Disability Benefits Project
SSI Coalition e-Newsletter
August, 2007
Welcome to the First SSI Coalition e-Newsletter
This is the first official
all-electronic edition of the SSI Coalition newsletter, published by the
Disability Benefits Project (DBP) support unit at the Disability Law Center (Linda
Landry, Barbara Siegel, and Svetlana Uimenkova). We have moved to an
electronic format for many reasons, not least of which is the greater
accessibility for people with disabilities.
As with all new endeavors, this is a work in progress. Please let us know what you like and what you
think can be improved. We will be
discussing the e-newsletter, and the way we deliver SSI/DI information
generally, at the next SSI Coalition meeting on
September 14th at Greater Boston Legal Services.
Next SSI Advocates Coalition Meeting
September 14, 2007 at GBLS
Brief Notes
Disability
Service Improvement (DSI): The Changes Have Begun
SSA Exploring Compassionate Allowances
New Ruling Clarifies Visual Field Test for Blindness
SSA
Extends Expiration Dates for Body Systems Listings
SSA
Renews Computer Matching Program with DHS
Statistics
on SSI Childhood Cases
House
Bill Would Extend SSI for Elderly and Disabled Refugees
Bill Introduced to Waive Waiting Period for Terminally Ill Disability Applicants
Virtual Hold at SSA Phone Centers
Affordability Tool on Commonwealth
Connector Website
Did You Know?
Citing
to Digital Hearing Recordings
Multilingual
Prescription Advantage Applications
Connector
Booth at Fenway Park
Federal Court Decisions
Binder
& Binder, P.C. v Barnhart
Administrative Decisions
SSI Overpayment. Lost File. Burden of Proof.
Stipend.
Work-Related
SSDI Overpayment. Waiver. Without Fault.
Work-Related
SSDI Overpayment. Waiver. Without Fault.
Work-Related
SSDI Overpayment. Remand from Federal Court. Current Ability to Repay.
SSI
Child’s Benefits. Continuing Disability Review. New Listing-Level Impairment.
Post Traumatic Stress Disorder. Basic
Mental Demands of Unskilled Work. DAA Materiality.
Regulatory Activity
Advance Notice of Proposed
Rulemaking: Compassionate Allowances. 72
Fed. Reg. 41649 (7/31/07).
POMS
Direct Contact With Public, GN 01070.300 et seq.
Program Expert Review of
FedRO, GN 04440.615.
Emergency Messages
EM-07049 Electronic Representative
Payee Accounting (eRPA )—INFORMATION (07/20/07)
HALLEX
Transmittal I-5-1-17 (07/03/07).
Findings Integrated Template (FIT) for bench decisions.
Internet Resources
Spotlight
on New Web Resources
NEXT
SSI COALITION MEETING
Greater
2nd Floor Conference Room,
617-371-1234
TDD 617-371-1228
The agenda will be posted on masslegalservices.org. For more information, please contact Linda Landry, Barbara Siegel, or Svetlana Uimenkova at DLC.
BRIEF
NOTES
Disability
Service Improvement (DSI): Changes Have Begun
►The Latest:
Proposed Suspension of FedRO Review.
SSA has published a notice of proposed
rulemaking (NPRM) at 72
Fed. Reg. 45701 (8/15/07) that would, at some point, suspend the use of the
Federal Reviewing Official (FedRO) step for new claims. Claims already at the FedRo level would
remain there so that SSA can continue to evaluate the effectiveness of the
FEdRO and Medical and Vocational Expert System (MVES). No date is specified for the cut-off date in
the proposed regulations. We'll have to wait for the publication of the final
regulations for that. After the cut-off
date, appeals of initial denials will go to reconsideration, as in the pre-DSI
days.
SSA states,
"We propose to modify our disability administrative adjudication processes
to suspend new claims to the Federal reviewing official (FedRO) level, now
operating in the
"Under
this proposal, we are amending part 405 with provisions that will suspend new
claims to the OFedRO and MVES/OMVE. This change will allow us to continue to
evaluate the FedRO and OMVE through the processing of claims already received.
