In October of 2010, the Social Security Administration (SSA) changed their internal process to allow disability examiners that make determinations on claims for Social Security Disability benefits to make expedited decisions for claimants diagnosed with medical conditions that are considered so severe, they clearly meet SSA’s disability standards. Normally, favorable disability determinations must be made in conjunction with a medical or psychological consultants approval. SSA amended their rules in 2010 to allow disability examiners at Disability Determination Services (DDS) to make decisions on the most severe claims without the medical or psychological consultation. This rule change was set to expire on November 14, 2014, but SSA took action to extend the expedited processing until November 13, 2015 by publishing an extension of the “susnset” date in the Federal Register.
The Social Security Administration’s (SSA) Office of the Inspector General (OIG) released a report on August 7, 2014 on the effect of SSA’s reduction in field office hours available to the local public. SSA’s field offices are the local offices situated throughout communities where the public can visit to receive face-to-face service from SSA personnel. Prior to 2011, most SSA filed offices were open to the public from 9:00 AM until 4:00 PM, Monday through Friday. In August of 2011, SSA began closing field offices 30 minutes earlier each day in order to provide SSA staff with more time to handle the backlog of administrative duties. In November of 2012, SSA again trimmed the hours available to the public by closing field offices at 3:00 PM. In January of 2013, hours were reduced yet again by closing field offices to the public at noon every Wednesday, which reduced the number of hours field offices were open to the public to 27 hours per week.
The OIG report concluded that the public was often unaware of the reduced field office hours, creating inconvenience for them, and ultimately resulting in reduced public satisfaction. The report also found that managers of field offices allowed for increased workload processing, but had the adverse effect of increasing wait times and creating crowds when the office is open to the public. The report comes on the heels of a Senate hearing held on June 18, 2014 regarding SSA office closures and service cuts at a time when the baby boomer generation is filing a record number of retirement, disability and survivor claims. The reduction in SSA office hours is said to be related to budget cuts and SSA staff attrition and limited means for the agency to replace the lost workers.
According to the report, SSA field offices vary broadly in the volume of customers they serve on a face to face basis: the Huron, South Dakota office averages 19 visitors a day, while a field office in Miami, Florida averages 568 visitors per day. The face to face services provided to the public include processing applications for benefits, Social Security numbers, or replacement Social Security cards.
The Social Security Administration (SSA), the agency’s Office of the Inspector general (OIG) (an independent unit responsible for ensuring the integrity and accountability of the agency), and the state of Michigan’s Department of Human Services issued a joint press release announcing a Cooperative Disability Investigations (CDI) unit to be based out of Detroit. The aim of the new unit is to identify and prevent fraud by applicants for Social Security disability benefits who reside in Michigan.
The new Detroit CDI unit is the 26th CDI unit covering 22 states and Puerto Rico. The CDI units collaborate with SSA, OIG, and state based Disability Determination Services (DDS) to investigate suspicious or questionable claims for disability benefits before a final determination of whether or not to pay benefits is made on the claim. The press release announces that the Detroit CDI unit is the first of seven new units to be opened before the end of the agency’s 2016 fiscal year. The CDI program was established in 1997, and SSA believes that its efforts have resulted in over $2.8 billion dollars in savings to Social Security’s programs.
Although fraud in government disability programs draws a lot of attention from the media and congress alike, given the size of the program fraud makes up a very small portion (estimated at less than 1%) of the entire program size.
The Social Security Board of Trustees released its annual report on the long-term financial status of the Social Security and Medicare trust funds on July 28, 2014. As has been projected for some time, the combined asset reserves of the Old-Age, Survivors and Disability Insurance (OASDI) trust funds are projected to have insufficient funds to pay out all benefits on a monthly basis by 2033. At that time, 77 percent of benefits will be payable. The report also reiterated that the Disability Insurance (DI) Trust Fund, which is kept separate from the Old-Age and Survivors (OAS) Trust Fund, will become depleted by 2016 at which time only 81 percent of benefits will be payable to disability beneficiaries. This projection also remains unchanged from last year’s report. (more…)
The Social Security Administration (SSA) published new instructions permitting the agency to process more claims in which entitlement or eligibility to benefits is premised on a same-sex marriage. The change in policy comes nearly one year after the Supreme Court of the United States struck down Section 3 of the Defense of Marriage Act (DOMA) in their landmark decision United States vs. Windsor. Section 3 of DOMA had defined marriage for the purpose of federal benefits as between a man and a woman.
