Acting Commissioner's Message On Hurricane Maria

From: ^Commissioner Broadcast 

Sent: Tuesday, September 26, 2017 3:15 PM
Subject: Hurricane Maria Update

A Message to All SSA and DDS Employees

Subject: Hurricane Maria Update

When Hurricane Maria swept across the Caribbean, it devastated Puerto Rico and the U.S. Virgin Islands.  We continue to work to account for our hundreds of employees in more than a dozen offices on these islands.  However, because communications are an ongoing issue, we still cannot reach about half of our offices or managers.  Please keep our colleagues in Operations, ODAR, the Puerto Rico DDS, OIG, and OGC in your thoughts and prayers.

All of our offices remain closed, severely impairing our ability to deliver service.  Limited power, spotty telecommunications, and extreme gas shortages will further impair recovery efforts.

On Friday, we put our Cycle 4 payments in the mail.  In Puerto Rico, the postal offices remain closed.  All payments destined for Puerto Rico and the Virgin Islands will be sent via express mail as soon as the United States Postal Service can get a plane into San Juan.  The New York Region is prepared to send a team to Puerto Rico when it is safe to do so.

I will keep you updated on the status of our employees and offices in the affected areas.  Recovery efforts are just beginning, but know that we are doing everything possible to reach and account for all SSA staff and restore our critical services to those in need.

Nancy A. Berryhill

Acting Commissioner

The Disability Backlogs Are A Disgrace

     The Altoona Mirror editorializes on the awful Social Security disability backlogs:

... [T]his nation, which, for the most part, prides itself on being compassionate, has, for the past half-decade, been guilty of an increasingly terrible disservice to individuals dealing with disabling physical and mental conditions. ..

Off Topic But I Hope I'll Help Somebody

     I'm going to succumb to the temptation of playing amateur physician and give readers a little advice that only a very few of you need. If you've got hidradenitis suppurtiva, see a dermatologist.

     First, I need to explain what hidradenitis suppurtiva is, since if you already know that you have it, you're probably already seeing a dermatologist. Hidradenitis suppurtiva is a skin condition that causes severe recurrent boils in the arm pits and groin areas. It's extremely painful. It can absolutely be disabling. It's just a matter of how frequently you get the boils and how long they last. (No, thank goodness, I'm not talking from personal experience. I've just heard enough about it from my clients, including one I saw recently.)  Most people who have hidradenitis suppurtiva don't get referred to a dermatologist because they don't get diagnosed. They keep going to general surgeons who keep treating the disease as a series of individual boils to be drained or excised rather than as a dermatological problem to be managed with medication. Almost every time I see a client with this problem I have to refer him or her to a dermatologist. Dermatologist do a better job of managing the problem than surgeons.

     Your first impulse on considering this may be that a skin condition couldn't possibly be disabling. Your second impulse is probably that if a skin condition is disabling, it must be an awful disease to have. Your second impulse is the correct one. Hidradenitis suppurtiva is a really nasty skin problem. There are other really nasty disabling skin problems. You don't want to be on disability for any of them.

     By the way, you might be surprised how often these cases come up before Social Security Administrative Law Judges. The incidence rate of this disease may be as high as 4% of the adult population so it's not rare. Statistically, it's almost a certainty that there will be at least on reader of this blog who has an undiagnosed case of hidradenitis suppurtiva. Of course, not everyone with hidradenitis suppurtiva is disabled by it. There are mild cases and there are severe cases. It's only the extremely severe cases that lead to disability claims.

And I'd Like To Have Flying Monkeys At My Disposal

     From a contracting notice posted by the Social Security Administration:

The Social Security Administration (SSA) is conducting market research/sources sought to help determine the availability and technical capability of qualified businesses providing an artificial intelligence interface that can provide customer service in a conversational manner. This is not a request for quotations or proposals, and we do not guarantee the issuance of a solicitation as a result of this notice. We will use the information we obtained from this research for planning purposes only. ... 