We expect to have approximately 15,500 cases pending FedRO review when this
rule becomes effective. We will complete the processing of those pending cases,
but will not assign to FedRO any more cases originally filed under the new
process in Boston . . . *if cases are at
the initial level in Boston or not assigned to FedRO on the effective date of
this rule, those cases will be assigned to State agencies for reconsidered
determinations or to administrative law judges for hearing*, whichever is
applicable in that particular New England State. In other words, States in the
Boston region, where the FedRO and MVES/OMVE are currently functioning, would
return to the same process they were following before August 2006, whether that
process was reconsideration under 20 CFR 404.907 and 416.1407 or the testing
procedures under 20 CFR 404.906 and 416.1406."
The stated
basis for suspending the FedRO level with further study of pending claims is
the budget. SSA states that the
expenditures for FedRO have been greater than anticipated and that suspending
this step for new claims will allow SSA to redirect funds to other areas, e.g.,
the hearing offices where claims are languishing for years in some cases. The Federal Register publication of the
proposed regulations goes into SSA's budget woes in some detail.
The comment
period on FedRO suspension ends on
SSA also
invites comments by
You may submit comments by: Internet
through the Federal eRulemaking Portal at http://www.regulations.gov;
e-mail to regulations@ssa.gov; telefax to
(410) 966-2830; or letter to the Commissioner of Social Security,
Proposed
Changes to the Quick Disability Determination Process. In a Notice of Proposed Rulemaking published
at 72
Fed.Reg. 37496 (07/10/2007), SSA proposes to amend its regulations to extend the quick
disability determination process (QDD), which is operating in Boston region, to
all of the State disability evaluation services. Under the proposed regulations, State
disability determination services do not have to maintain a separate QDD
unit. However, SSA proposes to retain
the existing requirement that all QDD claims be handled by designated
disability examiners who have the knowledge, training, and experience to
effectively carry out the QDD process.
Additionally,
SSA proposes to removes the requirement to process QDD cases within 20 days to
give state agencies “more flexibility in managing their case workload.” However, states “should strive to adjudicate
any claim referred under QDD within 20 days.”
Comment
period ended
►The Situation Prior to the
Recent
changes have been made to SSA’s disability determination process and more
changes are on the way. Prior
Commissioner Jo Anne Barnhart undertook a major renovation of SSA’s disability
determination procedures in 2006, the stated purpose of which was to enable SSA
to increase accuracy, consistency, and fairness in the process and to make the
right decision as soon as possible. Most
claimants and advocates alike would agree that the disability determination
process had grown sluggish and bloated, requiring multiple appeals and
involving delays counted in months and years. The question was, would the
Commissioner’s revisions actually improve the process for claimants? Now, with less than a year’s experience with Commissioner
Barnhart’s process, the new Commissioner, Michael J. Astrue, is beginning to
make his mark with additional changes.
Commissioner
Barnhart’s process, Disability Service Improvement (DSI) was rolled out in the
states in SSA’s Region I beginning August 1, 2006, for initial disability
claims only. SSA originally planned to
gradually roll out the new process, region by region, to avoid the stress of
sudden national change and to allow for
adjustments as the agency learned to implement the new procedures. Commissioner Astrue has quickly decided that
DSI needs revision and has indicated that he does not favor the gradual roll
out, preferring to make changes to the
DSI procedures for national implementation.
In fact, he has already begun the process of revising DSI. Read More…
►
Please note: You will need to log onto www.masslegalservices.org to read
the full article. If you do not have an
account or forgot your user name or password, go to http://www.masslegalservices.org/reset. It only takes a few seconds. If you are not able to get the document
online and would like a hard copy, please contact
SSA Exploring
Compassionate Allowances
In a recent Advance Notice of
Proposed Rulemaking published at 72
Fed. Reg. 41649 (7/31/07), Social
Security announced its plans to investigate methods of making “compassionate
allowances” to quickly identify individuals with “obvious disabilities.” The purpose of the notice is to give all
interested parties an opportunity for comments and suggestions prior to the
publication of a Notice of Proposed Rulemaking.
In addition to the Presumptive
Disability, Terminal Illness, and Quick Disability Determination process,
Social Security plans to create an “extensive list of impairments that we can
allow quickly with minimal objective medical evidence…” Specifically, Social
Security is seeking suggestions on how to identify impairments that could be
quickly allowed under the “compassionate” standard, what minimal amount of
medical evidence to consider in these cases, and what procedures to follow.
