New Schizophrenia Listing

     From the new mental impairment Listings:

12.03 Schizophrenia spectrum and other psychotic disorders (see 12.00B2), satisfied by A and B, or A and C: 
     A. Medical documentation of one or more of the following: 
          1. Delusions or hallucinations; 
          2. Disorganized thinking (speech); or 
          3. Grossly disorganized behavior or catatonia. 
     AND 
     B. Extreme limitation of one, or marked limitation of two, of the following areas of mental functioning (see 12.00F): 
         1. Understand, remember, or apply information (see 12.00E1). 
         2. Interact with others (see 12.00E2). 
         3. Concentrate, persist, or maintain pace (see 12.00E3). 
         4. Adapt or manage oneself (see 12.00E4). OR 
     C. Your mental disorder in this listing category is “serious and persistent;” that is, you have a medically documented history of the existence of the disorder over a period of at least 2 years, and there is evidence of both: 
         1. Medical treatment, mental health therapy, psychosocial support(s), or a highly structured setting(s) that is ongoing and that diminishes the symptoms and signs of your mental disorder (see 12.00G2b); and 
        2. Marginal adjustment, that is, you have minimal capacity to adapt to changes in your environment or to demands that are not already part of your daily life (see 12.00G2c) .

New Mental Impairment Listings

     To my surprise, Social Security has published new mental impairment Listings as final rules. I wasn't expecting them until after the election because that's what they said they planned to do. These are not effective until January. I'll post excerpts from them as I have time.
     Here are the new intellectual disability Listings:

12.05 Intellectual disorder(see 12.00B4), satisfied by A or B:

A. Satisfied by 1, 2, and 3 (see 12.00H):

1. Significantly subaverage general intellectual functioning evident in your cognitive inability to function at a level required to participate in standardized testing of intellectual functioning; and

2. Significant deficits in adaptive functioning currently manifested by your dependence upon others for personal needs (for example, toileting, eating, dressing, or bathing); and

3. The evidence about your current intellectual and adaptive functioning and about the history of your disorder demonstrates or supports the conclusion that the disorder began prior to your attainment of age 22.

B. Satisfied by 1, 2, and 3 (see 12.00H):

1. Significantly subaverage general intellectual functioning evidenced by a or b:

a. A full scale (or comparable) IQ score of 70 or below on an individually administered standardized test of general intelligence;

or

b. A full scale (or comparable) IQ score of 71-75 accompanied by a verbal or performance IQ score (or comparable part score) of 70 or below on an individually administered standardized test of general intelligence; and

2. Significant deficits in adaptive functioning currently manifested by extreme limitation of one, or marked limitation of two, of the following areas of mental functioning:

a. Understand,remember, or apply information (see 12.00E1); or

b. Interact with others (see 12.00E2); or

c. Concentrate, persist, or maintain pace (see 12.00E3); or

d. Adapt or manage oneself (see 12.00E4); and

3. The evidence about your current intellectual and adaptive functioning and about the history of your disorder demonstrates or supports the conclusion that the disorder began prior to your attainment of age 22.

What's The Solution?

     From WATE:

A young disabled Knoxville woman has lost her Social Security disability and Medicare assistance. She has epilepsy and until a year ago, had uncontrollable seizures. ...

Over the last 15 months, Amy Schnelle’s mom says her daughter’s health improved dramatically with the help of anti-seizure medications. Now, however, Amy Schnelle’s Medicare is ending and she can’t afford to buy the pills. Everything changed when Social Security sent a letter in May of this year saying her $1,200 a month check would be ending. ...

The Schnelles say what Social Security didn’t take into account is once her disability was dropped, she no longer can get the medications needed to control her condition. ...

Final Rules On Exclusion Of Evidence

     The following new final rules will appear in the Federal Register tomorrow:

§ 404.1503b Evidence from excluded medical sources of evidence.

