I See Dead People

     From a recent report by Social Security's Office of Inspector General (OIG):

In a 2009 audit, we determined SSA issued approximately $40 million in improper payments to more than 6,000 beneficiaries although it had received notification they were deceased. In a 2013 audit, we determined SSA had issued about $31 million in improper payments to 2,475 beneficiaries although it had received notification they were deceased. ...

Since our prior reviews, the number of beneficiaries who continued receiving payments after SSA recorded their death information on the Numident had declined. However, 1,281 beneficiaries, including 56 identified during our prior audits, continued receiving payments for months or years after SSA received notification they were deceased. SSA received death reports for these beneficiaries and recorded dates of death on the Numident. However, SSA did not record the death information on the beneficiaries’ payment records or terminate their benefit payments. System controls designed to prevent continued payments to deceased beneficiaries were not effective in these instances. 

Prior audit work has indicated a likelihood that some death entries on the Numident were erroneous, and beneficiaries were actually alive. However, we determined that 678 of the 1,281 beneficiaries had death certificate information or other Numident entries indicating their death information had been proven or verified. 

We estimate SSA issued the 678 beneficiaries approximately $20 million in improper payments. Further, we estimate SSA will issue approximately $6 million in additional improper payments over the next 12 months if these discrepancies are not corrected. ...

     Note that OIG seems a lot more concerned about payments made to dead people than the danger of mistakenly cutting off benefits to living people.

Who Do The Less Well Educated Retire Younger?

     From What Explains The Widening Gap In Retirement Ages By Education (footnotes omitted but bolding added):

Over the last three decades, the average retirement age has increased by about three years, to 64.6 for men and 62.3 for women. But this trend is not uniform across socioeconomic groups: for example, high school graduates are retiring just a bit later than in the 1990s, leading to a wide gap between them and college graduates. This brief reviews studies by the U.S. Social Security Administration’s Retirement Research Consortium (RRC) and others that examine several potential causes of the unequal increases in retirement ages by education....

The gains in the average retirement age since the 1990s have been driven almost solely by those with more education. Today, male college graduates retire three years later than high school graduates. While the story is more complicated for women because of the dramatic change in their labor force participation over the latter half of the 20th century, the overall message is similar: like men, the gap in average retirement ages by education has grown substantially. ...

Health is one of the most important factors contributing to the retirement decision. In fact, according to Munnell, Sanzenbacher, and Rutledge (2015), it is the single most important factor in earlier-than- planned retirement, even more than involuntary job loss. Health matters in two ways. First, workers who experience a health shock are more likely to retire early. Second, workers who were in poor health when setting their retirement expectations also tend to retire earlier than they had planned, suggesting that unhealthy workers are often too optimistic about their ability to work longer.

 Blundell et al. (2017) also find that both health shocks and initial health conditions are key factors driving employment status at older ages. Not surprisingly, their results show that the less-educated are generally in worse health. Their study adds that health is an especially important driver of retirement decisions among less-educated individuals: the association between health and employment is strongest among high school dropouts, and becomes weaker with greater educational attainment...

 

 

Why ALJs Approve Disability Claims

     I know that this blog is read by Congressional staffers who have never been involved in disability determination work at all as well as by upper level Social Security employees who also lack that experience. It's easy when you don't have this experience to develop attitudes towards disability claimants that have far more to do with your general political and social views than with the reality of disability claims. I thought I would reproduce here a portion of one consultative examination (that is an exam purchased by Social Security) on one of my clients, after having been careful to remove anything that could identify the individual. It may give you a peek at what goes on in these cases.

     This is a man who was 60 at the time of the exam. He has a high school education. He's done fairly heavy work.
     You'll have to trust me that there's nothing in the rest of this man's file that detracts one bit from the information given in this excerpt. In fact, the rest of the medical records only make the case seem stronger.

     This man's case is quite strong but not unusual. I've picked it mostly because it's not that difficult for a novice to appreciate.

Click on the image to view full size

     Let my explain a few things from this report.

