Disability

Some Updates from the Social Security Administration (SSA)

Here are a few updates from the SSA: *The SSA has announced that it will extend its prototype testing of (1) elimination of reconsideration and (2) the single decisionmaker (the circumstance in which a disability examiner makes an initial disability determination without getting a medical or psychological consultant to sign off on it) until September 25, 2015. Prototype testing has been ongoing since 1999. *The SSA has extended the pilot program allowing the SSA itself rather than the Administrative Law Judge (ALJ) to set the time and place of a hearing until August 10, 2015. The original motivation behind the… Learn More

Recent Congressional Hearings

This past June and July, Congress held a number of hearings related to the Social Security Administration (SSA). What follows is a brief rundown of each hearing: *On June 18, the Senate Special Committee on Aging held a hearing on SSA field office (FO) closures and service cuts. Since 2010, the SSA has closed 64 FOs and 533 mobile offices due to budget shortages. The shortages have also resulted in a loss of 11,000 SSA employees. Committee Chairman Bill Nelson of Florida and ranking Minority Member Sen. Susan Collins of Maine were upset that the SSA took these measures with… Learn More

According to the Trustees…

On July 28, 2014, the Social Security Administration’s (SSA) Board of Trustees released its annual report for the Social Security and Medicare Trust Funds. According to the report, which reads much like the 2013 version, if no action is taken, the combined Social Security Trust Funds will be solvent until 2033, at which point scheduled benefits would be paid at a level of 77%. The Disability Insurance Trust Fund itself, however, is in more immediate trouble. It is projected to remain solvent until late 2016, at which point its reserves will be depleted if Congress does not act. So what… Learn More

The Final Say on Scheduling Hearings

To accommodate growing numbers of disability hearings, the Social Security Administration (SSA) is making a few changes to the rules in order to speed up the hearing and decision process. The new hearing rules deal primarily with scheduling and notice procedures pertaining to video hearings. In addition to expediting the hearing and decision process, the new rules are designed to prevent people from manipulating the rules to cherry-pick Administrative Law Judges (ALJs) with higher allowance rates and avoid those with lower rates. According to the new rules, before scheduling a hearing, a claimant must be notified of the possibility that… Learn More

When is the Medical Improvement Review Standard (MIRS) Not Applicable?

The MIRS is the yardstick by which a disability beneficiary’s condition is measured over time; the Social Security Administration (SSA) cannot legally terminate someone’s benefits unless it can show medical improvement. However, there are several exceptions to the MIRS. Here are a few of those exceptions: 1. There is evidence that the disability decision was made in error. Such evidence could include: misinterpreting test results, or misapplying a listing or a rule to the claimant’s condition, or lack thereof. 2. Required medical evidence of the severity of the claimant’s condition was missing when the last review took place. This exception… Learn More

What is the Medical Improvement Review Standard (MIRS) and Why Does it Matter?

President Ronald Reagan signed the Social Security Disability Benefits Reform Act of 1984 (DBRA 1984), one of the primary components of which was the provision that benefits could not be terminated without evidence of medical improvement. The MIRS is the tool with which a beneficiary’s condition is evaluated over time. Section 2(a) of the DBRA 1984 defines the MIRS. It states that benefits cannot be terminated unless there is: “(1) substantial evidence which demonstrates that – (A) there has been any medical improvement in the individual’s impairment or combination of impairments (other than medical improvement in which is not related… Learn More

Improving the Disability Process

Earlier this year, the House Oversight and Government Reform Subcommittee on Energy Policy, Health Care, and Entitlements convened for a hearing on improving the disability process. On the panel of witnesses present were representatives from the Social Security Administration (SSA), the Government Accountability Office (GAO), and the National Association of Disability Examiners (NADE). Much of the hearing focused on the importance of Continuing Disability Reviews (CDRs)—specifically on the importance of the CDR as return on taxpayer investment, a money-saving tool, and on the current CDR backlog, which is somewhere around 1.3 million. Medical improvement standards were another of the issues… Learn More

New Bill May Help Fight Disability Fraud

On February 26, 2014, the House Committee on Ways and Means Social Security Subcommittee convened to discuss ways of preventing Social Security disability fraud. The hearing included several panels featuring a variety of witnesses from the Social Security Administration (SSA), the Unum Group, and the National Academy of Public Administration, among others, who testified to the problem of disability fraud and spoke about current and in-development fraud prevention efforts by the SSA. The centerpiece of the hearing, however, was Ranking Committee Member Xavier Becerra’s (D-CA) H.R. 4090, “The Social Security Fraud and Error Prevention Act of 2014.” The bill is… Learn More

Eligible Veterans Enjoy Expedited Disability Claims Processing

As of March 17, 2014, veterans meeting certain criteria now qualify for expedited disability claims processing. In order to be eligible, a veteran must be receiving official VA service-related benefits and have a 100% “Permanent and Total” VA disability rating. However, veterans meeting the 100% “Permanent and Total” criterion but who are receiving non-service related pension benefits are not eligible for expedited processing. In order to apply, veterans must submit a VA Notification Letter confirming their 100% “Permanent and Total” disability designation. All levels of the claims process will be expedited for eligible veterans. It is important to note that… Learn More

What does the Social Security Administration’s (SSA) Division of Quality (DQ) Do?

The Social Security Administration’s (SSA) Division of Quality (DQ) has been around since 2010 and is dedicated to making the disability process smooth, fair, and consistent for all. The DQ serves a number of important functions. It regularly evaluates a statistically meaningful collection of favorable and un-appealed, hearing-level Administrative Law Judge (ALJ) decisions for quality control. It also conducts decision studies focused on specific issues, offices, or subjects involved in the hearing process (for example: ALJs, or doctors). The reviews yield valuable data that help the DQ determine the most problematic areas of SSA policy and law, which in turn… Learn More

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