     (a) General. We will not consider evidence from the following medical sources excluded under section 223(d)(5)(C) (i) of the Social Security Act (Act), as amended, unless we find good cause under paragraph (b) of this section:

         (1) Any medical source that has been convicted of a felony under section 208 or under section 1632 of the Act;

         (2) Any medical source that has been excluded from participation in any Federal health care program under section 1128 of the Act; or

         (3) Any medical source that has received a final decision imposing a civil monetary penalty or assessment, or both, for submitting false evidence under section 1129 of the Act.

     (b) Good cause. We may find good cause to consider evidence from a n excluded medical source of evidence under section 223(d)(5)(C) (i) of the Act, as amended, if:

          (1) The evidence from the medical source consists of evidence of treatment that occurred before the date the source was convicted of a felony under section 208 or under section 1632 of the Act;

          (2) The evidence from the medical source consists of evidence of treatment that occurred during a period in which the source was not excluded from participation in any Federal health care program under section 1128 of the Act;

         (3) The evidence from the medical source consists of evidence of treatment that occurred before the date the source received a final decision imposing a civil monetary penalty or assessment, or both, for submitting false evidence under section 1129 of the Act;

         (4) The sole basis for the medical source’s exclusion under section 223(d)(5)(C) (i) of the Act, as amended, is that the source cannot participate in any Federal health care program under section 1128 of the Act, but the Office of Inspector General of the Department of Health and Hum an Services granted a waiver of the section 1128 exclusion; or

          (5) The evidence is a laboratory finding about a physical impairment and there is no indication that the finding is unreliable.

Social Security Remains Third Rail Of U.S. Politics

     From Public Policy Polling:

A new Public Policy Polling survey covering 5 key Senate battlegrounds finds that voters are strongly opposed to a number of changes that Republicans might pursue to Social Security if they get total control of the government after this fall. 69% of voters say they’re concerned about the changes Republicans might make to Social Security, and by a 33 point margin they say they’re less likely to vote GOP this fall if they’re informed about what changes Republican control could bring to the program. In this closely contested election Democrats should be talking more about Social Security, which could be a winning issue for them in these pivotal states.

Key findings of the survey which included voters in Florida, Nevada, Ohio, Pennsylvania, and Wisconsin include:

• Only 20% of voters would support privatizing Social Security by investing benefits in the stock market, to 68% who are opposed to that. There’s bipartisan agreement with Democrats (13/83), independents (24/64), and Republicans (27/53) all strongly opposed to privatization. By a 48 point margin voters say they’d be less likely to vote for a candidate who supported that - 63% would be less likely to, compared to only 15% who would be more likely to.
• Only 5% of voters support making any cuts to Social Security benefits, to 88% who are opposed to them. You’d be hard pressed to find any issue that Americans are in such strong agreement about. There’s more than 80% opposition from independents (5/91), Democrats (6/90), and Republicans (4/84) alike. 80% of voters say they’d be less likely to support someone who would cut Social Security benefits, to only 5% who’d be more likely to vote for someone wanting to do that.
• Only 28% of voters support raising the retirement age, to 62% who are opposed to doing that. Once again there’s bipartisan opposition with Democrats (18/74), Republicans (34/54), and independents (40/47) all firmly opposed to raising the retirement age. By a 44 point spread voters are less likely to support a candidate who would raise it - 58% say they’d be less inclined to vote for someone who wanted to do that, to only 14% who would be more likely to vote for them. 
• Only 14% of voters support changing the formula that increases benefits for inflation, to 62% who would oppose doing that. Democrats (11/69), independents (14/69), and Republicans (19/52) all stand together in opposing such changes.
• When informed about the possibility that Republicans might pursue some of these policy changes if they end up with control of the White House, Senate, and House after the election 53% of voters say that makes them less likely to vote for the GOP in November, to only 20% who say it makes them more likely to support the party’s candidates. Particularly notable is that among pivotal independent voters, 50% say possible Republican changes to Social Security would make them less likely to vote for the party to just 22% who would be more likely to do so.

Rep Payee Fraud In Michigan

     From The Herald-Palladium of St. Joseph, MI:

A Benton Harbor woman who stole Social Security benefits meant for disabled people was sentenced Monday to 2-5 years in prison.

