Sep 15, 2009

Elliptical Answers

Commissioner Astrue testified before the House Social Security Subcommittee back in March. He later provided some written responses to the Subcommittee which have now been posted online. There is much that I find of interest. Here are a couple of important questions and answers. Would you say that the Commissioner was completely forthcoming?
You stated in your testimony that by the end of the current year, the ALJ-to-staff ratio in SSA’s hearing offices will be 4.5 to 1. However, some have suggested that the ratio should be higher – as high as 5.25 to 1 – especially given the importance of working down the backlog quickly. Do you agree that hearing office productivity could be increased if the ALJ-to-staff ratio were higher than 4.5 to 1?

Because of the economic downturn, we are seeing an increase in the number of initial disability applications filed, which will ultimately lead to more requests for hearings. In addition to improving our business process and productivity, we will need more administrative law judges (ALJs) and staff to support them to process the projected increase in receipts.

However, it is not simply the number of staff in a hearing office that determines the most efficient hearing office composition, it is also the mix of employees in the particular office. We believe that, as long as we can provide the right combination of job functions, a ratio of 4.5 support staff – such as case pullers and decision writers – for each ALJ will allow us to continue reducing the backlog. Our goal for this year and into the next is to ensure that all offices have the most efficient mix of staff needed to support the ALJs. The American Recovery and Reinvestment Act (ARRA) funding will help us hire these critical additional support staff.

With the right mix of critical support staff and the addition of 148 new ALJs whom we are hiring this month, we anticipate seeing an accelerating decrease in the disability hearings backlog. The number of pending hearings has dropped five months in a row and is down for the year, and we should be able to continue to make progress even in the face of the current economic downturn.

Your timely support of the President's FY 2010 budget will enable us to hire ALJs and hearing office support staff earlier in the fiscal year, which will allow these new employees to complete training and become productive in processing workloads earlier in the fiscal year. ...

How many full-time equivalents (FTEs), in addition to current staffing levels, would be required in the Field Offices to address all their responsibilities? To reach these staffing levels how many more FTEs would the Field Offices require above the level of hiring that you are planning for FY 2009? How many hires above replacement level would the Field Offices receive if SSA is funded at the full FY 2010 President’s Budget request of $11.6 billion? Will you be able to place additional employees in every Field Office nationwide?


In FY 2009, we will hire over 6,000 new employees between March and the end of this fiscal year, replacing all staffing losses and adding critical new positions. We will assign the majority of these new employees to our front-line operations, where they will directly assist the American public. Although these new employees will help us improve the overall level of service, we will have a backlog of approximately 900 work years in post-entitlement work in FY 2009, i.e., actions we take after a claimant is awarded such as changes of address, stewardship reviews, etc.

If we are funded at the full FY 2010 President’s Budget, we will hire approximately 5,800 employees in FY 2010, replacing all staffing losses and filling 1,300 new positions, with the majority of the hires working in front-line positions. We will add 600 new workers in the DDSs and add about 700 new employees in the hearings offices. We will place these employees in the offices with the greatest need. Most field offices have received or will be adding additional staff, but not all will, due to changes in workloads, real estate constraints, and other issues.
There is more from the Commissioner in his answers to the Minority members and staff of the Subcommittee.

Sep 14, 2009

Proposed Endocrine Listings Changes Sent To OMB

Social Security and all other federal agencies must submit all proposed new regulations to the Office of Management and Budget (OMB), which is part of the White House, for approval before publication in the Federal Register. Social Security sent proposed changes to its endocrine system listings to OMB for approval on September 11. It would be nice if the listing for diabetes were made less harsh, but the trend at Social Security in recent years has been to make the listings longer and longer and harsher and harsher. The day may come when the listings run to hundreds of pages.

I still cannot believe that an amputation at the ankle due to diabetes is not enough to meet the listings. That is one of the changes made a few years ago. That is ridiculously harsh in my opinion. My guess is that there are few people even at Social Security who would argue all that much with my opinion on this point.

Astrue Finds "Callous Kumbaya Attitude" Beyond Comprehension

From Government Executive:
According to [Social Security Commissioner Michael] Astrue and other experts on disability claims, the faltering economy is causing an increase in applications of between 15 percent and 25 percent. SSA originally anticipated receiving 2.6 million to 2.65 million applications for disability benefits in fiscal 2009, but upped its prediction to 3 million and another 3 million for 2010. Recently, the agency adjusted its estimates again, increasing the projection for 2010 to 3.3 million applications. ...

