A Note on the web Version of the NEWsletter: The SSI Coalition newsletter is published bi-monthly by the Disability Benefits Project of the Massachusetts Disability Law Center. Although this is the 21st year of the newsletter's publication, the web version is relatively new and we are looking for feedback re: format, readability, etc. Please direct your comments to Barbara Siegel at bsiegel@dlc-ma.org.
SSI COALTION NEWSLETTER
JANUARY, 2003 Volume XXI, No. 1
MassHealth Falls Victim to State Revenue Shortfalls
First Circuit Rule Allows Citation to Unpublished Opinions
SSA Proposes Regulations Allowing Wage Garnishment
SSA Proposes Photo I.D. Pilot Projects
SSA Proposes Revisions to Multiple Body Systems Listings
SSA Issues New Ruling on Interstitial Cystitis, SSR 02-2p
Congress Adjourns Before Action on H. 4070
Attorney Fee Assessment Rate Remains 6.3%
SSA to Test Expansion of Electronic Wage and Rep Payee Reporting
New, Improved, Shorter Food Stamp Application
MLRI’s 2003 Basic Benefits Training Series
Updated Obesity Ruling. SSR 02-1p
Appeals Council Policy Change - Response Time
Notice of Proposed Rulemaking: Claimant Identification Pilot Projects. 67 Fed. Reg.69161 (11/15/02)
Notice: Rate for Attorney Fee Assessment Beginning in 2003. 68 Fed. Reg. 1647 (1/13/03)
SI 02302.200 (11/14/02). Charted 1619(b) Threshold Amounts
RM 00203.510 (12/20/02). Alien Without Work Authorization
SI 02302.015 (12/20/02). Section 1619 Related Policies
DI 31001.005 (11/15/02). Who is a Representative?
Stevens v. Barnhart, No. 02-1474, 2002 WL 31474176 (1st Cir. 11/5/02)
Martin v. Comm’r SSA, No. 02-1187, 2002 WL 31338845 (1st Cir. 10/18/02)
Veino v. Barnhart, No. 01-6202, 2002 WL 31750172 (2nd Cir. 12/10/02)
Torres v. Barnhart, No. 02-30051-MAP (D. Mass. 12/10/02)
Yang v. Barnhart, No. 01-2307 RHK/SRN (Minn.D.Ct. 9/26/02)
Nelson v. Barnhart, No. 02-90-B, 2002 WL 31599018 (D. Me. 11/20/02)
Appeals Council Remand. ALJ’s Credibility Finding Not Supported by Substantial Evidence
ALJ Work-Related Overpayment Waiver Decision
SSI COALTION NEWSLETTER
JANUARY, 2003 Volume XXI, No. 1
1. 2003 COLA Changes. Social Security and SSI recipients received a 1.4% Cost of Living Adjustment (COLA) for 2003. As a result of the COLA, the SSI Federal Benefit Rate (FBR) increased to $552 for an individual and $829 for an eligible couple in 2003. Including the Massachusetts SSI supplement, which has not changed since 1983, the monthly SSI benefit for a disabled individual in the full cost of living category is now $666.39.
Other SSI and SSDI threshold amounts tied to the 2003 COLA increased as well:
The Substantial Gainful Activity (SGA) threshold is $800 per month for disabled recipients and $1330 per month for blind recipients.
For SSDI beneficiaries, gross earnings above $570/month triggers use of a trial work month.
The SSI student earned income exclusion is $1340 per month, up to $5410 per year.
The 1619(b) threshold in Massachusetts is $28,766.
The Medicare Part B premium will increase 8.7% to $58.70 per month.
Click on http://www.masslegalservices.org/docs/2003_ssi_payment_levels_in_massa1.htm for more information on the COLA and other SSA changes for 2003. SSI payment charts for this and previous years are available in the Disability section of www.masslegalservices.org. For more information on Medicare changes for 2003, go to http://www.medicare.gov/basics/amounts2003.asp.
2. MassHealth Falls Victim to State Revenue Shortfalls. Over the past several months, due to lower- than- projected revenues and a growing budget deficit, there have been substantial cuts in the services covered by MassHealth, the state’s Medicaid program. Here are the highlights (or lowlights):
MassHealth Basic Cuts. Effective April 1, 2003, MassHealth Basic will be eliminated for about 50,000 long-term unemployed adults. MassHealth Basic is the Medicaid coverage available to long-term unemployed adults, people receiving Emergency Aid to the Elderly, Disabled and Children (EAEDC) benefits, and certain people receiving services from the Department of Mental Health. The planned MassHealth Basic cuts will only apply to the long-term unemployed, not to EAEDC recipients and low-income individuals receiving coverage as DMH clients. Although the governor had proposed to make the cuts effective February 1, 2003, such a change would require legislative action, which has not occurred.
The Process: On January 3, 2003, the Division of Medical Assistance (DMA) mailed to MassHealth Basic recipients an "Advisory Notice" informing them that their Basic coverage is slated to end in April (or possibly as early as February 15th if the legislature should act to move up the date). This notice included a Disability Supplement and a short Eligibility Update form exploring alternative bases of MassHealth eligibility, such as pregnancy or HIV status. Clients who file the Update form or complete and return the Disability Supplement will continue to receive MassHealth until DMA makes a determination that they are no longer eligible. This will include continuing assistance beyond April 1st if the Disability Evaluation Service (DES) hasn't made a determination on their claim by that date. Clients who are approved for an upgrade will be notified.
Clients will receive a second notice 14 days prior to the effective date of their MassHealth Basic closing, (either 14 days before the end of the MassHealth Basic program or after DES determines them non-disabled if they've filed a Disability Supplement). This second notice will include the right to a Fair Hearing, which will include the right to receive "aid paid pending the appeal" if DMA receives the appeal before the actual date of the MassHealth closing.
This means that advocates and outreach workers will have two opportunities to preserve an individual's coverage before it ends on April 1st, either by filing the Disability Supplement or if needed an appeal form before April 1st.
DMA’s Eligibility Operations Memo 02-20 describing these changes is at the Advisory Notice DMA sent to recipients and the MassHealth Eligibility Update form are at http://www.state.ma.us/dma/publications/EOMs/EOM02-20.pdf.
The notice DMA sent to recipients and the MassHealth Eligibility Update form are at http://www.state.ma.us/dma/whatsnew/BasicAdvanceNotice-1202.pdf
The Disability Supplement is at http://www.state.ma.us/dma/whatsnew/MADS-A_08_98.pdf
Please contact Neil Cronin at Massachusetts Law Reform Institute at ncronin@mlri.org or 617-357-0700 x326 if there are any questions. Additional information is available in the Health Care section of www.masslegalservices.org.
