Wedge Issue?

     The idea of raising Social Security benefits is increasingly becoming a favorite among more liberal Democrats. Senator Warren just came out in favor of the idea. This is not going to happen while Republicans control the House of Representatives. Theoretically, control of the House could change next year but it would take a Democratic landslide. More realistically, raising Social Security benefits could be in the Democratic platform in 2016. It would make a nice wedge issue. Republicans skew older.  More than half of Republican voters are over 50. One major problem for Democrats has been that the public doesn't understand the Affordable Care Act. They will eventually and I'm convinced they'll like it a lot but a 10% rise in Social Security benefits is easy to understand and easy for many who now vote Republican to like.

     By the way, I'm not terribly interested in hearing Republicans argue that raising Social Security benefits is bad because that money should go to younger people. A party doing everything possible to hurt public education ought to be ashamed to make that argument.

Congressional Hearing Tomorrow

     The Energy, Health Care and Entitlements Subcommittee of the House Committee on Oversight and Government Reform will hold a hearing tomorrow, November 19, at 10:00 on "Mismanagement of Federal Disability Programs." That title might be a tipoff to what to expect. Social Security's Inspector General will testify.

Washington Post Doesn't Like Idea Of Increasing Social Security Benefits

     The Washington Post editorial board doesn't think that raising Social Security benefits would be a good idea because the money should be spent on younger people. The Post doesn't explain exactly how the money should be spent on younger people. Maybe someone can help me out by telling me how the Post wants to spend more money on younger people.

     .I wonder if the bigger problem for the Post is that, as the editorial board puts it, raising taxes to pay more Social Security benefits would be "a massive transfer of income from upper-income Americans to the retired." I doubt that Jeff Bezos, the founder of Amazon and the new owner of the Post, likes the idea of transferring income from the wealthy to the retired.

Most SSA Employees Satisfied With Their Jobs

     According to a new Office of Personnel Management survey, 65% of Social Security employees express satisfaction with their jobs. While this is down considerably from 2010 when 74% of Social Security employees expressed job satisfaction, it is still higher than the government wide employee satisfaction rate of 59%.

Try Collecting 700,000 Signatures On A Petition To Address The Real Social Security Issues

     The McClatchy newspaper chain's Washington bureau reports that "chained CPI is on the table" in budget negotiations. Sure, it's on the table, as long as Republicans allow tax increases to be "on the table" which means chained CPI isn't on the table and won't be on the table.

     There's a lot of silly huffing and puffing about chained CPI that I don't understand. Current political conditions make any agreement by political leaders to adopt chained CPI impossible. Even if political leaders agreed to chained CPI, it's hard for me to believe it would pass Congress. There's zero public support for cutting Social Security and chained CPI is a cut.

     There are two real threats to Social Security at the moment, the probability that the Disability Trust Fund will run out of money in 2016 or 2017 and the immediate problem of the lack of administrative funding making it difficult for the Social Security Administration to operate. These are vastly more urgent than chained CPI yet Social Security advocacy groups seem obsessed with chained CPI while remaining almost oblivious to the threats to the Disability Trust Fund and the continued operation of the Social Security Administration. Oh yes, they put out press releases on these subjects but they don't spend their time collecting 700,000 signatures on a petition to address the real issues affecting Social Security.

All Relevant Evidence From Any Source In Its Entirety

     You may have noticed the extensive comments on my post about Social Security's plan to make attorneys responsible for obtaining "all relevant evidence obtained from any source in its entirety" concerning a disability claim. I had posed the hypothetical of a claimant who had received treatment for infertility. Some people thought that was irrelevant to a disability claim. Others felt it was relevant. People had strong opinions of the subject. Let me lay out a few more common situations for people to comment on:

