May 10, 2012

Fairies And Unicorns Are Real And Every Disabled Person Can Work

     The Social Security Advisory Board (SSAB) has met with  Christy Dunaway, an official of the Southeast Americans with Disabilities Act Center to talk about Social Security's disability programs, particularly work incentives. Here's a key quote from Dunaway:
One fundamental core value and belief underlies our comments today: All people of working age with disabilities can work if they have access to appropriate education, training, and vital supports such as technology assistance, transportation, and personal assistance services.
     This is absolute rubbish. It comes from a woman who tells us that she is disabled. In Social Security terms, she is not a bit disabled since she has regular employment. Impaired yes, but disabled no. She has no business trying to speak for a group of people whom she does not represent and whom she does not begin to understand. All the things that Dunaway say make it possible for anyone to work regardless of their disabilities are irrelevant to the vast majority of Social Security disability recipients. None of that matters if you are suffering from severe pain or devastating mental illness or are older and have a severe, chronic degenerative diseases. Would she really repeat the statement she made to a real, live person dying of cancer?
     People like Dunaway are a positive menace to truly disabled people. They are the reason we have politicians who are confused and dismayed that Social Security disability recipients fail to return to work. Dunaway and her ilk are mostly interested in federal grants to allow them to serve a tiny sliver of the handicapped community, most of whom are in wheelchairs. We have to make policy based upon the reality of who is drawing Social Security disability benefits and that's someone other than Dunaway and those few people whom she thinks are representative of the disabled population of this country.

May 9, 2012

NHC ALJs To Travel

     I am hearing reports that National Hearing Center (NHC) Administrative Law Judges (ALJs) will now be forced to travel to remote locations when the claimant declines a video hearing. The obvious reason for this is that claimants are frequently declining to do a video hearing with an NHC ALJ because the identity of the ALJ is being kept a secret until the day of the hearing. The whole reason for the "secret ALJ" policy has been the NHCs. 
     There are several problems with having the NHC ALJs travel like this:
  • Social Security doesn't have the money for the travel expenses.
  • The traveling will make the NHC ALJs much less efficient.
  • None of the NHC ALJs signed on to any travel, much less extensive travel.
  • It has been my impression that at least a few of the NHC ALJs wanted to be at a NHC because they wanted to avoid being in the same room as the claimant and the claimant's attorney. For them, the lack of face to face contact wasn't a bug. It was a feature.
     Defeat the NHCs and you probably defeat the "secret ALJ" policy. I think the NHCs are in trouble.

Washington State Congressman Fights Office Closure

     Congressman Jim McDermott is fighting an office closure in Seattle, Washington. 
     What sort of office closures do we get if Republicans control the White House, Senate and House of Representatives? Can field offices survive a Romney Presidency? Doing away with field offices could easily be the assignment of a Romney appointee as Commissioner of Social Security. Is it imaginable? Of course, getting rid of Supplemental Security Income would have to be the first step but where would you go from there? 
     If this seems inconceivable, you have not considered the consequences of the Ryan budget, to which Romney has pledged his support. It cuts domestic discretionary spending -- and that includes Social Security's administrative budget -- virtually in half.

May 8, 2012

DSM Coming In May 2013 -- What About Proposed New Psychiatric Listings?

     The 5th edition of the Diagnostic and Statistical Manual (DSM-5) is due out in May 2013. Many of my readers are now going "Huh? What's that?" The DSM is the Bible of psychiatry. It is an essential tool for the diagnosis of mental illness. Indeed, psychiatry was revolutionized by the advent of the DSM. Psychiatric illness is a major basis for awarding Social Security disability benefits. The DSM has had a huge impact upon disability determination at Social Security. While it is impossible to now predict what effect it will have, the DSM-5 is almost certain to be of considerable importance to Social Security. If you have an interest in disability determination at Social Security but are not involved in it on a day to day basis, just take it from someone who is, a new edition of the DSM is a big deal for Social Security.
     Social Security has been working on new Listings of impairments, that is regulations defining which disability claims based upon psychiatric conditions require quick approval, for more than four years. Social Security got a proposal approved by the Office of Management and Budget (OMB) in the waning days of the George W. Bush administration but never published it.  (No doubt, it would have been published if McCain had won.) After Barack Obama took office, the agency went back to the drawing board and got a new proposal approved by OMB to be published for notice and comment. This proposal was highly controversial. The comments are all in. At least in theory, Social Security could send final regulations over to OMB for approval at any time. Will Michael Astrue try to finalize proposed psychiatric listings while he is still Commissioner of Social Security -- before DSM-5 comes out? Astrue's term ends in January 2013. I was surprised that OMB approved publication of the proposal. Would OMB approve final regulations that contained the controversial elements of the proposal? Would Astrue want the proposed Listings without the controversial elements? Is it already getting too close to the election for controversial regulations? Would OMB approve anything important proposed by a lame duck Republican Commissioner of Social Security?

