Early Intervention

     Social Security is seeking information for an "early intervention mental health demonstration study." The agency is only giving 17 days to respond to its request for a good deal of information, suggesting that publication of the request is a formality, that Social Security has already identified a contractor.

     I hope this works but I'd be surprised if it does. Mental health problems aren't like appendicitis. They seldom crop up suddenly. If they do, it's usually something like a bad reaction to a prescription medication, a problem that wouldn't result in a person receiving Social Security disability benefits anyway. I have seen no sign that early intervention results in better long term results than late intervention. Less suffering but not less long term disability. You must have been disabled or be predicted to be disabled for at least a year to get Social Security disability. If mental health treatment is going to give you good relief for your psychiatric condition, you're not likely to get on benefits in the first place. In fact, even if you don't get good results from mental health treatment, you're not likely to get on benefits without a lengthy fight.

The "Vision Thing"

     The Social Security Administration has released Vision 2025, the long-awaited statement of how the agency expects to be operating ten years from now. I don't think I've ever read a more vacuous government document. Here's an excerpt from Acting Commissioner Colvin's message on the report to give readers a feel:

As the public moves confidently into the future, we must also change the way we operate. We are compelled to anticipate the social and technical advancements that offer new ways of navigating an ever-changing society. Our challenge is to embrace technological enhancements to achieve efficiency without sacrificing the personalized service for which we are known. Toward this end, we will build a stronger, ever-capable workforce, adopt engaging and contemporary training methods, expand our information and communication technologies, and modernize our operational capabilities. Of course, we must proceed toward this rapidly changing future, mindful of many present day realities. Our budgets will undoubtedly fluctuate, organized interests may express new agendas, social demographics will vary, and executive orders and congressional mandates will continue to affect the way we do business. Yet if we view such possibilities as opportunities, we can focus on creative solutions for meeting these challenges. Regardless of the complexities we might consider in the future, we must never disregard our customers’ expectations for excellence.

     No, it doesn't get specific at some later point in the document. It just stays at this level of advanced meaningless abstraction.
     Let me hasten to say that despite what I've quoted above, neither the Acting Commissioner nor upper management at Social Security is brain dead. They only produce such drivel because they're forced to. Here are the problems they're trying to address:

• The Government Accountability Office (GAO), egged on by some Republicans in Congress, keeps demanding that Social Security produce a "vision" for the future but it's not just any vision they want. For years, they have made relentless demands for a "vision" that does away with person to person service at Social Security because person to person service is just so passe in this age of the internet and so much money could be saved if we just got rid of the old fashioned idea that you should be able to actually talk with someone about your case. 
• The people at GAO have no clue about the complexity of Social Security. As far as they're concerned, it's just retirement benefits. Survivor and disability benefits are nothing more than a footnote. SSI isn't even a footnote as far as they're concerned. Mentally ill people? Let them use their computers! Cognitively impaired people? Surely, someone other than Social Security can help them with their Social Security problems. You can't expect government to do everything!
• Despite egging GAO on with its insane demands that Social Security plan for the elimination of face to face service, individual Republicans in Congress definitely don't want field offices closed in their districts. They believe, in the abstract, that technology can replace personal service but not when it comes to their districts. It goes without saying Democrats don't want field offices closed.
• Social Security management is well aware that doing away with face to face service is unthinkable. The programs they operate are far too complex to function without a field office structure. Not only can that not be done by 2025; it won't be possible by 2125.
• It's impossible to make any meaningful plans for service delivery in 2025 because of budget uncertainty. In fact, it's almost impossible to make meaningful plans for service delivery in 2016 because of budget uncertainty. 
• Even without budgetary uncertainty, who knows what technology will bring us by 2025. Does anyone think that Steve Jobs ever had a ten year plan for what would happen with the iPhone? Anyone who thinks they have a clear view of what will happen with technology in the future shouldn't be working for Social Security because they're delusional.
• Few people in upper management at Social Security now expect to be in upper management at the agency in 2025. They're responsible people but they're bureaucrats. They're mostly concerned with getting by from year to year. GAO's demands for a "vision" for 2025 are laughable, so Social Security produces a laughable "vision."

Sad

     From Social Security:

For 4/28/15, The Social Security Administration Offices at Headquarters are dismissing early as a precautionary measure. Please remain calm and follow all traffic commands. There are no credible threats at this time. Please adhere to the following schedule for an orderly dismissal. 10:30 am WOC Building/Childcare, 11:00 am Wabash/NCC/ Security West, 11:30 am West Building/East Building, 12:00 pm Annex/ RMB, 12:30 pm Altmeyer.

     Pray for everyone's safety and for the future of the city of Baltimore.

     Update: Social Security plans to open its central offices as usual on Wednesday.

Updated Disability Insurance Trust Fund Numbers

     Social Security's Office of Chief Actuary has released the first quarter numbers on the operation of the Disability Insurance Trust Fund. These numbers are crucial because the Chief Actuary's prediction is that the Disability Insurance Trust Fund will run out of money at the end of 2016.