• Claimant had an admission to a detox facility to help him stop drinking. This was two years before his alleged onset date. Claimant denies he is drinking now.
• Claimant has a Functional Capacity Evaluation (FCE) as part of her workers compensation claim. Claimant was represented by a different attorney on the workers compensation claim. Remember, Social Security, itself, says that FCEs are unreliable.
• Claimant claims that he is disabled by arthritis in his knees and back. He is also seeing a dermatologist for eczema which he says is an annoying but not a disabling problem.
• Claimant was hospitalized. Her entire hospital record runs to over a thousand pages. Which of the following should the attorney obtain? 1) Admission summary 2) Discharge summary, 3) Nurses notes, 4) Physician notes, 5) TPR records (that's temperature, pulse, respiration), 6) Lab reports, 7) Imaging reports, 8) Consultant physician notes, 9) Other test reports such as pulmonary function reports, EEG reports, cath reports, etc., 10) Surgery notes, 11) Pathology reports. Does it matter why the claimant was hospitalized? If the obligation on the attorney is to obtain the record "in its entirety", how do you rationalize making exceptions?
• Claimant sees a chiropractor for a few months for treatment for back pain.
• Claimant was in physical therapy for his shoulder pain for three months. He then decided to have shoulder surgery but it didn't help. The alleged onset date is the date of the surgery.

     What I'm suggesting is that this proposal may sound good but it's going to be impossible to draft it so that it's enforceable. Taken literally, the "in its entirety" language is unworkable. There is also no way to adequately define "relevant evidence."

Astrue Trashes Democratic Candidate At House Hearing

     Former Commissioner of Social Security, Michael Astrue, testified before some House subcommittee yesterday. The article I'm getting this from says it was the "Health Subcommittee" but the House Ways and Means Committee site doesn't show its Health Subcommittee having a hearing this week. Anyway, Astrue was there to trash Donald Berwick, who is running for governor of Massachusetts. Berwick used to be head of the Centers for Medicare and Medicaid Services (CMS). Astrue was blaming Berwick for the terrible rollout of the Affordable Care Act.

     The big problem with Astrue's criticism of Berwick is that Berwick left his position as head of CMS twenty-three months ago. Maybe the early planning for the Affordable Care Act rollout was lacking but most of the rollout preparation happened after Berwick left office. How much of the responsibility can one legitimately lay on Berwick? It's also clear from the description of Astrue's testimony that Astrue simply has a personal distaste for Berwick. I don't know whether Astrue's feelings are justified but they are irrelevant to the question of responsibility for the rollout of the Affordable Care Act or Berwick's qualifications for governor of Massachusetts.

NPRM On Obtaining And Submitting Evidence Coming

     From the description -- and a short description is all that's available now -- of a Notice of Proposed Rule Making (NPRM) that Social Security has sent to the Office of Management and Budget (OMB) for approval:

We propose to require claimants to inform us about or submit all evidence known to them that relates to their disability claim, subject to two exceptions for privileged communications and work product. This requirement would include the duty to submit all relevant evidence obtained from any source in its entirety, unless subject to an exception. We also propose to require a representative to help the claimant obtain the information or evidence that the claimant must submit under our regulations. 

     This NPRM may be changed as a result as a result of OMB concerns. At best, it will take some months to get this through OMB. OMB has slowed down greatly as a result of the government shutdown and sequestration. If this gets through OMB, it is still just a proposed rule. It would have to be published in the Federal Register. Social Security would have to allow comments on the NPRM and then consider them. My gut feeling is that this proposal will prove to be problematic. Let me list a few concerns that occur to me off the top of my head which may indicate why this is more complicated than it may seem at first:

• What does "all evidence known to them" mean? How far does this extend? A single hospital admission can generate more than a thousand pages of medical records. Does Social Security really want all of these? If Social Security doesn't really mean "all", how are attorneys supposed to decide what to obtain without using their judgment? Once attorneys start using their judgment, is this going to mean anything?
• What does "relate to their disability claim" mean? What if a client has had treatment for infertility or something else probably unrelated to their disabling impairment or impairment that the client may reasonably feel is none of Social Security's business? How does one determine what is "related" to the disability claim?
• How far does the duty to assist a claimant to obtain medical records extend? Medical records can be expensive to obtain. Are attorneys obliged to spend $500 to get medical records that Social Security, itself, declined to obtain? Does the Social Security Act even allow the imposition of this sort of financial burden on attorneys?
• When does an attorney have this obligation? If attorneys have this obligation at the initial level, they're going to be duplicating Disability Determination Services efforts. If attorneys do have this obligation at the initial level, maybe they just won't take on cases at the initial level anymore since the effort and expense will be disproportionate to the potential fees. Does Social Security wants attorneys to withdraw from initial and reconsideration representation?

     If Social Security goes ahead with this and it has teeth, expect endless controversies and unintended consequences. I know the Republicans in Congress are howling about Binder and Binder but be careful. This isn't simple. Those Republicans are going to be howling about something no matter what Social Security does.