Earlier this month, Nancy A. Berryhill, Acting Commissioner of Social Security, today announced three new Compassionate Allowances conditions: CACH–Vanishing White Matter Disease-Infantile and Childhood Onset Forms, Congenital Myotonic Dystrophy, and Kleefstra Syndrome. Compassionate Allowances are a way to quickly identify serious diseases and other medical conditions that meet Social Security’s standards for disability benefits.

“Social Security is committed – now and in the future – to continue to identify and fast-track diseases that are certain or near-certain to be approved for disability benefits,” said Acting Commissioner Berryhill.

The Compassionate Allowances program identifies claims where the applicant’s disease or condition clearly meets Social Security’s statutory standard for disability. Many of these claims are allowed based on medical confirmation of the diagnosis alone, for example pancreatic cancer, amyotrophic lateral sclerosis (ALS), and acute leukemia. To date, almost 500,000 people with severe disabilities have been approved through this fast-track policy-compliant disability process, which has grown to a total of 228 conditions.

By incorporating cutting-edge technology, the agency can easily identify potential Compassionate Allowances and quickly make decisions. For other disability cases not covered by the Compassionate Allowances program, Social Security’s Health IT program brings the speed and efficiency of electronic medical records to the disability determination process. When a person applies for disability benefits, Social Security must obtain medical records in order to make an accurate determination. It may take weeks for health care organizations to provide records for the applicant’s case. With electronic records transmission, Social Security is able to quickly obtain a claimant’s medical information, review it, and make a determination faster than ever before.

“The Compassionate Allowances and Health IT programs are making a real difference by ensuring that Americans with disabilities quickly receive the benefits they need,” added Ms. Berryhill.

For more information about the program, including a list of all Compassionate Allowances conditions, please visit www.socialsecurity.gov/compassionateallowances.

To learn more about Social Security’s Health IT program, please visit www.socialsecurity.gov/hit.

 

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Hurricane Irma Aftermath

September 20, 2017

Hurricane Irma has caused significant damage to the Jacksonville area.  The Florida Times Union recently reported that the storm has used the poor closer to the edge of ruin.  Individuals struggling before the storm have left people with even less.  Nearly 16% of the residents of Florida live in poverty and the losses that the storm caused are limiting options even more as their lives are up-ended.  Increased expenses, the loss of household possessions and the loss of a place to live have exponentially  increased the stress that indigent individuals feel on a daily basis.

 

For people who have disability applications pending, hearings have been canceled and due to office closures, Social Security is falling even further behind.  For people receiving disability, which is a fixed income, fleeing the storm may not have been an option.  The cost of cleaning up and finding a new place to live is pushing people even closer to the edge.

 

The Times Union reported that one couple who survive on disability checks had been living on a sailboat they purchased a year ago for $1,000 on eBay.  After the storm they stayed on cots in a shelter and are struggling to figure out if they could get a new boat if theirs was destroyed.  They subsequently learned that their boat was intact, but not all people have been so lucky.

 

 

From the Washington Post:

LEXINGTON, Ky. — A former administrative law judge has been sentenced to four years in prison for taking bribes from a Kentucky lawyer in a $600 million Social Security fraud case.

Eighty-one-year-old David B. Daugherty of Myrtle Beach, South Carolina, pleaded guilty in May to taking more than $600,000 in bribes in cases involving clients of Eric C. Conn, who is now a fugitive and was sentenced in absentia to 12 years in prison.

Conn represented thousands in eastern Kentucky in Social Security cases. Daugherty heard their appeals in Huntington, West Virginia.

Conn pleaded guilty to submitting false information to Social Security and making illegal payments to Daugherty. Then, he cut off his electronic monitor and disappeared.