    The Disability Insurance Trust Fund finished the first quarter of 2015 with $54.3 billion in U.S. government bonds. This was down $5.9 billion from the end of 2014. The Disability Insurance Trust Fund had lost $6.4 billion in the first quarter of 2014.

     There's no question that the Disability Insurance Trust Fund is doing somewhat better as time goes along. That's inevitable since the number of people drawing Social Security disability benefits is declining and the economy is growing. However, there's little doubt that the Disability Insurance Trust Fund will run out of money in the not too distant future. Because of the modest improvements in Trust Fund operations, I'd say that, absent some unexpected change, the exhaustion date is likely to be in the first half of 2017, perhaps around the end of the first quarter.

     Benefits do not stop if the Disability Insurance Trust Fund runs of money. There would still be enough income to pay at least 80% of benefits. However, it would be a chaotic situation with benefits reduced by varying amounts each month since trust fund income varies significantly from month to month. Some older beneficiaries would be shifted into retirement benefits since they're entitled to whichever is higher. That would reduce the draw down on the Disability Insurance Trust Fund but be an accounting nightmare.

Student Loan Debts Having Serious Effects On Social Security Recipients

     From The Hill:

A pair of Democratic senators is demanding to know more about the growing number of seniors who are seeing their Social Security benefits slashed to cover student loan debt.

Sens. Claire McCaskill (D-Mo.) and Elizabeth Warren (D-Mass.) sent a letter to the head of the Government Accountability Office (GAO) Thursday, calling for a study on this growing segment of senior Americans. The percentage of households headed by people aged 65 to 74 with student loan debt quadrupled from 2004 to 2010. ...

“Garnishing Social Security benefits defeats the entire point of the program — that’s why we don’t allow banks or credit card companies to do it,” said McCaskill, the top Democrat on the Senate Special Committee on Aging, in a statement. ...

In 2014, the government withheld $161 million in Social Security payments to cover student loan debt that had fallen into default....

Federal Bar Association Newsletter

     The Social Security Law Section of the Federal Bar Association has released its Spring 2015 newsletter. This is the only attorney group with members in private practice as well as members employed by the Social Security Administration.

NADE Newsletter

     The National Association of Disability Examiners (NADE), an organization of personnel involved in making initial and reconsideration determinations on Social Security disability claims, has released its Spring 2015 Newsletter.

More Seemingly Plausible Ideas From House Social Security Subcommittee

     A press release from the House Social Security Subcommittee:

Today, Social Security Subcommittee Chairman Sam Johnson (R-TX) introduced the Improving the Integrity of Disability Evidence Act of 2015. The bill will ensure that the Social Security Administration (SSA) uses medical evidence only from reputable sources when making a disability determination.

“Hardworking American taxpayers expect that honest information is used when making disability determinations,” Chairman Johnson said. “It’s just common sense to say if you can’t participate in Medicare, Social Security can’t consider your medical evidence. Americans want, need, and deserve a fraud-free disability program.”

According to a 2013 report released by the Senate Committee on Homeland Security and Governmental Affairs, some claimant representatives seek out doctors who will provide medical opinions leading to a disability-benefit award without question. The report gives an example of a lawyer who sought out doctors with licensure problems to provide medical opinions to support benefit claims.

The SSA’s regulations already prohibit the agency from purchasing consultative exams from medical providers whose license has been suspended or revoked because of concerns with professional competence or conduct. However, the SSA does not have any similar restrictions on medical opinions provided by a claimant. In addition, to protect beneficiaries and federal health care programs, the Center for Medicare and Medicaid Services is authorized to bar a provider from receiving payment from federal health care programs due to certain actions. By law, doctors who have been convicted of program-related crimes, abused patients, committed health care fraud, or have a felony related to a controlled substance cannot participate in Medicare.

This legislation would prohibit the SSA from considering medical evidence from doctors who are barred from participating in Medicare or who were assessed a civil monetary penalty for submitting false evidence by the SSA.

A similar provision was included in Chairman Johnson’s Stop Disability Fraud Act of 2014 (H.R. 5260) from the 113^th Congress, and in Social Security Subcommittee Ranking Member Xavier Becerra’s recently reintroduced Social Security Fraud and Error Prevention Act of 2015 (H.R. 1419).

     Let me explain why this seemingly reasonable idea is really bad. First, anyone representing Social Security claimants who seeks out doctors with disciplinary problems to examine their clients and give medical opinions is a fool. The reports will carry little weight. If you've got any sense, it's not worth even thinking about doing. Only one example is cited. Is this enough to justify legislation? Second, and more important, what do you do about the claimant who has the misfortune of having as their treating physician someone who runs into disciplinary problems? The patient isn't the one who has done wrong. They have no way of knowing that their doctor is going to run into disciplinary problems or, for that matter, that they have already run into disciplinary problems. Honestly, do you check on this yourself before seeing a new physician? Going ahead with this proposal would cause some very sick people to be denied even though they're done nothing wrong. A physician who has fraudulently overbilled Medicaid has done something wrong and should be punished but don't punish their innocent patients.