Jul 31, 2021

Opioid Use Among Disability Applicants


      From Trends in Opioid Use Among Social Security Disability Insurance Applicants by April Yanyuan Wu, Denise Hoffman, and Paul O’Leary:

... [W]e examined the prevalence of reported opioid use in a 30 percent random sample of initial-level SSDI applications stored in the Social Security Administration’s Structured Data Repository (SDR) from 2007 through 2017, considering differences by demographic and other factors. ...

Over the 11-year analysis period, more than 30 percent of SSDI applicants reported using one or more opioids. This is higher than the rate of opioid use in the general population (29 versus 19 percent in 2016). ...

Reported opioid use varied by age and demographic characteristics. SSDI applicants ages 4049 were the most likely age group to report opioid use; women were 3-4 percentage points more likely to report opioid use than men; and people with some college were the most likely education group to report opioid use.  

Reported opioid use is also correlated with application type. SSDI-only applicants who reported opioid use were 4-6 percentage points more likely to report opioid use than concurrent SSDI and SSI applicants.

Reported opioid use varied greatly between geographic areas. Applicants from Rhode Island, Massachusetts, and Washington, DC, reported lower-than-average rates of opioid use in 2007 and consistently throughout the analysis period. Conversely, applicants from Delaware, Nevada, and Michigan consistently reported the highest rates of opioid use.  ...

     Even without scientific proof, I think I can say without fear of contradiction that there are other medications used at a higher rate among disability applicants than among the population in general, such as medications for hypertension and diabetes, NSAIDS, muscle relaxants, diuretics, anticoagulants, anticonvulsants, antidepressants, antipsychotics, etc. My point is that we should expect a significant amount of opioid usage among disability applicants. Many of them are in pain and need opioid medications to help them cope. Opioids can be abused but they have important legitimate uses.

Jul 30, 2021

AFGE Trying To Straddle Fence On Vaccine Mandate

      In an interview with NPR, the head of the largest employee union at Social Security doesn't seem opposed to President Biden's announcement that federal employees must be vaccinated or be tested regularly for Covid-19. He just seems to want something in return for it. I think he's going to be disappointed on that score. 

     I'm sure de Juliis has many union members who hate the idea of being vaccinated. I'm pretty sure he's got a lot more union members who feel strongly otherwise. The tide is turning quite rapidly on opponents of vaccination. About two-thirds of the country is at least partially vaccinated and we're increasingly frustrated with Covid limitations that are only necessary because of the fools who won't get vaccinated. The unvaccinated aren't just a danger to themselves. They increase the risk of breakthrough infection among those who are vaccinated.

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What A Horror Show -- The Most Damning OIG Report I've Ever Seen

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

... We have initiated two reviews to assess SSA’s management of mail and controls over its processing of Social Security card applications during the COVID-19 pandemic....

 Key Concerns Related to the Agency’s Policies and Oversight of Mail

  • SSA has no performance metrics and does not maintain management information on the volume of incoming, outgoing, or pending mail. Consequently, the Agency does not have sufficient information to enable it to adjust staffing levels to ensure mail is processed timely.

  • SSA lacks comprehensive policies and procedures to track and return original documents—including driver’s licenses, birth certificates, passports, and naturalization documents—that customers provide as proof of eligibility for benefits or a Social Security number card.

Effects of Inadequate Internal Controls over Mail Processing

  • Some offices had backlogs of workloads that involved original documents. For example, one PSC [Program Service Centers, where benefits under Title II of the Social Security Act are processed]had more than 9,000 unprocessed original documents it had received as early as November 2020. We found that some of these documents were necessary to establish individuals’ eligibility for benefit payments.  
  • Some offices had backlogs of unprocessed applications for new or replacement Social Security cards. For example, one field office had 677 unprocessed applications dated as early as July 2020. We also observed a Social Security card center that had over 9,000 unprocessed applications dated as early as May 2021. As a result, individuals have yet to receive their original documents or Social Security number card. 
  • Some locations had backlogs of remittances or un-negotiated benefit checks. For example, one PSC had 247 unprocessed remittances or un-negotiated checks dated as far back as November 2019. Financial institutions are not obligated to cash uncertified checks that are more than six months old, which leaves the Agency at risk of not being able to collect the remittance check funds. 
  • There were large quantities of undeliverable mail at some PSCs. For example, at one PSC, auditors noted more than 200,000 pieces of returned mail, some of which were over one year old. Some of these pieces may require action, such as suspending or terminating beneficiaries’ payments.  
  • While all SSA facilities were locked, some offices stored original documents in unsecure locations, such as desks and bins. In addition, employees at three offices informed us the U.S. Postal Service or special carriers left mail or packages, which may have included original documents or personally identifiable information, outside the offices in publically accessible areas after business hours and over the weekends. 
  • Approximately 50 percent of field office managers reported they are overwhelmed by mail duties, and approximately 20 percent stated they are unable to keep up with mail workloads. Some office managers also told us they did not have adequate in-person staffing to keep up with mail duties while offices remained closed because of the COVID-19 pandemic. ...

     Update: This OIG report is already drawing attention from Fox and CNBC. Expect more media coverage. This is exactly the publicity needed at a time when Social Security's operating budget for FY 2022 is under consideration.

