Getting Media Attention Helps

From KIVI-TV in Boise, Idaho:

An 18-year-old Orofino teen with a rare disease that has left him partially blind and deaf has won his year-long fight to get Social Security benefits.

Jacob Walk has type-2 neurofibromatosis, a disease that causes tumors to grow on nerves throughout his body. He says he's accepted his prognosis, and knows the disease will likely leave him completely blind and deaf in the coming years. He's had eight brain surgeries and has at least 14 tumors on his spine.

The Lewiston Tribune reports Walk first applied for Social Security benefits more than a year ago, but was denied -- twice. He took his fight to the media and to lawmakers, and last week U.S. Sen. Mike Crapo told him a Social Security administrative law judge had decided in Walk's favor.

Hearing Office Processing Time Report

From the newsletter of the National Organization of Social Security Claimants Representatives (NOSSCR).

The Only Thing That Changed Was That His Story Ended Up On Television

From NBC New York:

Male Aquino would rather risk freezing to death in his cardboard box than move into a warm shelter filled with drug users. But after being featured in a series of NBC New York reports in recent weeks, Aquino's luck seems to have improved.

After applying unsuccessfully for disability benefits for eight years, Aquino suddenly received a Social Security check for almost $2,300 and a promise of $761 a month in the future.

He says the only thing that's changed was that his story ended up on television.

The 24 Month Medicare Gap

From the Associated Press:

Disabled by chronic back pain and unable to afford medical insurance, Lea Walker hoped President Barack Obama's health care overhaul would close a coverage gap that has trapped her and millions of other workers.

It won't.

Although disabled workers can expect improvements, the legislation moving toward final passage in Congress doesn't deliver the clean fix that advocates for people with serious medical conditions hoped for. Some of the neediest could find themselves still in limbo. ...

She started receiving monthly disability checks from Social Security, but found she would face a 24-month wait for Medicare. Insurance available through her husband's job was out of reach at $800 a month.

At any given time, an estimated 1.8 million disabled workers languish in the Medicare coverage gap, a cost saver instituted nearly 40 years ago. Many, like Walker, are uninsured. Lawmakers had hoped to eliminate the gap as part of health care overhaul, but concluded it would be too expensive. ...

"I think everyone needs to realize this is going to be a first, very major step toward health care reform and then there will be a need to come back in the next several years and make midcourse adjustments," said Sen. Jeff Bingaman, D-N.M., who pushed unsuccessfully to phase out the waiting period.

While I wish that Congress would deal fully with the problem now, this article makes the problem out to be worse than it is. Many, perhaps most, of the people in the 24 month waiting period will be eligible for Medicaid under the health care reform bills pending in Congress. Because Medicare lacks an adequate prescription drug benefit, Medicaid may be better for low income families anyway. These bills would also give Medicaid coverage to many of those who are stuck in the lengthy process of appealing Social Security disability denials.

By the way, I will make a prediction now. If some combination of the plans pending in Congress come into effect, a higher percentage of Social Security disability claims will be approved because of better documentation of illness. I think we can also hope that eventually the rate of disability in this country will decrease because of better access to medical care.

Newspaper Tries To Blame Social Security For Murder?

From the Boston Globe:

Two decades ago, Congress was abuzz over scandals involving indigent parents who fabricated behavioral problems in their children to get disability payments for mental disorders. Stunned by news of these so-called “crazy checks,’’ US lawmakers in 1996 enacted tougher standards for children to qualify for such benefits.

But in a highly unusual criminal trial set to start on Tuesday, prosecutors are expected to allege that stricter eligibility rules did not stop a financially strapped Hull couple, Carolyn and Michael Riley, from concocting an elaborate scheme involving powerful psychotropic drugs. By 2006, everyone in the family was on the federal disability rolls, except for the youngest child, 4-year-old Rebecca, whose application had been denied. As the parents were appealing that decision, Rebecca died in December 2006 of an alleged overdose of psychiatric drugs that she had been prescribed for bipolar and hyperactivity disorders.