- Pharmacy Co-Payment Increases. Effective January 1, 2003, pharmacy co-payments for many MassHealth recipients increased from 50˘ to $2.00 per prescription filled. A PHARMACY CANNOT REFUSE TO FILL A PRESCRIPTION FOR FAILURE TO PAY THE CO-PAYMENT. Recipients will owe the pharmacy for unpaid co-payments and pharmacies may use any legal means available to recoup the debt. Certain recipients, including children under 19 and pregnant women, are exempt from the co-payment. The DMA notice to members is at http://www.state.ma.us/dma/whatsnew/Copays-ES-1102.pdf and a Frequently Asked Questions sheet on the co-pays is at http://www.state.ma.us/dma/questions/faq_pharmacy.html
Optional Service Cuts. Effective January 1, 2003, coverage for certain optional services (chiropractic, prosthetics, vison care, including eyeglasses, and dentures) will be eliminated. Coverage for hearing aids was on the block but has been taken off the list and will not be cut. Coverage for physical therapy, occupational therapy and speech therapy will not be eliminated, as originally planned, but will instead be subject to additional prior approval requirements. A DMA notice regarding these changes is at http://www.state.ma.us/dma/whatsnew/memb-notice_OptionalServiceCutsEng-11-02.pdf, and an FAQ sheet is at http://www.state.ma.us/dma/questions/faq_cuts.html.
Q-2 Elimination. The Qualifying Individual-2 (Q-2) program, through which MassHealth paid the Medicare Part B premiums for Medicare beneficiaries earning between 135% and 175% of the federal poverty level, has been eliminated effective January 1, 2003. Payment of Medicare Part B premiums for certain low-income Medicare beneficiaries called Qualifying Individuals had been mandated by the federal Balanced Budget Act of 1997, but Congress did not extend the Q-2 coverage beyond December 31, 2002. The Division of Medical Assistance revised the regulations at 130 CMR 519.011 to reflect this change. To view DMA’s Eligibility Operations Memo 02-19 online, click here.
Please note that other MassHealth programs that assist low-income Medicare beneficiaries (Qualified Medicare Beneficiary, Special Low-Income Medicare Beneficairy, and Qualified Individual-1) remain in effect.
- Premium Increases. DMA has proposed regulations increasing premiums charged to various client groups, including families with children, people with disabilities covered by CommonHealth, and people with HIV, with incomes above 150% of poverty. DMA’s Notice of Proposed Amendment of Regulations is at http://www.state.ma.us/sec/spr/sprpub/011703g.pdf. The proposed regulations are in an attached file: http://www.masslegalservices.org/docs/484_draft_regs_with_changes_bolded.1-3-031.doc. Comments to DMA are due on January 27, 2003.
Dental Coverage Cuts. Dental coverage for adults was cut back dramatically effective March 15, 2002. As a result, MassHealth no longer covers diagnostic, preventive (e.g., cleaning), restorative (e.g., fillings), and endodontic (e.g. root canal) dental services for members aged 21 and older. The only exceptions are people who have "special circumstances" or who have received prior authorization for services. People may be considered to have special circumstances if they have a crucial medical need for dental care, for example, people with severe, chronic disabilities who are unable to maintain oral hygiene and those for whom oral disease may be life threatening. Prior authorization from DMA is required for services under the "special circumstances" exception. The bottom line is that for most adult MassHealth recipients, the only dental services covered are emergency care, tooth extractions, oral surgery, and dentures. Informational materials on the cuts and on the prior authorization process are available in the Health Care section of www.masslegalservices.org.
3. The Boston OHA Has Moved. The Boston Office of Hearings and Appeals is nowlocated on the 4th floor at One Bowdoin Square, on Cambridge Street, next to the Bowdoin stop on the MBTA Blue Line. Office hours are 8:00AM to 4:30PM. Contact information:
Telephone: (617) 523-3213
Fax: (617) 248-0978
E-mail: s3g-f1.boston.ho@ssa.gov
A map with the location of the new Boston OHA is included in this newsletter. For directions, go to: http://www.ssa.gov/oha/boston/boston.htm#directions
4. First Circuit Adopts Rule to Allow Citation to Unpublished Opinions. On December 16, 2003, the First Circuit Court of Appeals adopted proposed amendments to the local rules to allow parties to cite to unpublished opinions as "persuasive authority" in certain circumstances.
Local rule 32.3 provides, in part:
(b) Other circumstances. Citation of an unpublished opinion of this court is disfavored. Such an opinion may be cited only if (1) the party believes that the opinion persuasively addresses a material issue in the appeal; and (2) there is no published opinion from this court that adequately addresses the issue. The court will consider such opinions for their persuasive value but not as binding precedent.
The old rule, 36(b)(2)(F), only allows citation to unpublished opinions in related cases. To view the new local rules, go to http://www.ca1.uscourts.gov/ and click on the "What's New" link.
5. SSA Proposes Regulations Allowing Wage Garnishment. SSA has published proposed regulations to permit administrative wage garnishment (AWG) to recover past due debts, including Title II and Title XVI overpayments, owed to the federal government. See 67 Fed. Reg. 69164 (11/15/02). As described in the proposed regulations, AWG is a process whereby SSA orders the debtor's employer to withhold and pay to SSA up to 15% of the debtor's disposable pay every payday until the debt is repaid. ``Disposable pay'' is defined as:
the amount equal to your total compensation from an employer (including, among other things, wages or salary, bonuses, commissions and vacation pay) after deduction of health insurance premiums and amounts withheld as required by law other than amounts withheld under court order.
The proposed regulations set some limits on the circumstances under which AWG could be implemented. SSA proposes that AWG will apply only if all of the following conditions are met:
You are not receiving benefits under the program under which the overpayment occurred.
For an overpayment under title XVI, we are not collecting the debt by reducing your title II benefits.
We have completed our billing sequence (i.e., we have sent an overpayment notice, reminder notice and past-due notice) or we have terminated or suspended collection activity.
We have no installment payment arrangement with you, or you failed to make payment under such an arrangement for two consecutive months.
You have not requested that we waive collection of the overpayment, or you requested waiver but we determined that we would not waive collection.
You have not requested reconsideration of the initial overpayment determination, or you requested reconsideration but we affirmed the initial determination in whole or in part.
We cannot recover the overpayment by adjustment of benefits payable to someone other than you.
SSA would not use AWG to collect a debt from salary or wages paid by the United States Government or to collect a debt from a person who has been separated involuntarily from employment, until the debtor has been re-employed continuously for at least 12 months.
The proposed regulations include the following notice, due process, and hardship protections:
SSA proposes to send written notice to the beneficiary at least 60 days before taking AWG action (31 U.S.C. 3720D(b) only requires 30 days notice).
- The notice would include the following information:
* The debt is past due;
* The nature and amount of the debt;
* SSA intends to collect the debt by AWG;
* The amount that could be withheld from disposable pay (the payment schedule) under AWG;
* The debtor may inspect and copy our records about the debt;
* The debtor may ask SSA to review the debt (i.e., whether s/he owes the amount stated in the notice) or the payment schedule stated in the notice;
* The debtor may request an installment payment plan.
- The notice would also explain that at the expiration of 60 calendar days from the date of the notice, SSA would order the employer to begin withholding from the debtor’s disposable pay, unless within that 60-day period, the debtor pays the full amount of the debt, requests review of the debt or the payment schedule or requests to establish a written installment repayment plan. SSA would not take further action until it sends a written notice of its decision.
SSA would not send an AWG order to the employer before the expiration of 60 calendar days from the date of the notice.
If the debtor’s request for review is filed after the 60-day period, SSA will still perform the review, but would also send the AWG order to the employer. If there was good cause for failing to timely request review of the debt or the payment schedule, SSA would treat the request as if were received within the 60-day period and delay further action pending a decision.
