© Nick M. Do/Getty Images Social security card and form.

The Trump administration is proposing changes to Social Security that could terminate disability payments to hundreds of thousands of Americans, particularly older people and children.

The new rule would change aspects of disability reviews — the methods by which the Social Security Administration determines whether a person continues to qualify for benefits. Few recipients are aware of the proposal, which is open for public comment through January.

Critics of the plan liken it to the administration’s efforts to cut food stamps, among other entitlement programs, with insufficient information offered to explain curtailing benefits.

Social Security officials declined to comment. For years, Republicans have argued that Social Security benefits need to be reined in to save money.

The new rule, advocates for low-income Americans say, is just a way to push people off the disability rolls.

“I have serious concerns about this proposed rule,” said U.S. Sen. Bob Casey (D., Pa.), adding that it “appears to be yet another attempt by the Trump administration to make it more difficult for people with disabilities to receive benefits.”

In a similar vein, U.S. Rep. Brendan Boyle, a Northeast Philadelphia Democrat, said, “These changes seem arbitrary, concocted with no evidence or data to justify such consequential modifications. This seems like the next iteration of the Trump administration’s continued efforts to gut Social Security benefits.”

Typically, Americans who are too physically and/or mentally impaired to work may be eligible for one of two kinds of benefits: Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI).

While SSDI is for people who have worked at least 10 years, SSI is for low-income recipients who have seldom, if ever, been employed.

More than 16 million Americans receive either SSDI (8.5 million) or SSI (8 million). SSI benefits can run to $770 a month; SSDI payments, which are based on lifetime earnings, can range from $800 to $1,800 monthly, government figures show.

Merely getting benefits is an extraordinarily difficult task, often taking years and requiring applicants to compile reams of documents, then state and restate their cases in front of hearing officers, adjudicators, and judges.

Explaining the proposed rule change, Kathleen Romig, a senior policy analyst and Social Security expert at the Center for Budget and Policy Priorities, a left-leaning nonprofit in Washington, said, "Parts of what’s happening are mystifying. And it’s very complicated.”

The new rule is “the government trying to kick us out of SSI,” said Jahan Johnson, 34, a single mother of three children — two of them on SSI — in Northeast Philadelphia. Johnson, who is bipolar and suffers from scoliosis, is also on SSI.

“What they’re doing is wrong, and making life harder.”

Those already receiving disability benefits are subject to so-called continuing disability reviews, which determine whether they are still deserving of compensation for an injury, illness, or other incapacitating problem as their lives progress.

Not everyone gets reviewed within the same time frame. A person with a grave illness such as Lou Gehrig’s disease (ALS) is placed in a category called “Medical Improvement Not Expected,” and is subject to review every five to seven years.

A low-birth-weight baby, on the other hand, is categorized as “Medical Improvement Expected,” and the case is reviewed every six to 18 months, because growth and change are anticipated, Romig said.

A third category is “Medical Improvement Possible.”

All three categories are based on existing medical standards meant to help officials decide whether benefits are still warranted, said Kate Lang, senior attorney at Justice in Aging, a Washington-based nonprofit that focuses on health benefits for low-income older adults.

The proposed rule change would create a fourth category: “Medical Improvement Likely,” which would mandate disability reviews every two years, creating an additional 2.6 million reviews over the first 10-year period.

An estimated 4.4 million beneficiaries would be included in that designation, many of them children and so-called Step 5 recipients, an internal Social Security classification, said Jennifer Burdick, supervising attorney with Community Legal Services in Philadelphia.

When applicants try to receive disability benefits, they either have one of a list of specified medical impairments, or they suffer from a combination of disabilities that make working difficult or impossible, Burdick said. The latter group are Step 5 and are entitled to SSI or SSDI benefits, according to federal law.

They are typically 50 to 65 years of age, in poor health, without much education or many job skills. They often suffer from maladies such as debilitating back pain, depression, a herniated disc, or schizophrenia.

The inclusion of Step 5 people in the “Medical Improvement Likely” category appears to make little sense, advocates for recipients say.

Medical conditions generally deteriorate as already unhealthy people age, and no evidence exists that such beneficiaries are “likely” to improve, Burdick said.

Labeling them that way is “a radical departure from past practice,” she said. “There’s no medical or scientific basis to say they’ll get better.”

Compelling Step 5 recipients to be reviewed every two years shows “a hostility toward the basic Social Security Act, which takes a holistic view of the individual,” said Jonathan Stein, a former Community Legal Services attorney who is working with Burdick.

He said he believes the ultimate aim of the rule is to review Step 5 recipients so often that they ultimately lose their benefits because of the difficulties complying with the review process.

“There’s an underhandedness to this,” Stein said. “It’s ideological, not based on medicine or science.”

Lang, of Justice in Aging, said simply, “They’re out to shrink the rolls. And they’re setting people up to not comply.”

Stein cited writings by Mark Warshawsky, deputy commissioner for retirement and disability policy at the Social Security Administration, who has often proposed eliminating the criteria of older age, low education, and unskilled work experience in determining eligibility for SSI and SSDI.

And in March, the conservative Heritage Foundation, which often provides underlying rationale for Trump administration policies, released a statement that said, “Factors of age, education, and experience do not and cannot cause workers to be disabled from performing all work .... Only physical and mental conditions ... should qualify individuals to receive disability insurance benefits.”

Asked about the appearance of taking benefits from vulnerable Americans in an election season, Lang replied, “I don’t think they care about the optics very much. They’re just focused on saving money.”

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