Social Security Ruling 16-3p: A Disability Claimant's Honesty Doesn't Matter

     The Social Security Administration will be issuing Ruling 16-3p on Evaluation of Symptoms In Disability Claims tomorrow. Here's some excerpts:

...[W]e are eliminating the use of the term “credibility” from our sub - regulatory policy, as our regulations do not use this term. In doing so, we clarify that subjective symptom evalua tion is not an examination of an individual’s character. Instead, we will more closely follow our regulatory language regarding symptom evaluation . ...

In evaluating an individual’s symptoms, it is not sufficient for our adjudicators to make a single, conclusory statement that "the individual's statements about his or her symptoms have been considered" or that "the statements about the individual’s symptoms are (or are not) supported or consistent." It is also not enough for our adjudicators simply to recite the factors described in the regulations for evaluating symptoms. The determination or decision must contain specific reasons for the weight given to the individual’s symptoms, be consistent with and supported by the evidence, and be clearly articulated so the individual and any subsequent reviewer can assess how the adjudicator evaluated the individual’s symptoms. ... 

In evaluating an individual’s symptoms, our adjudicators will not assess an individual’s overall character or truthfulness in the manner typically used during an adversarial court litigation. The focus of the evaluation of an individual’s symptoms should not be to determine whether he or she is a truthful person. ...

New Acquiescence Ruling

     The Social Security Administration has released Acquiescence Ruling 16-1(7) concerning Boley v. Colvin, 761 F.3d 803 (7th Cir. 2014). I had written earlier about that 7th Circuit's decision.  It took an unusual degree of foolishness and arrogance at Social Security for this case to have reached the court of appeals.

Two New Rulings Coming Monday

     Even though it's in the middle of adjudicating about 1,500 cases of alleged fraud or similar fault, the Social Security Administration is issuing two new rulings on Monday, one dealing just with  the issue of similar fault and the other dealing both with fraud and similar fault.
     I don't know how much good it does to so conclusively demonstrate that you're changing the rules for one specific group of cases. It's like they're trying to bootstrap a weak case.

Patent Applied For

     A summary of a patent application filed by Jeffrey A. Killian of Grove City, OH:

A computerized system and method for determining eligibility for social security disability insurance benefits (SSDI) through a computer network who have been placed on a waiting list for medical treatment. The network provides access to State waiting list databases containing information relating to persons wanting to receive treatment for developmental disabilities and/or mental illness from a State licensed care facility and Federal Social Security records containing information relating to person's status of SSDI benefits and parental/marital information relating to person's eligibility of SSDI benefits. The system and method is programmed to automatically determine who is potentially eligible for SSDI benefits and determine those who are eligible for SSDI benefits based on the information identified within the State and Federal databases. Moreover, the computerized system and method may also automatically identify lump sum payments paid out on behalf of at least one person who want to receive treatment for disabilities and/or mental illness from a State licensed care facility, yet have been placed on a waiting list.

Hearing Backlog May Get Better In Buffalo, But Nationally?

     A local TV station reports that the Social Security Administration is working on the hearing backlog at one of the worst hit offices, Buffalo, but can we expect improvement nationally? Social Security says it will hire 200 more Administrative Law Judges (ALJs) this year and 250 in each of the next two years, which sounds like a lot, but is that enough to even take care of ordinary turnover as ALJs retire, quit and die, much less enough to improve the situation nationally?

OIG Report On Rep Payees

     Social Security's Office of Inspector General (OIG) has issued a report on the agency's efforts to police organizational and volume representative payees. Representative payees handle funds for claimants who are judged to be incapable of handling funds. The report talks about abuses by some of these larger rep payees. Social Security does not always obtain reimbursement from abusive rep payees. Sometimes, the agency allows a rep payee who has misused funds to continue to be a rep payee. This is sometimes appropriate if the misuse was minor and unintentional. The agency is supposed to reimburse claimants who are the victims of rep payee abuse but sometimes fails to. 