- Upon request, SSA would review the amount of garnished wages and would reduce the amount of withholding in the case of financial hardship. A finding of financial hardship would require evidence showing that withholding a particular amount from disposable pay would deprive the debtor of income necessary to meet ordinary and necessary living expenses. The minimum amount of withholding is $10.00 per payday, however. The financial hardship provisions do not apply in cases of intentional false statement or willful concealment of or failure to furnish material information.
However, the proposed regulations also provide that SSA’s decision to implement AWG is not an initial determination subject to administrative review procedures, and is not subject to judicial review.
The AWG regulations would be contained in a new Subpart E of Part 422 of the regulations at 20 CFR. Click here to view the proposed regulation. DLC’s comments are in an attached file: http://www.masslegalservices.org/page/97035.
6. SSA Proposes Photo I.D. Pilot Projects. In a notice of proposed rulemaking dated 11/15/02 (67 Fed. Reg. 69161), SSA proposed a number of pilot projects involving photographic identification of claimants. The pilots would take place in a few states across the country, not including Massachusetts. SSA describes the proposed rule as follows:
We propose to conduct pilot projects wherein we will request photographic identification from individuals filing for title II and title XVI disability benefits in specified geographic areas covered by the pilot projects. In addition, we would require individuals to allow us to take their photograph and we would make these photographs a part of the claims folder. We would permit an exception to the photograph requirement when an individual has a sincere religious objection. This process would strengthen the integrity of the disability claims process by helping to ensure that the individual filing the application is the same individual examined by the consultative examination (CE) physician.
The proposed rule provides, in part:
While not part of the regulatory requirement, each individual would be asked to provide some form of photographic identification. This identification would be photocopied and the copy made a part of the SSA claims folder. SSA personnel would continue to follow regular identification procedures by asking the individuals questions based on information in the SSA database to ensure that the individuals are who they hold themselves out to be. SSA personnel would obtain additional identifying information if there is a doubt about the identity of the individual. If the individual does not have photographic identification available or does not wish to provide it to us, SSA personnel would not require it but will still follow regular identification procedures as before the pilots went into effect.
We propose to conduct the pilots in the following designated geographic areas: (1) All SSA field offices in the State of South Carolina. (2) The Augusta, Georgia SSA field office. (3) All SSA field offices in the State of Kansas. (4) Selected SSA field offices located in New York City. The pilots would be in effect for a six-month period of time and would begin upon the effective date of the final rules."
While this is only a proposed rule at this point, it is another indication SSA's increasing focus on perceived fraud and abuse. Click here to view the proposed regulation.
7. SSA Proposes Revisions to Multiple Body Systems Listings. 67 Fed. Reg. 78196(12/23/02). SSA has published proposed rules revising the listings for evaluating impairments that affect multiple body systems (listings 10.00 & 110.00). Under the proposed revisions, SSA would:
change the name of the listing from "Multiple Body Systems" to "Impairments that Affect Multiple Body Systems;
add a new introductory paragraph that describes Down syndrome, and explains that it exists in ``non-mosaic'' and ``mosaic'' forms and that claimants who have the non-mosaic form would be considered disabled from birth, while a claimant with the mosaic form would be evaluated on an individual basis because of the wide variation in how it manifests;
specify the documentation required to establish disability under this listing, and explain that, in lieu of a copy of the actual laboratory report, SSA will accept medical evidence that is persuasive that a positive diagnosis has been confirmed by prior appropriate laboratory testing;
give examples of the many other impairments that can affect multiple body systems, such as trisomy X syndrome, fragile X syndrome, phenylketonuria (PKU), caudal regression syndrome, and fetal alcohol syndrome, and explain that, because the body systems that these impairments can affect vary, and the effects on each body system can differ in severity and progression, SSA would evaluate these impairments under the listing criteria of the affected body system on an individual case basis;
eliminate current listing 110.07A which is now outdated and unnecessary because of other changes in the listings and regulations, including the implementation of the functional equivalence policy more than 10 years ago, that provide better rules for evaluating infants and toddlers; and
- eliminate listings 110.07B through F, which are solely reference listings that refer adjudicators to another listing for the affected body system.
Comments are due by February 21, 2003. Click here to view the proposed rule. To view the proposed rule and submit comments online, click here.
8. SSA Issues New Ruling on Interstitial Cystitis, SSR 02-2p. 67 Fed. Reg. 67436 (11/5/02). Insterstitial Cystitis (IC) is a bladder disorder characterized by urinary frequency, urinary urgency, and pelvic and bladder pain. Its causes are unknown and there is no known cure, only treatment for some of its symptoms. IC may be associated with other disorders such as fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, and lupus. About 90% of people with IC are women. There is no definitive test for IC; diagnosis is by exclusion of other conditions. SSR 02-2p states that in evaluating IC, SSA will generally rely on the judgment of physicians diagnosing IC based upon review of the medical history, physical examination of the patient, and any necessary testing.
Although IC is not a listed impairment, the new Ruling makes clear that it is a "medically determinable impairment" that can, when accompanied by appropriate signs, symptoms, and laboratory findings, be the basis for a finding of disability. In some cases, IC may be medically equivalent to a listed impairment, but medical equivalence to a listing is not required for a finding of disability. The Ruling describes the ways IC can limit a person’s residual functional capacity (RFC), which is at issue at Steps 4 and 5 of the sequential evaluation process. For example, urinary frequency may necessitate trips to the bathroom as often as every 10 to 15 minutes, day and night, which can lead to drowsiness, fatigue, lack of mental clarity, and social isolation.
By confirming that IC is a "real" physical impairment, not an emotional problem as it has sometimes been labeled, SSR 02-2p lends credibility to claimants seeking benefits on the basis of IC. Moreover, the analysis in SSR 02-2p may be useful to advocates in representing people with similarly difficult to prove conditions such as chronic fatigue syndrome and fibromyalgia.
SSR 02-2p was effective upon publication, on November 5, 2002. Click here to view the Ruling.
9. Congress Adjourns Before Action on H. 4070. The "Social Security Program Protection Act of 2002" also known as H. 4070, died in Congress at the end of the 2002 legislative session. Similar versions of the bill had passed the House and Senate during the summer of 2002, but Congress failed to pass the final amended version before recessing in November. Significant provisions of the bill included:
- extension to SSI of withholding of retroactive benefits to pay attorney fees;
- cap on the attorney user fee to the lower of 6.3% of attorney fees or $100;
extension to SSDI of the bar on benefits for "fugitive felons" and persons fleeing prosecution;
- numerous provisions pertaining to misuse of funds by representative payees; and
- clarification that benefit planning, assistance and outreach and protection and advocacy services pursuant to the Ticket to Work and Work Incentives Improvement Act of 1999 are available to certain beneficiaries who no longer receive cash benefits, including those in 1619(b) status, receiving only state supplements, and in an extended period of Medicare eligibility.
Further action on these provisions will require reintroduction and passage of the bills again. Back to the sausage factory.
10. Attorney Fee Assessment Rate Remains 6.3%. 68 Fed. Reg. 1647 (1/13/03). SSA has announced that the attorney fee assessment rate for 2003 is 6.3% of the amount certified for direct payment to attorneys from retroactive Title II benefits. This is the same assessment rate as in 2002. SSA will continue to review the assessment rate on a yearly basis. Click here to view the notice.