This technology should be capable of undergoing both supervised and unsupervised learning for continuously improving its support capability. The technology should be able to remember actions and contextual details during conversations, and leverage the captured information for suitable responses to other users, as appropriate. ...

The new technology cannot require extensive training for proficiency. It must provide flexibility in offering technicians with a broad range of skillsets the opportunity to successfully share and complete tasks for the public. 

This technology should support seamless transition of conversation history of authenticated users across channels and sessions. ...

Online Social Security Fraud Decreasing

     From Social Security's Office of Inspector General (OIG):

... [I]n 2012, SSA implemented my Social Security, an internet portal that allows people to create a personal online account to access their Social Security information. In January 2013, SSA enhanced my Social Security to allow beneficiaries to change their direct deposit bank information. The innovation was helpful for SSA and beneficiaries alike; however, soon after SSA added the direct deposit function, the agency began to receive reports of misdirected benefits due to unauthorized direct deposit changes in my Social Security....

To address this issue, SSA said it would strengthen controls over my Social Security accounts to address fraud and improve service to beneficiaries. ...

Our auditors followed-up on this issue in a recent report, and they estimated the amount of misdirected benefit payments from 2014 to 2016 was considerably less than it was in 2013. ...

Hurricanes May Increase Social Security COLA

     From The Motley Fool:

... Unquestionably, these hurricanes were respective disasters for Texas and Florida, and it's going to take months for some individuals and families to get their lives back together. ... 

But the more immediate impact from the U.S. being hit with this double-whammy is that it's pushed crude oil prices, and thusly prices at the pump, higher. ... 

More importantly, per the BLS' August report that was released last week, the CPI-W increased to 1.9% on an annualized basis from the 1.6% reported in the previous month. This implies that Social Security beneficiaries are in line for a larger benefit increase in 2018 than was expected just a month or two ago. ...

Why Do More Experienced ALJs Approve More Disability Claims?

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

In FY [Fiscal Year] 2015, the most experienced ALJs [Administrative Law Judges] had, on average, higher allowance rates than ALJs who had fewer years’ experience. Also, on average, ALJs who had more experience had agree rates [the rate of accuracy according to Social Security management but I would submit that this number is meaningless since there is no way of validating these numbers, i.e., there is no gold standard of ALJ decisional accuracy] of about 84 percent — about 6 percent lower than the ALJs who had less than 5 years’ experience. 

     While I don't recall any prior studies on the issue, the increase in ALJ allowance rates with more experience is nothing new. Attorneys who represent Social Security disability claimants pay close attention to this sort of thing.It's been a matter of common knowledge among us for a long, long time. We've long speculated that this is caused by the training process for new ALJs. However, I have heard many new ALJs who had represented claimants in the past assure me that the training wasn't slanted. They were all surprised that it wasn't slanted.

     Although I've presented it here, I think the "agree rate" is meaningless. You're just fooling yourself if you think there's a gold standard of disability determination. It doesn't exist. It's never existed. It's never going to exist.

Updated CARES Plan

     From Social Security's newly updated CARES Plan for dealing with its hearing backlog:

The original CARES Plan issued in January 2016 assumed a certain hiring of Administrative Law Judges (ALJs) – 250 ALJs in each of fiscal years (FY) 2016, 2017 and 2018 along with the corresponding support staff. While we were able to hire 264 ALJs in FY 2016, an agency-wide hiring freeze hindered the hiring of corresponding support staff. At the start of FY 2017, the agency-wide hiring freeze continued and included ALJs followed by an Executive Order initiating a government-wide hiring freeze. While we were able to obtain an exception for hiring staff in the hearings operation, our funding level in FY 2017 did not support hiring at the levels originally assumed in the original 2016 CARES Plan. Our 2017 Updated CARES and Anomaly Plan builds on the tactical initiatives laid out in the 2016 plan. We are also introducing new initiatives in 2017. ...

