PBS To Run Story On Disability Backlogs

I am hearing that PBS News Hour with Jim Lehrer will be running a piece tonight on the rising number of disability claims being filed. Apparently, they will tie the trend into the economy.

I am a contrarian. I think the recent rise in the number of claims filed has little to do with the economy. It has to do mostly with a public perception that the election of Barack Obama as President means that it will be less difficult to be approved for Social Security disability benefits. This causes some percentage of the large milling crowd of potential disability benefits applicants to decide to take the plunge and file a claim.

Who Will Be In That 3%?

Press reports indicate that Democratic Senators are working on a plan to improve health care. The plan would cover 97% of Americans. This begs an important question: Who would in the 3% to be left out? I am afraid that people who are disabled but who are trapped in what amounts to a 30 month waiting period for Medicare will be a major part of the 3% who are left out. Does anyone know?

Update: I have found a copy of the Kennedy-Dodd bill which is the hottest health care bill at the moment. I see nothing in it that would eliminate the Medicare waiting period. This would mean that disabled people would be prominent among the 3% left out.

Too Good To Be True?

From SafeLink:

SafeLink Wireless is a government supported program that provides a free cell phone and airtime each month for income-eligible customers.

And on another SafeLink page:

The process to qualify for Lifeline Service depends on the State you live in. In general, you may qualify if...

You already participate in other State or Federal assistance program such as Federal Public Housing Assistance, Food Stamps and Medicaid.

OR
Your total household income is at or below 135% of the poverty guidelines set by your State and/or the Federal Government.
AND

No one in your household currently receives Lifeline Service through another phone carrier.

You have a valid United States Postal Address. In order for us to ship you your free phone you must live at a residence that can receive mail from the US Post Office. Sorry, but P.O. Boxes cannot be accepted.

In addition to meeting the guidelines above you will also be required to provide proof of your participation in an assistance program, or proof of your income level.

I have a real problem getting up with many of my low income clients because they lack telephone service. Social Security has the same problem since they are dealing with the same population. Is this legit?

Astrue Talks About Public Service

Social Security Commissioner Michael Astrue gave an interesting interview to Federal News Radio recently. You can hear the interview online. Some points I took away:

• Astrue hopes to open additional new Teleservice Centers in coming years.
• Astrue has a longstanding belief that it is a bad idea to contract out customer service. That was his position when working for a drug manufacturer and it remains his position at Social Security.
• Astrue has listened in on calls to teleservice centers and was surprised at the range of questions asked.
• No site has been selected for the new data center. He hopes that the General Services Administration (GSA) will select that site by early next year. He gave no clue on where it will be.
  

State Cuts Hurt The Disabled

From the Topeka Capital-Journal:

Christy Tatum moved four times in two months and is praying for a fifth move to a place she can really call home.

Doctors have diagnosed Tatum, a Topeka resident, with bipolar disorder and post-traumatic stress disorder.

The Social Security Administration, however, has refused her disability application twice, and she has heard the process to appeal that decision could take years she can’t afford.

Tatum now lives at the Topeka Rescue Mission and receives state aid, but she learned in June that the support — MediKan health coverage and $241 each month in general assistance — will disappear in five months.

The budget the Legislature approved for the fiscal year that starts today reduces MediKan and general assistance from 24 months to 18 months for residents for Social Security disability, and it removed the “hardship provision” for extensions. That means any Kansan “unable to meet federal disability standards” who has received the programs for 18 months since 2002 will be cut off. ...

Hancock said between 1,600 and 1,700 Kansans with pending disability cases will lose their MediKan and general assistance today because they have exceeded 18 months.

The "Content Model"

This morning's e-mail included a message from Nancy Shor, Executive Director of the National Organization of Social Security Claimants Representatives (NOSSCR), sent to all NOSSCR members. The e-mail concerned Nancy's other duties as a member of Social Security's Occupational Information Development Advisory Panel (OIDAP). Attached to Nancy's e-mail was a message to NOSSCR members from Dr. Mary Barros-Bailey, the Interim Chair of OIDAP, to which was attached a document titled "What is a Content Model?" I have e-mailed the panel asking that they post the entire lengthy document.

It is obvious from what I received that the Social Security Administration and OIDAP are interested in going ahead with essentially recreating the Dictionary of Occupational Titles (DOT), although in a format that would be more usable to Social Security than the DOT ever was. This would be a very expensive and time-consuming effort.

Let me make some very preliminary observations.

1. Even though the DOT was based upon many tens of thousands of job site observations, it is now widely accepted that the data in the DOT was far from authoritative even at the time it was published. Many jobs had only been viewed one time and data collection methods were inconsistent. Will Social Security be able to do better? People will be watching much more closely now than they were at the time the DOT was created.
   
2. Creating a DOT replacement will be an expensive endeavor. Does Social Security have Congressional and Office of Management and Budget (OMB) backing for this endeavor?
3. Will a DOT replacement created at the behest of Social Security have the credibility it will need? Nancy Shor's e-mail talked of possible Daubert challenges to whatever comes out of this. There is that problem, but a more direct problem is the Data Quality Act.
   
4. If this DOT replacment is to be done, would it not be better to have it done by the Deparment of Labor rather than Social Security?
5. The DOT replacment envisoned by the "Content Model" would include a good deal of information never previously gathered. How practical will it be to even gather this data? The "Content Model" may require collection of data about the mental demands of employment. Is it possible to define whether a job is "high stress" or "low stress" for instance?
   