11. SSA to Test Expansion of Electronic Wage Reporting and Electronic Reporting by Representative Payees of Expenditures of Beneficiary Funds. 67 Fed. Reg. 78848 (12/26/02). SSA has announced that it is seeking Office of Management and Budget (OMB) approval to begin testing electronic wage reporting by SSI recipients and other types of internet-based services. Previously, internet-based services were offered primarily to Title II beneficiaries. The notice states:
Beginning in April 2003, we will offer the opportunity for certain beneficiaries receiving benefits under title XVI of the Social Security Act, known as Supplemental Security Income (SSI), to report their wages electronically. We will initiate a 6-month Proof of Concept project to test the beneficiary acceptance of this technology for reporting wages. Participation in this Proof of Concept is voluntary. Individuals who must report wages include SSI beneficiaries, and, in some cases, the parent or spouse of the SSI beneficiary. In order to use SSA's electronic services, SSA must authenticate the person using its PIN/password process to protect the information in its records from those not authorized to receive it. This technology is expected to be more secure, less burdensome, faster and provide better customer service than other available options. The respondents are individuals who elect to conduct business with the agency in an electronic medium. . . . .
SSA is developing an Internet Representative Payee Report form (I623) to electronically report on the use of benefit payments made on behalf of Social Security beneficiaries and SSI recipients. As part of this process, SSA will conduct a proof of concept (POC) test that will be limited to 40 organizational representative payees. During the projected 6-month POC test, participating organizations will use the I623 to complete and file the representative payee report instead of using the paper SSA-623.. . . .
SSA will use the information collected through the I623 to determine whether the payments provided to the representative payee have been used for the beneficiary's current maintenance and personal needs and whether the representative payee continues to be concerned with the beneficiary's welfare.
SSA has asked OMB to approve the request by January 26, 2003, so comments should be submitted by that date. Click here to view the notice.
12. New, Improved, Shorter Food Stamp Application. For MOST food stamp households, the new application is only FOUR pages long. Households with kids under 19 or pregnant women, OR who are comprised solely of SSI/EAEDC recipients DO NOT have to fill in the fifth page on assets. Households that involve childless individuals who are not on SSI or EAEDC do have to provide this additional information.
DTA has also agreed that FS applicants can FAX in documents. Applicants do NOT need to handcarry them to DTA or mail in their originals. This policy is confirmed in the Field Operations memo DTA is about to release. In addition, many households are eligible for a waiver of the face-to-face interview and can conduct business by phone or mail instead. See Field Operations memo 2002-16.
The application is available on the Project Bread website: http://www.gettingfoodstamps.org.
DTA has agreed they will revise the application in January or February when they make changes due to federal rules on the standard utility allowance. If you have comments or suggested language changes, please contact Pat Baker at the Massachusetts Law Reform Institute. 617/357-0700 x 328; email: pbaker@mlri.org
13. MLRI’s 2003 Basic Benefits Training Series. The Massachusetts Law Reform Institute will present its 8-session Basic Benefits Training series over 6 days between January and April, 2003. Geared for less experienced legal services and social services providers, the series covers the basics of TAFDC, Food Stamps, SSI/SSDI, Emergency Assistance shelter, health care programs for elders as well as people under 65, Unemployment Insurance, and immigrants and public benefits. A schedule and descriptions of the sessions are included in this newsletter. The SSI/SSDI session will be on Monday February 24th from 1:15 to 4:00 PM. All sessions will be held at the Massachusetts Continuing Legal Education center in downtown Boston. Although the registration deadline was January 8th, registrations submitted after the deadline will be accepted as space permits. Series information and registration materials are in an attached file: http://www.masslegalservices.org/docs/bbt2003.pdf.
14. Updated Obesity Ruling. SSR 02-1p. This Social Security Ruling supercedes SSR 00-3p, which provided guidance on the evaluation of obesity in disability claims following the deletion of listing 9.09. The new ruling makes no substantive changes in SSR 00-3p’s guidance on the evaluation of obesity. SSA states that the new ruling was published because several of the rules that we apply under the SSR have been revised, including the adult mental disorders listing, the musculoskeletal listings for adults and children, and the regulations that we use to evaluate disability in children in the SSI program. The new ruling, just as the old, provides that obesity is a medically determinable impairment, may constitute a "severe" impairment, and may medically equal a listing. In addition, the presence of obesity may support the finding that a condition meets a listing, may increase the severity of some impairments and functional limitations and may result in a variety of exertional and nonexertional functional limitations. Click here to view the Ruling.
15. Appeals Council Policy Change - Response Time. At the September 2002 coalition meeting, it was noted by some that the Appeals Council seemed to be granting fewer days in which to respond after receiving the requested tapes and exhibits. Well, you were right. There has been a policy change.
As reported in the August 2002 NOSSCR mailing, Andrew Wakshul, Executive Director OHA Office of Appellate Operations, confirms that, effective 7/24/02, the Appeals Council is granting 25 days from the date on the cover letter that accompanies the tape and/or exhibits. This is a reduction from the prior practice of granting 40 days. Cases will be diaried for assignment to Appeals Council staff 30 days after the date on the cover letter.
If you want to request additional time, be sure to do so well within the allowed response period. You may find the Appeals Council stingier with additional time requests that it once was. However, delay in receiving the tapes/exhibits should be grounds for an extension. The Appeals Council mail sometimes gets mailed after the date on the cover letter. Be sure to hang onto the date stamped envelope that arrived in your office and check early to see whether you will have sufficient to provide your response.
Implementation. The first phase of the Ticket to Work rollout, which included Massachusetts, has been completed, and the second phase of the rollout got underway in November, 2002. The third and final phase of the rollout is expected to be completed by the end of 2003. To see a list of the states included in each phase of the rollout, go to http://www.ssa.gov/pressoffice/tickettowork.htm.
According to SSA, 198,618 Tickets were sent out to Massachusetts residents between February and July of this year. Of those who received Tickets, as of January 16, 2003, 429 were using them, primarily at the state vocational rehabilitation agency (the Massachusetts Rehabilitation Commission). So far, very few Tickets in Massachusetts have been assigned to Employment Networks. SSA’s Ticket Tracker is at: http://www.ssa.gov/work/Ticket/ticket_info.html#TicketTracker
Along with their Ticket, recipients receive a notice from SSA with information about the Ticket program and the #800 number for MAXIMUS, the Virginia-based company hired by SSA as the Ticket program manager. It is up to Ticket recipients to take the next step and contact MAXIMUS about using their Ticket. Upon request, MAXIMUS will send Ticket holders contact information for Benefit Counselors, Employment Networks and state VR agencies, and Protection and Advocacy services provided by DLC (see below). Additional information about the Ticket program and services offered by specific Employment Networks is available at MAXIMUS’s website http://www.yourtickettowork.com/.
Benefits Counselors Available. In addition to creating the Ticket to Work program, TWWIIA provided for Benefits Planning, Assistance and Outreach (BPAO) services for all SSI and SSDI recipients. Social Security has contracted with two organizations - Massachusetts Rehabilitation Commission and Massachusetts Project with Industry, Inc./ Resource Partnership - to provide these services. Comprehensive benefits counseling is available to all SSI/DI recipients, not just Ticket users, who wish to explore the possibility of returning to, or beginning, work. The BPAO counselors are available to meet with recipients and discuss the effect of earned income on the recipient’s entire benefits package, including SSI/DI, healthcare, food stamps, TANF and housing benefits.
