Where Are We This Afternoon?

     Social Security's ERE system which attorneys like me use to obtain access to the agency's records on our clients is working. However, there are persistent reports that there are major problem across computer systems at Social Security preventing many, perhaps most, agency employees from fully doing their jobs. I'm sure they're concentrating on what can be done without using the IT systems but I'm sure they can only do so much offline. Maybe something this extensive has happened previously but it certainly hasn't happened lately. This is a big deal and Social Security needs to get out a press release.

Where Are We This Morning?

     I had posted yesterday afternoon that ERE, the online system that I and other attorneys use to access the files that the Social Security Administration keeps on our clients, was down and had been down the entire day. Comments made in response to that post indicated that many systems used by Social Security employees were also down. 

    So, where are we this morning? I got into ERE without difficulty a few minutes ago but there were comments, apparently from Social Security employees even this morning saying that many of their systems are still down. Did I just happen to access ERE just as it came back up? Did I just happen to get into a system that's mostly non-functional? What about the systems that Social Security employees use? Are they back up?

     I think what has happened or may still be happening is a big enough deal that Social Security ought to send out a press release.

ERE Down

     Social Security's ERE system that allows those representing claimants at hearings before the agency to access their clients' files is down. It has been down most if not all of today. Social Security has the ability to e-mail those who have access to the system to let them know that there's a problem but has not done so.

GAO Report Critical Of Social Security's Treatment Of Disability Claims Complicated By Substance Abuse

     From a recent report by the Government Accountability Office (GAO):

... This report examines (1) what is known about the relationship between trends in prescription opioids and DI claims, and (2) how SSA [Social Security Administratino] considers potential prescription opioid misuse in its DI [Disability Insurance] eligibility decisions. GAO analyzed county-level data on opioid prescriptions and DI claims from 2006 through 2017; interviewed program staff involved in DI eligibility decisions in Alabama, Kentucky, and West Virginia, selected because of their high rates of opioid prescriptions and percentage of the adult population on DI; and reviewed case files for DI beneficiaries identified by the Centers for Medicare & Medicaid Services as being at risk for prescription opioid misuse or abuse. ... 

The numbers of opioid prescriptions and claims for the Social Security Administration’s (SSA) Disability Insurance (DI) program have each declined nationally in recent years, but rates vary widely across the country. National trends show both peaking between 2010 and 2014 and then declining. GAO’s analysis shows counties with the highest rates of both were concentrated in the Southeast (see figure). After accounting for economic, demographic, and other factors, GAO found that counties with higher rates of opioid prescriptions tended to have higher rates of DI claims from 2010 through 2017. These rates were also correlated with other factors. For example, counties with higher rates of each tended to have higher poverty rates. However, GAO was unable to determine whether there is a causal relationship between rates of opioid prescriptions and DI claims or other factors, given readily available data.

Program staff are required to evaluate and document substance use disorders (including opioids not taken as prescribed) when making certain DI eligibility decisions. Specifically, staff are required to evaluate potential substance use disorders for certain DI claims and deny benefits, for example, if the claimant would not be considered disabled if they stopped using drugs or alcohol. In addition, staff are generally required to document the rationale for their decision so that another reviewer can understand how they made the decision. However,staff in five of the six offices GAO visited in three states were confused about when to evaluate substance use disorders, and nine of 15 case files that GAO reviewed in which an evaluation was conducted did not have a documented rationale. SSA officials acknowledged the need to clarify policies on when to evaluate substance use disorders, and that a poorly documented rationale could lead to reversals or remands of decisions. Without ensuring that SSA’s policies are understood and that staff document their rationale, the agency may expend resources re-working cases and, in turn, delay benefits to individuals eligible for assistance.  ...

