"The Wheels Are Already Coming Off The Bus"

     From the Roanoke Times:

More than a million people, including 5,000 in Southwest Virginia, are trying to convince a skeptical federal disability program that they are too disabled to work. ...

Federal disability claimants who have been turned down for assistance, but who insist they deserve the aid, wait an average of a year and a half for a final decision from the Social Security Administration. ... 

People living in the Roanoke area wait nearly two years. The local office ranks 155th, or 10th from the bottom nationally, in average case processing time, according to agency data. 

A hiring freeze ordered by the Trump administration means there’s little to no chance for a substantial increase in staffing to address the problem, according to an association of judges who work in the system. 

“I shudder to think what will happen if we don’t get significant relief from the hiring freeze. We desperately need support staff,” said Administrative Law Judge Marilyn Zahm, president of the Association of Administrative Law Judges. 

“The wheels are already coming off the bus,” said Zahm, who hears Social Security cases in Buffalo, New York. ...  

One in three support jobs in the Roanoke office is vacant, according to association figures. One judge’s job is vacant as well. The backlog of disputed disability cases, which exceeds 5,600, isn’t large by national standards. But the office’s nine judges deal with above-average amounts of paperwork, which increases decision-making time. ... 

That’s especially true in Roanoke, where 29 percent of case files run more than 1,000 pages, above the national average of 22 percent. Small case files, those with fewer than 500 pages, make up 15 percent of Roanoke’s case load, well below the national average of 28 percent. A judge must read each file, including handwritten medical notes. ...

Inadequate Budget Causes Declines In Customer Service

     From the Center on Budget and Policy Priorities (CBPP):

Years of Social Security Administration (SSA) funding cuts have hampered the agency’s ability to serve the American people ...

The current 2017 spending measure, set to expire at the end of April, froze funding for basic SSA functions like staffing field offices and call centers at last year’s level. ...

SSA’s core operating budget shrank by 10 percent from 2010 to 2016 in inflation-adjusted terms even as the demands on SSA reached record highs. The freeze on SSA’s operating funds in the 2017 continuing resolution (CR) only stressed the agency further. Anticipating the CR, SSA imposed a hiring freeze in the spring of 2016 and then eliminated nearly all overtime when the CR began.  ... Beneficiaries and taxpayers are paying the price:

• SSA has lost 1,400 field staff since the hiring freeze began. As a result, 18,000 field office visitors every day must wait more than an hour for service. Nearly half of visitors must wait at least three weeks for an appointment.
• SSA’s teleservice centers have 450 fewer agents than they need to handle the 37 million calls they receive each year. As a result, most callers to SSA’s national 800 number don’t get their questions resolved. The average wait for an agent is 18 minutes, and nearly half of callers hang up before connecting. Another 13 percent of callers get busy signals.
• SSA has been able to hire more staff to address appeals for disability benefits, in part due to the $150 million in dedicated funding that policymakers provided for this purpose in 2017.  As a result, SSA has made initial progress in reducing its record backlogs. But that progress will disappear unless the President and Congress continue to provide adequate funding in the final 2017 appropriation bill and in future years.
• The hiring freeze and cutbacks in overtime have hampered SSA’s ability to complete behind-the-scenes work, leading to growing delays in processing applications or changing benefits when a beneficiary’s circumstances change. This creates unnecessary hardship for beneficiaries. It also costs taxpayers, since it allows overpayments to build up and delays their collection — increasing the risk that they will never be recovered. By the end of 2016, the number of pending behind-the-scenes tasks had more than doubled. ...

Why Do Claims Like This Get Denied?

     I just took on a client whose Social Security disability claim was medically denied even though the Disability Determination Service knew he recently had a Left Ventricular Assist Device (LVAD) installed. No, this wasn't some technical denial. No, there's no date last insured issue. They just flat said he wasn't disabled. An LVAD is a partial artificial heart. In this case, it's being used as a last ditch measure to help the patient survive until a heart transplant is available. This isn't the first time I've seen this sort of thing. I had another client recently who had an LVAD installed. He didn't make it out of the hospital alive after he had it installed. It was obvious he was headed in this direction but he was still denied.

