More People Get On Social Security Disability Benefits For Fibromyalgia Than You Might Think

     From the abstract of Social Security Work Disability And Its Predictors In Patients With Fibromyalgia by Frederick Wolfe MD, Brian T. Walitt MD MPH, Robert S. Katz MD, and Winfried Häuser MD, published in Arthritis Care & Research, a publication of the American College of Rheumatology:

During the study, 34.8% (95% CI 32.9, 36.8) of fibromyalgia patients received SSD [Social Security Disability]. The annual incidence of SSD among patients not receiving SSD at study enrollment was 3.4% (3.0, 3.9%), and 25% were estimated to be work disabled at 9.0 years of follow-up. By comparison, the prevalence of SSD in rheumatoid arthritis patients with concomitant fibromyalgia was 55.6% (54.3, 57.0) and was 42.4% in osteoarthritis. By study conclusion, 31.4% of SSD awardees were no longer receiving SSD. In univariate models, incident SSD in patients with fibromyalgia was predicted by socio-demographic measures and by symptom burden; but the strongest predictor was functional status (Health Assessment Questionnaire disability [HAQ]).

Efforts To Prevent Or Detect Fraud

     Social Security's Acting Commissioner, Carolyn Colvin, has sent a letter to the Chairman of the House Social Security Subcommittee detailing her agency's efforts to prevent or detect fraud in disability claims. It sounds as if a fair amount of Social Security's scarce resources will be devoted to this effort. I expect that Republicans will be disappointed with the results since I expect that little organized fraud will be found.

Chained CPI Will Not Be In President's Budget

     The President's proposed budget for Fiscal Year (FY) 2015, set to be released in early March, will not include a change to Chained CPI for Social Security's cost of living adjustment. Chained CPI is strongly opposed by Social Security supporters. Take a look at Fox News' take on this announcement.

"Electronic Matrimony"

     A message I received from the Social Security Administration:

Dear Colleague:

I have great news!  Social Security has made it even easier for people to apply online for disability benefits.  We have joined the Social Security disability benefits application, and the adult disability report in “electronic matrimony.”  It used to be that you had to complete both of these forms separately when applying for disability benefits.  Our new streamlined process puts both forms together all in one place.  Please refer to www.socialsecurity.gov/applyfordisability for more information.

Be advised that this application is for Social Security Disability Insurance benefits only.  To find out about applying for Supplemental Security Income benefits, visit www.socialsecurity.gov/pgm/ssi.htm.

Thank you for your support as we continually strive to improve our service to the American people.

Expediting For 100% Service Connected Vets -- A Bad Idea

     Yesterday, Social Security announced a plan to expedite Social Security disability claims for veterans who have been found 100% disabled by the Department of Veterans Affairs (VA). Let me explain why that was a bad decision. 

• This is NOT about expediting disability claims for wounded warriors. Social Security was already doing that. This announcement expedites disability claims for veterans whose disabilities are NOT the result of combat. You ask how that can be. Easy. A veteran gets VA service connected benefits for virtually ANY disability incurred while in military service. Heart attacks, cancer, off base automobile accidents, rheumatoid arthritis, kidney failure, etc. The only things excluded are disabilities which are the result of the veteran's own willful misconduct or abuse of alcohol or drugs 
• To expedite disability claims for one group of people is to delay them for everyone else, which is no minor matter when we consider the severity of the backlogs at Social Security. Vets receiving 100% service connected VA benefits for non-combat related disabilities are undeserving of this special attention because they already have substantial incomes of more than $2,800 per month. They can be hurting somewhat financially but most Social Security disability claimants are hurting much worse because they do not have any disability benefit from their former employer. If anyone gets expediting, it should be those who are in serious financial distress, not vets already receiving 100% service connected benefits. 
• This new policy makes it NO more likely that vets drawing 100% service connected benefits will be approved for disability benefits by Social Security. It's only expediting. I strongly suspect that this was a cynical attempt to head off legislative proposals that would automatically grant Social Security disability benefits to those who had been approved for 100% service connected VA benefits.

     Vets deserve our respect. We owe them a lot. They certainly deserve compensation for their service connected disabilities. Those who are disabled by combat related injuries deserve special treatment at Social Security. However, vets with non-combat disabilities don't deserve to have their disability claims expedited at Social Security.