The parents now face first-degree murder charges.

As I read this, I have to wonder whether the newspaper is accurately describing the case. First degree murder is normally something intended. Nothing about the story presented suggests that these parents were deliberately trying to kill their child. Felony murder is a death that may have been unintended but which happens during the commission of a felony. Are prosecutors saying the parents were trying to commit fraud on Social Security and their daughter died as a result of this fraud? That sounds like a stretch. How would you prove fraudulent intent by the parents? This sounds like a highly disordered family. It is not implausible to me that severe mental illness was rampant in the family. There is a significant genetic component to bipolar disorder.

I expect this newspaper is trying to make a political case using only a caricature of a criminal case. It makes me wonder about the validity of the political argument they are making.

By the way, I have a ready explanation for the increase in the number of children receiving SSI benefits on account of mental illness. Previously, it was believed that bipolar disorder was either rare or non-existent in children. Now child psychiatrists believe that bipolar disorder is not uncommon in children. This belief is bolstered by a National Institute of Mental Health study. Putting the label of such a severe disease on children leads to more of them receiving disability benefits. More children are being diagnosed with bipolar disorder not because of something to do with Social Security but because of research. If you want to blame a government agency for this, blame the National Institute of Mental Health but be prepared to argue with their rigorous scientific study.

GAO Report On ALJs

From Results-Oriented Cultures: Office of Personnel Management Should Review Administrative Law Judge Program to Improve Hiring and Performance Management, a report by the Government Accountability Office (GAO):

SSA [Social Security Administration] and HHS [Department of Health and Human Services] officials responsible for hiring new ALJs reported they were satisfied with the quality of the judges hired from OPM’s [Office of Personnel Management's] ALJ [Administrative Law Judge] register of qualified candidates in 2008. Despite their satisfaction with these ALJ candidates, agency officials raised several issues regarding ALJ hiring and offered suggestions to improve the process, including (1) opening the OPM registry to accept new candidates more frequently, (2) giving greater consideration to agency-specific knowledge and experience, and (3) providing additional agency flexibility in meeting the procedural requirements associated with selecting from the three best qualified candidates and awarding veterans’ preference. OPM officials reported they are working to address these issues and develop new approaches, where appropriate. ...

To safeguard the independence of ALJ decisionmaking, ALJ agencies are prohibited from rating or tying an ALJ’s compensation to their performance. Nevertheless, SSA and HHS officials reported using numerous other practices to manage ALJ performance. ALJ association officials were concerned some SSA performance management practices could affect ALJs’ decisional independence.

SSI Recipients Eligible For VA Benefits

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

To perform our review, we identified 2,390 SSI [Supplemental Security Income] recipients as of March 2009 (from 1 of 20 Social Security number segments) with military earnings during certain wartime periods who appeared to meet VA’s [Department of Veterans Affairs'] requirements for benefits. [This would have to be non-service connected VA disability benefits, a point that the report should have made clear. Some of these veterans would also qualify for service connected disability benefits from VA.] We randomly selected 100 cases from this population for detailed analysis. (See Appendix B for more details on our scope, methodology, and sample results.)

RESULTS OF REVIEW

We found that some SSI recipients appeared potentially eligible for VA benefits instead of SSI payments. Based on our review, we estimate SSA paid about $1.3 billion to approximately 22,000 SSI recipients who appeared to meet VA requirements for benefits. In addition, we estimate that SSA will continue to pay about $126 million in SSI payments over the next 12 months to individuals who appeared eligible for VA benefits instead of SSI payments.

Of the 100 cases in our sample,
• 45 appeared potentially eligible for VA benefits;
• 45 did not appear eligible for VA benefits; and
• 10 had military earnings, but we were unable to determine potential VA benefit eligibility.

Award To Medicare Rights Center

The Medicare Rights Center has received an award from the Social Security Administration for its outreach efforts on Extra Help, a program which helps low income Americans pay deductibles and co-payments for the Medicare prescription drug benefit.