New Conditions Added To Compassionate Allowance List

    Social Security is adding some new conditions to its compassionate allowance list of conditions that are supposed to result in having disability claims approved quickly. I think the least uncommon one on the adult list would be "Adult Heart Transplant Wait List – Status Levels 1-4."  Here's a description of what those status levels mean:

• 1 - 3: Most often hospitalized in ICU to support their heart.
• 4: This group is often at home but may need IV medications or VAD [Ventricular Assistive Device] to support their heart.
• 6: This group includes all others who are stable enough to remain home while they wait for a heart.
  

    I think anyone in status level 1-4 would easily meet a Listing anyway so I can't say this means much.

    Also, I've had clients who were on a heart transplant list and I don't recall any mention of a Status Level in their medical records.

Adverse Public Relations Potential No Longer A Hardship -- They Say

    From a recent update to Social Security's POMS (Program Operations Manual Series) manual:

To promote homogeneity between the Dire Need POMS and the Dire Need HALLEX instructions, we have revised the language in the Dire Need POMS. ...

We revised and clarified the definition of dire need. We also deleted language which suggested claimants with adverse public relations potential as hardship situations qualifying as dire need condition.

    I'd be amazed if they don't still scurry to resolve cases which get press attention.

For The Frustrated Social Security Disabilty Claimant

     I continue posting on my firm's separate blog directed at a different audience -- For The Frustrated Social Security Disability Claimant. Take a look at some of the recent posts on that blog.

• Top Five Myths About Social Security

• You Don't Have To Pay Upfront To Hire A Social Security Attorney

• A Poll

• You're Not The Only One Waiting And Waiting

• "What Do They Want Me To Do?"

• N.C. Medicaid Now Covers Weight Loss Drugs

• Who Runs The Show At Social Security?

• What Happens If I Die Before Social Security Finds Me Disabled?

• Field Offices Closed Today

• Is It The End If The Judge Turns Me Down?

In The Field

     Social Security's front line employees often complain that high level agency managers don't understand problems in the field, that no one listens to them. Whatever else you think of him, Martin O'Malley is getting out into the field. I'm attaching some photos posted on Twitter from his recent visit to the Jacksonville, FL field office. 

    By the way, O'Malley seems no more proficient at taking selfies than I am! Also, by the way, note that image of a motorcycle up on the screen in that last photo. I wonder if the employee was asked to get something up on the screen that had no PII. Could it even be an artificial image added later by Photoshop to avoid the PII problem?

 

     

Social Security Lump Sums Create Medicaid Problems

 

    Newsweek reports on a problem associated with Social Security that Social Security policymakers probably aren't aware of. The woman in the story had to fight for years for Social Security disability benefits. Finally, she was approved and paid but immediately lost her Medicaid. For SSI purposes, when she received that lump sum of back benefits, she had six months to spend it but there's no six month grace period for purposes of Medicaid. She became ineligible immediately. 

    There are things you can do to spend this sort of lump sum rapidly that give you lasting improvement in your life while retaining Medicaid or at least minimizing your period of ineligibility. You can pay off debts, repair your home which is probably in disrepair since you've been so poor, you can pay down your mortgage, replace worn out appliances and furniture, purchase new clothes, visit family members you haven't seen in years, etc. Just don't give any of it away! The problem is that most people who receive a large sum of money from Social Security or from some other source, such as an inheritance or personal injury settlement, don't see the problem coming and have no idea how to cope with it when it arrives. Often, they give the money to a relative or friend to hold for them which is much worse that useless.

They Could Do A Much Better Job If They Weren't So Understaffed

     From Challenges in Recovering Supplemental Security Income Overpayments, a report by Social Security's Office of Inspector General (OIG):

... SSA made errors on overpayments for 189 (47 percent) of the 400 sampled SSI recipients because it did not follow policies or use all available tools, to prevent, detect, or recover SSI overpayments. For example, overpayments could have been prevented or detected earlier, but employees made errors when they redetermined SSI eligibility. A redetermination is a review of a recipient or couple’s non-medical eligibility factors (that is, income, resources, and living arrangements) to determine whether the recipient or couple is still eligible for, and receiving, the correct SSI payment amount.

Errors also occurred because employees did not always (1) send recipients complete and accurate due-process notices before they initiated recovery of overpayments; (2) follow policy when they processed waivers of overpayments; or (3) follow policy and use available tools to recover overpayments. When SSA identifies an overpayment, it sends the overpaid person written notification of the overpayment’s cause and amount. Overpayment recovery can begin 60 days after SSA notifies the recipient of the overpayment if they have not requested a waiver of the overpayment collection or a reconsideration of the overpayment facts. If the individual is receiving SSI payments, SSA should begin recovery by withholding from ongoing payments. If the individual is no longer receiving SSI payments, SSA should attempt collection through various means including withholding from ongoing payments to a liable representative payee or spouse, cross-program recovery, referral for external collection through the Department of the Treasury or pursuing recovery from estates.

We estimate SSA did not follow its policies or use all available tools to prevent, detect, or recover SSI overpayments for 1.9 million recipients. For 1.7 million of these recipients, we estimated error amounts totaling over $7 billion. ...

    Not only does Social Security lack the manpower to do what OIG recommends, OIG fails to recognize that most of these SSI overpayments are small so going after all of them using every possible mechanism would not be cost-effective.

$81 Million AI Contract

     From a press release:

Accenture Federal Services has won an $81 million artificial intelligence and machine learning (AI / ML) contract from the Social Security Administration (SSA). The company will deliver end-to-end back office intelligent automation services to transform the way 250 million retiree and survivors’ benefits documents are processed every year. The forms are currently being received and managed via email, mail, and fax.

The Social Security Administration has already successfully deployed an enterprise hyperautomation platform that uses advanced deep learning and computer vision techniques to identify data from the agency’s electronic folder, extract text, transcribe data with the highest level of accuracy, and speed processing through downstream business processes. The platform uses internal enterprise data to intelligently and rapidly keep pace with high demand, expedite decision making, and control costs.

Accenture Federal Services will now take this project to the next level providing the licenses necessary to deliver an end-to-end, Infrastructure as a Software (IaaS) roadmap for intelligent automation installation, testing, and training. ...

Not Now, Not Later, Not Ever

     A Richmond, VA television station reports on a local case. SSI disability benefits were approved almost immediately for a child with a rare genetic disorder but the case has been sitting at the local Social Security field office for five months awaiting payment. 

    Undoubtedly, there's some complication. Anything complicated goes into the "Not now, not later, not ever" pile. They'll get to it when they have time but they never do. Why spend the time to complete action on one difficult case when you can easily process five uncomplicated cases in the same amount of time? Except that in this case they will because the case has been publicized.

    Is this happening because the Social Security employees are lazy? No, they're just overwhelmed with work and they're judged based upon the raw number of cases they complete. There's constant pressure to produce numbers. The easiest way to produce numbers is to work on the easiest cases first and let the difficult cases pile up. It makes sense from the point of view of an individual employee or manager but it's a horribly unfair situation as I expect those employees and managers know.

    By the way, when I say we're at the "Not now, not later, not ever" stage, I'm not exaggerating. I've got a fee petition pending at a payment center for more than three years. It's gathering dust because they're busy with other things, like answering Social Security's 800 number and the agency isn't tracking fee petitions. When are they ever going to be not so busy? It would take a major political change.