Contact information is as follows:
Project IMPACT (http://www.state.ma.us/mrc/ses/impact.htm)
617-204-3854; 1-800-734-7475; TTY: 617-204-3600
Serving Barnstable, Bristol, Dukes, Essex, Nantucket, Norfolk, Plymouth, and Suffolk Counties, and the City of Somerville.
BenePlan (http://www.resourcepartnership.org/services/specialists.html)
508-647-1722; 1-877-937-9675; TTY:508-652-7284
Serving Berkshire, Franklin, Hampshire, Hampden, Worcester, and Middlesex Counties (excluding Somerville).
Protection and Advocacy for Beneficiaries of Social Security (PABSS). The Disability Law Center has received a grant from SSA, pursuant to TWWIIA, to provide advocacy services to Ticket users and other SSI/DI recipients interested in returning to work. PABSS services include legal advocacy and representation to overcome barriers to obtaining and retaining employment, training and technical assistance, and information and referral. Examples of legal advocacy include representation in cases to ensure access to needed medical care, support services and assistive technology, advocacy in cases involving the Americans With Disabilities Act and reasonable accommodation issues, and resolving disputes with Employment Networks and Vocational Rehabilitation Services. At this time, PABSS services do not extend to representation in overpayment cases or any other action or proceeding against SSA (although DLC may do this type of advocacy under other grants). For more information about PABSS services, contact Ray Cebula (617-723-8455 x132), Linda Landry (617-723-8455 x154), or Barbara Siegel (617-723-8455 x129) at DLC. Also, please let us know what you’re hearing from people about the Ticket program, including feedback about SSA field office staff, MAXIMUS, the Employment Networks, the state VR agencies, and the Benefit Counselors.
For More Information About the Ticket to Work and Other SSI/DI Work Incentives:
http://www.ssa.gov/work (SSA’s work website)
http://www.yourtickettowork.com/ (MAXIMUS website)
1. Proposed Rule: Collection of Overdue Program and Administrative Debts Using Administrative Wage Garnishment. 67 Fed. Reg. 69164 (11/15/02). See Brief Note 5.
2. Notice of Proposed Rulemaking: Claimant Identification Pilot Projects. 67 Fed. Reg.69161 (11/15/02). See Brief Note 6.
3. Proposed Rule: Revised Medical Criteria for Evaluating Impairments That Affect Multiple Body System. 67 Fed. Reg. 78196 (12/23/02). See Brief Note 7.
4. Notice of Social Security Ruling: Social Security Ruling, SSR 02-2p; Titles II and XVI: Evaluation of Interstitial Cystitis. 67 Fed. Reg. 67436 (11/5/02). See Brief Note 8.
5. Notice: Rate for Attorney Fee Assessment Beginning in 2003. 68 Fed. Reg. 1647 (1/13/03). See Brief Note 10.
6. Agency Information Collection Activities: Emergency Request and Comment Request. 67 Fed. Reg. 78848 (12/26/02). SSA has announced that it will begin testing electronic wage reporting and representative payee reporting in April 2003. See Brief Note 11.
All POMS are available online at http://policy.ssa.gov/poms.nsf/. Click on "search" and type or paste in the cite of the section you want to view.
1. SI 02302.200 (11/14/02). Charted 1619(b) Threshold Amounts. The 1619(b) threshold in Massachusetts in 2003 is $28,766 per year.
2. RM 00203.510 (12/20/02). Alien Without Work Authorization. Nonwork Need for an SSN. The only valid nonwork reasons are (a) if a federal statute or regulation requires the alien to provide his/her SSN to receive a particular benefit or service, and (b) if a state or local law requires the alien legally in the U.S. to provide his/her SSN to get general assistance benefits to which the alien has established entitlement or a state driver’s license for which all other requirements have been met.
3. SI 02302.015 (12/20/02). Section 1619 Related Policies. Discusses relationship between 1619 and other work incentives such as Impairment Related Work Expenses and Plans to Achieve Self-Support. Note that Retrospective Monthly Accounting applies to 1619(a) benefit computations but not to 1619(a) eligibility and 1619(b) threshold determinations.
4. DI 31001.005 (11/15/02). Who is a Representative? Only named individuals may be representatives. A legal services organization, as a whole, cannot be a representative, but a claimant may authorize that his/her records be sent to a legal services organization as an entity.
Federal Circuit Court of Appeals
1. Application of Grid. RFC Between Exertional Levels. ALJ’s Step 4 Errors Don’t Bar Affirmance. Stevens v. Barnhart, No. 02-1474, 2002 WL 31474176 (1st Cir. 11/5/02) (unpublished). The ALJ found the Plaintiff, a 55-year old man with a combination of physical and mental impairments, able to return to his past relevant work in the light-medium range and therefore not disabled. A vocational expert testified at the hearing. On appeal, the Plaintiff argued that the ALJ erred both in defining his past relevant work and in finding that he had the residual functional capacity to return to it. The court agreed. That was not the end of the story, however. After ruling that the ALJ’s Step 4 decision was not supported by substantial evidence, the court asked the question "whether, if the ALJ had proceeded to the fifth and final step of the sequential evaluation, a finding of not disabled would have been compelled in any event." The Plaintiff argued that at Step 5, the ALJ would have been required to apply the Medical- Vocational Guidelines (the Grid), and that the appropriate Grid rule, based on an RFC for "light" work, would have directed a finding of "disabled." Rejecting this argument, the court found that there was substantial evidence to support the ALJ’s finding that the Plaintiff was capable of some medium work, and that therefore his RFC fell between the light and medium ranges and the Grids were inconclusive. The court went on to conclude that the VE’s testimony was sufficient to support a finding that the Plaintiff was able to perform other work in the economy. Denial of benefits affirmed. Decision is in attached file: http://www.masslegalservices.org/docs/3562_Stevens.pdf.
2. Mental Impairments. Conflicting Evidence. Martin v. Comm’r SSA, No. 02-1187, 2002 WL 31338845 (1st Cir. 10/18/02) (unpublished). Court affirmed denial of benefits where there was conflicting evidence regarding the effect of Plaintiff’s mental impairments on his ability to perform work-related activities. Conflicts of evidence are for the Commissioner (i.e., the ALJ), not the courts, to resolve. Decision is in attached file: http://www.masslegalservices.org/docs/6342_martin.pdf.
3. Continuing Disability Review. Second Circuit Remands Where Medical Evidence from Comparison Point Decision Not Included in Record. Veino v. Barnhart, No. 01-6202, 2002 WL 31750172 (2nd Cir. 12/10/02). In a continuing disability review (CDR) occasioned by the 1996 legislation barring SSI/SSDI benefits solely on the basis of substance abuse, the ALJ found that the Plaintiff was no longer disabled within the meaning of the Social Security Act. The Plaintiff, a Vietnam veteran, had been on SSDI since 1973 on the basis of post traumatic stress disorder, anxiety disorder, and substance abuse. In 1982, SSA conducted a CDR and found that the Plaintiff’s disability continued. In a CDR, SSA compares the Plaintiff’s current condition with his/her condition at the time of the most recent favorable disability determination, called the comparison point decision (CPD). The CPD in this case was the 1982 CDR. Although the medical records used in the 1982 CDR was apparently available at the time of the 1997 review (the Disability Hearing Officer who heard the Plaintiff’s initial appeal referred to and summarized them in her decision), the ALJ neither included the 1982 evidence in the record nor cited it in her decision. Without the evidence from the CPD, the court held, it could not determine whether substantial evidence supported the ALJ’s decision that the Plaintiff had medically improved. The court further held that the Disability Hearing Officer’s summary of the 1982 evidence was not sufficient to replace the evidence itself. Vacated and Remanded for supplementation of the record. The decision contains a good summary of the medical improvement standard used in CDRs. Decisions is in attached file: http://www.masslegalservices.org/docs/3272_veino.pdf.
