The Breath Of The Dead

     I remain distressed that Social Security's new Listings for liver disease remains as brutal as ever. One feature of dealing with clients with failing livers is officially called fetor hepaticus. It's sometimes called "breath of the dead." It's an extremely disturbing smell on the breath of some people with failing livers. I wonder whether any of those who drafted these Listings have ever smelled fetor hepaticus. The idea that anyone whose liver disease has progressed to this point can work seems preposterous once you smell it yet such patients are often denied Social Security disability benefits. It's not the smell that disables them. It's just obvious that anyone with that smell isn't long for this world. I can't emphasize too much just how viscerally disturbing fetor hepaticus is. It smells as if the person has already started dying on the inside. Why are patients in this condition being denied?

Presentation On New Occupational Information System

    On March 18, 2023, Charis Clark and Karen Litschgi of the Bureau of Labor Statistics (BLS) gave a presentation to the American Board of Vocational Experts (ABVE) on the Occupational Requirements Survey: Date and Upcoming Changes. By Freedom of Information Act request I have obtained the Powerpoint slide deck they used for the presentation. (I appreciate the Department of Labor's promptness in responding to my request.) I don't see any surprises in it but if you're interested in what's going on with Social Security's effort to have BLS create a new occupational information system for use in determining disability you should take a look. As boring as this may seem, it's vitally important to the future of Social Security disability determination. The seemingly never-ending process to develop a new system deserves close scrutiny. I don't trust Social Security on this. I'm not sure that anyone who knows much about this trusts Social Security.

    Below are links to the original Powerpoint version and to a version that I printed to PDF. If you're using the PDF version, you will see links in the upper left hand corner of the screens leading to notes apparently used by the presenters. Those notes were apparently not visible to the audience. If you use the Powerpoint version, those notes are visible at the bottom of the screen.

• Powerpoint version
• PDF version
  

    Update: You will have to ask permission to receive the file. I will approve these as quickly as I can. If you know of a better way of doing this sort of thing, I'd be interested.

Disability Incidence Rate Down

From What Factors Explain the Drop in Disability Insurance Rolls from 2015 to 2019? by Siyan Liu and Laura D. Quinby for the Center for Retirement Research at Boston College:

 

Average Age Of Disability Applicants Increased Sharply About 10 Years Ago

    From What Factors Explain the Drop in Disability Insurance Rolls from 2015 to 2019? by Siyan Liu and Laura D. Quinby for the Center for Retirement Research at Boston College:

 

Pillersdorf Honored

    The Louisville Courier Journal reports that Ned Pillersdorf is one of four lawyers nationwide who have been honored by the American Bar Association for volunteer legal work. Pillersdorf was instrumental in initiating and directing the legal response to the Eric Conn debacle.

    I think one element of Pillersdorf's work that needs to be especially noted is that he faced indifference, if not hostility, from the Kentucky bar. If this had happened in my state or most other states, I'm sure the bar would have organized a massive response. That didn't happen in Kentucky. Sure, there were some Kentucky attorneys who responded but most who have helped Conn's victims have been from out of state. It takes guts to stick up as Pillersdorf has done.

OHO Caseload Analysis Report

 

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Two Bills Advance

     Yesterday, the House Ways and Means Committee marked up two minor bills that would affect the Social Security Administration in small ways. One would allow minors whose Social Security numbers have been compromised to obtain new Social Security numbers. The other would provide for a single point of contact at Social Security for those whose Social Security numbers have been compromised. I'm sure the first is debatable and the second is pointless without additional funding. 

    I wouldn't bet on either bill advancing in the Senate. If they do, you never know what might get added.

New Digestive And Skin Disorders Listings

     The Social Security Administration will publish final rules to revise its digestive and skin disorders Listings in the Federal Register tomorrow. It runs to 159 pages in the PDF version! (It will be fewer pages in the actual Federal Register since that's three columns of small print.)

    One noticeable part is that they've changed the formula for determining SSA CLD, which has been used to determine whether claimants meet the Listing for chronic liver disease (CLD). It used to be exactly the same as the MELD formula used to determine whether individuals with chronic liver disease can get a liver transplant. Now it's just mathematically the same. I've speculated that the agency used the name "SSA CLD" to obscure the fact that it's literally easier to get a liver transplant than it is to meet the Listing for chronic liver disease. I'll speculate that they're going a step further to further obscure just how impossible it is to meet the Listing. They do note in the materials that a MELD or SSA CLD score that meets the Listing means that the patient has a 19.6% chance of dying in the next three months. They think that's a justification for their standard. I was not under the impression that the definition of disability required a person's condition to be quickly fatal.

    I also note that the new Listings make it impossible for claimants to meet the Listings for hidradenitis suppurtiva. Never heard of hidradenitis suppurtiva? Trust me, you don't want it. It's one of the most commonly disabling skin conditions.  For that matter, it appears that it will now be impossible to meet the Listings for psoriasis. For most people with psoriasis, the disease is annoying and unpleasant but manageable but that's not the case for a small percentage of people with psoriasis.