Articles from prior issues of The Advocate

November/December, 1995

Letter to the Editor

207 Oakridge Ave.
Kenmore, N.Y. 14217

Aug. 14, 1995

To the Editor:

The July/August, 1995 issue of the Advocate contained NADE’s testimony before the House Social Security Sub-Committee on the topic of backlogs in the disability program. Buried in our testimony are comments regarding CDR “reforms”. I strongly disagree with our testimony on this issue. Our testimony states, in part: “The DDSs are further hampered in reviewing CDRs due to the Medical Improvement Standard (MIRS) which requires that there be demonstrable improvement in the claimant’s condition. Where the claim was originally allowed by an ALJ, many times it is impossible to show that the condition has improved--thus only a limited number of case reviews result in cessation. If Congress is serious about conducting CDRs then SSA should revisit the whole CDR procedure and revise the Medical Improvement Review Standard to a baseline physical and/or mental performance level rather than the demonstrated medical improvement requirement.” Our recommendation to the Sub-Committee on this subject is to “Revisit and revise the Medical Improvement Review Standard, to permit cessation of benefits where appropriate.” I would like to think that this part of our testimony was not well thought out. First of all, it is not in SSA’s power to “revisit the whole CDR procedure and revise the (MIRS)”. This was mandated by Congress in the 1984 Amendments. SSA simply does not have the discretion to revisit and revise what Congress has mandated. In addition, in its continued attempts to persuade Congress to “rein in” the ALJs, NADE has proposed a “solution” that would do harm to all of the claimants allowed and/or continued by the DDSs.

I am not blind to the decisions made by the ALJs. I see many that do not seem correct to me. I would agree that ALJs allow many people who should not be allowed. (I think it is also indisputably true that DDSs deny people who should not be denied.) However, although ALJs seem to allow people who should not be allowed, the numbers of people allowed by the DDSs dwarf the numbers of people allowed by the ALJs. If NADE’s suggestion is adopted by Congress, the vastly larger number of “legitimate” allowances done by the DDSs will be threatened along with the smaller amount of “illegitimate” allowances done by the ALJs. It is also remarkable that NADE, which more than a decade ago testified in favor of a Medical Improvement Standard, is now recommending its elimination. It is as if NADE has forgotten why Congress mandated the MIRS in the first place. Has NADE forgotten that people were cut off from disability payments solely because the regulations or adjudicative climate changed, not because they were any healthier or more functional? Consider that the cardiac regulations were changed in the recent past. In may ways, the new regulations are harder to meet than the old ones. What will NADE say to a cardiac claimant allowed under the old regulations whose condition has not changed but whose benefits were ceased because we went back to “baseline assessments”?

Although I disagree with NADE’s effort to get Congress to enact a Social Security Court (because it will not solve the problem), I agree with our efforts to nudge Congress and SSA toward the “one book” approach to adjudication. Of course, this begs the question of which “book” to use. But that is another topic for another time. Nevertheless, NADE should not take out its frustrations on the claimant/recipient. I am sure if we put our collective heads together, we can come up with ways to reform the MIRS without eliminating it. For instance, one common sense reform would be to create an exception to the MIRS for impairments which we would currently view as not severe even though they were allowed/continued at CPD. Although this involves some degree of substitution of judgement to creep into CDRs, that is preferable to the suffering which will result if NADE’s suggestion ever becomes law. Back in the “bad old days” before the MIRS existed, some claimants, whose benefits were ceased had to choose between food and medicine. Some literally jumped off the Brooklyn Bridge. This is not an exaggeration. These things happened. They will happen again. I would like to remind NADE of the saying, “Those who forget the past are condemned to repeat it.”

Sincerely yours,

Bob Kanner