Federal District Court
1. ALJ’s Flawed Assessment of Pain and Non-Exertional Limitations Leads to Remand. Torres v. Barnhart, No. 02-30051-MAP (D. Mass. 12/10/02). Federal District Court in Massachusetts vacated denial of benefits and remanded case where it found that the ALJ’s analysis ignored the record evidence of Plaintiff’s cognitive impairments, understated her physical limitations, improperly assessed her subjective complaints of pain using the Avery factors, and inadequately assessed her nonexertional limitations. ALJ’s single hypothetical question to the vocational expert, consequently, failed to accurately reflect Plaintiff’s limitations. Decision at: http://www.masslegalservices.org/docs/8770_torres.pdf
2. Minnesota Federal District Court Adopts Broadened Immigrant SSI Eligibility Yang v. Barnhart, No. 01-2307 RHK/SRN (Minn.D.Ct. 9/26/02). Using a broad analysis, the court adopted a Magistrate Judge’s Report and Recommendation holding that a lawful permanent resident was "lawfully residing" in the U.S. on 8/22/96, because she had an adjustment application pending based on a petition from her U.S. citizen son. The order was entered after SSA changed its position and consented to adopt the report.
In this case, the Plaintiff had entered the U.S. in 1987 on a vistor’s visa. In June, 1995, her adult son, a U.S. citizen, filed a Petition for Alien Relative on her behalf. On April 11, 1996, the INS informed Plaintiff’s family that the petition had been approved and that Plaintiff could file a change of status request. Plaintiff filed an Application ro Register Permanent Residence on April 28, 1996. Plaintiff was granted lawful permanent resident status on August 28, 1996. Plaintiff applied on February 28, 1998, which was denied on the grounds that she did not meet the definition of "lawful presence" on 8/22/96. The case does not provide Plaintiff’s age or whether she had worked enough to earn 40 QCs in the Social Security Insurance system. It appears, however, that only SSI alien status eligibility avenue open to Plaintiff is the one based on having been "lawfully present" in the U.S. on 8/22/96, meeting the definition of "qualified alien", and meeting the disability standard.
The Balanced Budget Act of 1997 (BBA), which expanded the restrictive 1996 Welfare Act SSI alien status eligibility criteria to establish the alien status eligibility criterion relied on by Plaintiff, did not define "lawful presence." When SSA implemented the provision, it adopted the definition of "lawful presence" in the regulations of the Department of Justice at 8 C.F.R. § 103.12. These regulations were developed for the "lawful presence" requirement for Title II benefit applications filed on or after December 1996, which was added by the 1996 Welfare Act.
The overall definition of "lawful presence" in the DOJ regulations is as follows:
an alien who has been inspected and admitted to the U.S. and who has not violated the terms of the status under which he or she was admitted or to which he or she has changed after admission
8 C.F.R. § 103.12(a)(2). The regulations also describe several specific statuses meeting the definition of "lawful presence." SSA has not promulgated regulations to implemented the 1996 Welfare Act and BBA alien status eligibility criteria, but has published a detailed set of POMS instructions. The lawful presence criteria for SSI are found at SI 00502.142 B.2.
Lawful permanent residence status also meets the definition of "lawful presence" in the DOJ regulations, but Plaintiff was not granted this status until 8/28/96 - 6 days too late. The specific status described in the DOJ "lawful presence" regulation that is closest to Plaintiff’s status on 8/22/96 seems to be the following:
(4) An alien who belongs to one of the following classes of aliens permitted to remain in the U.S. because the Attorney General has decided for humanitarian or other public policy reasons not to initiate deportation or exclusion proceedings or enforce departure: ..... (vii) Aliens who are the spouse or child of a U.S. citizen whose visa petition has been approved and who have a pending application for adjustment of status.
8 C.F.R. § 103.12(a)(4)(vii). See also POMS SI 00502.142 B.2. b. Plaintiff apparently did not meet this definition of "lawful presence" because she is not the spouse of the child of a U.S. citizen, and it was her adult U.S. citizen son who filed the relative petition on her behalf. The ALJ found she did not meet any of the definitions of "lawful presence" in the POMS.
The court, did not dwell much on the details, going for the big picture instead and using a Chevron analysis. The court states that the Balanced Budget Act did not define the term "lawful presence", permitting use of the plain meaning of the term. The court distinguished the DOJ regulations on the grounds that they explicitly apply to Title II of the Social Security Act and that the Title II "lawful presence" requirement is not limited to aliens already in the U.S. on 8/22/96.
Accordingly, the court found that it was not required to defer to Social Security’s interpretation of "lawful presence." The court finds that Plaintiff’s circumstances on 8/22/96 meet the ordinary definition of "lawfully" residing as found in Webster’s dictionary: constituted, authorized or established by law. Specifically, the court states that the INS authorized Plaintiff’s residence in the U.S. by its approval of the Petition for Alien Relative and its invitation to Plaintiff to file a change of status request for lawful permanent residence. Decision is available at DLC.
3. Severity. Multiple Sclerosis. Episodic Impairments. Nelson v. Barnhart, No. 02-90-B, 2002 WL 31599018 (D. Me. 11/20/02). Federal District Court in Maine remanded case where ALJ improperly denied claim at Step 2 of the sequential evaluation process on the ground that the Plaintiff’s impairments were not severe at the alleged onset date of June 1, 1998. The Plaintiff had been diagnosed with MS in 1965, at the age of 23. In 1998, he experienced a series of exacerbations and remissions in response to treatment. By June, 1999, his condition grew worse and he no longer responded to treatment. In deciding that the Plaintiff did not have a severe impairment on the alleged onset date, the ALJ found that, although the Plaintiff’s allegations of symptoms were credible, the symptoms were not consistently debilitating prior to June 1, 1999. The ALJ’s analysis, the court held, improperly collapsed Step 2 and Step 5. At Step 2, a de minimis test is applied, designed only to screen out groundless claims. A denial on severity grounds is only warranted when the medical evidence establishes only a slight abnormality that has no more than a minimal effect on an individual’s ability to work. In this case, the court held, the fact that the Plaintiff was able to achieve periods of remission as a result of treatment did not preclude a finding that his condition was "severe" for purposes of Step 2.
In an interesting footnote, the court mentions that, at oral argument, SSA’s counsel raised a duration argument based on Walton v. Barnhart, 122 S.Ct. 1265 (2002). Counsel for SSA argued that since the Plaintiff’s impairment was found not to have been "severe" for "twelve straight months," the ALJ need not have reached the question of whether it was disabling for twelve months. The court didn’t buy it. As the court pointed out, Walton did not hold that a condition must be "severe" day in and day out for twelve straight months. The court further stated that nothing in Walton suggested that the Plaintiff could not meet the 12-month duration requirement (i.e., inability to engage in substantial gainful activity for at least twelve months) simply because his condition tended to wax and wane. Decision in attached file: http://www.masslegalservices.org/docs/6701_nelson.pdf.
