Social Security Administration change in disability rules could cut benefits to tens of thousands

Anita Wadhwani | Nashville Tennessean

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A Trump Administration proposal to require more frequent paperwork reviews of people receiving Social Security disability benefits could cut benefits to tens of thousands of people across the nation.

The plan has alarmed advocates for people with disabilities, who say the rules will place older adults and children at risk for losing benefits in a federal program already under scrutiny for taking years to process disability paperwork and wrongly denying qualified applicants.

"This is kind of at the 'world's-on-fire' level in the social security disability world," said Jen Burdick, an advocate for federal disability program reforms who also serves as an attorney with Community Legal Services of Philadelphia.

"It's really just a backdoor way to cutting people from the program," she said.

Social Security Administration officials say the plan is designed to ensure taxpayer-funded benefits are going only to those who deserve them. The rule would ensure more frequent checks to verify if someone's health has improved enough to go back to work.

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"We expect that the changes we are proposing would enhance program integrity and ensure that only those who continue to qualify for benefits will receive them," a statement from the agency said.

The agency also expects to save money. The reviews will add $1.6 billion in administrative costs over the next ten years, but save $2.8 billion in disability benefits by cutting beneficiaries — a saving of about $1.50 in for every dollar spent.

The projected savings, however, are significantly lower than in the past. In its annual report submitted to Congress in August before the new rules were unveiled, the Social Security Administration noted that every dollar spent on disability reviews had yielded $19 dollars in benefit costs.

"I don't think it's a very efficient use of money," said Kathleen Romig, a senior policy analyst at the Center on Budget and Policy Priorities who opposes the new rule.

Social Security Administration oversees two disability programs, SSI for low-income individuals without a work history and SSDI for workers who become disabled. In total, more than 16 million adults and children receive disability benefits, including roughly 170,000 in Tennessee.

To qualify, adults must demonstrate they have a long-term medical or psychological condition that prevents them from working. Children are eligible for disability if they are blind or have severe functional limitations that are expected to last a year or result in death. SSI recipients must also be low-income.

Once on disability, adults and children are subject to "continuing disability reviews" by Social Security staff. The reviews require recipients to submit medical records and other documents to prove they are still too incapacitated to work.

The reviews vary depending on a person's condition. Individuals whose conditions are expected to improve with time - babies born prematurely, for example - are in a category called "medical improvement expected" and reviewed every six to 18 months.

People with debilitating or terminal conditions are in a category called "medical improvement not expected" and reviewed every five to seven years.

The Social Security Administration is proposing a new category, "medical improvement likely" that would review some of these recipients every two years. Federal officials estimate they would conduct an additional 4.4 million reviews over the next decade in this new category if the news rules take effect.

The proposal did not estimate how many people would lose benefits, but experts who reviewed the plan calculated that the estimated number of reviews and projected savings reported by the agency would result in tens of thousands of people losing disability benefits each year.

Reviews require recipients to submit large volumes of medical records, work and income documentation, a complicated and burdensome process for many living with disabilities. People go through a similar process when they first apply for disability -- a process that can take two or more years to complete. Denial rates are high nationwide. In Tennessee, 72 percent of all disability claims were rejected in 2017.

The reviews are conducted by state agencies delegated to assess disability claims by the Social Security Administration.

A Tennessean investigation earlier this year found that some doctors hired by the state's Department of Human Services raced through their reviews of disability paperwork at an implausible pace while earning six-figure salaries.

The doctors are paid by the case to review medical records that can sometimes stretch to thousands of pages. Outside experts and former and current state employees said it was impossible to review cases so quickly without making mistakes that lead to wrongful denials of disability benefits. The report prompted a Government Accountability Office investigation into the Social Security Administration’s use of consultant doctors that remains ongoing.

Lawyers who help people initially apply for benefits are typically paid by getting a portion of disability benefits that have accrued over the years-long process. In the ongoing review process, people on disability would have to pay a lawyer themselves - something most people on disability cannot afford to do.

"I worry about people's ability to navigate this especially because it's so frequent," Romig said.

"It's certainly going to mean more people are going to lose benefits," she said. "I'm worried that putting this increased paperwork on people is going to lead to people being terminated who continue to qualify."

The rules remain open for public comment until Jan. 31. In a letter sent Dec. 19, Congressional Democrats asked the administration to extend the period to March 16. Comments may be submitted online here or mailed to the Office of Regulations and Reports Clearance, Social Security Administration, 3100 West High Rise Building, 6401 Security Boulevard, Baltimore, Maryland 21235-6401.

Reach Anita Wadhwani at awadhwani@tennessean.com; 615-259-8092 or follow her on Twitter @AnitaWadhwani