 

Great article from the Washington Post about a Vocational Rehabilitation Counselor’s efforts to help her clients in Roanoke, Alabama.  It’s a long, but very worthwhile, read:

She wanted her clients to look to her for inspiration, so Teresa Boullemet stamped out her cigarette, popped a peppermint, sprayed herself with perfume and applied fresh lipstick. “Are you going to the farthest corners of the world today?” her assistant asked as she walked to her car. “Roanoke,” Boullemet said. “Say a prayer for us.” And then, carrying pamphlets saying she provides “guidance and choices” to disabled people interested in working, she set out for what may not be the farthest corner of the world, but is certainly one of the farthest corners of Alabama.

Vocational rehabilitation counselor is Boullemet’s official title, a job she does for the state Department of Rehabilitation Services, but she thinks of it in far simpler terms, because the questions she tries to answer seem so simple. Can this person work? Is there someone who would hire them? And if so, how can she connect the two?

They are questions that have become increasingly urgent in a country that is hardening its stance toward recipients of government benefits. Wisconsin wants to be the first state to require childless Medicaid applicants to undergo drug testing. Georgia has dropped thousands from its food-stamp rolls after instituting work requirements. And the Trump administration has proposed a budget that would further erode the social safety net, slicing hundreds of billions of dollars over the next decade from Medicaid, food stamps, children’s health insurance and programs that serve the disabled. Taken together, the policies either amount to an assault on the vulnerable, according to Democrats, or, according to Republicans, a promotion of the most American of values: the dignity of work.

“If you’re not truly disabled,” Mick Mulvaney, director of the Office of Management and Budget, has said, “we need you to go back to work.”

The “strength of our communities depends on able-bodied Americans earning paychecks,” Sen. Marco Rubio (R-Fla.) has said.

“If they can get back to work, then by all means, we should help them,” Sen. Tom Cotton (R-Ark.) has said.

That was Boullemet: the one who helped, at least in Randolph County, where more than 1 in 8 working-age adults receive disability benefits, and where she is the person they go to see when they want to get off them. She believes work leads to confidence, confidence to hope, and hope was the only way someone could go from letting the government support them to supporting themselves.

But as she drove farther into the remote county, she tried not to dwell on the realities of that transition, that only about 10 percent of her clients get off disability and that nationally, the number is even lower — 3.7 percent of disabled workers do so within 10 years of the first payment. She instead focused on the immediate. She would meet with three clients today, which was three opportunities to apply the lessons she had learned from years of coaxing people back to work. Always smile. Always look them in the eye. Give homework that makes them vested in their rehabilitation. Never get fewer than three phone numbers, because she knows how easy it is for the poor to vanish.

There was one client, however, who Boullemet didn’t worry would disappear, but whom she worried about nonetheless, and that was the client she was seeing today.

She knew that Lisa Daunhauer had drawn benefits since 2011 through the Social Security Disability Insurance program and that the only job she had found was at the bottom of the American economy, as a cashier at Walmart. She also knew Daunhauer, whose disability was anxiety, depression and bipolar disorder, had nearly been fired from that job, an occurrence that was likely to destroy her chances of working again anytime soon. It had now come down to six weeks. Daunhauer had to find a way through the next six weeks to complete Walmart’s probationary period to have a shot at getting a needed raise and, eventually, becoming one of the rare few to get off disability.

Boullemet was worried about all of that, and those were the only facts of Daunhauer’s life that she knew.

On the morning of her meeting with Boullemet, Lisa Daunhauer awoke with a nervous stomach on the couch, where she spends almost every moment she’s not at Walmart. She looked around her government-subsidized apartment, seeing nearly everything she owned. The end table she’d built with wood found on the side of the road. The dirtied lamp she’d taken from her mother’s house. The electric fan she runs because air-conditioning is too expensive. And the Bible verse, stitched onto cloth and framed: “The lord lift up his countenance upon thee, and give thee peace.”

On this morning, peace was a breakfast of two pills — Lamictal for bipolar disorder, Prozac for depression — washed down with iced tea in a Burger King cup, followed by episode after episode of reality television to distract herself from a life that hadn’t gone according to plan. It had begun firmly ensconced in the middle class. There had been a college degree, a marriage, three children, a steady job working with medical records, and a big four-bedroom house in the Atlanta suburbs.