• "Glucometer 399". This means his blood sugar was quite high the day he was seen. He's a diabetic.
• "Degenerative changes greatest at the L4-5, L5-S1." He's got arthritis in is low back. That's actually fairly normal in a man of his age but it still hurts.
• "He does seem to have a bit of peripheral lateral deficit on the right eye." You expect vision problems in an older diabetic. It's part of the damage that diabetes does to the body. However, this deficit could have some other cause.
• "He has quite a bit of peripheral edema bilaterally very hard, woody type edema." Edema is swelling. Peripheral means it's in his lower legs. "Hard, woody type edema" sounds bad and is bad. It's a sign of poor blood circulation. This man's obesity is also contributing to the problem.
• "He has numbness to his fingertips, numbness to the plantar aspect of both feet and the dorsum of both feet and basically the entirety of both legs ..." Diabetics typically develop peripheral neuropathy, that is nerve damage in the lower legs and sometimes their hands. It's a serious matter. Diabetics can't feel their feet very well which can lead to poor balance. Our feet are supposed to be constantly feeling the ground beneath them. Take away that feedback and you're more likely to fall. You're also more likely to injure your feet without knowing it. Other medical records show that the numbness in this man's hands is mostly due to carpal tunnel syndrome.
• "Hypersensitivity and numbness to the lower legs." It's weird but with peripheral neuropathy, your legs can be exquisitely sensitive to touch yet numb at the same time. Just a light touch can be painful even though you can hardly feel it.
• "Tandem gait is definitely abnormal." Tandem gait is where a physician asks a patient to try to walk while placing one foot immediately in front of the other. This man's balance is poor so he has a hard time doing it.
• "A stent to his LAD years ago." LAD is the Left Anterior Descending coronary artery. Stents are great. They help keep a diseased artery open. In this case it was an important artery supplying blood to the heart itself. A stent has helped this man for many years but he's still got heart disease and it's almost certainly getting worse over time.

     I guess my point here is to explain why Social Security Administrative Law Judges (ALJs) approve almost half the cases they hear. It's because the claimants whose cases they're hearing mostly have fairly serious health problems. Most aren't as serious as this man's but they're still serious. 

     If you have no real experience with these cases, you can say things like "There's something else he can do." However, when you actually have to face a 60+ year old man who's never done anything that didn't involve a lot of exertion that doesn't seem to make much sense, especially when the man doesn't have much education and his health is rapidly deteriorating.

     What I'm saying here is that even if you're a Republican Congressional staffer and you're a true believer in personal responsibility and you just know that Social Security approves too many disability claims, if you were a Social Security ALJ you'd still probably approve 40% or more of the cases you heard because it wouldn't be theory anymore. It would be flesh and blood people and you'd have a solemn responsibility to fairly judge the cases.

Memorial Day

I'll Be Happy To Reach The End Of This Story

     Eric Conn may have reached a plea deal on the many criminal charges he still faces. Unfortunately, the problems will continue for many of his former clients for a very long time.

Researchers Suggest Ending Early Retirement

     A new study from researchers associated with the Federal Reserve Bank of Dallas suggests that the availability of early retirement benefits makes people poorer. Of course, chaining people to their jobs until they drop dead might also make them less poor, in one sense.

     There's a ruthlessly mercenary aspect to this -- the unstated premise that nothing in life can have worth unless it can be measured in dollars. There's also a failure to understand that many, perhaps most, who retire at age 62 are not doing so because they really want to retire but because they're too sick to go on working even though they're loath to file a disability claim.

     This is a report that could only have been written by younger people.

Study On Deaths While Awaiting ALJ Hearings

     From a study by Social Security's Office of the Chief Actuary on Probability of Death While Pending an Administrative Law Judge Determination:

There are two key findings. First, the death rate for individuals who are awaiting an ALJ determination has declined somewhat over the period from 2006 to 2017. Second, the death rate for this group, while it is two to three times as high as that for the general population, is only about one-fourth of the death rate for workers who have been awarded disabled worker benefits and are in their first two years of benefit entitlement. ...

Click on each table to view full size

     The summary given above is accurate but I don't see why anyone would find this report reassuring. There are far too many people waiting for hearings and thousands of them die each year. 

     To give a full report on this issue shouldn't the Office of Chief Actuary have looked at what happened to those disability claims after the claimants died? The vast majority of those cases didn't die with the claimant. Someone was entitled to whatever benefits accrued before the claimant's death. Sure, some of those claims were denied but I'm pretty sure that the vast majority of those claims were approved after the claimant died. Isn't that an important?

Solving Social Security Problems The Old Fashioned Way -- Getting News Media Attention

     From a television station in Arizona which hides its call letters:

The whole situation didn't seem plausible. A 7-year old's financial life entangled with a complete stranger's.

She is now 14 years old. The Peoria girl's Social Security number was used fraudulently and repeatedly since she was a second grader and as recently as last year. She had businesses and bank accounts connected to her. Debt collectors were calling her house.

But, the Social Security Administration would not issue the girl a new number. Not after begging from her mom, not with detectives and attorneys pleading her case, not even after Senators John McCain and Jeff Flake got involved, sending letters to SSA on the child's behalf.  For 7 years, denial after denial. Then her story aired on ABC15.

"48 hours later, I get a phone call from Social Security and they offered us a new number," said the girl's mother, Jill Carlon. ...

It sounds easy now, but Carlon will tell you it has been anything but. Over the past 7 years, Carlon said Social Security recommended she press charges against the fraudster, local charity founder Jacqueline Harris, if she wanted to obtain a new number for her daughter. Harris was then convicted of one felony count of possession of a forgery device. Then Carlon said the goal post moved. If she wanted a new number, Social Security said she would have to change her daughter's name. She did that too. But it still wasn't enough to get a new number. ...