1. Appeals Council Remand. ALJ’s Credibility Finding Not Supported by Substantial Evidence. ALJ found claimant with back pain and mental impairments not entirely credible and ultimately not disabled. In vacating the ALJ’s decision on substantial evidence grounds and remanding the case, the Appeals Council found that the hearing decision failed to consider the following factors in evaluating the intensity, persistence, and limiting effects of the claimant’s alleged symptoms: medical opinions; daily activities; the location, duration, frequency, and intensity of pain or other symptoms; precipitating and aggravating factors; and the type, dosage, effectiveness and side effects of medication . The Appeals Council’s remand order specifically notes the ALJ’s failure to adequately evaluate the opinions of the claimant’s treating sources. Congratulations to Tara Doucette, GBLS. Decision at http://www.masslegalservices.org/docs/4611_1-03nlacdec.pdf.
2. ALJ Work-Related Overpayment Waiver Decision. Claimant, who has mental retardation, received Title II Disabled Adult Child (DAC) benefits on the earnings record of his deceased father. His mother was his representative payee. In 1992, the claimant began working in a supermarket collecting carts. By September, 1995, he had completed his 9-month trial work period and 36-month extended period of eligibility (EPE) and was continuing to earn above the substantial gainful activity (SGA) level, then $500 per month. Under the regulations, earning above SGA after the end of the EPE is supposed to trigger the termination of Title II disability benefits. The claimant’s mother never reported his income to SSA, however, and he continued to receive DAC benefits. An overpayment of $10,463 accrued between 1995 and 1998. Claimant’s mother filed a request for waiver of the overpayment, but she did not appeal the existence or amount of the overpayment.
The ALJ granted the waiver. In finding that the claimant was without fault in causing the overpayment, the ALJ noted that the claimant’s mother was a single mother caring for two adult disabled children. Although he expressed some skepticism about the claimant’s mother’s testimony (she said that she believed her son was entitled to the DAC benefits regardless of his work because his condition was unchanging and the benefits were based on his father’s earnings), the ALJ gave her the benefit of the doubt. The decision cautioned, however, that the mother’s claim not to know her reporting obligations would not work in the future.
With regard to the second part of the waiver analysis, the ALJ found that repayment of the overpayment would create a financial hardship for the claimant and his mother. The ALJ found that they had no excess funds from which to make payments, and noted that the mother had used the overpaid benefits to care for herself and her children, keep current with her household bills, and maintain a home for her disabled children. Finally, without citing any additional factors, the ALJ found that recovery of the overpayment would be inequitable and against good conscience. The waiver was prospective only - the ALJ did not disturb any prior recoupment of the overpayment from the claimant’s tax refunds.
One other noteworthy aspect of the decision is that the ALJ’s decision discussed the validity of the overpayment itself, even though the only issue at the hearing was the waiver. The "appeal" issue in this case was whether or not the claimant’s work at the supermarket was subsidized and therefore not SGA at all. There were conflicting reports from the claimant’s employer regarding the amount of extra supervision required by the claimant and the ALJ concluded that the work was not, in fact, subsidized and went on to the waiver analysis.
This type of conflation of waiver and appeal issues is not unusual and is something for advocates to look out for. On the one hand, in waiver cases, it can work to a claimant’s advantage when there are legitimate grounds for attacking the overpayment and an appeal was never filed. On the other hand, there can be negative consequences when an ALJ waives an overpayment that was appealed and should have been lowered or eliminated altogether. For example, if a claimant has an overpayment in the future and requests a waiver, s/he is in a better position to have the waiver granted if there were not previous waivers granted.
Congratulations to Attorney Miriam Johnson-Hoyte. Decision at: http://www.masslegalservices.org/docs/2330_1-03nlaljdec.pdf.
** Note to all advocates: Please send your ALJ and Appeals Council decisions to DLC so we can share them. All reported decisions are available at DLC.
1. www.masslegalservices.org. The new, revamped statewide legal services website is now up and available for your use. This website is a collaborative effort of all the MLAC-funded legal services programs, including the Disability Benefits Project of the Disability Law Center, which manages the Disability section of the website. Our goal is to use the website to keep advocates informed of new developments in SSI/SSDI law and practice, share practice materials and resources that are at the heart of disability benefits practice, and help make internet-based legal research accessible and even fun for advocates.
In November, 2002, we posted the first electronic version of the SSI Coalition newsletter on www.masslegalservices.org. Look for the January, 2003 newsletter online soon. We plan to post old editions of the newsletter over time. The electronic newsletters have links to many documents and resources that are mentioned but not included in the paper versions. In addition, because it is on the website, it is keyword searchable. If you are currently receiving the newsletter by mail and would like to switch to the electronic version, please contact Barbara Siegel at 617-723-8455 x129 or . Save trees, space, and money - GO ELECTRONIC!
In order to have access to the advocate-only material on the website, you need to sign up and log in. To do this, go to You don’t need to be in legal services to benefit from the website, however. Many of the materials posted in the Disability and other sections are available to public.
This website is a work in progress. Over time, we will continue to add and update resources. Your feedback is essential to keeping this website vital and useful. Please let us know what you would like to see, if you see anything that needs to be changed, or if you have any problems using the website. If you have resources you want to share with other advocates, let us know. Please direct your comments and questions to Barbara Siegel at bsiegel@dlc-ma.org.
2. Online Services at www.ssa.gov. Over the past year, SSA has expanded the ways in which applicants, beneficiaries, and employers can transact business with SSA via its website. SSA’s internet-based activities include:
- Applying for SSDI and Social Security Retirement Benefits. SSA is taking applications for Title II disability benefits on the internet. Filing online gives the applicant a protective filing date, but does not eliminate the requirement of a paper or "hard copy" application. After the applicant completes the application online, s/he must print it out, sign it, and mail or take it to SSA within six months of electronic submission. The Disability Report (SSA-3368) that must accompany the application cannot be filled out online. Applicants can either download it from SSA’s website, fill it out and send it in, or call SSA to arrange an appointment to complete the form with an SSA claims representative (SSA’s website has a guide to filling out the Disability Report). Similarly, online applicants will need to either mail or take certain documents (e.g., proof of birth, citizenship, and earnings) to SSA. The application instructions on the website are quite thorough and detailed, but may be overwhelming to some applicants. The SSDI application is available at . No plans for on-line SSI applications have been announced.
Requesting Earnings Reports and Benefit Estimates.
- Requesting Letters Confirming Social Security Benefit Information.
Replacing Lost or Damaged Medicare Cards.
- Submitting W-2 Wage Reports (employers).
Coming soon: SSA is planning to test electronic wage reporting by SSI recipients, deemors, and spouses, and reporting by representative payees. See Brief Note 11. To find out about SSA’s online services, well, online, go to http://ssa.gov/onlineservices/index.html.
3. Legal, Policy, and Practice Resources on SSA’s Website, www.ssa.gov. Here are just a few of the resources available, FREE OF CHARGE, on Social Security’s Website:
- HALLEX Online.