     I imagine that Social Security will find a simple way of responding to GAO's findings. They'll just make the current rule -- when in doubt, deny -- even more explicit. They certainly won't do anything to help people with dual diagnoses -- substance abuse plus another physical or mental impairment. If anything, the GAO report seems only to be telling Social Security to find a better way of checking off boxes rather than encouraging them to take a serious look at the problem.
     The GAO itself could have taken a more in-depth look at the problem. They fail to mention that the dual diagnosis issue primary concerns one psychiatric illness -- bipolar disorder -- which has a dramatic overlap with substance abuse strongly suggesting a genetic link. It's literally impossible to tease out what's caused by bipolar disorder from what's caused by substance abuse because it's all one disease entity. The GAO investigators also failed to understand that the Social Security Administration itself changed its policies in 2013 to put the burden on the claimant to prove a negative -- that their substance abuse isn't material to the determination of disability. If you're not a lawyer, let me clue you in on something well understood by lawyers. It's impossible to prove a negative. For instance, I can tell you that I've never used crack cocaine -- I haven't -- but how can I prove it? That's the whole point of Social Security's current policies. Put an impossible burden on the claimants and then deny them. The GAO report says in a footnote that Social Security told them that Social Security Ruling 13-2p, the policy change I mentioned earlier, really didn't change anything. That's seriously revisionist history. The policy in effect before the ruling was 180 degrees different. It's like this every time Social Security changes its policies. The agency insists that it hasn't changed its policies when it's obvious that it has.

Inauguration Day 2021 Is A Year From Today

New CCD Positions

     The Coalition for Citizens with Disabilities (CCD), the major umbrella group of organizations that help the disabled, has issued three recent statements concerning Social Security. CCD opposes the plan to increase the frequency and alter the targeting of continuing disability reviews. CCD supports expanding Supplemental Security Income (SSI) to the U.S. territories of Puerto Rico, Virgin Islands, Guam and Samoa. (By the way, does anyone know the status of litigation on this issue?) CCD supports ending the five month waiting period for Disability Insurance Benefits.

Final 2019 Trust Fund Numbers

     Social Security has posted the final calendar year 2019 numbers for the Social Security Disability Insurance Trust Fund. The fund declined by about $4 billion last year. As of the end of the year, the fund balance was $93 billion. The Old Age and Survivors Insurance Trust Fund gained $6.4 billion in the last calendar year. Its balance stands at $2.8 trillion.

Social Security Wants To Study Attorney Fee Alternatives

     From a contracting notice posted by the Social Security Administration:

... Disability claimants who have an Appointed Representative (AR) have an increased likelihood of award at the hearings level, but not earlier in the disability adjudication process.  Experts have suggested that the current attorney fee structure, under which representatives receive 25 percent of claimants’ back benefits up to $6,000, encourages representatives to work with claimants later in the disability adjudication process. 

In April of 2019, SSA convened a Technical Expert Panel (TEP) to discuss a potential demonstration that would alter the incentives for representatives to work with applicants at the reconsideration level of adjudication.  The TEP discussed alternatives to the current attorney fee structure as well as opportunities to improve representatives’ access to case information and documentation.  The TEP provided SSA with recommendations to test as part of a future demonstration to increase representation at the reconsideration level and improve the quality of that representation to help SSA arrive at the correct outcome as soon as possible.

SSA is considering a few options for alternative fee structures. One, a minimum fee, that would ensure that ARs receive at least a certain amount for all awarded claims, or 25 percent of back benefits, whichever is greater, up to $6,000. This minimum amount would likely be around $2,500. We consider this level because it is close to the current average fee of $2,900. In theory, this guaranteed minimum could induce ARs to take some claims that they otherwise would not have taken, while minimizing the risk of paying extra for claims that the ARs would have taken under current policy.

A second option is a flat fee for awarded claims. This flat fee would likely be around $3,000, for the same reasons mentioned earlier. In this case, the flat fee is slightly above the average payment to increase representation. 

The AR Demonstration (ARD) will test at least one alternative fee structure and will evaluate the impact and quality of representation at the reconsideration level of adjudication and other outcomes. ...

     See also this study that was completed last summer.
     The interesting thing is that raising the fee cap isn't even being considered. I think that would help more claimants get representation than a minimum fee. The problem isn't so much that attorneys are scared of getting a low fee as it is that attorneys are scared of getting no fee. Raise the minimum fee and the risk-reward ratio is altered so that we take on more iffy cases. I think this proposal would only affect my behavior in cases such as a claimant who is already receiving early retirement benefits and that's not that much left to get for them if disability benefits are approved. It would not affect my behavior in cases at the initial and reconsideration levels since I already take on those cases. It might affect the behavior of others who don't take on cases at the initial and reconsideration levels but I think most already are taking on cases at the initial and reconsideration levels. Right now the group that has the most difficulty obtaining representation are those under the age of 50. This proposal would do nothing for them. The flat rate fee would be especially bad since it would make the risk-reward ratio even worse. We would still have the same risk but the reward for a win would be less. It's the risk-reward ratio that Social Security needs to be looking at.