... Proactive Analysis and Triage for Hearings (PATH) – PATH is a new initiative introduced in FY 2017. However, this initiative builds upon successful screening and data analytic tools developed for the SmartMands and National Adjudication Team (NAT) initiatives from the 2016 CARES Plan. PATH also incorporates the robust use of naïve Bayes classification that will identify cases likely for allowance prior to hearing assignment. Through this initiative, we will assign appropriate staff to review and process cases identified through our screening methodologies. We plan to continue developing the PATH methodology in an effort to use this robust analysis at all levels of disability processing. Through PATH, we expect an increase in non-ALJ adjudications (reversals, on-the-record decisions), which will create a significant savings and opening a hearing slot for another case where a hearing is necessary. Our early projections for PATH modeling efforts in March 2017 suggested that approximately 3 percent (about 22,000) of unassigned cases pending at the hearing level could be identified by this model to be appropriately reviewed for a fully favorable decision without a hearing. We continue to monitor the percent of cases that are selected through the PATH model to validate our expected outcomes and will continue to update and improve our triage models as we learn from and incorporate the results of our efforts. ...

Move from Office-Based to National-Based First-In First-Out (FIFO) Model – This is a new initiative in FY 2017 that enhances the method of FIFO workload assignment by sharing resources across the country and matching up resource availability. This assists in prioritizing cases that have been waiting the longest. We will begin testing in the Seattle Region with the first stage of our process, when the hearing office first gets the case. We expect to see a balance in wait times and reduce bottlenecks in key parts of case processing (e.g., case intake, workup). ...

Pre-Hearing Conference (PHC) Expansion – We introduced this initiative with our original CARES Plan. As of December 31, 2016, over 30 participating offices conducted over 6,000 PHCs since May 2015. Data showed PHC participants had completed their hearing without postponement or rescheduling 56 percent of the time compared to 28 percent for those who did not participate in a PHC. Due to competing priorities, we paused this initiative in December 2016 to allow offices to focus on decision writing. With support from special anomaly funding, we will resume the PHC program on a limited basis in FY 2017, eventually normalizing the practice of PHCs for unrepresented claimants nationwide. Overall, we should see an increase the number of successful first time hearings a reduction in postponed hearings that needlessly take up hearing slots. ...

Voluntary Standby List – This CARES initiative is new for FY 2017 and may be supported by special anomaly funding for systems support to develop new notices. We will create the opportunity for claimants to have their hearings sooner by filling empty hearing slots on short notice. Participation will be voluntary, and participants must sign a waiver of advanced hearing notice should a spot become available. We expect to increase flexibilities with scheduling hearings by filling every available hearing timeslot. ...

     I salute those who drafted this document for trying but the only things that will really work are hiring more personnel and getting serious about screening cases for approval by a senior attorney or at what has been referred to informally as "re-recon." They can't do much hiring now because of budget constraints. While this plan talks of screening cases for early approval the way they have actually done this has been so restrictive that almost no cases have been disposed of. It appears to me that they are almost literally terrified of doing anything that results in more claims being approved even if, as here, it's just a matter of claims being approved earlier. Virtually all the cases approved in the past in the senior attorney and re-recon programs would have been approved eventually.

     Unfortunately, I'm not expecting anything but a worsening of the backlogs until there's a change in the control of the House of Representatives. That will get more resources for the agency and bring about different ways of thinking.

     By the way, the backlogs would have been much worse except for a major downturn in the number of Social Security disability claims filed. I hear that the agency's actuaries can't figure out the downturn. I can. Prospective claimants are discouraged by the huge backlogs and high denial rates. They delay filing claims. It may seem irrational to delay filing a disability claim because of bad backlogs. Wouldn't you want to get your place in line as soon as possible? Sure, if you're rational but humans are deeply irrational beings, especially when they're facing a crisis in their lives, as is the case with newly disabled people.