The entire Hearings, Appeals and Litigation Law Manual (HALLEX) is now available on SSA’s website and on the website of the SocialSecurity Advisory Service (SSAS). A direct links is available at http://www.ssa.gov/OP_Home/hallex/hallex.html. The HALLEX contains guiding principles and information on procedure and practice for SSA’s Office of Hearings and Appeals. It can be an extremely valuable source of information for advocates representing claimants at the OHA and beyond.
- POMS Online. SSA has made the POMS availlable on its website at http://policy.ssa.gov/poms.nsf/poms?OpenView. The good news is that SSA’s online POMS are searchable, browsable, and free. Users can search the POMS using key words, browse the POMS section by section, or find a specific section by entering the cite as a key word. Nifty features of the online POMS include the ability to click on links to referenced cites within documents, and links to recently issued POMS (released within 7, 15 and 30 days). A notice on the website states that the public version of POMS is identical to the version used by Social Security employees except that it does not include internal data entry and sensitive content instructions. It also does not include Emergency Transmittals, Program Circulars, or the Transmittal Sheets that list changes to specific POMS sections.
- Social Security Act, Regulations, and Rulings. Including proposed regulations and regulations issued since the most recent hard copy version of the CFR. The link is at http://www.ssa.gov/regulations/index.htm#. Links to many of the research sources on SSA’s website are available at www.masslegalservices.org in the Disability section.
- Representing Clients Site. SSA has added a special site for advocates to its website. The "Representing Clients" site is at www.ssa.gov/representation. It has lots of fee-related materials including fee petitions, fee agreements, fee agreement procedures, a model fee agreement, and a downloadable Petition to Obtain Approval of Fees (SSA-1560-U4).
- Office of Employment Support Programs (work incentive and Ticket to Work information): www.ssa.gov/work.
- Multi-Language, Immigration, and Other Gateway Sites on SSA’s Website. The Multi-Language Gateway has links to SSA general information in 14 languages and to an interpreter services page which states, in 15 languages: "If you need an interpreter to conduct Social Security business, we will supply one on request, free of charge." See also POMS GN 00203.011 for SSA’s interpreter policy. The Immigration site has information about interpreters, basic benefits, field offices, obtaining Social Security numbers, immigration status requirements for employment,, as well as links to other agencies. Much of the information on SSA’s website is available in Spanish via the En EspaÁol Gateway. SSA now also has Gateway sites for Women, Asian Americans and Pacific Islanders, and American Indians and Alaska Natives. All of these sites can be accessed by clicking on links under the heading "Special Gateway Pages" on SSA’s home page.
4. A New Government Website to Screen for Benefit Eligibility: www.GovBenefits.gov. The U.S. Department Labor has created a website that members of the public can use to help them determine if they might be eligible for various government benefit programs. The process is relatively simple and user-friendly (for people who have computers and internet access, that is). Visitors to the website provide some basic, non-identifying demographic information, then answer 64 yes/no questions about their financial, household, disability, family, and other circumstances. With the press of a button, a list of benefits for which they might be eligible appears. In addition to providing a brief description of each program, the list includes contact information and internet links for people who want additional program or application information. The website screens for scores of benefit programs from dozens of agencies, including educational loans, food stamps, and all of the major SSA benefits. Since many programs have complicated and/or state specific eligibility criteria, there are limits to the website’s utility, but it can be a good starting point.
5. New Federal Website for Disability Related Government Resources. The new website is http://www.disabilityinfo.gov/ It is intended to be an online resources for people with disabilities, linking employers to people with disabilities seeking jobs.
6. Website for Ford v. Apfel Implementation: http://www.wnylc.net/ford/ford.html. SSI financial eligibility notices were found unconstitutional in the nationwide class, Ford v. Apfel, 87 F.Supp. 2d 187 (E.D.N.Y.1999). SSA is in the process of implementing the decision on kind of a 5 year plan. Among the notice defects was the lack of budget calculations. Starting 7/29/02, notices involving no income or "simple" unearned income (e.g., Social Security benefits, Veterans benefits, Workers Compensation, child support) have been revised to include budget worksheets. See POMS SI 02005.000. Remember that advocates can use the modified Reconsideration Request and Good Cause Statement on the Ford website.
7. Court Websites. Court websites post court rules, dockets, opinions, forms, fee schedules, directions, and lots of other useful information.
U.S. Supreme Court: http://www.supremecourtus.gov/
1st Circuit Court of Appeals: http://www.ca1.uscourts.gov/
Federal District Court, District of Massachusetts: http://www.mad.uscourts.gov/
Federal District Court, District of Maine: http://www.med.uscourts.gov/
Federal District Court, District of New Hampshire: http://www.nhd.uscourts.gov/
Federal District Court, District of Rhode Island: http://www.rid.uscourts.gov/
Federal District Court, District of Puerto Rico: http://www.prd.uscourts.gov/
Federal Judiciary (links to all federal courts): http://www.uscourts.gov/
Massachusetts State Courts: http://www.state.ma.us/courts/
8. Social Security Advisory Service: www.ssas.com. The Social Security Advisory Service is a private organization, not related to SSA, for Social Security advocates. It publishes a quarterly newsletter available by subscription only, but has lots of useful information and links on its website. A link to the complete HALLEX was recently added to the website (click on the "Hot Links" button, and select HALLEX). The Public Files page has classic advocacy materials such as the 8/30/96 Emergency Message (EM) on Drug Abuse and Alcoholism, and the list of the 137 Sedentary Unskilled Occupations in the D.O.T. SSAS Connect is a public posting board for discussion of Social Security related issues. Connect discussions are archived by date and can be browsed, although there is no search function.
9. Medical Websites
- Merck Manual online: http://www.merck.com/pubs/mmanual
- medical periodicals: http://www.mosby.com/
- National Library of Medicine Journals: http://www.ncbi.nlm.nih.gov/pubmed/
pain management materials: http://www.painnet.com/
Centers for Disease Control: http://www.cdc.gov/
http://www.hepatitis-central.com (hepatitis information)
http://www.nichq.org (National Initiative for Children’s Healthcare Quality - information on child health including asthma, ADHD, cystic fibrosis and more)
The Greater Upstate Law Project has collected an excellent list of medical websites, many with links, at its website http://www.gulpny.org/.
10. Need information about a doctor?
- For information on Massachusetts doctors, go to http://www.massmedboard.org/ (MA Board of Registration in Medicine) and click on "Physician Profiles."
http://www.abms.org (Americal Board of Medial Specialties)
http://www.ama-assn.org (American Medical Association)
http://www.fsmb.org (Federation of State Medical Boards)
http://www.fsmb.org (American Osteopathic Association)
http://www.ada.org (American Dental Association)
11. MassHealth Defense Group: http://64.82.65.67/medicaid/news.html. Affiliated with the Massachusetts Law Reform Institute and Health Care for All. Information about changes and proposed changes to the MassHealth programs.
12. THOMAS, for tracking federal legislation: http://thomas.loc.gov.
13. Government Printing Office, access to CFR and Federal Register: http://www.access.gpo.gov/su_docs/index.html
14. For general reference: http://www.refdesk.com/.
% Many thanks to advocates for sharing their Web finds with us.
http://www.masslegalservices.org/docs/3090_hinton_save_the_date.pdf