Comments must be submitted by
New Ruling Clarifies
Visual Field Test for Blindness
Social Security Ruling, SSR 07-01p,
published at 72
Fed.Reg. 41796 (7/31/07), clarifies how Social Security will use automated
static threshold perimetry testing to determine statutory blindness based on
visual filed loss.
Automated
threshold perimetry measures the retina’s sensitivity to light at predetermined
locations in the visual field. For
purposes of meeting the statutory blindness standard, SSA will consider the
automated threshold perimetry test only if all of the following criteria are
met:
§
The test is performed according to very specific
technical parameters set out in the Ruling;
§
the tests can be considered reliable according to the
standard set out in the Ruling and the
test results are not inconsistent with clinical findings and the individual’s
daily activities;
§
the individual has a visual filed loss as reflected
by specific findings;
§
the individual is statutorily blind based on the
visual filed loss as reflected by technical measurements set out in the Ruling.
The
individual will be considered statutorily blind based on the visual filed loss
if his/her widest diameter in the better eye is less than or equal 20 degrees
and this finding is consistent with the
other evidence in the case record, including the evidence of a medically
determinable impairment that could result in the visual filed loss.
Social
Security will continue to use comparable visual field measurements obtained by kinetic
perimetry (Goldmann perimetry) as an alternative to automated static threshold
perimetry. Only one type of testing is
needed to establish statutorily blindness.
The Ruling
took effect on
SSA
Extends Expiration Dates for Body System Listings
SSA has extended for one year (July, 2007-July, 2008), the expiration dates for several “Listings of Impairments” (Appendix 1, Subpart P, Part 404 of 20 C.F.R.)
The evaluation criteria for the following Listings were extended:
Growth
Impairments (1000.00);
Respiratory
System (3.00 and 103.00);
Digestive
System (5.00 and 105.00);
Hematological
Disorders (7.00 and 107.00);
Endocrine
System (9.00 and 109.00);
Neurological
Disorders (11.00 and 111.00);
Mental
Disorders (12.00 and 112.00);
Immune
System Disorders (14.00 and 114.00).
The full text of SSA announcement
is at 72
Fed.Reg. 33662 (
SSA
Renews Computer Matching Program with DHS.
As of
DHS will provide SSA with:
P Information
on resident aliens who are SSI recipients and who have left or plan to leave the
P Information on Social Security number holders who have been
removed from the
Interested
parties may submit comments via telefax to (410) 965-8582 or by writing to the
Associate Commissioner, Office of Income Security Programs, 252 Altmeyer
Building,
Margaret A. Hostetler is appointed Deputy Commissioner
for Policy. For over 20 years, Ms. Hostetler had been a staff member of several
Congressional Committees, including the House Ways and Means Committee, the
Senate Governmental Affairs Committee and the House Budget Committee. Most
recently, she was the Senior Legislative Representative with the AARP Economic
Affairs Federal Division. She holds a Master of Business Administration from
the Wharton School at the University of Pennsylvania and a Bachelor of
Science degree from the Pennsylvania State University.
Dr.
Jason J. Fichtner is appointed Associate Commissioner for Retirement
Policy. Prior to his appointment, he was a senior economist with the Joint
Economic Committee in the U.S. Congress.
Dr. Fichtner has served as an adjunct assistant professor at the
Georgetown Public Policy Institute at Georgetown University. He holds a
doctorate in Public Administration and Policy from Virginia Polytechnic
Institute and
David A. Rust is is serving as Acting Deputy
Commissioner for Disability and Income Security Programs following the
resignation of Dr. David B. Gray shortly after his appointment.
For
more information about who does what at SSA, see SSA’s organizational chart
online.
Statistical Information on
Children Receiving Supplementary Security Income
Social Security's Office
of Policy has released a compilation of statistical
information on children receiving Supplemental Security Income (SSI).
In
December 2006, almost 1,079,000 blind and disabled children were receiving SSI payments-an increase of more than 42,000
since December 2005. They made up 14.9% of the more than 7 million SSI recipients.
In
calendar year 2006 (the most recent year for which complete data is available),
SSA received 460,000 SSI applications for children (17% of 2.6 million SSI
applications received during that period).
More than 170,000 children were awarded SSI payments in 2006 (more than
20% of the 838,000 persons awarded SSI in that period).
