New Neurodevelopmental Listing

     From Social Security's new mental impairment Listings effective January 17, 2017:

12.11 Neurodevelopmental disorders (see 12.00B9), satisfied by A and B:

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

          1. One or both of the following:

           a. Frequent distractibility, difficulty sustaining attention, and difficulty organizing tasks; or

            b. Hyperactive and impulsive behavior (for example, difficulty remaining seated, talking excessively, difficulty waiting, appearing restless, or behaving as if being “driven by a motor”).

        2. Significant difficulties learning and using academic skills; or

       3. Recurrent motor movement or vocalization. [So in the original; must be typo. They only had a few years to work on it.]

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).

Errors In Applying WEP

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

SSA [Social Security Administration] needs to improve its controls to ensure WEP [Windfall Elimination Provision] is timely and accurately applied for Federal pensions. We determined WEP should have been applied to 14 of the 250 beneficiaries sampled . We did not identify any beneficiaries for whom GPO should have been applied. Although SSA was aware these 14 beneficiaries had a government pension, the Agency did not reduce their benefit payments for WEP. The 14 beneficiaries received about $372,000 in overpayments. Based on our sample results , we estimate SSA overpaid about $129 million in Old-Age, Survivors and Disability Insurance benefits to about 4,900 beneficiaries.

If There's Another Side To This Story SSA Better Start Telling It

     From KOAT:

On Thursday, Congresswoman Michelle Lujan-Grisham walked into Albuquerque's Social Security Office, just like anyone else who needs help - but she said she didn’t receive a warm welcome and after an hour, was escorted from the building by federal officers. ...

 

The democratic representative was accompanying a 90-year-old woman to an appointment. 

She wanted to stay incognito - to see first-hand how the office is handling requests. In the past, Lujan-Grisham has criticized the local Social Security Administration for not offering a drop-off zone at its new downtown location. 

After an hour wait with the elderly woman, she said they got help but then got an alarming surprise. 

“Two armed officers show up, tap me,” Lujan-Grisham said during an interview with KOAT-TV Friday. “They challenge me about my access, they challenge me about my right to be there.” 

She said she told them like any citizen, she has a right to be there because it’s a public building, but they persisted. 

“They ask me to leave where I am,” Lujan-Grisham said. “They want to escort me and have a conversation with me.” 

After a few more minutes, Lujan-Grisham said the officers booted her from the building.

“It was purposeful, it was deliberate,” Lujan-Grisham said. 

She’s spent the last day trying to get an explanation from the Social Security Administration and from Federal Protective Services, a division of the Department of Homeland Security, with no luck. 

No one from either agency returned phone calls and emails KOAT either on Friday. ...

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 ....