Waiting On Congress

There are three major Social Security matters pending action by Congress.

The current federal fiscal year ends on September 30, 2009. The Labor-HHS Appropriations bill that will fund Social Security's administrative operations has been passed by the House of Representatives and has been reported out of committee in the Senate. It now goes to the Senate floor and then to a conference committee to work out differences between the House and Senate versions of the bill. Will it be passed before the end of this fiscal year? We'll see. If not, Congress will surely pass a continuing funding resolution that will keep Social Security going at the rate of the preceding fiscal year, but continuing funding resolutions make planning tough.

Withholding of fees for certain non-attorney representatives of Social Security claimants sunsets in February 2010 unless this is extended by Congress. I do not want to alarm anyone but there is no visible sign of movement on this.

Withholding of fees for representing claimants for Supplemental Security Income (SSI) also ends in February 2010 unless this is extended by Congress. Again, I do not want to alarm anyone but there is no visible sign of movement on this.

Quotas On Disability Claims Approval Alleged

From the Press-Register (a newpaper which is based somewhere in Alabama, but try finding which city using their online edition!):

Some former medical consultants at the Alabama agency deciding thousands of Social Security disability claims each year say they were pressured to approve more applications, an assertion backed by e-mails obtained by the Press-Register. ...

The Social Security Administration's inspector general, a kind of an internal watchdog, is now conducting a review of how claims are handled, a spokesman said last week. Citing that review, Tommy Warren, director of Alabama's Disability Determination Service, declined comment on the e-mails. He said that for comparison purposes, the agency lets employees know what the allowance rates are in other Southern states, but added that it does not have goals.

The e-mails, sent by supervisors at the Birmingham-based agency between 2006 and last year, urged consultants to shoot for a 30 percent "allowance rate." ...

Among eight Southern states, the agency had the highest allowance rate (44.3 percent) statewide for applications for disability insurance. It ranked 5th for SSI claims at 29.5 percent allowance and, at 23.2 percent, was third in approving "concurrent claims" for both disability insurance and SSI.

That showing came some two years after a supervisor voiced concern about how Alabama stacked up in the region.

"If you have consistently had allowance rates below 30 percent, you need to look at your decisions very closely," she told dozens of consultants in a January 2006 e-mail. Similar exhortations followed in 2007 and last year.

"If your allowance rate is below 30 percent, refer back to your plans of action and continue to work on bringing your allowance rates up," another supervisor wrote in a May 2008 e-mail. ..

At a meeting last year, consultants were told "that our (office) had one of the lowest allowance rates in the country," said Samuel Popkin, a clinical psychologist hired to evaluate claims of mental impairment. "The tone and implication . . . was that that was not a good thing."

"I certainly felt the pressure, let's put it that way," said Gordon Rankart, also a psychologist.

Rankart, who worked for the Birmingham disability office for some 6½ years, said he was repeatedly "hammered" over his allowance rate. Both his and Popkin's contracts were not renewed. Popkin said he was not told the reason. Rankart said he was informed that his work had problems. "This has nothing to do with my work performance and I'm not going to pretend that it does," he said.

Again citing the inspector general's review, Warren declined to say whether allowance rates are a factor in renewing consultant contracts, but noted that the agreements can be ended by either side with 30 days' notice.

Begun in May and prompted in part by an anonymous complaint, the inspector general's review is aimed at ensuring that the Alabama agency's claims-handling process is fair and that applications are "being adjudicated the way they should be," said Wade Walters, the agency's assistant inspector general for external affairs in Baltimore.

The review is expected to be completed by year's end.

Let me throw out an explanation why Alabama should not have a low rate of allowance of disability claims. On the whole, Alabama's workforce is poorly educated, has weak job skills and has lousy access to medical care. This combination leads to a high rate of disability claims and should lead to a high rate of approval of those claims since the definition of disability that Social Security must use makes education and work experience relevant in determining disability and poor access to medical care leads inevitably to poor public health. Poor education, weak work skills and poor access to medical care are the case across most of the South.