Jill Mae Williams was also ordered by Berrien County Trial Court Judge Arthur Cotter to pay $260,089 in restitution to the Social Security Administration and $25,185 to the Michigan Department of Health and Human Services.  ...

According to [prosecutor Jane] Wainwright, Williams had arranged for herself to become the “payee” for Social Security benefits for 10 vulnerable adults in Benton Harbor and was taking much of the money for her own use. ...

The people she was charged with stealing from were disabled and/or could not read and write. ...

GAO Report On Household With More Than One SSI Recipient

     From a recent report by the Government Accountability Office (GAO):

In May 2013, an estimated 15 percent of the 7.2 million households with blind, aged, and disabled individuals receiving Supplemental Security Income (SSI) cash benefits included more than one SSI recipient, according to GAO’s data analysis. Of the estimated 1.1 million households with multiple SSI recipients, most included two recipients (953, 000) and at least one adult recipient between ages 18 and 64 (695,000). Most households with multiple recipients did not have any child recipients, though an estimated 190,000 had one child recipient, 111,000 had two, and 3 0,000 had three or more. Few households reported having married couple recipients (an estimated 90,000). Most multiple recipient households reported that members of one family — those related by birth, marriage, or adoption —lived in the household (an estimated 941,000). GAO was unable to determine the specific relationships of recipients in these households.

The Social Security Administration (SSA) provided households with multiple SSI recipients almost 30 percent, or an estimated $1.2 billion , of the total $4.3 billion paid in SSI benefits in May 2013, according to GAO’s data analysis. In that month, multiple recipient households received an estimated average of $1,131 in SSI benefits, compared to $507 for single recipient households. Further, consistent with federal law that applies a lower maximum benefit rate to married couple recipients, GAO’s analysis found that households with nonmarried multiple recipients received a higher estimated average monthly benefit payment than married recipient households. ...

[A]ccording to SSA staff, SSA’s claims management system lacks the ability to automatically connect and adjust claim records of those living in households with other SSI recipients, as it is structured around providing benefits to individuals. For example, if a mother lives with two of her children who are both SSI recipients, and the mother reports changes to her income, SSA’s system does not automatically adjust both children’s benefit amounts to account for this change in income. In addition, the system is unable to automatically process claims when two SSI recipients marry or separate, so staff must manually complete forms and calculate benefits outside the claims management system, which is time consuming and error prone, according to staff GAO spoke with in three of five selected field offices . SSA officials said the agency has not assessed the risks associated with the system’s limited ability to automatically process claims for multiple recipient households, and has no plans to improve the claims management system to address related issues. ...

     To be sure, there are some issues with households with multiple SSI recipients but the Republican interest in the subject seems to harken back to Ronald Reagan's fables (and they were fables with little basis is fact) about "welfare queens." Households with more than one SSI recipient are hardly living large on $1,131 per month. There's almost never a sinister explanation for why there is more than one SSI recipient in a household. Usually, it has to do with factors such as people who are mentally ill associating with each other (because that's who will associate with them) and families with more than one child suffering from the same congenital abnormality.

Boring OIG Report On DCPS

     From a recent report by Social Security's Office of Inspector General (OIG):

In a February 13, 2015 letter to the Inspector General, Sam Johnson, Chairman of the Subcommittee on Social Security, House Committee on Ways and Means, expressed his continued concerns regarding the development of DCPS [Disabilty Case Processing System]. Specifically, Chairman Johnson requested that we provide regular reports to keep the Subcommittee informed of SSA’s DCPS-related efforts. This report is one in a series of reports that examines SSA’s progress in developing and implementing DCPS. ...

We concluded that SSA’s reported costs of $356 million for the DCPS project for the 8-year period ended September 30, 2015 were reasonably accurate. However, we noted issues with SSA’s processes for capturing and reporting contractor and labor costs. While we did not consider these issues to be sufficiently significant to materially affect the overall DCPS cost figure, we believe they warrant SSA’s attention....