Now, there was an empty apartment, an ex-husband who was dead, and a weathered Chevrolet hatchback she steered through a town that, 15 years ago, she had never even heard of, let alone expected to call home. But that had been before the divorce, the bankruptcy, the drinking, and the time she checked herself into a hospital in May 2005, telling doctors, according to medical records, “I’m having a hard time dealing with life and I don’t want to live.” Then came the morning her manager had smelled alcohol on her breath, fired her, and Daunhauer went to her psychiatrist. “That’s what it’s there for,” the psychiatrist told her of disability insurance. “To get you past whatever it is you’re going through.”

Teresa Boullemet, a senior rehabilitation counselor with the Alabama Department of Rehabilitation Services, makes the hour-long drive between Roanoke and Anniston, Ala. Boullemet is helping Daunhauer transition back into the workforce. (Bonnie Jo Mount/The Washington Post)
Daunhauer, who receives disability for anxiety, depression and bipolar disorder, has a college degree and experience working with medical records. She hopes to return to school to pursue a career in nursing. (Bonnie Jo Mount/The Washington Post)

She was 15 minutes early to her appointment, so she sat for a moment, looking at a desolate shopping strip that had a discount clothing store, three vacancies and the career center. It had been years since she received her first disability check, and was she past whatever it was she had been going through yet? Or was she more stuck than ever?

Her monthly disability payment, now worth $1,348, wasn’t enough to live on in the Atlanta suburbs, so she had moved with her three young children to her mother’s place in rural Roanoke, a factory town of 6,000 residents along the Georgia state line.

At first, Daunhauer had liked how isolated it felt, how nothing ever seemed to happen. But as the years went by, the quiet began to feel suffocating, and she started thinking about working again. She moved into an apartment so small that her youngest child, Jacob, 17, had to remain with her mother, and started writing to employers.

“I have 16 years of experience in a medical office setting. I am a hard worker, dedicated and dependable,” she wrote in her cover letter. “I am currently unemployed, but . . . I could be an asset to your organization.”

She stepped into the career center and walked past a line of brochures. “Does your LIFE need a COACH?” one asked. “Hiring TODAY to Protect Alabama TOMORROW!” promised another. The seat she found was beneath a list of the 40 positions most in demand in the state, none of which, she had learned, applied to her.

Was it too late? she had been asking herself lately. Could a divorced 52-year-old living alone on disability turn it around? Was it her? Or Roanoke?

It was a question she had raised with others, including on one of the rare nights she had dinner with Jacob.

“This is a depressing town,” he told her.

“It’s just not the town,” she said. “It’s the atmosphere that I live in.”

“It’s the people,” he said.

“There are no jobs,” she said. “You can’t earn a living.”

“There’s nowhere to,” Jacob said. “Except at Walmart.”

And that was what she was thinking about, her job at Walmart, when she heard a rustle in the back of the career center and saw a door open. Out limped a heavyset man with a white beard, then a woman with toenails painted electric orange.

“Hey, Miss Lisa,” Boullemet said, waving for her to come back and talk.

Daunhauer stood, followed Boullemet into the back room, and the door closed.

Six weeks. She had to make it only six more weeks.

But Boullemet understood the odds. She knew there were real reasons so few people, even those with relatively minor disabilities, worked themselves off benefits. She would see it when people told her they couldn’t do anything that would endanger their government payments and health insurance. Or when someone would come to see her once, seemingly committed to working, and then disappear. Or when her clients would get so nervous they’d quit their new jobs — or go on a bender — right before the start date. But by far, Boullemet’s most common experience was for no one to call her at all. Some days, she would just sit and wait.

In Alabama and nationally, about 2 percent of all disability beneficiaries participate in the federal workforce reentry program that Boullemet has worked with for more than a decade. The participation rate is so low that some experts say Ticket to Work — which helps people get back to work after they have spent months, years even, convincing the government that they cannot — is beyond repair.