May 7, 2012

Union Agreement Signed

     The Social Security Administration and the American Federation of Government Employees (AFGE), the union that represents most of its employees, have finally signed a new agreement. This is now subject to ratification by union members.

The Attack Pieces Continue

     Here's a Reuters piece attacking the Social Security disability programs as being in part disguised unemployment.  Here are a few excerpts, with some comments by me in brackets and bolded:
  • ... Chris Low, chief economist at FTN Financial, said over time, disability will rob roughly $250 billion - or 1.6 percent - from total output each year once the economy returns to full employment, probably within the next five to seven years. This will also widen the budget deficit.
  • Duggan and other economists say the major change in the growth rate stems from a series of reforms in the mid-1980s, which changed the focus of screening from medical criteria to working ability. [The golden age that Duggan longs for was actually a brief, bizarre period of extreme harshness that was extraordinarily unpopular and quickly abandoned.]
  • "They are not encouraged to go back to work. [Actually, there are encouragement galore to return to work. You just don't know what you're talking about] I have gone to multiple meetings on a program called 'Ticket to Work' and there were only five people who showed up," she said. [The article is so poorly written that I cannot figure out who "she" is. The bigger problem, though, is "she" doesn't consider the possibility that the reason why so few people show up for Ticket to Work is that there are so few people drawing Social Security disability with a potential to return to work.]
  • If people do return to work, they could lose benefits such as health insurance, which further discourages some from looking, said Richard Johnson, Director of the Program on Retirement Policy at The Urban Institute in Washington.[No, actually, they are allowed to continue to receive Medicare for a very long time after going back to work. Why is Johnson giving interviews about something he doesn't understand?]
  • "If you provide incentives to people to go back to work, they do that," Barry Lundquist, President of The Council for Disability Awareness, a non-profit organization which advises disabled workers.[Lundquist advises disabled workers but doesn't know about the abundant work incentives that already exist? Maybe, they don't go back to work despite the incentives because the definition of disability used by Social Security assures that they're just too sick.]
     The drumbeat of articles along this long don't happen by accident. They are promoted by some entity or entities. The same ill-informed people keep getting quoted again and again. At least, they seem very concerned that work incentives be added to the Social Security disability programs. Adding another work incentive to the long list of work incentives that already exist would mostly be harmless.

May 6, 2012

Another Disability Benefits Attack Piece

     Bloomberg News is out with a piece attacking Social Security disability. It's a rehash of very argument you've ever heard that it's easy to get Social Security disability benefits, that it's a disguised unemployment program and that almost no one receiving disability benefits ever returns to work. The suggested solution is to make it more attractive for those receiving disability benefits to return to work. 
     How do you write something like this without it occurring to you that the baby boom generation might have something to do with the surge in disability claims and without finding out that there are already endless work incentives in the Social Security disability programs? Neither point is mentioned.

Disability Claim Estimated To Be Worth $260,000

     I noticed in a footnote to what was otherwise a boring report by Social Security's Office of Inspector General that Social Security's "actuary estimated the present discounted value of expected benefits for an average disabled worker award in 2011 was about $130,000 from the Disability Insurance Trust Fund and $130,000 from the Medicare Trust Fund."  In 2008, the National Academy of Social Insurance had estimated the value of an approved disability claim at $414,000 and they were only looking at the value of the cash benefits.