Aug 4, 2016

This Sounds Like A Sting Operation

     From a press release:
On August 2, 2016 a Federal Grand Jury in the District of Puerto Rico returned a 16-count indictment charging one doctor, Americo Oms-Rivera, his secretary Mayte González Muñoz, and Francisco Cabrera Alvarado, a former Social Security Administration (SSA) employee, for fraud in the application process for SSA disability insurance benefits in Puerto Rico, announced United States Attorney for the District of Puerto Rico, Rosa Emilia Rodríguez Vélez. ...
The indictment alleges that on or about September 24, 2013, Person A was introduced to Oms-Rivera to discuss his intentions of applying for disability insurance benefits. During said meeting, Oms-Rivera informed Person A that he/she needed to seek treatment for a period of five to six months before the paperwork was submitted to SSA. Oms-Rivera told Person A that once Person A’s disability benefits were approved, he would take a percentage of the check as payment.  The scheme involved, among others, the following acts alleged in the indictment:
  • On or about January 14, 2014, Person A had the first medical appointment with Oms-Rivera. During this visit, Person A informed the doctor that he/she was interested in obtaining SSA disability insurance benefits. Person A reported that his/her medical conditions were high blood pressure and migraines from time to time. In response, Oms-Rivera prescribed Prozac, a non-controlled narcotic, used for depression and panic disorders and Restoril, a Scheduled IV narcotic used to treat insomnia symptoms.
  • Person A made additional visits to Oms-Rivera for purported medical treatment. During these visits, Oms-Rivera and Person A discussed the disability application process and Oms-Rivera prescribed Prozac, a non-controlled narcotic, used for depression and panic disorders; Restoril, a Scheduled IV narcotic, used to treat insomnia symptoms; Ambien, a Scheduled IV narcotic, used to treat insomnia; and Xanax, a Scheduled IV narcotic, used to treat anxiety and panic disorders.
  • Oms-Rivera and defendant González-Muñoz referred Person A to Cabrera, a former SSA employee who worked as a non-attorney representative. Cabrera assisted Person A in his application for SSA disability insurance benefits.
  • On May 21, 2014, Cabrera met with Person A in order to assist him/her to fill out the Adult Function Report, SSA Form 3373. During said meeting, Cabrera coached Person A as to what to write in the form in order to get Person A’s disability benefits approved.
  • On June 10, 2014, González charged Person A $600 for the Psychiatric Medical Report and $1,440 for backdating his/her medical file and creating 24 fictitious medical appointments.
  • On or about October 22, 2015, the Psychiatric Medical Report signed by Oms-Rivera was submitted to SSA indicating that Person A was totally disabled to return to work as of that date or in the near future. In the Psychiatric Medical Report, Oms-Rivera falsely represented to SSA that Person A’s first medical visit was on October 15, 2013. Oms-Rivera further reported a total of approximately 11 fictitious appointments that never took place. This was done to create the appearance of a longer history of medical treatment.

Going To Hell In A Handbasket

     Below is Social Security's Hearings Caseload Analysis Report for the first nine months of fiscal year (FY) 2016, which began on October 1, 2015. This was published in the newsletter of the National Organization of Social Security Claimants Representatives (NOSSCR). That newsletter is not available online.
     Here are some signs of just how badly things are going:
  • The adjusted case receipts for the nine month time period were 746,300. The dispositions were 662,522. This means they were only able to handle 89% of the workload they received.
  • They had 977,736 cases pending at the beginning of the FY and 1,121,267 cases pending as of the end of June (actually June 24, which the agency treats as the end of June). That's a 15% increase in the backlog.
  • Look at the bizarre stops and starts in overtime. It went from 109.75 hours in November 2015 to 48,924.74 hours in December but then declined to 85.5 hours in March. Why? Social Security surges its overtime as soon as it gets an appropriation. That number then rapidly declines as the money starts to run out. It's boom or bust.
  • Take a look at the note at the bottom. The Senior Attorney program only disposed of 732 cases in this nine month period! This is ridiculous. It's less than the productivity you'd get from two Administrative Law Judges. That number of Senior Attorney decisions could be multiplied by 100 without having causing harm. All that would happen is that the sickest claimants, the ones who will certainly be approved anyway, would be approved more quickly. The Senior Attorney program has been subjected to such extreme limitations that it cannot function. It's a waste of resources. Don't tell me that agency management cares about the backlog. They know well that the Senior Attorney program could be a huge help in holding down backlogs but they either don't care or they're adopted the attitude of many Congressional Republicans that the only good disposition of a Social Security disability claim is a denial.

Click on report to view full size

Aug 3, 2016

Listings Extended

     From today's Federal Register:
We are extending the expiration dates of the following body systems in the Listing of Impairments (listings) in our regulations: Musculoskeletal System, Cardiovascular System, Digestive System, and Skin Disorders. We are making no other revisions to these body systems in this final rule.

Proposed Regs On Representatives Coming Soon

     Social Security's proposed Rules of Conduct and Standards of Responsibility for Appointed Representatives have already cleared the Office of Management and Budget (OMB). It only took a little over a month. Some change was made in the proposal while it was pending at OMB but we'll probably never know what. The proposed regs should appear in the Federal Register in the near future. Remember, it's just proposed regulations.
     By contrast, the final regs that would change the mental impairment Listings are still pending at OMB. They were submitted on May 23.
     
    

Aug 2, 2016

Jul 31, 2016

New Security Requirements

     From Social Security:
The Social Security Administration (SSA) has added an extra layer of security for our customers when they interact with us online using the my Social Security suite of services. my Social Security account holders are required to use their cell phone, in addition to their username and password, as an additional authentication factor during online registration and every sign in. 
We implemented multifactor authentication (MFA) to comply with Executive Order 13681, which requires federal agencies to provide more secure authentication for their online services. We are committed to using the best technologies and standards available to protect our customers’ data. MFA is just one of the ways we ensure the safety and security of the resources entrusted to us. Since we launched my Social Security in May 2012, we have provided this added security of MFA as an option to our customers.
Now, all new and current my Social Security account holders will need to provide a cell phone number able to receive text messages. People will not be able to access their personal my Social Security account if they do not have a cell phone or do not wish to provide the cell phone number. We expect to provide additional options in the future, dependent upon requirements of national guidelines currently being revised.
     Don't anybody tell Social Security that it's possible to get text messages without a cell phone.