Opioids And Social Security Disability

      There's a newly published study on The Effects of Opioids on Labor Market Outcomes and Use of Social Security Disability Insurance which purports to find that increased opioid use led to both more employment and more disability claims, which is a surprising if not confounding result. 

     One problem with the study is that the author did not attempt to measure the actual use of opioids. The author measured "marketing payments from opioid manufacturers and distributors to physicians as an instrument to predict opioid prescribing."

     I wonder if the study has cause and effect backwards. Wouldn't a population with more disabled people than average be one that an unscrupulous opioid manufacturer would want to target? Aren't disabled people an obvious market for opioids? Don't you intensify sales efforts in a geographic area where your marketing campaign seems to be paying dividends? 

Disability Trust Fund Reserves Increasing Despite Pandemic

      There's reason for concern over the status of Social Security's Retirement and Survivor's Insurance Trust Fund. Because of the pandemic, F.I.C.A. revenues are down, while payments to retirees continue. However, despite a decline in revenues, the Disability Insurance Trust Fund's reserves are increasing because payments to disabled beneficiaries keep going down. By the way in reading the table below, keep in mind that there is considerable seasonality in F.I.C.A. payments. Compare each quarter of this year to the same quarter in the preceding year and look at the overall picture.

In Office Appointments Now Available In Limited Circumstances

     From Social Security's Covid-19 webpage:

Due to the COVID-19 pandemic, you can only enter our offices if you have an appointment. For more information regarding appointment availability for your situation, please select the statement that applies to you:

• I need help with benefits.
• I need help with my Social Security Number (SSN).

I need help with benefits

Generally, we will schedule an in-person appointment in dire need situations. Dire need exists when you:

• Are without food or shelter, including utilities or are without medical care or coverage and need to apply for or reinstate benefits.
• Currently receive benefits and have an urgent need for payment to meet expenses for food, shelter, or medical treatment, and you cannot receive the payment electronically.

If you believe you qualify for an in-person appointment, call your local office. You can look up the phone number for your local office by accessing our office locator. Please note that appointments may not be immediately available, depending on local health and safety conditions and staffing.

I need help with my Social Security Number (SSN)

We are prioritizing requests for in-person SSN services for:

• Individuals age 12 or older applying for their first SSN card.
• Individuals who need to update or correct their SSN information (such as your name, date of birth, or citizenship) to obtain income, resources, or medical care or coverage, or other services or benefits (for example filing a tax return, applying for housing, or seeking an Economic Impact Payment).

If you believe you qualify for an in-person appointment, call your local office. You can look up the phone number for your local office by accessing our office locator. Please note that appointments may not be immediately available, depending on local health and safety conditions and staffing.

Regs To Allow AAJs To Hold Hearings Approved

      In August Social Security asked the Office of Management and Budget (OMB) to authorize final regulations to allow Administrative Appeals Judges (AAJs), who currently only handle cases at the agency's Appeals Council, to hold hearings in place of the Administrative Law Judges (ALJs) who currently hear them. ALJs would still be allowed to hold hearings even under these regs. It's just that AAJs could start doing it as well. Those regs have just been approved by OMB. This must have been considered a very high priority matter. OMB rarely acts that quickly on regs.

     You may think, AAJs, ALJs, what difference does it make? They're all judges, right? Not really. Unlike ALJs, AAJs enjoy zero decisional independence. There would be nothing to prevent Social Security from imposing quotas on AAJs, telling them they could approve benefits for no more than, let's say 25% of the cases they hear. They can't do that with ALJs. I don't know what point there could possibly be in these regs unless you wanted to remove that decisional independence.

     To be honest, there is something that might prevent Social Security from imposing quotas on AAJs and that is public opposition. My feeling has long been that if ALJs didn't exist, Social Security would have to invent them. As problematic as they can sometimes be, ALJs add a necessary legitimacy to the process. Take them away and you'd soon have a crisis and the AAJs themselves would be screaming the loudest about their lack of decisional independence. I doubt that the people behind these regs realize that. A maximalist, public opposition is a sign I'm on the right track, attitude is part of this Administration's DNA.

     Social Security will make these regs final by publishing them in the Federal Register. Unless they're even more bloody minded than I think, I expect they'll wait until after the election to publish these. 

     They can't make ALJs disappear immediately. Even if you told ALJs they could either become AAJs or be riffed, which would be the harshest way of doing this, it would take months if not years to accomplish.

     If Trump is re-elected, expect to see a big controversy over implementation of these regs. Don't expect knee-jerk support for this from Congressional Republicans. Republicans apply for Social Security disability benefits. In fact, rural areas, where the GOP is strong, produce a higher rate of disability claims than urban areas where Democrats are strong.