“You have to get them before they’re declared disabled,” said Bruce Growick, a retired Ohio State University professor who helped shape the program. “Once you declare them disabled, forget it. You’re climbing a mountain you’ll never get to the top of.”

There are, however, always those who try. People such as the five disability beneficiaries Boullemet saw one morning at a center that works with the disabled. They sat around a big table, and Boullemet pulled out a notebook, crossed her legs and smiled.

“What would you like to do?” she asked.

There was a long silence, until, quietly, one person named Brenda said, “I love to clean.”

“Housekeeping?” Boullemet said. “Very good.”

“I just want to get a job,” said Joycelynn, a woman with glasses. “I applied to a bunch of places.”

“We’ve had just a small, small number actually called for interviews,” said Candace Green, a center employee. “So far, it just hasn’t worked out.”

“I applied to Jack’s, Burger King, Subway, Dad’s Bar-B-Que,” Joycelynn said.

“So many places,” Brenda seconded.

“Well, we’ll do more career exploration,” Boullemet said. “What you like. What you don’t like. What you’d like to do.”

“I like to stay busy,” Joycelynn said.

In Roanoke, more than half the businesses on Main Street have closed, and some that remain in town — discount stores, fast-food restaurants and Walmart — pay less than a disability check. (Bonnie Jo Mount/The Washington Post)

“I don’t like to be bored,” Brenda added. “Sometimes, I’ll sit on the floor with a toothbrush and scrub the floor.”

There were times when Boullemet would come out of meetings like this — in which she thought just one person, maybe two, could get hired — make the long drive home, and, trying to distract herself from the barriers separating her clients from work, reach for a Nora Roberts novel on tape. On those evenings, it didn’t seem like it was just about finding the right job, or getting a client to return her calls, but everything. It was the lack of transportation. A lost photo ID. The weight of living in a community where more than half of the businesses on Main Street had closed, and some of the ones that remained in the town — discount stores, fast-food restaurants and Walmart — paid less than a disability check.

Then morning would come again, and Boullemet would be back on the road, feeling better about her clients’ chances, convinced that the next meeting always had the potential to unearth another “diamond” like Lisa Daunhauer, who was sitting across the table from Boullemet, hands clasped in her lap.

Daunhauer, an earnest woman with short brown hair and blue eyes, was different from most of Boullemet’s clients. She had years of experience working in a professional setting, a college degree in fashion merchandising and a clear motivation to work: She wanted to afford an apartment large enough to accommodate Jacob. Her job interview at Walmart had gone great, and on Feb. 15, Daunhauer started on the cash register. “A true success story,” Boullemet said.

But she had begun to see signs of tension. Daunhauer was almost too desperate to succeed. In the first six months of employment, all new Walmart employees were given four strikes before they were fired, and the pressure of that had seemed to work against her. She worked so hard, punishing herself over the smallest of mistakes, that she became sick from the stress and missed two shifts — two strikes. Then she overslept and was late — half a strike. Then she was absent again when her daughter was ill — another strike. And finally, in early June, she became hopeless about her chances of succeeding at Walmart and, for no greater reason than that, skipped work. It should have been an automatic termination. But her manager, Rhonda Walker, had decided to give her another chance, and now Boullemet was listening to Daunhauer say how much that had meant to her.

“That gave me so much confidence,” she said.

“It made you feel valuable, didn’t it?” Boullemet said.

“I’ve never felt that in any job.”

“That’s just fabulous,” Boullemet said. “So you’re feeling like you’re in a good place?”

“Right now.”

Boullemet gave Daunhauer a long look. For years, she had worked with people with mental illnesses who were trying to go back to work. Things could seem fine, great even, and then the next day, everything would change.

“Just be patient with yourself,” Boullemet said. “We don’t want you to overload yourself.”