     On the whole, I'm sure the agency could do better but rep payees have always been and will always be a problem area for Social Security. It's hard to get people to be rep payees. There's only so much the agency can do. The problems identified are, in my opinion, minor.

Claims Rep Accused Of Fraud

     From the Reading, Pennsylvania Eagle:

Federal investigators have charged a Bernville man working for the Social Security Administration of allegedly defrauding the agency of more than $6,000.
Miguel Gutierrez, 42, was charged Friday by the Eastern District of the U.S. Attorney's Office in Philadelphia with three counts of wire fraud for the incidents that began in October. - See more at: http://www.readingeagle.com/news/article/bernville-man-charged-with-defrauding-social-security-administration#sthash.ObpE4ebl.dpuf

 Federal investigators have charged a Bernville man working for the Social Security Administration of allegedly defrauding the agency of more than $6,000.

Miguel Gutierrez, 42, was charged Friday by the Eastern District of the U.S. Attorney's Office in Philadelphia with three counts of wire fraud for the incidents that began in October. ...

Gutierrez was employed as a claims representative in the Social Security Field Office in Reading when he allegedly used access to the agency's computer system to redirect benefit payments intended for third-party individuals into his own bank account. He allegedly received three stolen benefit payments totaling approximately $6,166.66 from October to December. ...

Gutierrez was employed as a claims representative in the Social Security Field Office in Reading when he allegedly used access to the agency's computer system to redirect benefit payments intended for third-party individuals into his own bank account. He allegedly received three stolen benefit payments totaling approximately $6,166.66 from October to December. - See more at: http://www.readingeagle.com/news/article/bernville-man-charged-with-defrauding-social-security-administration#sthash.ObpE4ebl.dpuf

Federal investigators have charged a Bernville man working for the Social Security Administration of allegedly defrauding the agency of more than $6,000.
Miguel Gutierrez, 42, was charged Friday by the Eastern District of the U.S. Attorney's Office in Philadelphia with three counts of wire fraud for the incidents that began in October. - See more at: http://www.readingeagle.com/news/article/bernville-man-charged-with-defrauding-social-security-administration#sthash.ObpE4ebl.dpuf

Federal investigators have charged a Bernville man working for the Social Security Administration of allegedly defrauding the agency of more than $6,000.
Miguel Gutierrez, 42, was charged Friday by the Eastern District of the U.S. Attorney's Office in Philadelphia with three counts of wire fraud for the incidents that began in October. - See more at: http://www.readingeagle.com/news/article/bernville-man-charged-with-defrauding-social-security-administration#sthash.ObpE4ebl.dpuf

Social Security Disability Claim Files Getting Longer And Longer

     The Springfield, Ohio News-Sun is running a piece on Social Security's horrendous hearing backlog. It's always good to see these pieces but they seldom contain any information that's not already well known to regular readers of this blog. Here's a few nuggets of news from this piece:

Judge Marilyn Zahm, the [Administrative Law Judge] association’s president, said each case is a very labor intensive process ...

Zahm said the size of the case files has exploded in recent years, particularly as new regulations have been added. As a result, up to 30 percent of the files now contain more than 1,000 pages of medical evidence, she said.

“Do you have any idea how long it takes to review 1,000 pages of medical evidence?” said Zahm. “We are the only adjudicatory body that I’m aware of that allows such loose requirements for representatives.”

A work analysis study commissioned by the Association of Administrative Law Judges in 2014 found it would take a judge more than seven hours to process and render a legally sufficient decision on a case containing 652 pages, the national average for that year.

But with an expected quota of at least 500 dispositions a year, a judge would have available only 2.5 hours per case, the study found. ...

     I doubt that the rapid increase in the size of Social Security disability claim files registers with Social Security management. They never look at these files. It's all very abstract to them. The increasing file size matters. It takes more Administrative Law Judge (ALJ) time and it takes more time for those of us who represent Social Security disability claimants. ALJ productivity standards need to be adjusted. The fees paid to those who represent Social Security disability claimants need to be adjusted.