6. OIDAP and Social Security are interested in gatering data on the extent to which jobs may be restructed to accommodate workers' impairments. Social Security's position to this point has been that Americans with Disabilities Act (ADA) accommodations to workers' impairments may not be considered in determining disability. There are many in the rehabilitation community who regard "disability" as essentially non-existent, that with sufficient accommodation anyone not in a coma can work and that it is the duty of society to provide whatever level of accommodation is required. I find this absurd and dangerous, not just for disabled Americans, but for the American economy. Basing disability determination on a theoretical level of accommodation that can never be achieved in the real world would have a devastating effect upon millions of Americans. In the real world the ADA is virtually a dead letter. The Courts have interpreted it almost out of existence. There have been recent legislative efforts to give the ADA more substance, but it is far from clear that these efforts will succeed. It will never achieve the goal of allowing any person to work regardless of the extent of their impairments. In my view any discussion at OIDAP about accommodation is cause for great alarm.
   

Dead And Not Dead

From a recent report by Social Security's Office of Inspector General (OIG):

Based on our results, we estimate that as of January 2008, about 6,100 beneficiaries in current payment status had a date of death recorded on their Numident record. We estimate that approximately 1,760 of the 6,100 beneficiaries were actually deceased, and that SSA made approximately $40.3 million in improper payments to the deceased beneficiaries after recording their date of death in SSA's records. Further, we estimate SSA would make approximately $6.9 million in additional improper payments over the next 12 months if these discrepancies were not corrected.

In the overall picture, this is a low error rate, but still, that is over 4,300 people who are listed as dead who are not dead. Goodness knows how many were erroneously denied benefits for months.

By the way, notice that OIG seems a lot more concerned with the erroneous payments than the erroneous denials of benefits, even though it looks like erroneous denials of benefits are a bigger problem. And, yes, I know that the report indicates that the 4,300 living people listed as dead in Social Security's records are actually still on benefits, but I imagine that many, perhaps all of these folks had to go to some trouble to get their benefits reinstated and remain at risk for disruption in their benefits.

E-Pulling Has E-Failed -- And An Attempt At An Explanation Why Such A Foolish Idea Ever Got Tried

From a recent report by Social Security's Office of Inspector General (OIG) (emphasis added):

Our objectives were to (1) assess the results of the Social Security Administration's (SSA) Electronic File Assembly (ePulling) pilot project and (2) determine whether the assessment procedures were effective in deciding when the Office of Disability Adjudication and Review's (ODAR) hearing offices were ready to implement ePulling. ...

ODAR expects ePulling to increase the efficiency of the EF preparation process and reduce the time it takes to prepare a case for hearing. ODAR estimates that ePulling may result in an annual reduction of 402 work-years and a savings of $16.6 million. ...

From June through December 2008, ePulling was used to prepare the files for 773 cases. ...

The 773 cases prepared using ePulling contained 250,938 pages. For each page, ODAR assessed the ePulling software's accuracy in identifying four categories of information: type of document, document's source, document's beginning date, and document's ending date. ODAR found that multiple corrections were required for the pages processed. In fact, 433,790 corrections were required for the 250,938 pages processed. ...

Since June 2008, the contractor has made five enhancements to the ePulling software. To determine whether the enhancements improved the accuracy of the software, ODAR processed the same 10 cases through each ePulling software enhancement. In addition to the 10 cases repeatedly tested, ODAR selected 5 to 10 new cases to test each enhancement. ... As shown in Table 2, following the January 2009 enhancement, the accuracy rates computed from this limited number of cases in the areas of type of document (65 percent) and source of document (75 percent) show accuracy rates comparable to the rates ODAR calculated for the 773 cases (see Table 1). In the area of dates of document (64 percent), the accuracy rates were slightly better for the 15 to 20 cases as compared to the accuracy rates reported for the 773 cases, which was in the 40-percent range. However, accuracy rates declined between June 2008 and January 2009. ...

We interviewed six employees in the Tupelo, Mississippi, Hearing Office and three employees in the Minneapolis, Minnesota, Hearing Office who prepared cases using ePulling. All nine employees stated that ePulling increased case preparation time when compared to the traditional EF preparation process. ...

We recommend that SSA:

1. Perform a complete assessment of the ePulling pilot project results before expanding the use of ePulling to other hearing offices. The assessment should ensure that ePulling will not adversely affect file preparation time or any other aspect of the hearings process.

2. Consider if historical data can corroborate or improve upon the current 3-hour case preparation time estimate used to assess ePulling's impact on hearing office productivity.

3. Determine whether the ePulling pilot testing should also include cases with more than 300 pages. ...

SSA agreed with our recommendations.

Regular readers may recall that I have been extremely skeptical about e-pulling. I wish I could claim great prescience, but I cannot. I think that almost everyone familiar with pulling exhibits knew from the beginning that e-pulling could not work.

Lisa DeSoto appears to be the person most directly responsible for the e-pulling experiment. She is now gone from Social Security. We may never know whether e-pulling had anything to do with her departure. However, I do not want to blame Ms. DeSoto too much. The underlying problem is that Social Security was being given grossly inadequate resources to perform its mission. Social Security management knew that things were falling apart, but they were under enormous pressure to manage their way out of the problem. They resorted to a variety of "Hail Mary passes" such as e-pulling. All or virtually all of these "Hail Mary passes" failed, wasting money and staff time. These "Hail Mary passes" also misled Congress about the resources the agency needed to get its work done. Why give Social Security more money and personnel when Social Security managers are promising that "Hail Mary passes" are going to save the day? But, of course, Social Security managers were only telling Congress what it wanted to hear.

The real problem was that the Republican controlled Congresses between 1994 and 2006 were just irresponsible. They underfunded Social Security to the point that its managers tried desperate measures. I am sure that the Democratic controlled Congresses since 2006 have made and will continue to make mistakes, but they are not starving Social Security to the point that its managers repeatedly try "Hail Mary passes." Even a Republican like Michael Astrue should be able to appreciate that.