White House or Congress) would be that around half of the people who are in the 24 month waiting period have no Medicare, no VA medical care and no health care insurance, even though they have been acknowledged as disabled by their government. Does this sound right? Is it defensible?

Senate Appropriations Committee Chair Having Problems

Appropriations are the lifeblood of all federal agencies including the Social Security Administration. Anything that affects the appropriations process is of considerable importance to the Social Security Administration. It seems as if Robert Byrd of West Virginia has been a Senator since shortly after the Civil War. He has been chairman or ranking minority member of the Senate Appropriations Committee for decades, but he has long been the most respected of the elders in the Senate, but for some time now there have been whispers about the effects of age on Byrd's ability to lead the Appropriations Committee. Those whispers are getting much louder. From Politico:

Oh, the full dialogue from the blogpost below according to WaPo's Paul Kane (and other reporters in the gallery) who heard the full shouting match between Sen. Robert C. Byrd and Sen. Jim Bunning, shouting from their seats across that aisle at each other:

Bunning: "Regular order!"

Byrd: "Who said that?"

Bunning: "I did."

Byrd: "Who are you?"

Bunning: "I'm a senator."

Byrd: "You're a great baseball man."

Bunning: "I'm a senator; I have the same rights as you."

Byrd: "Yeah, man, you're a senator." [Ends by laughing hysterically at Bunning.]

Jul 7, 2008

McCain On Budget And Social Security

From Jobs for America: The McCain Economic Plan, put out by John McCain's campaign:
Comprehensive Spending Controls: John McCain will institute broad reforms to control spending:
  • The McCain administration would reserve all savings from victory in the Iraq and Afghanistan operations in the fight against Islamic extremists for reducing the deficit. Since all their costs were financed with deficit spending, all their savings must go to deficit reduction.
  • A one-year spending pause. Freeze non-defense, non-veterans discretionary spending for a year and use those savings for deficit reduction. A one-year pause in the growth of discretionary spending will be imposed to allow for a comprehensive review of all spending programs. After the completion of a comprehensive review of all programs, projects and activities of the federal government, we will propose a plan to modernize, streamline, consolidate, reprioritize and, where needed, terminate individual programs. ...
Reform Social Security: John McCain will fight to save the future of Social Security, and he believes that we may meet our obligations to the retirees of today and the future without raising taxes. John McCain supports supplementing the current Social Security system with personal accounts – but not as a substitute for addressing benefit promises that cannot be kept. John McCain will reach across the aisle to address these challenges, but if the Democrats do not act, he will. No problem is in more need of honesty than the looming financial challenges of entitlement programs. Americans have the right to know the truth and John McCain will not leave office without fixing the problems that threatens our future prosperity and power.

I Had Wondered About This

You knew about disability claims for children under Title XVI of the Social Security Act, but did you realize there can be disability claims for children under Title II of the Social Security Act? They do and curiously enough, Social Security applies adult standards to these child disability claims. Seems odd to me. Here is some information from a recent addition to Social Security's Program Operations Manual Series (POMS):
Effective 9/1/81, P.L. 97-35 discontinued spouse's, mother's, and father's benefits when the youngest child-in-care attains age 16, unless the child is disabled. Although the spouse’s, mother’s, or father’s benefits may cease, the child's benefits continue to age 18 regardless of whether he or she is disabled. A disability determination for the alleged DMC [DisabledMinor Child] is needed only to entitle the mother or father to continue to receive benefits. ...

To determine if a child is disabled for the child-in-care provisions use the sequential evaluation process applicable to Title II Adult and CDB claims. See “Sequential Evaluation” (DI 22001.000).

At step 3 of the disability evaluation process (Does impairment(s) meet or equal a listing?), consider Part “B” of the listings first. If the child’s alleged impairment(s) does not meet or equal a Part “B” listing, consider the Part “A” listings.

NOTE: The “functional equivalence” policy applicable to Title XVI child cases (see DI 25225.001) does not apply to DMC, or any other Title II cases.

It is not clear to me from this whether the adult listings apply or the child listings. It would be weird to refuse to apply the child listings, but everything else about this policy is weird.

Jul 6, 2008

Waiting In Indiana

From the Indianapolis Star:

Dana Smith waited three years for a judge to agree she qualifies for Social Security disability payments.

Had she lived in a state other than Indiana, the wait could have been much shorter.

That's because Indiana has one of the worst records in the country for processing the disability claims of people unable to work because of medical or psychiatric reasons. ...

For a determination at the Indianapolis offices for Social Security disability or Supplemental Security Income, the average applicant waits 749 days from the time of filing until a hearing before an administrative judge, the step necessary if claims are denied -- and most are.

Most Americans wait 505 days, the Social Security Administration estimates. ...

Nationwide, the Social Security Administration has 10 percent fewer judges to hear case appeals than it did a decade ago, while the number of cases has increased by more than 176 percent, said Carmen Moreno, regional communications director for the Social Security Administration's Chicago region, which includes Indiana.

By the way, this appears to be another story generated by Allsup.

Jul 5, 2008

Poll

Jul 4, 2008

Jul 3, 2008

Binder And Binder Lawsuit

On the separate Social Security Perspectives Blog I have posted copies of a trademark infringement complaint filed by Binder and Binder against a competing entity and the answer filed by that defendant. The materials are interesting for the insight they provide into the methods of operation of Binder and Binder, one of the largest entities representing Social Security claimants, and the importance of internet advertising to its operations. Binder and Binder appears to combine a law firm with a number of non-attorney corporations in a unique corporate structure. Binder and Binder appears to make extensive use of internet advertising.

Because of technical limitations in Blogger, these federal court filings are spread over several posts and you must click on each page separately to view it full size. There is no simple way for a reader to download the whole thing, unless you have a Pacer account, in which case you can download all the papers filed with the Court.