Problems and challenges facing the Social Security and Supplemental Security Income (SSI) disability programs


To The






July 13, 2000

Mr. Chairman and Members of the Subcommittee, on behalf of the members of the National Association of Disability Examiners (NADE) I want to take this opportunity to thank you for holding this series of hearings on the problems and challenges facing the Social Security and Supplemental Security Income (SSI) disability programs today. Our membership is committed to the preservation of the disability program and deeply concerned about the problems we encounter in the administration of these programs. Those concerns have been described in earlier testimonies before this Subcommittee and will not be reiterated here. We would, however, like to address those issues involving the solvency of the disability trust fund and return to work barriers and incentives.

The Social Security and SSI disability programs play a vital role in the lives of millions of Americans. Disability benefits provide an important safety net for disabled individuals and their families. However, we believe that the majority of those who apply for these benefits would prefer to remain in the workforce. We welcomed the recent efforts of the Congress and of the Social Security Administration (SSA) to facilitate and encourage a beneficiary’s efforts to return to work by removing barriers such as loss of medical coverage and by authorizing and establishing return – to- work demonstration projects.

Individuals who understand that their claims will be reviewed at the appropriate time are much more likely to take advantage of return to work initiatives. We strongly support SSA’s focus on continuing disability reviews (CDRs) and we appreciate the Congressional initiatives to provide the necessary funding to conduct these reviews. The public should be able to expect that the Social Security Administration (SSA) will administer the disability program in a cost-effective manner. We believe it is vital that sufficient resources continue to be made available to permit SSA to become-and remain-current on these reviews. These reviews are vital because of the importance they have on the economic security of the disability trust fund and on the public’s confidence in the disability program. However, while we support the present CDR initiative, we believe this process would be more effective if the current Medical Improvement Review Standard (MIRS) were revised. (A copy of NADE’s analysis of this subject is attached for your review.) . Although time-limited benefits are common in many private disability programs, and have been proposed as one means to encourage claimants to obtain appropriate treatment and rehabilitation to re-enter the work force, we do not advocate such a proposal for the Social Security or SSI disability programs at this time. Unlike private insurers and other disability programs, the programs administered by Social Security do not award benefits for partial or short-term disability. By definition, individuals who are awarded Social Security or SSI disability benefits are unable to engage in any substantial gainful activity for a period of not less than 12 months. These individuals should be able to expect that SSA will not terminate those benefits unless there is a change in their condition that would warrant termination. At the same time, however, we believe that disability benefits should be paid only to those who meet the statutory definition of disability and that individuals who are capable of returning to the workforce do so. This requires an efficient and effective CDR process.

The CDR process has not been utilized in the way it was envisioned. SSA’s need to utilize limited funds for more pressing needs have made it impossible to pursue the CDR process without the recent special appropriations from the Congress. NADE firmly believes that if CDRs can be conducted timely, if genuine errors in decision-making can be corrected at the CDR level by changes in the MIRS, and if additional disincentives to return to work can be eliminated, then a medical review standard can serve both the disabled population and the general public better than the wholesale changes that time-limited benefits would entail.

The General Accounting Office, in their July 13, 2000 testimony, noted that, “In recent years, SSA has piloted numerous incentives to redesign and thereby improve its disability determination process.” NADE has supported these efforts and many of our members are, or have been, involved in piloting and prototyping this new process. We would hope that simplifying and streamlining the process would enhance and support the current return to work initiatives.

While NADE supports efforts to make the decision making process more efficient, we do not support change for the sake of change. It appears that SSA is planning to go forward with national roll-out of the new disability claims process before data – including the impact this new claims process has had on both administrative costs and program costs -has been fully assessed. Earlier we contacted Commissioner Apfel expressing both our concerns with and suggestions for national roll-out. A copy of that correspondence accompanies this testimony.

We would also like to take this opportunity to express our concern that several of the states involved in the prototype of the new disability claims process are reporting that hundreds of claims have been received for which they have yet to initiate any case development. These claims are sitting untouched, filed away, until such time that the DDS has sufficient staff to initiate the required development. This backlog of cases was created as the DDS’s made the required adjustments to begin processing claims in the new manner prescribed by the prototype. The DDS’s were not given sufficient lead time or training to prepare for the new process. These backlogs do not serve the public interest, improve a claimants potential for return to work, or enhance the public’s confidence in the disability program.

NADE is concerned about the viability and stability of the Social Security and SSI disability programs and the integrity of the disability trust fund. We appreciate your willingness to solicit a wide range of viewpoints and suggestions for improving these programs. NADE feels honored to be invited to submit our views and we offer the expertise of our members, working with the Subcommittee, as a means to achieve that goal.