Brace Yourself: OMB Clears Mental Listings

The Office of Management and Budget (OMB), which is part of the White House, has just approved a set of amendments to Social Security's mental impairment listings. The notice says that changes were made in the amendments while they were under review.

OMB had approved a set of amendments to the mental impairment listings in the waning days of the George W. Bush Administration but Social Security Commissioner Michael Astrue declined to publish that set. We have no way of knowing how that set of amendments differed from the set just approved by OMB. We have no way of knowing what changes were made in the proposal while it was pending at OMB this time. In fact, we have no way of knowing what is in this set until it is published in the Federal Register.

Amendments to the mental impairment listings are potentially quite controversial. These listings have a greater effect than any other listings. Mental illness is among the most important causes for disability. Mental illness remains a controversial topic with the public, many of whom regard it as largely imaginary. Over the decades that I have been involved with Social Security, I have seen the agency take somewhat extreme positions on the evaluation of mental disability.

I should know better than to make predictions but I will do so anyway. I predict that Social Security will make it dramatically more difficult to be found disabled as a result of mental retardation. I have never understood why, but this group has been at the top of Social Security's hit list for about a decade. I also predict that Social Security will make it more difficult for adults to be found disabled as a result of bipolar disorder and dramatically more difficult for children to be found disabled as a result of bipolar disorder. Maybe, they will propose to make it less difficult for schizophrenics to be found disabled. They ought to. They may try to slip in something to alter the standards for determining disability for those who have both a substance abuse disorder and another mental disorder. Anything along that line would be extraordinarily controversial and might not withstand judicial review. One safe prediction is that the preamble to the proposed mental impairment listings will be very, very long.

Expect that these proposed changes will appear in the Federal Register soon, perhaps next week. The public will have an opportunity to comment. Social Security must consider these comments and again obtain OMB approval before this proposal can be made official.

A Badge Of Seriousness

From Paul Krugman's blog:

A lot of the Beltway establishment has a thing about Social Security — in a way, by the way, they don’t have a thing about Medicare, which is a vastly more important long-run problem. No matter how much you talk logic or numbers, they’re obsessed with the idea that Social Security must be cut; as I wrote back when, somewhere back in the 90s talking tough on Social Security became a badge of seriousness, and facts just can’t make a dent in that social convention.

The Consequences Of Poor Service

The Center for American Progress recently commissioned a nationwide survey by Hart Research Associates on American attitudes towards their government. Here is an excerpt from the conclusion of the report:

Public confidence in government is at an all-time low, according to our survey. A common interpretation of this and other recent negative shifts in public sentiment toward the federal government is that it reflects an ideological rejection of “big government.” The results of our survey, however, reveal that Americans have not significantly changed their opinion of what government should do or its proper role. Indeed, clear majorities want more federal government involvement in areas like developing new energy sources, reducing poverty, and improving public education. Moreover, they expect government’s role in improving people’s lives to grow rather than shrink in importance in the years ahead.

How, then, can today’s undeniably negative sentiment toward federal government be explained? Americans’ critical view of government, the survey data reveals, has much more to do with perceptions of government’s competence than concern over “mission creep.” People’s concern is not that government is addressing too many problems, but rather that it will not succeed in carrying out its critically important tasks. And looking forward, people say quite clearly that their priority is improving government’s performance more than reducing its size. Americans
want a federal government that is better, not smaller.

Social Security is a lot more competent than the public gives it credit for being but the service the agency gives the public can only be rated fair at best. That is a big step up from what it was two years ago but it is still inadequate. It is almost impossible to get through on the telephone to Social Security's field offices. It can take several minutes to get through to a live person when one calls the agency's 800 number. Once callers get through to a human, far too often they receive inadequate or misleading information. Disability claims and appeals take entirely too long.

For the most part, I do not blame Social Security employees for these problems since the root cause is inadequate staffing. The only blame I assign to Social Security management is for not speaking out more clearly to tell the public why service is so inadequate.

Poor government service has political consequences, as Thomas Frank has written:

Conservatism ... seems actively to want an inferior product [government service]. Believing effective government to be somewhere between impossible and undesirable, conservatism takes steps to ensure its impotence. The result is predictable enough: another sour truckload of the mother's milk of conservatism, cynicism toward government.

Watch Out!

It looks like Social Security's Cooperative Disability Investigations office in Tampa is hiring the Georgia Bureau of Investigations to do surveillance for them, in Georgia, I suppose.

