Effects Of Focused Reviews Of ALJs

     In 2012, Social Security's Office of Inspector General (OIG) did a study on 24 of the agency's Administrative Law Judges (ALJs). Twelve had the agency's highest allowance rates for disability claims and twelve had the lowest. OIG has now gone back to look at what happened. Here's the result:

... The majority of the 24 ALJs from our first review were no longer among the ALJs with the highest and lowest allowance rates in FY 2016 because their allowance rates changed or they were no longer judges. Social Security Administration (SSA) data for FY 2016 indicated 

• 6 were still among the ALJs with the highest and lowest allowance rates, 
• 1 had been on administrative leave since 2014 following several reviews by the Agency, 
• 1 had become a senior attorney, 
• 7 were no longer among the ALJs with the highest or lowest allowance rates, and 
• 9 were no longer with the Agency. 

Of these 24 ALJs, the Agency had conducted focused reviews on 10. Further, 7 of the 10 ALJs who had a focused review were no longer among the ALJs with the highest or lowest allowance rates or had since left the Agency....

      The report omits information that would show which group -- high allowers or low allowers -- was most affected by the focused reviews. In fact, were any low allowing ALJs selected for focused review? I'm under the impression that the agency does not regard low allowing ALJs as a problem.
     Whether intended or not, the report notes that the allowance rate for all ALJs declined from 67% in 2012 to 55% in 2016.

In Today's Eric Conn News

     A documentary filmmaker will soon start work on the life of Eric Conn.

Headcount Continues To Decline

      The Office of Personnel Management (OPM) has posted updated figures for the number of employees at the Social Security Administration -- and the downward trend continues:

• March 2017 62,183
• December 2016 63,364
• September 2016 64,394 
• December 2015 65,518
• September 2015 65,717
• June 2015 65,666
• March 2015 64,432
• December 2014 65,430
• September 2014 64,684
• June 2014 62,651
• March 2014 60,820
• December 2013 61,957
• September 2013 62,543
• December 2012 64,538
• September 2012 65,113
• September 2011 67,136
• December 2010 70,270
• December 2009 67,486
• September 2009 67,632
• December 2008 63,733
• September 2008 63,990

It Keeps Getting Weirder

     Ned Pillersdorf is an attorney who lives and practices in the same area of Kentucky where Eric Conn used to live and practice but Pillersdorf is no friend of Eric Conn. He brought a class action lawsuit against Conn on behalf of Conn's former clients. He's also brought a class action lawsuit against Social Security on behalf of Conn's former clients whose benefits have been and are being cut off. Nevertheless, Eric Conn has decided to communicate with Pillersdorf. See below for a fax, apparently from Conn, received recently by Pillersdorf. Click on the image below to see it full size.

Misdirection Indeed

      From the Associated Press:

A fugitive Kentucky lawyer at the center of a nearly $600 million Social Security fraud case has fled the country using a fake passport and has gotten help from someone overseas with a job to help support himself.

The flamboyant disability lawyer Eric Conn, in an email exchange with The Lexington Herald-Leader over the weekend, told the paper he flew to a country that does not have an extradition agreement with the U.S.

The paper reported Sunday that it tried to verify Conn's identity by asking him questions that only he could answer, including his Social Security number, which it obtained from court documents, and details about one of his marriages. He answered correctly, the paper said. ...

He surrendered his passport in April 2016 after being indicted. An accomplice outside the country obtained a fake passport for him, an email said.

Conn said the day after cutting off the monitor he used the passport to fly out of the U.S.

He made a reference in one email to being on another continent but did not say which.

Conn said he boarded a commercial flight without any significant problems but did not say where he caught the flight.

He did say he worked to misdirect authorities. For example, Conn said he used his credit card to buy a ticket to fly out of John F. Kennedy International Airport in New York. He said however that he never intended to go there because of the likelihood the FBI was monitoring his transactions.

He used a different, pre-paid credit card to buy a second ticket and used that one to leave the country, he said. ...

But It Makes For Good Sound Bites

     From the Coalition for Citizens with Disabilities (CCD), the umbrella group for American organizations helping the disabled:

Legislative proposals such as H.R. 2792 would bar payment of Social Security and Supplemental Security Income (SSI) benefits to people with an outstanding arrest warrant for an alleged felony or for an alleged violation of probation or parole. This would revive an old, failed policy that had catastrophic effects for many people with disabilities and seniors, employing procedures that did not withstand judicial scrutiny. 

Does NOT Help Law Enforcement Secure Arrests 

The Social Security Act already prohibits payments to people fleeing from law enforcement to avoid prosecution or imprisonment. The Social Security Administration (SSA) currently notifies law enforcement of the whereabouts of every person with a warrant for an alleged felony or an alleged violation of probation or parole who turns up in SSA’s databases. This bill would not change these policies and procedures. 

Cuts Off Social Security, SSI for Hundreds of Thousands of People Whom Law Enforcement is Not Pursuing 

Based on prior experience with SSA’s failed former policy, the people who would be affected are those whose cases are inactive and whom law enforcement is not pursuing. 

  Most of the warrants in question are decades old and involve minor infractions, including warrants routinely issued when a person was unable to pay a fine or court fee, or a probation supervision fee. 

  Many people are not even aware that a warrant was issued for them, as warrants are often not served on the individual. 

  Some people will be swept up as a result of mistaken identity, or paperwork errors, which can take months or even years to resolve. 