Lisa Daunhauer lets her dog, Macy, into her apartment. Daunhauer, who has three children, is wearing a jersey in support of her 17-year-old son Jacob’s former football team. Her place is too small for both her and Jacob, her youngest child, so he lives with her mother in Roanoke. (Bonnie Jo Mount/The Washington Post)

The following day, Daunhauer was sitting alone in her apartment, waiting for her next shift. Every now and again, she reached for her phone to flip off one of the several alarms she always set to make sure she’d never oversleep again.

Her phone went off. This time, it wasn’t a reminder. It was another message about Jacob.

Her former mother-in-law, Betty Daunhauer, was pressuring her for an answer to a text she had sent the day before. “Make the decision on what is best for Jake and stick to it,” Betty had told her. “He is not mature enough to know what is best for him.”

She put down the phone, sat with her hands on her knees, and, feeling a tightness in her chest, thought of Jacob. He had lately taken to wearing a grill of gold teeth, a giant fake gold watch and gold rings, including a diamond one on his pinkie. She knew he was just trying to be like his favorite rappers, but it confused her. And now here were these messages on her phone, asking her to make a decision she feared would only widen the distance between them.

Should she send Jacob, who has had disciplinary issues, back to the military academy in the fall? Would he hate her if she did? If he remained in Roanoke, she wanted him staying with her, and how could that happen in a one-bedroom apartment? Why was she always failing him? Why couldn’t she act like an adult? Why was she so weak?

“I don’t know what I’m going to do,” she said, beginning to cry, and again, “I don’t know what to do.”

Fear and insecurity: These emotions dominated in her life. She had been afraid to be alone, so she married a man she knew she shouldn’t have. She had been afraid of not providing enough for her children, so she ran up so much credit card debt that she had to declare bankruptcy. When her therapist told her about disability, she had been afraid then, too, of what might happen if she didn’t apply. And once she started receiving the payments, and was living alone, she had been afraid that this would be the rest of her life, so she decided to get a job.

Her phone went off again.

“Hello?” she said to Betty, who had agreed to help pay for Jacob’s schooling. “No, you can talk to me now.” She put her hand to her forehead. She gestured with her left hand. She sat cross-legged, ankle jiggling. She tried to steady her voice, to hide that she had been crying, to be strong, but then it was coming back again.

“I just don’t know what to do about Jacob!” she said into the phone. “I don’t even know if I’m going to have a place to live!”

And that was another fear. Walmart, which had raised her hourly wage from $9 to $10, paid her about $1,000 every month. She had recently asked her landlord if that would affect her housing subsidy, but she still didn’t know the answer to that question, or many others. Under the Ticket to Work program, her disability benefits would terminate if she made more than $1,170 per month — “substantial gainful activity” — following the completion of both a nine-month trial work period and a consecutive 36-month period, and who knew if she’d ever make that much at Walmart. Even if she did, or found another job, would it be worth sacrificing the certainty of a government benefit for the uncertainty of the labor force? Where would she find the confidence for that, when she couldn’t even talk to her son’s teachers in person?

“I can’t do face-to-face. I can’t do it!” she told Betty. “After I talked to [one teacher], I felt like a fool. . . . I felt ridiculous. Like I was being mean and ugly. I was upset, and I try not to do that. I still feel bad about myself when I do that. And that’s just me. I guess I just got to work on that.”

“I can’t, I can’t, I can’t,” she said.

“It hurts me,” she said.

“Oh my gosh,” she said.

“I just don’t know,” she said.

She got off the phone, promising Betty she’d talk more the next day, then put her face in her hands and breathed as deeply as she could. She did it again. And again.

These were the secrets she kept. She never wanted people to know how emotional she became, or all the regrets she had, or that she still bought wine or beer, whatever was cheapest, and alone in her apartment, numbed herself. Or that she might tell people she was “determined” to get off disability, but was in fact silently questioning that determination.

Her phone went off again.

It was an alarm. She had to go to work.

“Is it time?” she said. “Please, don’t tell me it’s time.”

