Study On CEs

The Social Security Administration recently released a 2008 study of consultative medical examinations (CEs) performed by Comprehensive Occupational Medical Services (COMS), a contractor. Not all, but many, disability claimants are sent to these exams conducted at Social Security's expense. I have no idea why Social Security took so long to release this. Here are a few findings from the study:

• The mean Quality Rating (QR) of the CE’s reviewed was 2.97 within a range of 1-5: “1” represents an unsatisfactory and unredeemable CE Report and “5” a superbly documented, consistent, and logical report. This finding implies that the majority of CE Reports reviewed were sufficient to provide the DDS with enough clinical information to make an informed claim decision, but were deficient in the amount of clinical detail provided. The common deficiencies noted included: an inadequate history of present illness(es), failure to note medications or medication dosages, an absent or incomplete review of systems, omissions of important details of the physical findings, most commonly involving the musculoskeletal or neurological body systems, and an absent or qualitative medical source statement (MSS).
• Medical evidence of record (MER) was often not forwarded to CE providers. On the other hand, when MER was forwarded, it was unusual to find in CE Reports an adequate description of what items of MER were reviewed by the CE provider. COMS did not find any current policy or regulatory guidance requiring the inclusion of such information in CE Reports.
• The mean QR for CE’s associated with allowance decisions was statistically higher than for denials.
• COMS found that about 25% of X-Rays purchased by DDS’s as part of the CE process were probably unnecessary. Also, most purchased X-Rays, even when apparently indicated based on other CE findings or MER, do not demonstrate important pathological findings for SSA purposes.
• A consistent theme expressed by the DDS’s is that it is difficult at current fee levels to recruit and (retain) CE providers, especially specialists.

This Is Odd

From a notice posted by Social Security on FedBizOpps:

Region X of the Social Security wishes to identify vendors who may provide Verbatim Hearing Recordings (VHR) at various locations. The government contemplates the pursuit of up to three Indefinite Quantity Indefinite Delivery type contracts. One contract would provide all VHR needs in the States of Washington and Idaho, one contract would provide all VHR needs in the State of Oregon, and one contact would provide all VHR needs in the State of Alaska. The period of performance would be one year, with four one-year option periods.

There are a couple of things that I find surprising about this notice. First, my understanding is that Social Security has been contracting with individuals who perform this service rather than trying to contract out the service for an entire state. Second, on April 27 of this year Social Security Commissioner Astrue told the House Ways and Means Committee that "We are in-sourcing verbatim hearing reporting to further improve ALJ productivity."

Can someone tell me what is going on? This is not such a small thing to the hundreds of people who work as hearing reporters.

Processing Time Report

Below are a couple of reports from Social Security on processing times and workloads at Social Security hearing offices. Click on each page twice to view full size. These come from the newsletter of the National Organization of Social Security Claimants Representatives (NOSSCR). That newsletter is not available online.

Compare the processing time as it has changed over time:

• January 25, 2007 -- 508 days
• February 29, 2008 -- 511 days
• March 8, 2009 -- 499 days
• April 24, 2009 -- 505 days
• June 3, 2009 -- 505 days
• September 29, 2009 -- 472 days
• July 5, 2010 -- 415 days
• July 30, 2010 -- 410
• September 5, 2010 -- 398 days
  

Obama Supports $250 Payments

From the Chicago Tribune:

President Obama will press Congress to send a one-time payment of $250 to senior citizens to help them get through another year without an increase in their Social Security benefits, White House officials said Friday. ...

But the plan faces opposition in the Senate, which defeated a similar measure last year, and among Republicans concerned about long-term funding of the Social Security system.

AFGE Questions Progress On Backlogs

From a press release:

The American Federation of Government Employees questions the validity of SSA management claims that progress is being made on disability claims backlogs; and that efficient management practices are improving office performances. “While resources are limited and field office staffing levels have not increased in relation to additional workloads, SSA management continues to use smoke and mirrors in measuring the amount of work completed at field offices,” noted Witold Skwierczynski, president of AFGE’s Council of Field Operations Locals for the Social Security Administration. “SSA management has been manipulating the disability claims process, making it appear that offices have become much more efficient due to management improvements, when the biggest increase has been in claims that are denied on technical grounds.”

Such manipulations include processing claims for individuals who clearly are ineligible for benefits, and padding statistics by taking unnecessary actions such as reissuing Medicare cards to every client in the office whether or not they request such cards. ...

“It’s outrageous that some SSA managers are condoning the practice of using system tricks and having employees do unnecessary work to better statistical performance. These practices adversely affect service delivery at SSA and detract from the mission of the agency to assist those in need,” concluded Skwierczynski.

The Importance Of Social Security

Doubleclick on the thumbnail of a page from a recent Washington Post/Kaiser Family Foundation poll to get an idea of what Americans think about Social Security.

Benefits Slashed In Britain

From the Daily Mail:

Hundreds of thousands of claimants are to lose their disability benefits as Britain’s bloated welfare budget takes the strain of public spending cuts.

More than £1billion is due to be slashed from the disability living allowance bill, forcing around 400,000 to seek work. ...

[Chancellor George] Osborne also plans to introduce tough new medical assessments for the three million claiming disability living allowance.

President Favors Raising Income Cap

From Reuters:

President Barack Obama said on Thursday he favored raising more revenue for Social Security to prolong the solvency of the U.S. retirement fund, rather than just cutting benefits or making people work longer.

Obama told a televised youth town hall event that he thought the best approach was to increase the amount of income subject to Social Security taxes above the current cap set around $106,000, but he did not rule anything out.