The policy changes allow the agency to recognize some non-marital same sex relationships, such as civil unions or domestic partnerships, as marriages for the determination of entitlement to benefits. A married individual may be eligible for various Social Security family benefits if the earnings record of their partner or spouse proves more lucrative than claiming benefits on their own record. However, in states that do not recognize same-sex marriage or unions, the agency is still prevented from extending spousal benefits to same-sex couples residing in those states. Applications for benefits in states that do not recognize same sex marriage remain on hold until those states change their laws, or sweeping federal legislation is passed.
SSA worked closely with the Department of Justice in arriving at their most recent policy change regarding benefits for same-sex couples. Acting Commissioner of Social Security Carolyn Colvin cited respecting state laws in arriving at this decision.
The United States Senate Special Committee on Aging recently released a report and held a hearing in an investigation on “Reduction in Face-to-Face Services at The Social Security Administration.” The investigation was concerned that SSA’s continuing budget constraints at a time when Baby Boomers are retiring and filing disability claims in record numbers has resulted in the loss of 11,000 agency employees, the closure of 64 field offices and 533 contact stations, the reduction in hours field offices are open to the public, as well as the reduction of services available in-person. In an effort to leverage technology to keep up with demand, SSA is shifting many of their services online or over the phone.
At the hearing, the Senators remarked that they were concerned that SSA was not seeking public input regarding the decision to close field offices, citing the long term strategic goal of SSA to utilize online systems as the primary means of serving applicants and beneficiaries. The committee’s concern was that the demographic population the agency serves most, the elderly and the disabled, are not accustomed to doing business online and rely on in-person services. SSA’s Deputy Commissioner for Operations testified at the hearing that the agency is fully committed to sustaining a field office structure the provides face-to-face services to those who need or prefer such service, but are adjusting services based on the growing demand to interact with the agency electronically and in response to budget constraints.
The agency currently requires representatives to utilize electronic services when availablee, and in an effort to stay innovative, efficient, and compliant, The Advocator Group leverages technology whenever possible in our dealings with SSA. Our representation services minimize the need for claimants to interact directly with SSA or visit filed offices. We support SSA’s efforts to adopt innovative technological changes to become more efficient in their claim handling. Staff attrition at SSA will undoubtedly have some impact on the agency’s ability to process claims, but leveraging technology when working with SSA will allow The Advocator Group to minimize this impact.
President Barack Obama announced on June 20, 2014, that he was nominating Carolyn Colvin as Commissioner of Social Security. Colvin has been the Acting Commissioner since February 2013 since the former Commissioner, Michael Astrue, departed the role. Colvin had been Deputy Commissioner of the Social Security Administration (SSA) since January 0f 2011. Her appointment as Commissioner is subject to Senate approval.
If appointed as the Commissioner, Colvin will have the same supervision and direction over the agency that she did as the Acting Commissioner, however, many feel that she will have more power to command resources and support from Congress. The appointment as Commissioner provides a structured term (6 years) and allows an agency head to initiate large-scale or agency wide changes that a Commissioner with Acting status may be less apt to make given the uncertainty of their future in the role. Nomination by the President and confirmation by the Senate also significantly bolsters the credibility of the role. Colvin’s nomination comes during a critical period for the agency, as the Disability Trust Fund is projected for insolvency by 2017 if changes aren’t made, and budget cuts have led to staff attrition and the closing of SSA offices. Furthermore, the backlog of Social Security Disability claims that was reduced under Astrue has begun to increase again to an average wait time of over 400 days to receive a hearing after a denied claim.
Under the supervision and direction of the Commissioner, The Office of the Commissioner is directly responsible for all programs administered by SSA. The Office of the Commissioner is responsible for the development of agency policy, administrative and program direction, program interpretation and evaluation, and the development of recommendations on methods of advancing social and economic security through social insurance. The Commissioner provides executive leadership to SSA and supervision over its major components.