The
rates of both applications and awards for children have gradually increased
after the1990 decision in Sullivan v. Zelbey. They dropped slightly
after welfare reform legislation was enacted in 1996. The number of
applications for children has continued to increase slowly since then, but
their percentage share of all applications has gradually decreased.
In
addition to 1,079,000 recipients who are currently considered as “children” for
program purposes, the SSI rolls in December 2006 included almost 731,000 adult
recipients who first became eligible for SSI payments before age 18. Twenty
percent of these recipients first became eligible during 1974–1980 and thus
have been receiving SSI for much of their lives.
On July 11, 2007, the
House passed H.R.
2608, the SSI Extension for Elderly and Disabled Refugees Act by voice vote.
The bill was sent to the Senate where it awaits action. The House-passed bill
would amend section 402 of the Personal Responsibility and Work Opportunity
Reconciliation Act of 1996. SSI-related provisions of H.R. 2608 would:
P Extend temporarily
the 7-year eligibility period for refugees, asylees, and certain other
humanitarian immigrants to 9 years
for the period from fiscal years 2008 through 2010 (October 1, 2007 through
September 30, 2010);
P Exempt
those refugees, asylees, and certain other humanitarian immigrants with pending
naturalization applications from the time-limited eligibility period;
P Apply
retroactively to those non-citizens whose SSI benefits had previously ceased
solely due to the expiration of the 7-year period as well as to eligible
individuals whose 7-year period would expire before October 1, 2010;
P Provide
for prospective monthly payment of additional SSI benefits over the duration of
extended eligibility;
P Revert to
the 7-year SSI eligibility period for refugees, asylees, and certain other
humanitarian immigrants for months after September 30, 2010.
The
Bill would be effective October 1, 2007.
You can track the progress of the bill at http://thomas.loc.gov.
Dwindling SSA Workforce
The
Office of Personnel Management released statistics on the number of employees
at the Social Security Administration as of March 2007. The numbers as compared
to previous year are:
·
March
2007 - 61,867
·
December
2006 - 63,410
·
September
2006 - 63,647
·
June
2006 - 64,814
·
March
2006 - 64,297
Over the last two years the Social
Security Administration lost nearly 7% of its workforce. At the same time the agency experienced a
surge in disability claims as well as a dramatic increase in its Medicare
responsibilities.
Social Security
Disability Reform Bill Waives Waiting Period for Terminally Ill
In June of 2007, a bill was
introduced in the House of Representatives to provide a waiver of the
five-month waiting period for Social Security disability benefits for
terminally ill individuals. The legislation is named after Joseph H.
Seall of
Congressman
Chip Pickering (R-Miss) and Congressman Earl Pomeroy (D-N.D.) introduced the
Joseph H. Seall Act of 2007 (HR 2713). Pomeroy serves on the Social Security Subcommittee
of the
The Pickering-Pomeroy legislation allows the Commissioner of Social Security to waive the statutory five-month waiting period for disability benefits when an individual is terminally ill. The measure also requires the Commissioner of Social Security to conduct a study of the Social Security disability claims process and make recommendations to Congress for improvements and reforms.
SSA implements Virtual Hold to
Improve Phone Customer Service
Virtual Hold Technology®, LLC (VHT), the
leading developer of virtual queuing solutions, announced in June of 2007 that the
Social Security Administration will implement Virtual Hold in customer service
contact centers. SSA processes more than
50 million calls per year. When the
number of incoming calls exceeds the number of available SSA representatives,
customers must remain on hold. After
implementing Virtual Hold, SSA customers will be informed of the estimated hold
time and will be given the choice to hang up, yet keep their place in
line. The Virtual Call system will
automatically call them back when it’s their turn to speak to an SSA
representative.
SSA
hopes to increase customer service satisfaction and save a projected $1.7
million on their phone bill in the first year by using Virtual Hold.
New Citizenship and Identity Verification Requirements
Effective
July 2006, as a result of the federal Deficit Reduction Act of 2005, all US
Citizens/Nationals are required to verify their citizenship and identity as a
condition of MassHealth
eligibility. MassHealth matched 80%
of its active caseload since the new requirements went into effect in July of
2006.
In
July of 2006 MassHealth Operations instituted the use of electronic matches to
assist members with the new verification requirement. MassHealth can now electronically match the
records with the Department of Transitional Assistance (which identifies former
recipients), the Social Security Administration (identifies former SSI/SSDI
recipients and recipients of Medicare).