From the Social Security Update, e-broadcast today:

Beginning in April, many people applying for Social Security disability benefits will be able to sign and submit the Authorization to Disclose Information to Social Security (Form SSA-827) form electronically, as the last part of the online process.

When claimants file for Social Security disability insurance or SSI benefits, they generally sign form SSA-827 (Authorization to Disclose Information to SSA), which serves as the claimants’ written request to a medical provider or other source to release information to us. Currently, claimants generally sign the SSA-827 so that SSA can obtain medical and other records related to the claim. Acquiring a signature on this form can often take weeks, causing unnecessary delays in processing claims for one of the most vulnerable segments of our population.

Social Security requests more than 15 million medical records each year on behalf of people applying for disability benefits. A signed SSA-827 accompanies each request. By accepting electronically signed forms, medical providers will help their patients’ claims go through faster. On average, this should reduce disability application processing time by nine days per claim.

The Health Insurance Portability and Accountability Act (HIPAA) and other applicable laws permit the use of electronic signatures, and Social Security is encouraging medical providers to treat the new electronic signature the same as they would a “wet” signature on the SSA-827.

If you love SSA stats, you’ll love the links in Social Security’s Research, Statistics and Policy Analysis page.

This November 2011 snapshot details SSA/SSI entitlements last month by benefit type with new beneficiary numbers, total benefits paid and average monthly benefits paid. If you refer SSDI claims to our firm, you know that we provide you with this kind of information/analysis (and then some!) to help you manage your own corporate caseloads…just another benefit in working with a law firm that speaks SSA’s language.

Under the new rule, current health insurance industry regulations would be changed to “non-health eligibility underwriting rules may be applied to child-only coverage, provided such eligibility rules are uniformly applied to all applicants applying for child-only coverage.” My understanding of this law is that insurance companies can now refuse to provide coverage to infants born to fully-insured parents. The result of this new law is that insurance companies in Oklahoma will now start refusing coverage to newborns who are born will medical problems – in other words – the newborns who will need insurance coverage the most.

I imagine the scenario will look something like this: Baby is born, parents have full coverage (for themselves). Upon birth, Baby has serious medical issues which require immediate attention or Baby will suffer serious consequences (up to and including death). Parents must make decision about very expensive health care procedures, in a very short amount of time. If the insurance company decides not to cover Baby, parents are stuck with the enormous – presumably tens of thousands of dollars – bill. Remember – these parents are fully covered by the insurance company.

In the press release, Governor Fallin has approved this law for political reasons: note the reference to the President’s health care bill AND the admission that the new rule “isn’t perfect.” The people of Oklahoma need to be made aware of this law. The people of Oklahoma need to know that the birth of child could result in a nightmare of choices: the health of their newborn or a pile of medical bills. Medical bills are already the cause of the majority of bankruptcies in this country, and this law will add another avenue to medical bankruptcy. If Oklahoma is allowed to pass such a law, no doubt other states will also move to do the same.

For some background, though, for some 18 months “child-only” policies for ages 19-and-under have not been sold by any insurance company doing business in Oklahoma, a response by insurers to new federal regulations in the Patient Protection and Affordable Care Act. Insurance Commissioner John D. Doak said that Gov. Fallin’s signature should revive that market for the vast majority of uncovered children. As of now, children 0-19 are not able to be covered by child-only policies and their parents are not able to buy a child-only policy in the state of OK. The only way they can cover a child under the age of 19 is to buy a family policy. What the Governor has signed will now allow insurance companies in the state of OK to offer child-only policies to cover ages 0 – 19.

So, what was signed seems focused on allowing the ability for child-only insurance to be purchased by “parents or guardians whose incomes don’t qualify for government programs (SoonerCare) and who cannot or choose not to buy private coverage for the whole family.”

A special enrollment period for coverage will take place in January and February 2012.

Those in opposition include Linda Terrell, executive director of the Oklahoma Institute for Child Advocacy, as well as the Oklahoma Hospital Association and the Oklahoma Institute for Child Advocacy. Attorney Leah M. Kanne of Bassett Law Firm, LLC (and Oklahoma resident) agrees. Attention needs to be drawn to this, in the hopes the Oklahoma legislature will repeal the law in its next session.

Remember the days of the Unknown Comic? Well, those days are back, now in the form of the Mystery Judge.
Earlier today, I received a copy of an email that a colleague received from her local ODAR: ”Beginning next week, December 19, 2011, SSA is making a change that affects you. All pre-hearing documents will no longer display the assigned Administrative Law Judge’s (ALJ’s) name. The ALJ’s name will not be provided to claimants or representatives before the date and time of the hearing.

This change does not abridge a claimant’s right to object to the ALJ who will conduct the hearing as stated in 20 CFR 404.940 and 416.1440. There is no statutory and/or regulatory requirement to inform an individual of who the assigned ALJ is. The Act simply requires us to provide claimants “reasonable notice and opportunity for a hearing.”

At this time, we do not have any more information available. We are providing you this notice so that you will know that no error or omission has been made in our correspondence with you. Please note that the ALJ’s name will also not be provided at the time we schedule your hearing. Since we are not able to provide the name of the ALJ prior to the hearing, please do not call and ask. Thank you.”

One could come to many assumptions as to why SSA is acting on such a controversial move. In part, this initiative could be directed at a type of forum shopping in which representatives have been declining video hearings when they see that the assigned judge is on the lower end of the allowance curve. The issue is not only about stopping possible ALJ shopping by representatives, but to control ALJ’s as well. Cases will be able to reassigned at the last minute or last couple of weeks to a different ALJ, since one has not been named or listed at any earlier stage.

However, ALJ’s are human, too. The disadvantage here is that, without knowing the assigned ALJ, there is no way to know the expectations and idiosyncrasies of the ALJ. Some judges require briefs, but don’t share that in advance. If an attorney appears before such and ALJ, who has that expectation, the attorney could be chastised on the spot. If an attorney appears before an ALJ who won’t accept any medical records or evidence before a hearing, and an attorney has two new relevant pages, your claim will get postponed when you arrive. Having had prior knowledge, had a rep known not to arrive with new medical evidence, the entire issue could have been avoided.

Not only do different judges benefit from different preparation by attorneys, but some need you to set aside more time than others, some need clients to be prepared in different ways, some need written arguments in advance, and some need you to be prepared to make specific presentations at the hearing…

I am sure NOSSCR will have a lot more to say on the new ODAR policy. NOSSCR already sent a broadcast email to members to expect impaired efficiency at hearing offices as a result of this new policy, NOSSCR will be protesting its implementation to Glenn Sklar, ODAR Deputy Commissioner.

Read more in the Wall Street Journal article, Disability-Benefits System Faces Review.