A recent article in the Philadelphia Daily News regarding new proposed rules affecting Social Security disability benefits, explains very well how the rules will prevent many otherwise eligible claimants from receiving Social Security disability benefits. The article is important enough to be printed here in full:
On the grand scale, the battle over the prospective overhaul of Social Security has ended for now. Disputes continue, though, in the arena of the fine print.
That is particularly true for the part of the system that provides $79 billion a year in monthly payments to 8.3 million disabled workers and dependents.
In recent months, the Social Security Administration has proposed revisions to two sets of rules governing who qualifies for disability, revisions it says are designed to streamline and update cumbersome and outdated regulations.
Advocates for the disabled argue that the pending changes will have the effect of denying funds to thousands of people with severe mental and physical handicaps.
The changes do not require congressional approval.
One set of proposed new rules would save Social Security an estimated $6 billion over the next decade by raising the ages at which applicants for disability are subjected to less stringent eligibility criteria.
An age-based system has been in place since 1978, on the theory that it is harder for older people to find a job than for younger workers after a devastating accident or illness.
The other changes would revise the slow, cumbersome, multistep process by which applications for disability status have been resolved. Among disability advocates, these prospective changes have generated considerable opposition.
“While justice delayed can be justice denied, justice expedited can also result in justice denied,” Marty Ford, co chair of the Social Security Task Force of the Consortium of Citizens With Disabilities said in congressional testimony.
In announcing the proposed new rules last year, Social Security Administrator Jo Anne B. Barnhart said she was guided by questions President Bush had put to her, including why it took so long to get a final disability decision and why obviously disabled people could not get a near-immediate decision.
“My goal was to address the President’s questions and ensure that we make the correct decision as early in the process as possible,” Barnhart said. “The regulation we are proposing would do just that.”
Under current rules, the process has five steps. The initial determination is made in a state office by officials who never actually see the applicant. Then comes reconsideration, a hearing before an administrative law judge, review by an Appeals Council, and finally, access to the federal courts.
What is striking about the process, beyond its complexity, is how many applicants ultimately get benefits after being initially turned down.
On average, 37 of every 100 applicants are approved in the first round, according to the Congressional Research Service. Of the 63 denied, 22 typically pursue an administrative appeal, and 16 win. Then some of those losers go to federal court and win there.
In extreme cases, the whole process has been known to take more than three years.
To speed things up, Barnhart has proposed a quick determination process for the obviously disabled; the elimination of the Appeals Council, to be replaced by a board that would pick its own cases to review; and the imposition of hard deadlines for submission of evidence and rules against reopening cases.
The new deadlines have generated the most criticism, with advocates noting that it can be difficult for the disabled to obtain medical records and that the severity of an impairment often worsens as time goes on.
In a letter to Barnhart, Rep. Thomas H. Allen (D., Maine) wrote that adding “artificial time limits and other technical barriers” to the process “would be unfair and unjustified.” Rep. Jim McCrery (R., La.), who chairs the House subcommittee on Social Security, has expressed similar views.
Mark Lassiter, a spokesman for the Social Security Administration, said the final version of the rules would be published in coming weeks. He said the new regulations initially would be imposed only on one region of the country, so officials could see how they worked.
Drawing less attention have been proposed changes in the existing set of age-related rules used to determine disability.
Here’s an example of how they work – under current regulations. If you are over 55, have done physical work for years, and suffer a severe impairment that leaves you unable to do such work, you are presumed qualified for benefits, even though you might still be physically able to do desk work.
Under the proposed changes, this benefit of the doubt would henceforth be limited to people 57 and older; similar upward adjustments of two years would be made in other categories.
In advocating the age shifts, the Social Security Administration cited “our adjudicative experience, advances in medical treatment, changes in the workforce… and current and future increases in the full retirement age.”
Opponents argue that nothing has changed about the toll taken by physically demanding labor and that those most affected would be African Americans, the less educated, and people with lower incomes.
Said Thomas D. Sutton, a Trevose-based lawyer active in the National Association of Social Security Claimants’ Representatives: “Cuts in disability benefits should not fall disproportionately on the shoulders of middle-aged workers who once were able to build bridges and dig tunnels, but have been significantly limited by the infirmities of age and illness.”
Under Social Security, disability benefits are intended for working people who have a medical or physical condition that is expected to last at least a year or to result in death. The average monthly benefit is about $900, and about 2.4 million Americans applied last year.
Factors in determining eligibility include the severity of the condition and the degree to which it leaves the individual unable to work. Payments typically last until retirement age, when recipients get retirement benefits instead.
- A year ago, President Bush was pushing Congress to let workers invest part of their Social Security taxes into private accounts. But he couldn’t even get leaders in his own party to go along, and the idea faded into the background.
- He is being far more circumspect now, calling only for a bipartisan commission to look at Social Security, Medicare and Medicaid.
- This would be the second such commission of the Bush presidency, following the President’s Commission to Strengthen Social Security of 2001.
- A new commission aside, the general sense in Washington is that any serious effort to overhaul Social Security (with possible impact on the disabled) must await this fall’s congressional elections and perhaps the 2008 presidential contest as well.