The South is where I practice, so I have some knowledge of this. Indeed, I see this in a particularly vivid way since my office is in Raleigh, which has a well-educated population with high work skills and good access to medical care, but many of my clients live in poor communities 50 to 100 miles away. Compare the populations and the number of disability claims and disability benefits recipients in Robeson County and Wake County, NC sometime. The difference is stunning. It would be even more stunning to compare Cary, NC and Red Springs, NC. I can recall having a day of hearings in Robeson County some years age with a visiting Administrative Judge (ALJ) who had just came in from Boston. I had three clients in a row who were illiterate. The ALJ asked me pointedly if all my clients were illiterate. I told him that until the early 1960s Robeson County had had three separate school systems. The school system for whites was lousy, the school system for blacks was much worse and the school system for Lumbee Indians was much worse still. Most older Lumbees at that time were illiterate. (The passage of time since the integration of school systems has made this situation better, thank goodness.) I had happened to have had three hearings in a row with older Lumbees. In context, there was nothing remarkable about their illiteracy. The hearing assistant who was a local was nodding her head in strong agreement with what I was saying. The ALJ seemed stunned. (By the way, the story of the Lumbees is fascinating. They are one of the largest of native American tribes but remain unrecognized by the federal government largely because of the opposition of other Indian tribes and an extraordinary amount of simple discrimination which was aided and abetted for many years by Jesse Helms. Before I finish digressing, read about the 1958 battle -- and I do mean a battle -- between the Lumbees and the Ku Klux Klan, a truly great story.)

Poor education, weak job skills and lousy access to medical care are not spread evenly across the population. One very large group in Alabama, African Americans, is much more affected than others. I won't go any farther along this line since you can see where it leads.

The real story here is that Social Security may have quotas or goals for approval of disability claims. You can criticize this because you think the quotas or goals are too high or you can criticize this because you think the quotas or goals are too low or you can criticize the whole idea of quotas or goals. The way in which you criticize quotas or goals may suggest something about your political or social views.

Astrue: Agency "Moving Backwards"

From the Des Moines Register:

Todd Lindberg has lived for a year and a half in a storage garage in northwest Des Moines. He sleeps on a well-worn couch in a dark corner of the building, amid construction equipment, tools and snowmobiles.

With most of one foot amputated and part of the other missing, he qualifies for federal disability benefits that would pay for an apartment and groceries.

But getting those benefits is not easy.

A massive backlog of unresolved disability claims at the Social Security Administration has kept Lindberg and millions of others waiting years for benefits they earned while in the work force. The delays have led to splintered families, foreclosed homes and suicides.

Last year, a 49-year-old Missouri truck driver died in the lobby of a Social Security office while waiting to be called into the office for a hearing on his three-year-old claim for benefits. During the past year, the number of people waiting to have their claims processed has increased more than 30 percent, from 556,000 to more than 736,000. The head of the Social Security Administration, Michael Astrue, has acknowledged that the situation might soon get worse. The agency is "moving backwards" in its efforts to keep pace with a recession-driven influx of new claims, he said. ...

Social Security's West Des Moines hearing office handles most of the cases from Iowa. Individual judges there have tried to catch up on their workload by hearing 70 to 80 cases each month, as opposed to their usual 50 to 60 cases.

"That's too many cases," said Denzel Busick, the office's chief administrative law judge. "We can do that for a while," he said, "but you wouldn't want us doing that on a sustained basis because, as a judge, you start to think, 'What am I forgetting here? What am I overlooking?' ...

There is almost universal agreement about the cause of the disability backlog: Funding and staffing levels at the Social Security Administration have gradually dropped to their lowest levels since 1972, while the number of Americans applying for disability benefits has increased. Early this year, the number of unresolved cases was declining, but the economic crisis is making things worse: As the job market tightens, people with limited abilities have fewer job opportunities.