Impact of Cuts would be Severe 

Resolving these warrants can be extremely hard and costly: people often must go before a judge in the issuing jurisdiction, and typically need counsel to assist them in navigating the process. Often, people have moved in the intervening years and live far from the issuing jurisdiction. Cutting off benefits will not help resolve the warrant. 

  Social Security and SSI provide the only source of personal income for over one in three beneficiaries. Losing this income will cause many people to become homeless and unable to meet their basic needs – much less, resolve a warrant. 

  A very high percentage of people who would lose benefits have mental illness or intellectual disability. Many are unaware of the violation, may not have understood the terms of parole or probation, or may have other misunderstandings about their case. 

Congressional Hearing Scheduled

     From a press release:

House Ways and Means Social Security Subcommittee Chairman Sam Johnson (R-TX) and Oversight Subcommittee Chairman Vern Buchanan (R-FL) announced today that the Subcommittee s will hold a joint hearing, entitled “Complexities and Challenges of Social Security Coverage and Payroll Tax Compliance for State and Local Governments.” Section 218 of the Social Security Act allows state and local governments to extend Social Security coverage to their employees through a voluntary agreement with the Social Security Administration. The hearing will focus on the complexity of Social Security coverage and payroll tax compliance under Section 218. Members will also discuss the responsibilities of the Social Security Administration, the Internal Revenue Service, and State Social Security Administrators in ensuring proper administration. The hearing will take place on Thursday, June 29, 2017 in 1100 Longworth House Office Building, beginning at 10:00 AM.

Fraud Story From South Florida

     From the Christian Science Monitor (a newspaper with a distinguished history but I'm surprised it's still around):

In December 2009, the Iowa Republican demanded to know how a Miami psychiatrist was writing more than 96,000 prescriptions for Medicaid patients. It was nearly twice the number of the second highest prescriber in Florida.

The psychiatrist, Dr. Fernando Mendez-Villamil, responded with a tartly worded message of his own. “I never thought I would be faulted for working hard or for being very organized and efficient,” he wrote the senator. ...

Even after Dr. Mendez-Villamil was kicked out of Medicaid and barred from Medicare, he continued to operate an elaborate network of bribes, kickbacks, and payoffs that helped hundreds of fake patients fraudulently obtain Social Security disability payments. ...

Through a check of pharmaceutical records, Crespo [the detective investigating the case] discovered that the doctor was prescribing large amounts of quetiapine, a drug approved to treat psychiatric patients diagnosed with bipolar disorder. It is sold commercially under the name Seroquel.

According to federal agents, there is a well-established black market in quetiapine, with street names including “jailhouse heroin,” and “Susie Q.” ...

Crespo found that many of Mendez-Villamil’s patients were receiving Social Security disability payments. The doctor had provided the medical assessments necessary to verify that his patients’ mental conditions rendered them completely disabled. Acting on those medical assessments, the Social Security Administration had awarded a large number of his patients full disability benefits. ...

Crespo estimates that Mendez-Villamil helped 3,500 to 3,800 individuals fraudulently obtain Social Security disability payments. “At one point he was disabling up to 10 people a week,” the agent says.

For $1,500 to $3,500 in cash, Mendez-Villamil would falsely diagnose anyone as having a severe mental disorder that would qualify him or her to receive Social Security disability payments. ...

Once the payment was received, the doctor’s staff prepared a patient file that was typically back-dated a year or more to show the condition was chronic and to create a fake paper trail purporting to document a prolonged period of medical treatment, according to court documents.

“It was just straight back-dating, you come in today and I started treating you last year,” the agent says. ...

Crespo wasn’t the only government official concerned about Mendez-Villamil. “I had administrative law judges calling me and telling me this guy is a crook,” the agent says. ...

Confronted with the fruit of Crespo’s detailed investigation, Mendez-Villamil pleaded guilty to health-care fraud in May 2016. He agreed to pay the government $50.7 million in restitution. He is serving a 12-½ year sentence in federal prison and has surrendered his medical license.

According to a statement signed by Mendez-Villamil as part of his guilty plea, the psychiatrist’s false diagnoses caused Social Security to make $20.3 million in undeserved disability payments to various “patients” between 2002 and January 2016. ...

With Mendez-Villamil behind bars, the question remains: What about all those patients fraudulently receiving Social Security disability payments?

“A lot of them are now off the rolls and are starting to pay the government back,” Crespo says. ...

     I have a few thoughts. First, I've never before heard of Seroquel abuse. Apparently, it is a thing but I don't think it's a big thing. One thing that kept this going was that the doctor apparently avoided prescribing opioids or benzodiazepines. Large numbers of prescriptions for those drugs, which have important medical uses but which are commonly abused, would have been a red flag that would have more quickly brought down this doctor. Second, where was Florida Disability Determination Services (DDS)? They make determinations at the initial and reconsideration levels on Social Security disability claims. They should have been the first to ask questions about what this doctor was doing. I'm glad to see that ALJs were raising a red flag. Third, I've been representing Social Security disability claimants since 1979 and I've never seen anything like what this physician was doing. I've seen at least a couple of cases where it seemed obvious that a physician was operating a Medicaid mill and was probably involved in Medicaid fraud but there was no Social Security involvement. I know that both of those physicians were investigated repeatedly. I never had any information on them that would have helped an investigator. Reports from these physicians were almost completely useless in proving disability. Their office notes were mostly illegible scribbles. If you're running a Medicaid mill, you don't take the time to create real office notes. Even if the notes had been legible, ALJs knew not to trust anything these physicians said. I routinely advised clients who were seeing these physicians to change doctors.