Charles Hall’s excellent blog today posts a note about a request for comments on drug and alcohol addiction as a disability. SSA’s attitudes have veered back and forth on this over the years. In the early 90′s it was a disability, with the hope that people would get treatment if they got benefits. Though treatment was required it was not widely avaialble, so in the mid 90′s that avenue to disability was slammed closed, though sometimes people had mental illness which ould otherwise qualify them.

SO now: from a Request for Comments to be published in the Federal Register tomorrow:

We are requesting your comments about our operating procedures for determining disability for persons whose drug addiction or alcoholism (DAA) may be a contributing factor material to our determination of disability. …

To provide guidance on how we interpret the DAA provisions of the Act, we issued instructions to our employees in an Emergency Message on August 30, 1996.

We are asking for your comments on the procedures we follow when evaluating DAA. In particular, we would like your opinion about what, if any, changes you think we should make to our instructions. For example, do you have any suggestions about:

What evidence we should consider to be medical evidence of DAA?
How we should evalua te claims of people who have a combination of DAA and at least one other physical impairment?
How we should evaluate the claims of people who have a combination of DAA and at least one other mental impairment?
Whether we should include using cigarettes and other tobacco products in our instructions?
How long a period of abstinence or nonuse we should consider to determine whether DAA is material to our determination of disability?
Whether there is any special guidance we can provide for people with DAA who are homeless?
Social Security’s position has been that if it is impossible to separate the effects of DAA from the effects of other psychiatric illness that the combined effect of both may be considered disabling. This situation is frequently present in individuals suffering from bipolar disorder, a psychiatric illness which has a high degree of association with DAA. A change in this policy would be of considerable importance.

Here are the links: Drug Addiction and Alcoholism; Request for Comments ,
4900 [2010-1834]
[TEXT]
[PDF]

Charles says: The talk of whether a period of abstinence should be required before a person could be found disabled is worrisome. The statute does not forbid disability payments to alcoholics and drug addicts. It merely prohibits consideration of alcoholism and drug addiction in determining disability. A person may have a raging substance abuse disorder but be found disabled due to other health problems. This has always bothered some people. They find drug abuse and alcoholism so loathsome that they believe that no one alcoholics or drug addicts should be on Social Security disability benefits even though the statute says otherwise. One interpretation of this notice is that Social Security has a desire to move towards forbidding benefits to anyone with a substance abuse problem.

Our experience is the same as that of Charles. The main thing we look for is whether, absent addiction, the person would still be disabled. In other words, getting clean and sober doesn’t cure AIDS. But it might go a long way toward aleviating depression.

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There is a little-understood aspect of laws in 15 states that allows those states to offset retirment benefits they pay to employees Why? Because they can. Legislatures see a way to recoup funds for the state budget by offsetting a portion of the SOcail Security benefits earned agains the state benefit. Change is afoot.

The San Francisco Chonicle reports today that “in California and 14 other states where teachers do not participate in Social Security, second-career educators who previously held private-sector jobs where they paid into Social Security see some of that money evaporate in retirement because of a decades-old law. They can lose up to $381 a month of their own benefits – Social Security income that their payroll taxes should have guaranteed them.

“In Young’s case, her teacher’s pension will reduce the amount of Social Security she receives from her previous career. The pension also will cut what she can receive from her late husband’s Social Security benefits. Overall, she expects to lose several hundred dollars a month of retirement income – even though she and her husband both fully paid into the Social Security system.” Read more:

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Social Security (SSA) is in the long process of collecting comments on proposed changes to the Listing of Impairments for Endocrine Disorders. These changes would abolish diabetes as a separate “listing,” which would mean that proving cases of disability based on disabetes would be more difficult.

There is a comment period on the proposed rules that is open until February 12. The changes are based on the presumption that advances in medical care have made diabetes a manageable condition, not one that is disabling. The current regulations allow a finding of disability in advanced cases of diabetes, where conditions such as peripheral neuropathy or loss of a limb can be attributed to the unconrtolled disease, and prevent work.

The Listings were last revised in 1985 and also cover other endocrine disorders such as pituatary disorders and disorders of the adrenal cortex. The link to the proposed regulatory changes and comment section can be found here:

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Michael J. Astrue, Commissioner of Social Security, today announced that the agency is making new data about beneficiaries and the agency’s disability and hearing processes available to the public.

Here are a few examples of the valuable Social Security datasets available today:

* Researchers can find out about the work-related experiences of our beneficiaries receiving Social Security disability benefits and give us policy guidance for our disability programs.
* The public can see information about hearings workloads and a breakdown of the types of decisions made by Administrative Law Judges.
* Researchers can study the effects of current and proposed legislative and program provisions.
* People who have requested a hearing on their disability claim can estimate the amount of time they may have to wait for the hearing to be held and for a decision.
* The public can see general information requested under the Freedom of Information Act.
To read the President’s Memorandum on Transparency and Open Government, click here:

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Today’s Wall Street Journal explores the sufficiency and relability of the federal disability program.

“The WSJ says that “disability-insurance benefits from the workplace and the government are getting harder to come by—and that’s putting more pressure on consumers to purchase their own coverage in case a medical condition keeps them from working.

“But disability insurance can be confusing. Policies may include conditions that make it tough for people filing claims to actually qualify for the benefits. And some policies may limit payouts for certain diagnoses, particularly mental illness. To protect themselves, consumers considering buying disability coverage need to read the fine print.

“The percentage of companies that paid all or part of the cost of workers’ private long-term disability insurance fell to 48% last year, from 59% in 2002, according to LIMRA, an association of financial-services and insurance companies. Many employers are “taking a step back in terms of what they pay and putting the onus on employees” to purchase richer benefits if they choose, says Michael Bailey, a principal at Mercer, a consulting unit of Marsh & McLennan Cos.”  See full article here:

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From the (California) Capitol News: The worst recession in decades is a scary period for many American families. But it is a time of particular peril for those living with work-limiting disabilities, especially in states such as California, where involuntary furloughs and layoffs of state employees who process Social Security disability claims further bog down a system that is already in crisis.

The Social Security Disability Insurance (SSDI) system worked well for decades, but it is creaking under the weight of a growing population of people with disabilities, increasing demands on the Social Security Administration and a wave of government retirements. Social Security employees work as hard as they can to help people who deserve care, but their best efforts are only slowly winnowing down a hearing backlog of nearly 723,000 disabled Americans—including 66,000 Californians—waiting months or years to receive their rightful benefits.

The recession is making things even worse. From 2004 through 2007, application levels were stable, with the SSA processing between 2.1 million and 2.2 million SSDI applications each year. Last year, more than 2.7 million people filed SSDI applications. See article here:

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