Jul 29, 2021

Guidance On Long Covid

      From Guidance on “Long COVID” as a Disability Under the ADA, Section 504, and Section 1557 issued jointly by the Office of Civil Rights at the Department of Health and Human Services and the Civil Rights Division at the Department of Justice (footnotes omitted):

Although many people with COVID-19 get better within weeks, some people continue to experience symptoms that can last months after first being infected, or may have new or recurring symptoms at a later time.1  This can happen to anyone who has had COVID-19, even if the initial illness was mild.  People with this condition are sometimes called “long-haulers.”  This condition is known as “long COVID.” ...

Long COVID is a physiological condition affecting one or more body systems.  For example, some people with long COVID experience:

  • Lung damage
  • Heart damage, including inflammation of the heart muscle
  • Kidney damage
  • Neurological damage
  • Damage to the circulatory system resulting in poor blood flow
  • Lingering emotional illness and other mental health conditions
Accordingly, long COVID is a physical or mental impairment under the ADA, Section 504, and Section 1557. ...

     I expect that Social Security will "consider" long COVID in determining disability. Decisions will say that long COVID  was "considered" but determined to have been a non-severe impairment.


No Additional Money For Social Security In Bipartisan Agreement On Emergency Supplemental

      The emergency supplemental appropriation bill pending in the Senate had included additional funding for the Social Security Administration. There is now a bipartisan agreement on the bill and it appears that additional money for Social Security didn't make the cut. Starving Social Security for operating funds appears to be a fundamental GOP goal.

Jul 28, 2021

Broadcast E-Mail To SSA Personnel

 From: ^Human Resources Internal Communications <Human.Resources.Internal.Communications@ssa.gov>

Sent: Wednesday, July 28, 2021 9:01 AM
Subject: New CDC Guidance and COVID-19 Workplace Reminders

TO:  All SSA Personnel

SUBJECT:  New CDC Guidance and COVID-19 Workplace Reminders

A Message to All SSA Personnel

While the Centers for Disease Control and Prevention (CDC) updated guidance on the Interim Public Health Recommendations for Fully Vaccinated People yesterday, all SSA personnel are reminded that we continue to follow the policies in our current Workplace Safety Plan (WSP), which include properly wearing a face mask and maintaining physical distance in all offices, along with adhering to self-screening criteria.  

SELF-SCREENING:  Prior to entering SSA facilities, everyone must self-screen.  If the answer to any of the screening questions is “yes,” you must not enter SSA facilities, regardless of vaccination status.  The self-screening questions are:

  • Do you have any symptoms of COVID-19 including:
    • Cough or sore throat;
    • Fever (100.4 degrees or higher);
    • Chills;
    • Shortness of breath or difficulty breathing;
    • Muscle pain or body aches;
    • Headache;
    • New loss of taste or smell; or
    • Gastrointestinal symptoms like nausea, vomiting, or diarrhea.
  • Within the last 14 days, have you:
    • Been diagnosed with COVID-19;
    • Received instructions from a public health authority (local health authority, medical professional, etc.) to self-monitor for symptoms or self-quarantine;
    • Traveled outside the country, including on a cruise ship; or
    • To your knowledge, been in close physical contact (within 6 feet) with a person who was diagnosed with COVID-19 within 14 days of your contact with them.

FACE MASKS AND PHYSICAL DISTANCING:  Everyone must wear face masks covering the nose and mouth at all times in SSA facilities and avoid close contact with other people.  Close contact is defined by the CDC as being within 6 feet of another person for a total of 15 minutes or more during a 24-hour period.  Everyone must physical distance at least 6 feet while in SSA facilities.

TESTING:  Free COVID-19 testing is available from many local pharmacies.  The CDC recommends that anyone with symptoms of COVID-19 or who has had a close contact with someone who tested positive for COVID-19 get tested (refer to screening questions above), regardless of vaccination status.  Remember to stay away from other people pending a test result and consult with your healthcare provider. 

VACCINATION:  According to the CDC, vaccines for COVID-19 are safe and effective at preventing COVID-19, including severe illness and death.  We encourage all eligible employees to become vaccinated as soon as possible.  The agency continues to offer up to 4 hours of administrative leave for vaccination and up to 2 days of administrative leave for any adverse reactions to vaccination.  To find a COVID-19 vaccine near you:  Search vaccines.gov, text your Zip Code to 438829, or call 1-800-232-0233.

Payment Centers Are A Mess

      Here's a note recorded by a legal assistant in my firm's database: "TC [Telephone Call] Mid Atlantic PSC [Program Service Center] (816) 936-3910 and he said they have it [a fee petition] but they're taking about a year to process fee petitions and we are about half way."

     How can law firms be expected to represent Social Security claimants in this sort of environment? And we're paying a user fee for this sort of service!

     It's not just attorney fees that are a problem. All sorts of things are a problem for the payment centers. It's obvious that they "fast track" the simplest work and almost nothing else is getting done. However, even the "fast tracked" work is slow.

     I'm not blaming the people. They're just overwhelmed.

Reopening Plans At Two Other Agencies

      From a Federal News Network piece on agency reopening plans:

... The Agriculture Department is eyeing an Oct. 1 reentry date for some — but not all — of its employees. ...

At the Labor Department, offices will reopen on a phased basis    , starting with 50% of the workforce no earlier than Sept. 7 ...