New York Police Officers Being Investigated

From the New York Post:

Up to 24 retired NYPD cops, some already getting tax-free disability pensions, are being investigated for allegedly feigning mental illness to add Social Security benefits to their juicy incomes -- even as they declared themselves sane enough to pack a pistol, The Post has learned. ...

The case began two years ago when Social Security investigators on an unrelated corruption case noticed that one lawyer represented an inordinate number of retired cops filing Social Security claims, a source said. ...

The retired cops appear to have used only a handful of lawyers to fill out the paperwork to support their bogus Social Security claims of mental illness -- and collect up to an additional $3,500 monthly on top of their disability pensions, the source said.

All of the cops also used the same group of shrinks, all of whom wrote prescriptions for medications. It was not clear whether the retired officers actually took the drugs. ...

The probe has already snared one former cop who was convicted on fraud-related charges, a source said. He was sentenced to prison, but details weren't immediately available.

Additional arrests are anticipated, although no breakdown was immediately available on the number of lawyers, psychiatrists or retired cops involved.

"I'd be very surprised if there are not further arrests," one insider said. ...

Lawyers allegedly involved in the fraud also face potential fee-gouging charges, a source said.

They're barred from charging more than $6,000 or 25 percent -- whichever is less -- of the monies awarded to a Social Security claimant, and those fees are supposed to be paid by the Social Security Administration, not the clients.

A source said one lawyer charged the retired NYPD cops far more than that to put them onto the government's gravy train -- a year's worth of SSA benefits, paid in cash.

I rarely read the New York Post. When I do, I am reminded of the words of the late Alabama governor, George Wallace, who said, "You gotta put the hay down where the goats can get to it."

Two Hearing Offices To Open In Ohio

From the Cleveland Plain Dealer:

Thousands of people in Ohio waiting for hearings on their Social Security disability cases -- some for more than a year -- should see that wait shortened by months after two new hearing offices open in Ohio on Aug. 16.

The two new local hearing centers, in Akron and Toledo, will bring a total of 119 new jobs to the state and increase the number of hearing offices in Ohio from four to six. ...

The ultimate goal is to reduce the average wait -- at all offices -- to 270 days by 2013, Social Security Commissioner Michael Astrue said in a telephone interview this week.

"The cavalry is coming over the hill," Astrue said.

"This is very good news from a backlog point of view, but it's also very important to have realistic expectations."

The centers will begin hearing cases by the end of August, Astrue said. But it will take months for them to get up to speed as new judges complete training and staffs settle in.

"You'll start to see some real contributions after about three months," Astrue said. "And that will increase steadily for the next nine months or so."

When the two new offices are fully staffed, Ohio will have 65 administrative law judges hearing disability cases across the state, 22 more than it has now....

Of the 147 offices in the United States, Columbus was dead last with an average wait time of 632 days, according to July data provided by the Social Security Administration. Cleveland was in 137th place with a delay of 549 days.

Social Security's 75th Anniversary On August 14

From the Sacramento Bee:

Evelyn Sekula's widowed grandmother struggled to survive during the Depression. Like millions of other elderly people, she had no pension and no savings.

"She had no income at all except for what my father gave her," said Sekula, 90, who lives at the Atria El Camino Gardens senior residence in Carmichael. "She was always looking for a way to make money. My father probably gave her $10 a month."

Today's older adults were children and teenagers when President Franklin D. Roosevelt changed the face of aging on Aug. 14, 1935, when he signed the Social Security Act into law.

They remember the difficult years when old age took place in a bleak, Dickensian landscape of need dotted with poor houses for those whose families couldn't support them. And they remember the difference that Social Security made in ordinary people's lives.

They also remember their parents' fears that Social Security amounted to socialism. Yet on the edge of the program's 75th anniversary, most of them can't imagine retirement without the small cushion of funds and dignity that Social Security provides. ...

"If it wasn't for Social Security, I'd be living under a bridge," said Jeneva Hammonds, 84 ...

"Social Security was the first government program instituting the concept that we have a collective responsibility for each other," said American River College gerontology department Chairman Barbara Gillogly. "Before that, there was no real concept of retirement.

"Most people worked until they died or were too ill, and then they were at the mercy of their family and friends."

E-File Access Delayed

A few hundred attorneys already have online access to Social Security's electronic files. There is some frustration that this has not been made available to everyone who represents Social Security claimants. I am hearing that the problem is technical. Social Security would like to allow people to sign themselves up online -- with proper security controls -- but the software is not cooperating. Social Security can only sign people up in person which dramatically slows down the process. The latest word is that Social Security hopes to automate the process by November.