Astrue says the agency has been making inroads, reducing processing times by 4 percent each of the past two years. The recession, however, has reversed the progress on the backlog of cases. At the beginning of 2009, SSA had 550,000 cases pending at the state level. The state-run SSA-funded Disability Determination Services do much of the initial processing and eligibility determination for applicants. The number of claims pending at the state level, which does not account for applications at other stages of adjudication, is now up to 725,000. ...

"We've been stymied at the state level," Astrue says. "There's this callous 'Kumbaya' attitude that if there's going to be pain, everyone has to suffer. For me, it's beyond comprehension that you would make a civil service suffer unnecessarily and make claimants in desperate need of assistance wait much longer than they otherwise would." ...

Astrue says having that budget in place by the start of the fiscal year would be a tremendous benefit to the agency.

"There's a possibility - I don't even know the last time this happened - that we could have an appropriation by the start of the fiscal year," he says. "For planning purposes, being able to plan for the full fiscal year is enormous; we should be able to deliver much more use to the public."

I might not have used the word "kumbaya" in discussing the matter but I too find the state government furloughs of Disability Determination employees beyond comprehension.

By the way, I'm still not buying that the increase in claims filed has that much to do with the recession. My understanding is that the huge increase in claims filed did not start until after the inauguration of Barack Obama. I think this has far more to do with public perceptions about the adjudicative climate at Social Security.

SSAB On Health Care Costs

The Social Security Advisory Board (SSAB) has issued a report with the title The Unsustainable Cost of Health Care. The basic premise of the report, that health care costs are increasing at an unsustainable rate, is beyond debate. What is odd is that the report fails to discuss in any meaningful way the possibility of the so-called "public option," a government run insurance program that competes with private insurers, as a solution or part of a solution for this problem. The possibility of a single payer system is not even hinted at. There may well be no public option in the final plan passed by Congress and signed by the President, but this is certainly on the table. Instead of evaluating the public option as a possible fix for the problem the report states that one reason for increasing health care costs is that too many people have health care insurance! The report says flatly that reducing the ranks of the uninsured would lead to a greater problem with health care costs. The report seems to offer a compilation of plans backed by Republicans as the only possible solutions for the problems identified.

I do not understand why Democrats on the SSAB would sign on to this document.

It is my opinion that the SSAB as presently constituted is a waste of money. This report is certainly a waste of money. Why do Democrats in Congress keep funding SSAB?

Update: One poster noted that the SSAB was set up by statute. That is true but statutory bodies can be defunded. Without an appropriation, SSAB dies. It has happened to other agencies in the past. One that I recall well was the Administrative Conference of the United States (ACUS). ACUS still exists as a statutory body, but it offended Republicans and was defunded in 1995. For that matter, maybe ACUS should be revived.

Another Year With A Continuing Resolution?

When Congress is unable to complete work on an appropriations bill by the beginning of a fiscal year (FY) -- October 1 -- it passes what is called a continuing resolution that allows the agencies involved to continue spending at the same rate until an appropriations bill is passed.

Take a look at the status of the appropriations bills for FY 2010 which begins in 16 days. Social Security is covered by the Labor-HHS bill. It does not seem likely that all of these bills will be passed by the end of the month. Continuing resolutions hamstring agencies. They make planning difficult.

How Far Will This Go?

From The Hill:
Rep. Carolyn McCarthy (D-N.Y.) introduced legislation this week that would provide seniors and others who receive Social Security payments a one-time $150 payment to make up for the loss of the COLA [Cost Of Living Adjustment]. The bill has 14 Democratic cosponsors.

First Meeting Of Social Security Board Happened On This Date In 1935


Picture from left to right are Arthur J. Altmeyer, John G. Winant (Chairman), and Vincent M. Miles.

Sep 13, 2009

"Emergency Clause" For Disability Determination

The budget crises that are causing many states to partially furlough their employees, including disability determination employees who make initial and reconsideration determinations and whose salaries are paid by Social Security, has led to the issuance of a new item in Social Security's Program Operations Manual Series (POMS) concerning the "emergency clause." The "emergency clause" is what Social Security is calling an agreement with a state to transfer some of that state's disability determination workload to Social Security for adjudication at the Office of Central Operations (OCO), Program Service Center - Disability Processing Branch (PSC-DPB), or Disability Quality Branch (DQB).

Unfortunately, Social Security has only very limited ability to help any state, so this may mean little. It may also make it more difficult for OCO, the PSCs and the DQBs to process their regular workloads. I am sure that Social Security realizes that this is borrowing from Peter to pay Paul, but they must feel that they have no choice.