Social Security Ceases Collecting Aged Overpayments

The Acting Commissioner of Social Security, Carolyn Colvin, issued a press release on April 14 announcing that she directed employees of the Social Security Administration (SSA) to cease referring debts owed to the agency to the Treasury Department that are over 10 years old.  SSA had been notifying the Treasury Department of amounts that it had overpaid to beneficiaries, either because of SSA’s error or the beneficiary’s.  The Treasury Department was then withholding the amount of the overpayment reported by SSA from the beneficiary’s tax return.

The press release indicates that Colvin intends to undertake a review of SSA’s responsibility and discretion with regard to referring debts to the Treasury Department.  She also encouraged anyone who feels they were assessed with an aged overpayment which was offset by the Treasury Department to “request an explanation or seek options to resolve the overpayment.”


SSA Issues Guidelines for Evaluation of Chronic Fatigue Syndrome

The Social Security Administration (SSA) has issued a Ruling (SSR 14-1p) which provides guidance for decision makers in Social Security Disability (SSDI) and Supplemental Security Income claims (SSI) involving chronic fatigue syndrome (CFS).  SSR 14-1p, effective April 4, 2014, establishes the evidentiary requirements needed to establish that a claimant for disability benefits has a “medically determinable impairment” of CFS, and how CFS will be evaluated in claims for disability benefits and disability reviews. (more…)


Medicare Changes Implemented for Same-Sex Spouses

The Department of Health and Human Services (HHS) issued a press release on Thursday, April 3, 2014, announcing that the Social security Administration (SSA) has implemented changes to the Medicare program for same-sex spouses pursuant to a landmark decision by the Supreme Court of the United States in 2013.  Namely, SSA is now able to process eligibility requests for Medicare Special Enrollment Periods (SEP) when an individual has health coverage based on the employment of a same-sex spouse.  They also announced reductions in late Medicare enrollment penalties for certain individuals who have coverage based on the employment of their same-sex spouse. (more…)


SSA Launches Fraud Prevention Unit in New York

On Monday, March 31, 2014, the Acting Commissioner of Social Security, Carolyn Colvin, issued a press release announcing a new branch of the Social Security Administration (SSA) dedicated to fraud prevention and detection.  The fraud prevention unit will be based in Jamaica, New York and will use trends identified in past cases of fraud as well as additional analysis to create systems to identify fraud in Social Security Disability applications.

The launch of the fraud prevention unit follows recent adverse media attention of high profile fraud cases, such as the Kentucky attorney alleged to be in cahoots with a West Virginia Administrative Law Judge to fraudulently process disability claims, and the large scale arrests made in Puerto Rico and New York City of individuals purportedly engaged in falsifying claims for Social Security benefits.

The fraud unit will employ 20 disability examiners who will examine claims and trends in an attempt to prevent fraud.  The Advocator Group encourages the exposure of fraud at any level for the greater good of federal benefit programs.  Fraud in the Social Security program generally draws high profile scrutiny in the media and ultimately results in an adverse impact to those who face challenging health issues and need to go through the application process to receive benefits.  The Acting Commissioner announced in her press release that the fraud incidence rate in the Social Security program is a fraction of one percent.


SSA Begins Expediting Disability Claims for Vets

As previously announced, the Social Security Administration (SSA) launched their initiative to expedite the processing of Social Security Disability claims for veterans who have been issued a 100% disability rating by the Department of Veteran’s Affairs (VA). SSA released instructions to its employees for processing these claims on March 17, 2014, the day before acting Commissioner Carolyn Colvin issued a press release touting the initiative as “another milestone for those who have sacrificed so much for our country.”

Per the instructions, Social Security Disability applicants who provide SSA with proof that they have been issued a 100% permanent and total disability compensation from the VA will be provided with expedited claim processing through all levels of development, adjudication, and appeal. The instructions indicate that a new flagging process has been added to their claim handling system to ensure the claim gets priority processing. The VA rating does not guarantee an award of benefits, however, as a disability examiner will still need to determine whether the veteran also meets Social Security’s strict standards of disability, but a 100% disability rating from the VA will move the application to the forefront for a quick decision.