Why So Many Disability Claims From Rural Areas?

     The Washington Post is running an article on rural disability. There's a far higher incidence of Social Security disability claims in rural areas. The drift of the article is that this is related to the lack of job opportunities in rural areas, i.e., people can't find jobs so they file disability claims.

     I think there is a link between lack of job opportunities in rural areas and Social Security disability claims but I think it's more complicated than this article presents. What happens when there are poor job opportunities in an area but better job opportunities elsewhere? Some people leave to pursue job opportunities elsewhere. Those who leave are on average younger, better educated, smarter and healthier than those who stay. Those left behind are people who are more likely to file disability claims regardless of the job opportunities in their community. Those left behind also have much worse access to health care than those who leave. Health care in most rural areas sucks. Even if you have insurance, it's hard to get good medical care and many in rural areas lack health care insurance. You're more likely to get sick and stay sick if you have poor access to health care.

     Those of us who represent Social Security disability claimants like to talk about demographics and access to health care as factors in determining who files disability clams. Newspaper reporters don't like to write articles about demographics and access to health care. It's boring. They like nice simplistic explanations since those are easier for them to understand and convey to readers.

     By the way, there's nothing new about the higher incidence of disability claims in rural areas. I live in Raleigh, which was a fair sized and relatively prosperous city when I started practicing Social Security law in 1979. Raleigh and surrounding cities such as Durham, Cary and Chapel Hill have gotten much bigger and more prosperous since. This area has always been surrounded by poor rural counties. From the beginning of my practice, I've gotten more clients from the less populous rural areas than from the urban areas. The incidence of disability has always been higher in rural areas.

Was This Fake News Concocted In Russia?

    From the New Jersey Herald:

Widely circulated online reports crediting President Donald Trump for 2017 increases in retirees' Social Security checks don't accurately portray how the system works.

Social Security payments are based on a government measure of inflation, and are set automatically without any involvement of the White House. ...

Some of the online stories accurately use numbers from Social Security's website, showing that the 0.3 percent increase ...

But the figures are not, as one version said, Trump's "first move to fulfill his campaign promise" to protect Social Security.

Problems At AALJ

     There's a dispute at the Association of Administrative Law Judges (AALJ), the employee union the represents Social Security's ALJs. The Treasurer is being accused of "mishandling, misappropriating or otherwise misusing union funds or properties." AALJ is part of a larger union, IFPTE (International Federation of Professional and Technical Engineers), which is being asked to investigate. You can read the accusation, the response and an audit report. (Access to this uploaded file expires on April 4 so read it while you can and download it if you want to save it.)

Social Security Gets Hiring Freeze Exceptions

Granting exceptions

     Upon taking office, Donald Trump did what Republican Presidents have often done in the past, order a federal hiring freeze. This is based upon a general contempt for the work that federal agencies do and the federal employees who do the work. 

     These hiring freezes always start breaking down as it becomes apparent that voters will be discomfited by understaffed federal agencies. Social Security is usually one of the first agencies where it becomes apparent that a hiring freeze will cause visible problems.

     The Office of Personnel Management (OPM) is in charge of administering Trump's hiring freeze and can grant exceptions to it. OPM has now granted an exception to the hiring freeze to allow Social Security to hire Administrative Law Judges, hearing support staff and processing center employees. Unfortunately, there is no exception so far for field office staff.

Three Rulings Rescinded

     From today's Federal Register:

We are rescinding the following SSRs [Social Security Rulings]: 

      • SSR 96–2p: Titles II and XVI: Giving Controlling Weight to Treating Source Medical Opinions. 
      • SSR 96–5p: Titles II and XVI: Medical Source Opinions on Issues Reserved to the Commissioner. 
     • SSR 06–03p: Titles II and XVI: Considering Opinions and Other Evidence from Sources Who Are Not ‘‘Acceptable Medical Sources’’ in Disability Claims; Considering Decisions on Disability by Other Governmental and Nongovernmental Agencies. 

These three SSRs are inconsistent or unnecessarily duplicative with our recent final rules, Revisions to Rules Regarding the Evaluation of Medical Evidence, published in the Federal Register on January 18, 2017 (82 FR 5844).