Watchdog: Follow the Money

EXography: Seven steps to keep disability insurance solvent

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Percentage of residents collecting government disability checks by county, where red is highest and green is lowest. Click each county for more info, including cost per resident and portion of recipients who have previously paid into Social Security. (Graphic by Luke Rosiak/Washington Examiner.) Watchdog,Watchdog Blog,VA Disabilities,Social Security,Entitlements,Luke Rosiak,Follow the Money,Spending

Fraudsters concocting tenuous and unprovable medical conditions to draw thousand-dollar checks for life through a disability program funded by Social Security taxes are so common that they will topple the nation's safety net, according to a judge who sees such cases full-time.

Federal spending on the Supplemental Security Income program — disability benefits for the poor — has increased 70 percent since 2000 to $57 billion, while disability payments for those who have paid some Social Security taxes has risen from $56 billion to $144 billion.

But there is a solution, according to a detailed proposal drafted by administrative law judge Paul R. Armstrong and shared with the Washington Examiner.

Among the proposed reforms:

* Add a category called “disabled but expected to recover.”

Disability rulings are currently for life, and can be revoked only if the case is one of the tiny and shrinking fraction to receive a follow-up audit by the Social Security Administration.

The applicants are often people as young as in their 20s, who have never worked and for whom a determination of disability can mean nearly a half-century of guaranteed government payments.

Under this new proposed status, Armstrong writes, "disability benefits would automatically be cut off for such beneficiary at a certain date set out in the disability order," with the burden of proof being on the recipient to extend it, rather than on the SSA to prove it's not needed, as it stands now.

* Don't give people a disability check without attempting to provide them with services we already pay for that have the goal of helping people with disabilities find work.

"The system fails to refer current applicants to resources created for their benefit, especially the federal-state Vocational Rehabilitation System, prior to the determination of their disability status," Armstrong notes.

* Have a taxpayer advocate in the hearings, not just a one-sided hearing with a client's lawyer or representative.

Not having a hearing akin to a trial with no defense counsel present would also help keep those seeking disability payments from wantonly lying without fear of consequence, because they would be grilled in a cross-examination.

"One simple reform that would make a big difference is including a professional from the SSA to represent the government (and ultimately, the American taxpayer) in decisions made by ALJs ... some claimant attorneys withhold evidence from the [judge] showing the claimant's condition improved," Oklahoma Republican Sen. Tom Coburn said this month.

* The rapidly-growing contingent of disability recipients on the dole because of mental issues — 19 percent — deserve extra scrutiny.

A psychologist who performed disability reviews, Alfred Bradley Adkins, testified recently before a Senate committee on how easy it is to get a doctor to write a diagnosis of medical difficulties that can't be scientifically confirmed.

“Of the 568 [reviews Adkins performed], I’m sure I found the vast majority had significant depression, anxiety issues,” he said. How many did he say would not qualify for disability payments? “Probably not even five… Probably zero,” he admitted sheepishly.

Armstrong believes “referral for a vocational evaluation and possible placement in an evidence-based supportive employment situation will arguably screen out malingering, divert a good percentage of applicants to gainful employment, and allow for a more accurate assessment of the working capacity of the applicants.”

* Step up audits that determine whether the disabled poor who have been receiving disability checks are still eligible.

The audits generally check whether the people are still as poor as they say they are. In 2010, overpayments to supposedly poor people who didn't actually qualify totaled at least $3.3 billion.

SSA cut down on the number of “re-determinations” starting in 2007, pointing to lack of funding, though it has no trouble paying out on the disability claims themselves, and its own figures indicate that every dollar spent on redeterminations saves $6 over a decade.

* Raise the retirement age used in determining disability payments in tandem with the rest of America.

The rules make a claimant close to retirement age far more likely to receive a ruling of disability, but that age has not been increased even as the threshold for normal Social Security retirement benefits has been raised to 67 and continues rising.

* Move disability for the poor to the states.

This idea is more radical and comes from the Cato Institute, not Armstrong. But it would deal with the serious problem: States have hired consultants to move as many poor residents as possible from welfare, which is partially funded by the states, to federal disability.

Providing a block grant to each state would remove this incentive — one that’s particularly perverse because disability payments are for life while welfare benefits have a five-year limit.

It would also encourage them to keep disability payouts in line with previous decades, which is not too much to ask for, given medical advances and an economy significantly less dependent on physical labor.

Previous Examiner disability coverage:

* In survey, many disability recipients admit they could work but don't want to

* What portion of your county's workforce is on disability? Hint: up to one-third.

* Disability fraudsters steal from the truly needy

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