CMS Withdraws Proposal to Stop Covering Some Drugs

In January, the Centers for Medicare and Medicaid Services (CMS) proposed new rules which would end a requirement that Medicare health insurers provide coverage for all drugs classified as antidepressants and immunosuppressants. This week, CMS withdrew these proposed changes, seemingly because of pressure from both Congress and drug companies. Marilyn Tavenner, the Administrator of CMS, sent a letter to Congress withdrawing the proposal based on “the complexities of the issues and stakeholder input.” (more…)


President, SSA Propose Budget for 2015

The President issued his proposed budget this week, structured on proposals to speed job growth, strengthen the middle class, and improve the nation’s fiscal position for the long-term.  The proposed budget would provide $12.1 billion in funding to the Social Security Administration (SSA), up from $11.7 billion for the 2014 fiscal year.

Among the highlights for SSA would be $100 million  appropriated for a customer service modernization initiative, $150 million to be used to further reduce wait times, and $400 million for SSA to partner with other Federal agencies to develop strategies to help people with disabilities remain in the workforce.  The proposed budget would also begin to establish mandatory funding in 2016 for Continuing Disability Reviews (CDR – the process by which SSA reviews disability benefit recipients to ensure their conditions remain severe enough to prevent them from working), and also proposes offsets of Social Security benefits to repay government debts or to account for months in which a beneficiary also receives an unemployment benefit.  The budget would also make the Social Security earnings record more accurate by implementing quarterly wage reporting as opposed to the annual reporting currently in place.  Notably missing was a plan to reduce the cost of living adjustment (COLA) over time for beneficiaries who receive benefits longer.  This concept, known as Chained Consumer Price Indexing (or chained CPI) was in the President’s proposed budget last year, but proved to be unpopular in his political party. (more…)


Court Dismisses Social Security Judges’ Suit Against SSA

Last year, The Association of Administrative Law Judges (AALJ), the union that represents many of the Social Security Administration’s (SSA) ALJs, sued SSA in Federal Court asserting that the directive to issue 500-700 decisions a year resulted in an illegal quota that violated the judicial discretion provided to them in the Administrative procedures Act (APA).  SSA asked the court to dismiss the case, asserting that the court did not have jurisdiction over the matter because the Civil Service Reform Act (CSRA) set forth administrative remedies for “personnel actions” involving federal employees and the ALJs did not seek review through that process.  The court agreed and dismissed the case on February 26, 2014.  The ALJs will now have to seek relief through the CSRA if they hope to avoid the guidelines set forth by the agency. (more…)


Social Security Updates Medical Listings

The Social Security Administration (SSA) has been busy updating some of the medical criteria they use in making determinations of whether an individual claiming disability benefits meets their criteria.  For use in their disability evaluation, SSA maintains a “Listing of Impairments” which are impairments that are considered to be so severe that they prevent all work activity.  If a claimant for benefits meets the criteria set forth in one of the listed impairments, they will be considered to meet the criteria to receive disability benefits without an analysis as to whether or not they could work in their prior occupations or any other jobs.  Since late 2013, SSA has been publishing proposed changes for many listings and extending the effective dates for others.



SSA Proposes Rule Changes Regarding Submission of Evidence

The Social Security Administration (SSA) has issued a Notice of Proposed Rulemaking in the Federal Register in which they propose to clarify ambiguity regarding what evidence in support of a claim for disability benefits must be submitted by claimants and representatives.  In essence, they propose to require the submission of all evidence obtained from any source in its entirety.  This rule would be subject only to exceptions regarding privileged communications and a representative’s analysis of a claim, such as their theories or notes not intended for disclosure. (more…)