The new list of compassionate allowances for Social Security benefits includes Alzheimer’s disease, rather unexpectedly. Although the national associations had been lobbying for this for years, what finally tipped the scale was a patient who went to a SSA panel meeting on the compassionate allowances, and spoke from the heart about his 14 month struggle to get benefits after his diagnosis. Sometimes, it pays to be your own advocate.

The list previously had 50 conditions — 25 rare diseases and 25 cancers. The change adding 38 conditions is effective March 1

Here is the story:

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.

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:

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:

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:

The Social Security Administration has been working for years to reduce its backlog of disability claims, which now stands at 780,000 claims. It even hired and trained 8,600 new employees last fiscal year.

But any progress it made has come to an abrupt halt. Largely because of the recession, Americans filed 400,000 more disability claims than predicted last year and the agency expects 700,000 more to be filed this year than in 2008.

SSA is not alone. Agencies across government that provide federal assistance are seeing their workloads explode as Americans seek unemployment insurance payments, health care insurance, school lunches, food stamps and college loans. Benefit claims and payouts have jumped in the last year at assistance programs run by the Labor, Veterans Affairs, Agriculture, Education, and Health and Human Services departments, among others. See article here:

Many do not realize that federal Social Security disability claims are processed by state workers before the denial that sends them to a judge.  As more states are decimated by falling tax revenues,  there have been staffing redductions, layoffs and reductions on hours worked.  While there have been very small improvements in the backlogs at the hearing offices, now the delays are manifesting at the initial and reconsideration stages.  I guess that is one way to improve the hearing office  statistics: reduce thenumber of cases being sent there!  Here is an article that discusses the impact of these RIF’s:<a>

There have been vast increases in pending cases across the country. This chart, courtesy of NOSSCR, details the initial and reconsideration pending cases by state. Click on image to enlarge. 

A nationwide surge in Social Security disability claims has hit Michigan disproportionately hard.

The flood has caused a case logjam at the state’s five Social Security hearing offices, which have some of the longest wait times in the nation: nearly two years.

The delay in benefits approval, experts say, can mean a slow slide into poverty, with laid-off workers eating up their savings or even losing their homes. Older workers with health problems are increasingly turning to disability to stay afloat after losing their jobs because they are often less likely to find new employment, experts say. See story here:

According to Social Security Commissioner Michael Astrue and other experts on disability claims, the faltering economy is causing an increase in applications of between 15 percent and 25 percent. SSA originally anticipated receiving 2.6 million to 2.65 million applications for disability benefits in fiscal 2009, but upped its prediction to 3 million and another 3 million for 2010. Recently, the agency adjusted its estimates again, increasing the projection for 2010 to 3.3 million applications. …

Astrue says the agency has been making inroads, reducing processing times by 4 percent each of the past two years. The recession, however, has reversed the progress on the backlog of cases. At the beginning of 2009, SSA had 550,000 cases pending at the state level. The state-run SSA-funded Disability Determination Services do much of the initial processing and eligibility determination for applicants. The number of claims pending at the state level, which does not account for applications at other stages of adjudication, is now up to 725,000. …

“We’ve been stymied at the state level,” Astrue says. “There’s this callous ‘Kumbaya’ attitude that if there’s going to be pain, everyone has to suffer. For me, it’s beyond comprehension that you would make a civil service suffer unnecessarily and make claimants in desperate need of assistance wait much longer than they otherwise would.” …