But in a sidebar, we get the traditional Republican response that Social Security must reorganize its way out of the backlogs:

U.S. Sen. Charles Grassley said he is not sure additional spending by the Social Security Administration would help reduce the backlog. He said the agency needs to change its structure, in part by fast-tracking initial decisions on claims, improving the productivity of judges and transitioning to electronic record keeping."More money can't solve all of the problems," Grassley said. "You can never satisfy these bureaucracies if you always accept the excuse that they need more money."

Where Are The Grownups?

From the Wisconsin State Journal:

State officials are considering furloughing some 200 workers who determine Social Security benefits for the disabled at the same time they are forcing those employees to work costlier overtime hours.

To help close a gaping budget hole, the state is furloughing almost all of its employees, including the workers who help decide who can claim federal disability payments, even though furloughing those workers won’t actually save money because they’re paid by the federal government. ...

An Interesting Union Note

Joe Davidson in his Federal Diary column at the Washington Post notes that John Gage, the head of the American Federation of Government Employees (AFGE), used to work as a disability examiner for Social Security. AFGE represents a good slice of the federal workforce, including most Social Security employees.

Decision Time At OIDAP

Social Security's Occupational Information Development Advisory Panel (OIDAP) has scheduled a meeting for September 16-17 in Los Angeles. Perhaps, I should say that Social Security scheduled the meeting since there are strong signs that OIDAP is almost completely controlled by Social Security. On the agenda, "discussion, deliberation and voting by the Panel on core recommendations to be included in the upcoming report to the agency."

OIDAP held its first meeting February 23-25, 2009 and they are going to be making major decisions less than seven months later? Social Security drags its feet on this issue for decades, but demands that the Panel make decisions with far ranging implications in such a short time? I have the strong impression that OIDAP is nothing more than an effort to provide cover for decisions that Social Security made before OIDAP was created.

By the way, I requested a copy of the briefing books that OIDAP has handed out to panel members at its meetings. No response from OIDAP even though OIDAP's website promises that "Materials presented are available on request." Social Security's occupational information system needs credibility. This is a poor way to develop that credibility.

ALJ Steverson Loses Job

Social Security brought charges before the Merit Systems Protection Board (MSRB) seeking the removal of London Steverson, an Administrative Law Judge (ALJ). An ALJ working for MSRB issued an initial decision that suspended Steverson from his job for 35 days. Social Security appealed. The MSRB has now decided to remove Steverson from his job altogether.

Steverson had been charged with improperly using agency letterhead for personal purposes, storing sexually oriented material on a government computer, using a government computer for a personal business, giving misleading and incomplete responses when questioned about some of the charges and using the agency's address and mail for personal correspondence. The MSRB sustained all charges against Steverson.

Update: Wikipedia contains some information about London Steverson, probably self-supplied.

Health Vault

A press release from Social Security:

Michael J. Astrue, Commissioner of Social Security, announced today that the agency has entered into an agreement with Microsoft to test the use of Microsoft’s HealthVault application in the disability process. HealthVault is a free online service that enables people to gather, store and manage their families’ health information, and share that information with their physicians and healthcare providers. These “personal health records” contain the same types of information that Social Security generally obtains from people applying for disability benefits.

“The use of personal health records holds great promise for ensuring that the medical information we collect from someone applying for disability benefits is accurate and complete,” Commissioner Astrue said. “Combined with other advancements in health information technology, our use of HealthVault should result in faster decisions for disability applicants. I look forward to working closely with Microsoft, a world-wide leader in information technology.”

Social Security and Microsoft are developing a technical prototype connecting the two organizations that will be available later this year. The agency also will collaborate with Microsoft to study current personal health record standards, gaps in those standards, and options for filling those gaps.

Social Security is a recognized leader in the use of health information technology. It is the first government agency to use the Nationwide Health Information Network (NHIN), a safe and secure method for receiving instantaneous access to electronic medical records. The NHIN is an initiative of the Department of Health and Human Services and is supported by multiple government agencies and private sector entities.