     If Trump loses, this will go away, one way or another. The most likely way is the Congressional Review Act that allows Congress to hold an up or down vote on regs adopted in the last few months before a change of Administration. Even the current Senate might well vote these regs down. If that fails a Biden Administration could refuse to implement the regs and could eventually go through the rulemaking process to repeal them.

    

Doctor Pleads Guilty

      From a press release:

Defendant Americo Oms-Rivera plead guilty before United States District Judge Francisco A. Besosa to conspiracy to commit wire fraud ...

The defendant admitted that starting on March 2009, until on or about October of 2015, the defendant and other co-conspirators knowingly and willfully conspired and agreed together and with each other, to devise a scheme and artifice to defraud the SSA, and to obtain money and property by means of materially false and fraudulent pretenses, representations and promises. For example, Oms Rivera would backdate medical records of patients applying for disability insurance benefits by creating fictitious medical appointments that never took place. This was done to create the appearance of a longer history of medical treatment and for the purpose of tricking or deceiving the SSA into approving disability insurance benefits.

As part of the plea agreement, Oms Rivera will pay SSA $321,000 in restitution, and agreed to the forfeiture of a property at Palmas del Mar, Humacao.  In addition, Oms Rivera will surrender his DEA license, and will be excluded from participating in SSA cases, as well as Medicare, Medicaid and all other federal health care programs. ...

Arrests In International Fraud Scheme

      From a press release:

Two Riverside County [CA] men were arrested today on an indictment alleging they participated in an international conspiracy that deceived elderly victims into sending more than $500,000 in cash by pretending to be federal agents threatening them with arrest on bogus warrants.

The federal grand jury indictment unsealed today charges a total of three Lake Elsinore residents with conspiracy to commit mail fraud and wire fraud:

• Anuj Mahendrabhai Patel, 30, a.k.a. “Mike” and “Indio”;
• Elmer Miranda Barrios, 35, whose aliases include “Welbin Raul Mejia” and “Joe Rodriguez”; and
• William Margarito Barrios, 36, Elmer Barrios’s cousin, who faces an additional charge of being an illegal alien who re-entered the United States following deportation....

According to court documents, from April 2019 until March 2020, other members of the conspiracy, some of whom are believed to be in India, telephoned victims and pretended to be government employees or law enforcement officers. Using a number of false pretenses – including phony badge numbers and using spoofed government telephone numbers – the co-conspirators convinced the victims, most of whom were over the age of 55, that their identities or assets were in trouble. 

For example, some victims were told that their Social Security numbers had been linked to crimes and that there were warrants issued by courts authorizing the victims’ arrests. The co-conspirators further told the victims that in order to clear the warrants, they should withdraw their savings and send cash by mail to other members of the scheme. ...

The total loss alleged in this case is approximately $541,420 ...

Disability Claims Filed And Approved Continue To Decline

 

     Social Security has posted updated statistics showing the number of disability claims filed and approved through the end of September. Here are the numbers of claims received at Disability Determination Services (DDS) by quarter this year:

• Q1 -- 325,683
• Q2 --  306,518
• Q3 -- 296,974

 And here are the numbers of awards at all levels:

• Q1 -- 196,386
• Q2 -- 163,629
• Q3 -- 149,909

     There is a very important footnote to these stats telling us that:

Because the application data are tabulated on a weekly basis, some months include 5 weeks of data while others include only 4 weeks. This weekly method of tabulation accounts for much of the month-to-month variation in the monthly application data. This method also occasionally causes quarterly data to have either 12 or 14 weeks of data instead of 13 weeks, annual data may include an extra week of data.

      Despite the footnote, it seems clear that there has been a big decline in the number of disability claims filed and approved over the course of 2020. If you were of the opinion that the number of disability claims is strongly related to the unemployment rate, you've been proven spectacularly wrong, at least for this year. And don't try to say the decline in disability claims filed is due to the special Pandemic Unemployment Assistance. Those ended on July 31. If that was what was holding down the number of disability claims we should have seen a dramatic increase in claims filed after it ended but, instead, they kept going down.

     I think that the number of claims filed is down due in large part to the increased difficulty that people have filing claims. I don't know what else it could be. Some people need more help than others.

EM On Representation Of Claimants

      For whatever reason, Social Security has seen the need to issue an Emergency Message reminding its staff that claimants often have representation and that there are statutes, regulations and policies concerning the agency's dealing with those representatives. Perhaps some may have thought that due to the pandemic the basic rules could be ignored. 

     By the way, for those who don't know, Social Security "Emergency Messages" don't normally address emergencies. Of course, by this point we don't know what most of the "Emergency Messages" do address. So far this year, the agency has released at least 49 Emergency Messages to its staff but has released only 4 of those to the public. Government in the sunshine? Not so much at Social Security.