Sunday, May 8, 2016

How German social security carriers ignored a couple of statistics questions

It has been two years since the blogster asked several of the German agencies that are the equivalent of the Social Security Administration for information on how the German version of social security disability claims are adjudicated as well as details on the number and types of appeals filed by claimants.

All press offices ignored the inquiry, so the blogster goes with what's known.

Back in 2014, three events that stirred the blogster's curiosity occurred at almost the same time. The first was a very short article in the local newspaper accusing health insurance providers of opaque practices regrading rehabilitation measures. The other two were cases of disability claims equivalent to American SSD claims.
What was interesting in both cases was that the claims were denied "based on available records". At the same time, both claimants assured the blogster that their respective specialist doctors were unhappy with the carrier and assisted in the appeals process.
The eventual outcome was that both were put on full disability.

When both claimants said "oh, they put you on six hours, so they don't have to pay, that happens all the time", some reading seemed indicated.

As with earlier research on the German basic means tested Hartz IV (similar to SSI but without the disability requirements; more a combination of food stamps (SNAP) plus other benefits like Section 8 housing), it turns out that the legal basis for social security disability was changed in the early 2000s when numerous cuts were made.

At issue is what is called Substantial Gainful Activity in the American system. Where the SSA has a base amount of money earned ($ 1130 in 2016 for a non-blind person) with some allowance for higher earnings and exclusions for lower ones (e.g. not eligible as a substitute bus driver because it does not indicate the person was unable to work more), German disability uses a daily work hours scheme based on the potential hours of work a claimant is supposed to be able to perform: less than 3 hours (full disability), between 3 and 6 (50% disability), six or more (0%, ineligible). 

After the substantial rules changes, the number of new SSD recipients in Germany went down by about one third (280 000 in 1996, 180 000 in 2011). 

The process documents and statistics requested in 2014 would allow the blogster to definitively confirm or exclude that internal directives or "performance targets" at one or more insurance carriers were a second major factor in denying claims.

If you work at one of Germany's social security insurance carriers and want to help, send us an email.

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