Proposed Regs On Submission Of All Medical Records

     Social Security has published  proposed regulations in the Federal Register requiring disability claimants and their attorneys or other representatives to notify the agency or submit all medical records concerning a Social Security disability claim.

     This proposal includes a statement that "When you submit evidence from another source, you must submit that evidence in its entirety." I don't know how to interpret this other than to mean that if I request a hospital record, I must request and submit the whole thing, which can easily run over 1,000 pages on a single hospitalization. Even an overnight hospitalization will result in hundreds of pages of records. The proposal says explicitly that Social Security intends to simplify matters by removing all discretion from the claimant and attorney. I could, in the alternative, simplify notify Social Security that the claimant was in the hospital but these days it's unlikely that an ALJ would, on his or her own, request the hospital record. In terms of outpatient records, if the claimant has been going to the same physician for 20 years, if I'm going to obtain and submit the record, I don't see how I can limit it to a particular time period. I would have to request the entire record. Social Security says that I have no discretion. Also, I don't see how I can not request lab reports, x-ray reports and other documents contained in the physician's records. I would have no discretion.

     By the way, if I, as an attorney representing a Social Security disability claimant, has no discretion to not request the entirety of any medical record, why should Social Security?

     I think that Social Security means well but this is unworkable. On its face, it wouldn't increase the quantity of medical records that claimants and their attorneys submit; it would reduce it by making it impractical for an attorney to obtain and submit many records.

House Social Security Subcommittee Schedules Hearing

     The House Social Security Subcommittee has scheduled a hearing for 10:00 on February 26 on:

[T]he Acting Commissioner’s plan and legislative recommendations for preventing conspiracy fraud.  The Subcommittee will also hear the recommendations of public and private sector experts to stop disability fraud schemes before benefits are awarded and to deter criminals from attempting to cheat the system.

     Disability fraud schemes are actually almost non-existent at Social Security and not that hard to identify when they do occur but that won't stop Republicans from scheduling these hearings. You say, nonsense, I've been reading about all these fraud conspiracies at Social Security. Really? How closely did you read those stories? There have been three recent "schemes" alleged. One was in Puerto Rico. It's being prosecuted. As described by Social Security, that scheme was unsophisticated and easily identified. If the charges are true, those involved were fools, which is not surprising since most criminals are fools. A second, similar scheme is alleged in New York City but the local U.S. Attorney declined to prosecute, a fact which should cause any reasonable person to wonder just how strong the evidence is. In the third case, there have been lurid allegations of bribery and other wrongdoing in the Kentucky-West Virginia border area but no one has been charged. These is reason for concern about those allegations since the people making the allegations are suing to try to recover money. They have a financial motivation. The Department of Justice has refused to get involved in that civil lawsuit, suggesting that the charges will be difficult to prove even by a preponderance of the evidence standard, not to mention the beyond a reasonable doubt standard that applies to criminal cases.

     By the way, it should now be obvious why the Acting Commissioner wanted to rush out the proposed "submit all the evidence" regulations.

Memo To ALJs: Schedule 50 A Month And You Can Have Telework

     From a memorandum sent to all Social Security Administrative Law Judges (ALJs) today by the Chief ALJ:

... Considering the necessity for quality, timely, and policy compliant hearings and decisions, and historical data, scheduling an average of at least fifty (50) cases for hearing per month will generally signify a reasonably attainable number for the purposes of this contractual provision [the contract is between Social Security and the ALJ union]. I want to emphasize that this provision concerns the number of hearings scheduled, not cases heard or dispositions issued. Accordingly, if you schedule at least an average of fifty (50) cases for hearing per month during a twelve-month rolling cycle, then management generally will determine you have scheduled a reasonably attainable number of cases for hearing for the purposes of this contractual provision. Conversely, if you schedule fewer than an average of fifty (50) cases for hearing per month during a twelve-month rolling cycle, then management likely will determine you have not scheduled a reasonably attainable number of cases for hearing, unless there are extenuating circumstances. ... 

When, after consideration of all factors, management determines that you have not scheduled a reasonably attainable number of cases for hearing, they will inform you of the determination and of the possibility that your ability to telework may be restricted. If management concludes there is no acceptable reason for not scheduling a reasonably attainable number of hearings, then they may restrict telework by not approving telework or canceling previously approved telework days. Again, management will consider any extenuating circumstances in making this determination....