At the edge of Roanoke is the Walmart Supercenter, the only Walmart for dozens of miles. On the day the government checks arrive, which was today, people come from all over the counties of Chambers, Clay, Tallapoosa, where about 1 in 6 working-age adults receive disability, and the parking lot fills early, empties late, and employees are told to take spaces far from the store, where Daunhauer now parked, half an hour early.

She stepped out. On top of a blue polo, she pulled on her Walmart vest — “Proud Walmart Associate,” it said — and on top of that, she clipped on her nametag: “Our People Make The . . . Difference.”

She walked toward the entrance, a knot of nerves. She knew that some customers probably would pay with aid from the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), and that required complex procedures on the cash register. During training, she had been told it was important to get it right. Then less than a week into the job, a manager voided one of her transactions because of an error. She had stood by watching, feeling ashamed and unworthy, and later became so anxious that she accidentally tore another WIC check.

But there was always a chance that today would be different, so she hustled in and assumed her position at cash register number 4, between two disinterested-looking teenage employees.

The store was mobbed. A large woman in pajamas pushed a shirtless toddler in a grocery cart. Some customers tooled about on scooters. A woman’s T-shirt said, “I didn’t claw my way to the top of the food chain to eat vegetables.”

“You having a good day today?” Daunhauer asked the first customer, who handed her four $20 bills for a bill that came to $76.28.

Daunhauer handed him $23 in change.

“I gave you 80,” the customer said, “and you’re giving me a 20.”

Daunhauer laughed nervously.

“Wait a minute,” she said, only now realizing the mistake. “Thank you for being so — oh my goodness. Wow.”

Then he was gone, and Daunhauer, trying to keep her composure, was on to the next customer.

“Would you like everything in a bag?”

And the next.

“Have a good day.”

In came Andre Patterson, one of Boullemet’s other clients, who spent $182.23 of his disability check on groceries and left. In came Daunhauer’s former roommate, who, hugging Daunhauer, said, “I didn’t know you got a job!” In came Jacob, who asked to borrow $20 and said, “Have you been crying?”

“Why?” she said.

“You look like you’ve been crying.”

“Earlier today,” she said quietly, again considering her dramatic mood shifts, which she recently admitted to herself weren’t always “situational,” triggered by a bankruptcy or divorce. It was her. She was disabled, and maybe she should stop trying to convince herself otherwise.

One hour went to the next, the shift passing without a single WIC customer, until the very end of the night, when a well-dressed blond woman laid out peanut butter, eggs, cheese, grapes, cereal and two WIC checks.

Daunhauer slid on her glasses and, squinting, started punching numbers. She looked up. The line behind the woman was getting longer and longer.

“Is it WIC?” a manager called to her.

“It’s WIC,” Daunhauer said, then to herself: “I don’t want to mess it up.”

She tried scanning the checks. It didn’t take. She sighed angrily.

The line was getting longer.

She tried scanning the checks again. But this time, it worked. The receipt came out, and the woman was through.

Nothing had to be voided. She didn’t mess up. She didn’t fail.

“I figured it out,” she yelled to the manager.

She walked outside, where she saw that nearly all of the cars were gone except for her hatchback. She drove home and cut the lights. It was nearly midnight. She went inside her apartment, sat down on the couch and fell asleep.

She was there again six days later.

It was a bad day.

Boullemet called her twice, but Daunhauer, for the first time, ignored the calls. She had instead been talking to someone at a suicide hotline, who hadn’t been trying to get her through the next six weeks, or off disability, but through the next hour. And now she was looking at the clock, seeing she had to work again in five hours, saying, “I can’t deal with it anymore; I can’t make the decisions that everyone expects of me. . . . Nothing is the way I ever thought it would be.”

Today she wouldn’t find a way to go into Walmart. She would quit. She would decide she wasn’t one of the 3.7 percent who get off disability. For now, she was one of the rest, and she just had to find a way to live with it

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