New IRMAA Regs

From today's Federal Register:

We are modifying our regulations to clarify and revise what we consider major life-changing events for the Medicare Part B income-related monthly adjustment amount (IRMAA) and what evidence we require to support a claim of a major life-changing event. Recent changes in the economy and other unforeseen events have had a significant effect on many Medicare Part B beneficiaries. The changes we are making in this interim final rule will allow us to respond appropriately to circumstances brought about by the current economic climate and other unforeseen events, as described below.

Does this seem hopelessly confusing and boring? Yes, but it affects real people and somebody has to administer it. Computers cannot do much of this. A lot of this cannot be done from a remote call center. It takes warm bodies spread out in offices around the country.

Hearing Office Average Processing Time Report

Courtesy of the National Organization of Social Security Claimants Representatives. Click on each page twice to view it full size.

It's Time To Earn That Award

Social Security Commissioner Michael Astrue received an award from the Alzheimer's Association for adding Alzheimer's to the list of cases eligible for "compassionate allowance" of disability claims. I consider the "compassionate allowances" list as meaningless since Social Security was already approving everybody on the compassionate allowance list and generally doing so rapidly. To me, the award seemed undeserved since nothing of consequence had happened.

Now, the Alzheimer's Association is announcing new diagnostic criteria for Alzheimer's disease. These new criteria are expected to double or triple the number of people being diagnosed with Alzheimer's disease. Quickly adopting these new criteria for purposes of adjudicating Social Security disability claims would actually be of benefit to Alzheimer's patients and their families. Will the Commissioner step up and do something meaningful to justify that award he received?

Personnel Changes In Chief ALJ Office

The latest issue of the Social Security Forum, the newsletter of the National Organization of Social Security Claimants Representatives (NOSSCR) has a brief article about some changes at the Office of Chief Administrative Law Judge (CALJ) at Social Security. There are now thee new Associate Chielf ALJ positions:

• ALJ Paul Lillios will be the new Associate Commissioner [did they mean Associate Chief ALJ?] for Field Procedures and Employee Relations. He is currently the Regional Chief ALJ for the Chicago Region.
• ALJ John Costello will be the Acting Associate Chief ALJ for Administrative Management and will be responsible for the evaluation of service delivery and processing of cases. He has been the Hearing Office Chief ALJ in Rochester, NY, and has been involved in the training of new ALJs.
• The new Associate Chief ALJ for the National Hearing Center position is vacant for the time being.

Updated Hearing Office And ALJ Stats

Social Security has posted the following updated data:

• Administrative Law Judge (ALJ) dispositions (I can get the other datasets to sort but not this one.)
• Average time for adjudicating request for hearing (Lansing, Michigan is the worst at 25 months. Ponce, PR and Huntington, WV are the best at 7 months.)
• Hearing office workload data (Birmingham, AL has the highest backlog at 11,700 cases. Ponce, PR has the lowest at 321.)
• Hearing office dispositions per ALJ per day (Honolulu has the highest at 3.66. Miami has the lowest at 1.35.
• Hearing office average processing time (Middlesboro, KY is the best at 261 days. Anchorage, AK is the worst at 652 days.)
• Hearings held (Atlanta has the highest number 5,876 from October 1, 2009 to May 28, 2010 and Honolulu has the lowest number for any office open for the entire period, 336.)

By the way, I would love to get some data on Social Security field office and teleservice center operations. What percentage of telephone calls are being answered at the field offices? What is the average wait time at the field offices? How long are people on hold before a live teleservice center employee talks with them? What percentage of callers to the teleservice centers get accurate and complete answers to their inquiries? I think that Social Security is collecting all this data and a lot more but it is not being released.

Aspirational Goals For Those Who Represent Social Security Claimants

The North Carolina Advocates for Justice (NCAJ) is an organization of attorneys who represent plaintiffs, mostly in personal injury matters, but also in matters such as workers compensation and Social Security. The NCAJ's Disability Advocacy Section (DAS) is composed of about 300 attorneys who represent Social Security claimants. This section is probably the most active such state-wide group in the country. The DAS recently approved a list of aspirational goals for DAS members. These goals are, as they are labeled, aspirational. There was no intent to set a legally enforceable standard. The list is not exclusive. A good attorney may have standards that go beyond this list. While some items on the list may seem quite basic, experience has shown that none of these can be taken for granted.

DISABILITY ADVOCACY SECTION ASPIRATIONAL GOALS & OBJECTIVES

1. Have regular contact with client and return all client’s telephone calls.
2. While the case is pending, develop the medical evidence, including obtaining treatment notes and medical source statements, and submit them to SSA [Social Security Administration] as soon as practicable, and seek on-the-record decision where appropriate.
3. Meet in person with client, inform client of scope of representation and adequately prepare client well in advance of hearing.
4. Be familiar with the legal and factual issues in client’s case; develop a theory of the case; be prepared to present the case; and where appropriate prepare and deliver a one-two page brief a few days prior to the hearing.
5. Do not withdraw from representation after hearing is scheduled absent special circumstances.
6. Take some of the hard cases, like Hyatt cases [an NC class action], cessation cases, overpayment cases, remote dates last insured cases, and Medicaid cases, including pro bono cases.
7. Assist in getting client paid after a favorable decision and inform client of rights and options after adverse decision.
8. Familiarize yourself with services in your community which may be available to your clients, such as vocational rehabilitation, Veterans’ Administration, free medical clinics, food banks, shelters, domestic violence programs, and mental health services.
9. Know the doctors in your area and promote good relationships with them and their staffs. Pay them promptly for records and their time. Let them know of favorable outcomes and how their assistance is appreciated (with client's permission).
10. Continue educational and professional development; stay apprised of new laws and regulations; improve knowledge over and above requirements of the State Bar.
11. Be active in professional organizations, e.g., NCAJ DAS and NOSSCR [National Organization of Social Security Claimants Representatives]. Volunteer to provide education to colleagues, civic groups, local community groups, support groups, and the public at large. For example, speak at a CLE [Continuing Legal Education], chair a CLE, write an article, or speak at a public event about some aspect of Social Security law.
12. Know who your elected representatives are and contact them about important legislation.
13. Be familiar with and comply with the requirements of 20 CFR [Code of Federal Regulations] §404.1740 Rules on conduct and standards of responsibility for representatives.

Bonuses Change For Goss

Stephen Goss, Social Security's Chief Actuary, who is reportedly concerned that Commissioner Astrue wants to get rid of him, received $49,000 in bonuses in 2006 when Jo Anne Barnhart was Commissioner of Social Security. He got no bonus in 2007 after Michael Astrue became Commissioner of Social Security. There is no information available to the public on bonuses at Social Security since then.

House Social Security Subcommittee Hearing Witness List Released

Here is the witness list for the July 15 hearing before the Social Security Subcommittee of the House Ways and Means Committee:

• W. Lee Hammond, President of the Board, AARP
• Ethel Zelenske, Co-Chair of the Social Security Task Force, Consortium for Citizens with Disabilities
• Kelly Ross, Deputy Policy Director, AFL-CIO
• Sylvester J. Schieber, Ph.D., Independent Consultant, New Market, Maryland
• Virginia Reno, Vice President for Income Security, National Academy of Social Insurance
• Nancy Altman, Co-Director, Social Security Works