The U.S. House of Representatives Committee on Oversight and Government Reform held hearings on consecutive days, June 9th and June 10th, to question Social Security Administrative Law Judges (ALJ) with a high rate of approving claims for disability benefits, and the Acting Commissioner of the Social Security Administration (SSA), Carolyn Colvin. Four ALJs with very high rates of approving disability claims, were called before the committee to explain their methods. The ALJs, whose high approval rates make them extreme outliers among the approximately 1,400 ALJs that make disability determinations for SSA, were handpicked by the Committee and three of them had to be subpoenaed to appear and testify. The ALJS chosen, some of whom were going through disciplinary proceedings with SSA, were not representative of ALJs as a whole: On average, SSA ALJs approve less than 50% of claims they are tasked to make decisions on, and there are many ALJs on the opposite end of the spectrum that approve very few claims. Senator Tom Coburn, a notorious critic of the Social Security Disability program as he made clear in his appearance on 60 Minutes last year, also testified at the hearing.
The following day, a second hearing was held by the Committee to question Colvin about the agencies oversight of the judges as well as reviewing the claims of individuals who are currently receiving benefits but may no longer be disabled. Colvin testified to the funding woes that have made hiring and allocating resources with the agency difficult. She also refused to answer questions regarding the specific disciplinary actions pending against the ALJs, but noted the complexities regarding removing or reprimanding ALJs due to the discretional independence they are afforded by the Administrative Procedures Act. Colvin was also unprepared to respond to questions of what, from a legislative perspective, the lawmakers could do to help give SSA more control over the ALJs. The Chairman of the committee, Representative Darrell Issa, hinted that another hearing would be held to address that issue. In all, the hearings seemed to be somewhat of a blunt instrument for the conservatives on the committee to voice their distaste for the SSDI program as a whole. To the contrary, other lawmakers noted that even the removal of outlier ALJs would not improve the solvency of the disability trust fund (which will be cash strapped by 2017 as a result of demographics such as aging baby boomers and women in the work force – SSA actuaries have predicted this since the 1980’s ), and legislative time would be better spent on long term solutions to ensure adequate funding for long term payment Social Security benefits.
The Advocator Group Supports Men’s Health Month to Increase Education and Awareness of Health Issues and Potentially Disabling Conditions
We are proud to support Men’s Health Month in June, as men comprise approximately 42% of our client base, and we value the opportunity to educate them on health conditions that impact them. Many Americans are not properly educated about disability statistics or insurance, and therefore find themselves physically, emotionally, and financially unprepared when illness or injury renders them unable to work. Additionally, because men often prioritize their family’s well-being over their own, they are far less likely to take preventative health care measures throughout their lifetime.
Many American wage earners are not prepared for a loss of income because they underestimate their likelihood of becoming disabled due to their current health or non-physical job. However, the Council for Disability Awareness reports that a typical, non-smoking American male who works an office job and maintains some regular physical activity stands a 38% chance of becoming disabled for five years or longer during his career.
Along with not being properly educated about their chances of becoming disabled, many men also do not take the simple, yet significant steps necessary for early detection of health problems. The Men’s Health Network states that women are 24% more likely to visit the doctor for regular health screenings than men, causing many men to battle illnesses that could have easily been prevented, and ultimately contributing to the trend of men dying younger than women.
The Social Security Administration (SSA) published two rulings in the Federal Register on June 2, 2014. Social Security Ruling (SSR) 14-2p provides guidance on how the agency evaluates diabetes mellitus (DM) in claims for disability benefits, and SSR 14-3p does the same for endocrine disorders other than DM. Social Security Rulings (SSR) are decisions by SSA based on analysis of legal or administrative decisions, or other interpretations of the law of regulations. SSRs do not have the same legal effect as statutes, regulations, or case law, but they are binding upon all components of SSA. Therefore, SSA decision-makers are required to follow the guidance and instructions in SSRs in administering SSA’s benefit programs. Both SSRs had an effective date of June 2, 2014. (more…)