New Childhood Listings For Depression, Bipolar And Disruptive Mood Dysregulation Disorder

     From Social Security's new mental impairment Listings for children:

112.04 Depressive, bipolar and related disorders (see 112.00B3), for children age 3 to attainment of age 18, satisfied by A and B, or A and C: 

     A. Medical documentation of the requirements of paragraph 1, 2, or 3: 

          1. Depressive disorder, characterized by five or more of the following:

               a. Depressed or irritable mood; 

               b. Diminished interest in almost all activities; 

              c. Appetite disturbance with change in weight (or a failure to achieve an expected weight gain); 

               d. Sleep disturbance; 

               e. Observable psychomotor agitation or retardation; 

               f. Decreased energy; 

               g. Feelings of guilt or worthlessness; 

               h. Difficulty concentrating or thinking; or

              i. Thoughts of death or suicide. 

          2. Bipolar disorder, characterized by three or more of the following: 

               a. Pressured speech; 

               b. Flight of ideas; 

              c. Inflated self-esteem; 

              d. Decreased need for sleep; 

              e. Distractibility; 

            f. Involvement in activities that have a high probability of painful consequences that are not recognized; or

              g. Increase in goal-directed activity or psychomotor agitation. 

         3. Disruptive mood dysregulation disorder, beginning prior to age 10, and all of the following: 

               a. Persistent, significant irritability or anger; 

               b. Frequent, developmentally inconsistent temper outbursts; and 

               c. Frequent aggressive or destructive behavior. 

     AND 

     B. Extreme limitation of one, or marked limitation of two, of the following areas of mental functioning (see 112.00F): 

          1. Understand, remember, or apply information (see 112.00E1). 

          2. Interact with others (see 112.00E2). 

          3. Concentrate, persist, or maintain pace (see 112.00E3). 

          4. Adapt or manage oneself (see 112.00E4). 

     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 112.00G2b); 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 112.00G2c).

NRA Does Its Thing

     According to a recent report by Social Security's Office of Inspector General (OIG), the agency received 90,920 comments on the recent Rule-Making proposal to have the agency report the names of individuals who have been assigned a representative payee to the National Instant Criminal Background Check System, where it could be used to prevent individuals from purchasing firearms. The agency must go through all of these comments. I'm sure that the vast majority are nothing more than the repetition of National Rifle Association talking points but it's still a huge number of comments to go through, by far the most in Social Security's history. I can predict that without a lot of pressure from the White House, this one will go on the back burner.

Security Issues With Social Security's Online Systems

     Social Security's Office of Inspector General (OIG) has released only a stub of a report on security in Social Security's online services but it's enough to strongly suggest there are problems. The agency admits that it needs a "higher degree of confidence in users’ asserted identities" and OIG says it is "imperative" that the agency do so "as soon as possible."

The Backlogs Are Horrible

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

As of March 2016, ODAR [Office of Disability Adjudication and Review] had about 1.1 million pending claims awaiting a hearing decision with the average age of 318 days, measured as the time from the date of the hearing request. The volume and age of pending hearing cases has increased since FY [Fiscal Year] 2010.

With respect to the claims awaiting a decision, we found:

• claimants’ average age was 45, and about 6 percent of pending claims involved claimants under age 19;

• about 45 percent of hearing requests nationwide awaited assignment for pre-hearing preparation; and

• approximately 7,400 claimants were deceased.

We found wide variations in workloads by hearing office nationwide. For instance, the average pending cases per ALJ ranged from 502 in the Boston Region to 972 in the New York Region. We also found that the proportion of individuals awaiting a decision in Georgia as related to the number of disability beneficiaries in the State was three times higher than that in Massachusetts.

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Are You Kidding Me? A 48% Error Rate?

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

Our objective was to determine whether the Social Security Administration (SSA) correctly completed manual actions to bill for Medicare premiums owed by beneficiaries whose monthly Social Security benefit was less than the monthly Medicare premium. 

When an individual entitled to Medicare Part B receives a monthly Social Security benefit, SSA deducts the monthly Medicare premium from the benefit . However, some individuals’ monthly Social Security benefit is lower than the monthly Medicare premium. SSA must bill these individuals for the remaining amount of the Medicare premium. ...

 SSA incorrectly calculated the Medicare premium owed for 120 (48 percent ) of the beneficiaries we reviewed who had a monthly Social Security benefit lower than their monthly Medicare premium. Based on these results, we project 33,092 beneficiaries paid incorrect amounts totaling almost $21.9 million for Medicare premiums because of SSA’s errors. These errors included miscalculations, erroneous system inputs, and failure to update beneficiary records correctly. As a result, some beneficiaries paid more than the correct amount for Medicare premiums, while others paid less ....

This Is Outrageous

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

We continue to find that SSA [Social Security Administration] needs to improve controls to ensure it pays child beneficiaries’ withheld benefits pending the selection of a representative payee. Based on our random sample, we estimate that SSA did not pay 6,615 beneficiaries approximately $9.2 million in withheld benefits.

Finally, we estimate that SSA only paid 2,423 of the 13,464 beneficiaries we identified during our 2010 audit. This occurred, in part, because SSA did not send letters to 4,233 beneficiaries and pay 214 beneficiaries who were in current pay on another record. ...

New Neurocognitive Listing

     From Social Security's new Listings of impairments for mental disorders effective January 17, 2017:

12.02 Neurocognitive disorders (see 12.00B1), satisfied by A and B, or A and C:

      A. Medical documentation of a significant cognitive decline from a prior level of functioning in one or more of the cognitive areas:

          1. Complex attention;

          2. Executive function

          3. Learning and memory;

          4. Language;

          5. Perceptual - motor; or

          6. Social cognition.

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).

     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 year s, 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) .

How Do You Spell That?

     From Psychology Today:

Naming a baby is a big decision, one many parents agonize over. ...

In discussion groups online for expecting mothers, many say they want to choose a unique name because “different is good” or “I want him to stand out.” Others dismiss names that are “too popular” because “I don’t want them to be one of three kids with the same name in their class.” ...

In a 2010 paper, my co-authors and I found that the use of common names declined precipitously between the 1950s and 2007 in the Social Security Administration database of the name of every American with a Social Security number (which is nearly everyone). In the 1950s, 1 out of every 4 boys had one of the 10 most popular names. By 2007, only 10% did. Fitting in went from being desirable to being undesirable, and uniqueness went the opposite way. It was yet another sign of American culture becoming more individualistic – more focused on the self and less on social rules. ...

But then the Great Recession hit. People started talking about a “cultural reset,” and in fact charity donations and interest in social issues did go up, suggesting a rise in communalism. But signs of a sustained increase in individualism, such as a continuing rise in positive self-views, also appeared.

So what happened with names? In a paper published today, we found that the trend toward unique names continued during the recession, especially for boys. Unique names are more common now than they were 10 years ago. Thirty-four percent of boys received a name among the 50 most popular in 2004-06, compared to only 30% during the 2008-10 recession years and 28% in post-recession 2011-15. For girls, the decline was from 24% to 22% to 21%. ...

This research shows the hidden power of culture. Across the country over the last few decades, parents were collectively deciding not to choose common names for their children. How does something like that happen? It’s a mysterious process – somehow the value of uniqueness became more prominent. We know it happened, but exactly how and why is a bit of a mystery. For now, we can take comfort that our kids will be less likely to be confused with another who has the same name – but more likely to be asked the question “And how do you spell that?”