Don Wortman 1927-2020

     Don Wortman, who served as Acting Commissioner of Social Security in the late 1970s, has died at the age of 92. Wortman had an incredibly varied career as a federal employee, working at various times with Medicare and Medicaid, refugee resettlement, Head Start, the Atomic Energy Commission, the CIA and the GAO in addition to Social Security.

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Another Useless Study Coming

     From a Request For Information (RFI) recently posted by the Social Security Administration:

The purpose of this study is to collect information about the service, medical, and employment needs of individuals exiting Social Security disability programs because of medical improvement.  It also serves to produce testable policy recommendations that help the study population become self-sufficient.  This study will involve conducting qualitative and quantitative data activities, including focus groups and a survey, to gather information about the needs of Exiters and Possible Exiters from the Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) disability programs after a determination of medical improvement.  Furthermore, this effort will involve small-scale use of Motivational Interviewing (MI) to gain more insight about their needs and what motivation is necessary to promote work activity among this population.  The ultimate goal of this information gathering is to identify potential interventions and to inform policy recommendations that are likely to help Exiters and Possible Exiters achieve sustainable, substantial employment leading to self-sufficiency. 

SSA expects to make public all study data, subject to legal and privacy considerations.  Any offeror delivering services under this contract will not be barred from providing services for any subsequent Exits demonstration.

The purpose of this RFI is to obtain information, for planning purposes, regarding (1) the availability and capability of potential sources that can provide the required services described in the attached draft Statement of Work (SOW) and (2) to seek industry comments regarding the noted SOW.

In-Person CEs Resuming In At Least One State

     I had posted yesterday that it was time for Social Security to either schedule in-person consultative medical examinations (CEs) or to make decisions without them -- that the agency couldn't just hold disability claims in suspense indefinitely. It turns out that I wasn't the only one thinking that. My office was told today that North Carolina Disability Determination Services (DDS) has resumed scheduling in-person CEs.

Increased Provision Of Online Services Has Not Reduced Demand For Telephone And Field Office Services

     The Social Security Advisory Board (SSAB) has issued a brief report recommending that the Social Security Administration "use evidence-based measures to evaluate access to agency services" which isn't the most exciting recommendation you'll find even in the context of government advisory board reports. There's another more complete report which adds detail. However, the brief report includes this chart which I think is far more interesting than the text in either report. (Click on the image to view full size.)

     What I get from this is that the dramatic increase in internet services provided by the Social Security Administration has had almost no effect upon the demand for services provided in person or over the telephone.

     The idea that Social Security can wean the public off personal service so that in the future the public will just deal with the agency through its online services is bunk. There's no reason to expect that's ever going to work. By all means, provide online services but don't expect that online services will ever replace field offices and telephone service.

Reduction In April OHO Receipts Probably Linked To Covid-19

      This was obtained from Social Security by the National Organization of Social Security Claimants Representatives (NOSSCR) and published in its newsletter, which is not available online to non-members. It is basic operating statistics for Social Security's Office of Hearings Operations. Click on the image to view full size.

     At my firm the number of requests for hearing went back up to something like normal in May but I don't think that will last. Many, many cases are on hold at Disability Determination Services (DDS) now waiting for that date when consultative examinations (CEs) can be scheduled once again.

     By this point, I think it's time to fish or cut bait. Either try to schedule the CEs or make decisions without them. I don't think the CE situation will change fundamentally until there's a vaccine for Covid-19 and early next year is the soonest that blessed day might arrive. DDS can't keep holding onto these cases for such an indefinite period. We need to get past the mindset that Covid-19 will magically disappear in the next few weeks. Not gonna happen.

Hypothetical?

     Here’s a hypothetical question that really isn't so hypothetical: Patient A is immunocompromised due to a history of treatment for cancer. Patient A has been told by her doctor that she should not leave the house except to go to medical treatment until the threat of being infected with Covid-19 has completely passed. That threat will not completely pass until well over half of the population has immunity to Covid-19 either because they have had the disease or because they have been immunized for the disease. This may not happen in the next year. Patient A's old job did not allow working from home. Does patient A meet the definition of disability in the Social Security Act? In answering this question, you're not allowed to assume away the premises of the question because you think the Covid-19 threat will somehow disappear on its own or that immunocompromised people don't really need to strictly avoid risk of exposure to Covid-19.

Probably Isn't Good Enough

     I happened to re-read this somewhat chilling note I made on a client a couple of months ago:

He's not in psych treatment now. Didn't like his treating doc asking if he had access to guns and didn't like the meds he was taking. [I] Told him he needs to get back in treatment. He was in special forces.

     Guns really are a problem in this country. This man probably won't harm himself or other people. Probably.