The Social Security Advisory Board (SSAB) has issued a
report giving information about "non-profit third party efforts" to help Supplemental Security Income (SSI) claimants. One major reason for SSAB's interest in these efforts is that this could "free up resources for the agency."
I think there are some practical things that Social Security could do to increase the help available to SSI claimants, one of them being to stop threatening criminal prosecutions of those who try to help people file claims online, but before we talk about what Social Security could do, let's talk about what's happening now.
One example of what the SSAB would like to see more of is SOAR (SSI/SSDI Outreach, Access and Recovery). SOAR is a joint project of the Department of Housing and Urban Development (HUD) and the Substance Abuse and Mental Health Services Administration (SAMHSA) at the U.S. Department of Health and Human Services (DHHS). However, while SOAR has other intentions, it has a major goal of
reducing local government costs for homeless shelters and indigent medical care by getting homeless people on SSI, thereby getting them on cash SSI benefits and also getting them on Medicaid. SSAB wants to see more of projects like SOAR so that Social Security's administrative burden can be reduced. It seems like this is like a dog chasing its tail. Wouldn't be it simpler and more direct to just give the Social Security Administration adequate resources so it could help people with their SSI claims instead of trying to encourage other government agencies to spend their money to help people with SSI claims? Trying to find ways to shift costs from one government agency to another is understandable but in the big picture it's inefficient.
One type of program which SSAB does not mention, perhaps because they are unaware of it or perhaps because it does not fit into their formula, is the effort that many hospitals make to get people on SSI. Why would hospitals do this? It's simple. Uninsured person enters the hospital through the emergency room, is admitted and quickly runs up a bill of tens of thousands of dollars. The same uninsured person may be back in the hospital again before long running up another big bill. The hospital wants to get the uninsured person on SSI because that makes them eligible for Medicaid which means the hospital gets paid tens of thousands of dollars now and perhaps hundreds of thousands of dollars over the long term. Thus, the hospital hires someone to help the person file and pursue an SSI claim. Again, there is an element of tail chasing here. In a rational society shouldn't the hospital be able to just call Social Security and depend upon them to do the work required to get the claimant on benefits? Since Social Security does not have the staff to do this, the hospital has to step in and spend its money. This amounts to a tax imposed upon the hospital because of inadequate staffing at Social Security.
I am sure that there are some true volunteer effort to help people with SSI claims but I have not seen or heard of many. I think the reason is that, while it can be emotionally rewarding to help lift a person out of abject poverty, it's also gritty work. It's hard to stay in contact with poor people. They keep moving around. The vast majority of SSI claimants suffer from depression at the least. Many suffer from bipolar disorder or schizophrenia. More than a few SSI claimants are unpleasant to deal with. A significant percentage have substance abuse problems. Some of them smell bad and dealing with people who smell bad may be even tougher than it sounds. You're never going to see large numbers of volunteers signing up for this sort of work.
I can suggest a couple of things that would help reduce Social Security's SSI workload a bit:
- Quit threatening to criminally prosecute those who help people file claims online. Social Security's official position is that while you may help a person fill out claim forms online, the claimant must physically push the "send" button on the computer himself or herself. If you get the information over the telephone and get the claimant's permission to submit the claim and then hit the "send" button, you've just committed fraud in Social Security's view. Of course, Social Security, itself, does the same thing all the time but it's not fraud when their employees do it. This is nuts.
- If Social Security cannot give claimants the help they need, everyone needs to recognize that the only group likely to give expert, sympathetic help on a large scale is attorneys. My firm and others do help people file claims but there is a shortage of attorneys willing to do this. This reason is money. Most attorneys feel like the money just isn't there. They don't think they can make a profit representing claimants at the initial and reconsideration levels, much less helping them file claims. Unless we are willing to look at ways of increasing the financial rewards for helping people file claims, I don't think we'll see much more of it. Is this self-serving? Sure, but I'm just the messenger. It's the marketplace that's saying that the pay for performing this service isn't high enough. More "education" isn't going to solve this problem. More exhortation isn't going to solve the problem. You can't order the problem out of existence. It's time to listen to what the marketplace is saying. I have no particular idea for how this can be done but I'm sure it would be possible to come up with some ideas if the will existed.If we're not going to fund the Social Security Administration adequately, we'd better come up with some ideas.
