Sep 2, 2014

More From Patricia Wen On Child SSI

     Patricia Wen at the Boston Globe has written a new piece on children's disability benefits under Supplemental Security Income. The piece contains words and phrases such as "controversial", "dramatic growth" and "replaced welfare." The piece seems to have little if any new information.
    The hard numbers show that 1,083,874 children received SSI in July 2013 and 1,074,908 received the benefits in July 2014. That's not dramatic growth. That's a modest decline. Ms. Wen doesn't report this.
     Ms. Wen got a lot of attention for her original series of articles on SSI child's disability. She doesn't seem to have anything new to report on the subject but she keeps repeating what she originally wrote.

23 comments:

Anonymous said...

I have a question.

Shouldn't parents be responsible for their sick children or children that claims to be disabled? I mean,parents laid down,and had them. Where is the responsibility?

It's different for adults with disabilities. If an adult is unable to perform sga,who will assist the adult other than SSA or a similar program?

Anonymous said...

Answering your question:

The costs of properly supporting a child with a very severe long-term disability can quickly beggar even a relatively well-off middle class family. Except in rare cases, you don't know when you have children whether they will have such a condition. For many families, the needs of the disabled child exceed the family's ability to provide support.

The question is whether we as a society want to provide some modest cash support to the most destitute families caring for these severely disabled children. If you think so, then you support SSI for children. If you think not, then you don't.

I personally feel better about the USA as a country that we do support them.

Anonymous said...

for kids, the disability standard should be: does the child have a medical impairment of such severity that it requires his parent(s) to be absent from work an excessive amount of time such that he/she can provide necessary care for said claimant.

the reality is that the vast, vast, vast majority of kids getting SSI are merely ADHD. A condition that is 100% controllable with meds. For these kids, give the parents access to free meds. that's it. They're in school all day, so no need for parents to take off work. They only return for follow up visits with their Dr ever 3-6 months, so again, no need for $$ to supplement the parent's income.

are there kids who have medical problems of such severity that it devastates his family because of required round the clock care? yes. but I'd estimate that at least 90% of the kids getting SSI currently, do not fall within this category.

Anonymous said...

Also, let's not forget that Medicaid (which a family qualifying for SSI would also presumably qualify for) provides most all expenses related to the actual medical care for a (disabled) child receiving Medicaid benefits...

Anonymous said...

In response to 12:25 PM, September 02, 2014.


With the passage of the affordable care act(obamacare),and or a parent's employer insurance,there is NO need for minors to receive SSI. Thusly responsibility should totally be with the parent.

The child SSI program is a waste of money. In a time of tight federal budgets,it should be eliminated.

But to accommodate any parent who believes a child should get cash benefits,SSA or the government should increase Fica taxes on a parent for this purpose.

Anonymous said...

The primary thought in the article was that SSI for kids was now larger than traditional welfare. It was more attractive due to the higher payments and had not faced the varied restrictions imposed by the welfare reforms of the Clinton era. As stated many times by others Congress should at least look at a family max for SSI kids like that imposed under SSA programs.

Anonymous said...

Poor people seeking out more money. Now that's a shocker. Maybe we could raise welfare benefits to see if people then move from SSI to welfare. that might demonstrate cause and effect. Perhaps this is just another example of how the South uses the federal government to subsidize low welfare benefits much like corporations allow Federal programs like SNAP to help subsidize low wages and lousy benefits.

Anonymous said...

I think it's important to note that eligibility for childhood SSI benefits was changed forever by the decision in the Zebley vs Sullivan court case...

Anonymous said...

Interesting stream of thoughts - with many of the comments based on lack of knowledge (ignorance?) of the key issues.

ADHD is NOT 100% controllable - read the medical research. Medication and therapy works for many kids - but not all despite the best efforts of parents and clinicians. A more convincing argument in that line is why does the program give benefits to so many kids with speech/language delays which is the 2nd largest number?

Do families with kids need some support? Certainly - especially with those who are undergoing treatment requiring many medical appointments, etc.

Is the amount too high? I'm in the group that would say - yes - why are we paying children the same potential amount as adults.

To the writer who said the Zebley decision is forever - well not really - the Zebley decision does not mandate benefits - the decision was on HOW medical eligibility is determined. Congress can curb the program anytime it wants - and they did in the late 1990's with legislation which pulled back some of qualification criteria put into place by regulations established from Zebley.

A key issue from the Boston Globe article is that with the dramatic change AFDC benefits - many families have turned to SSI for income - and unfortunately many families with one or both parents unemployed are relying on SSI for their kids for family income.....so we are creating a generation of people who don't try to work.

A key change of the program would be to limit benefits for SSI kids - put on a family maximum - and give higher benefits for families who have children with catastrophic conditions - primarily physical impairments - but perhaps also severe cases of autism.

Anonymous said...

A point of clarification, Mr. Hall on the growth of the program - the article's point is the growth of the program over the last decade or more - NOT just the last year comparison - and if one looks at the longitudinal data - you will find dramatic increase in children receiving payments over the last 10 to 15 years - especially since the change in AFDC.

Anonymous said...

SSI is for food clothing and shelter - all of which a parent is supposed to provide to a child. If an adult received any one of these items for free, let alone all three, the would be subject to a B living arrangement and a 1/3 reduction intheir SSI check. I will never understand why children are not subject to these same rules.

I am all for making sure the children receive any and all medical services they may need, but the cash benefits for many of the recipients just does not make sense.

Anonymous said...

Children ARE subject to the 1/3 reduction if they get free or below-market housing.

But a lot of times the money is being used for food, clothing, and shelter. For example, if the family lives in public housing or has a section 8 voucher, the household rent goes up when the kid gets SSI. Also, the parent could be unemployed and using the SSI to pay rent or mortgage.

Anonymous said...

@9:31 - my children do get free rent... Last I checked i don't charge them. So why does an SSI child not have the same benefit from their parent?

Anonymous said...

I agree that SOME modifications to kids' SSI probably need to be made, but most are not "merely ADH." Since the changes in regulations mentioned previously, there must be "marked" limitations in several domains for the children to qualify--a high standard of proof; this has greatly reduced the number of awards which I've seen. Because of the limitations of the ACA and limits of what Medicaid will pay, the problems of access to proper treatment for the children remains a problem in severe cases.

Anonymous said...

No, you are right, most of them are ODD and have no discipline from their parents...

Anonymous said...

Several domains being 2 out of 6...

Anonymous said...

I'd have to agree with 1:02pm, in addition there may also be some jealousy, I saw that online over the years cause I get SSI, though I have no children, nor did I ever get SSI or anything beyond food stamps before getting SSI, but then I'm severely disabled and unable to work, which to some seems to be some sort of mean and religious taboo of the stupid kind. That's My 2 cents.

Anonymous said...

Make that 1:02am.

Anonymous said...

Wow there sure seems a lot of sentiment amongst the posters against helping low income disabled kids. I sure am glad that I am not that cynical. I think that Dickens wrote "The Christmas Carol," with some like you in mind.

Anonymous said...

@10:45
so then how do you explain when kids have their age 18 redetermination, 90% get kicked off SS? wouldnt you think that if these kids were truly disabled, now that they have medicaid and $$, they would have reams of medical records showing that they regularly returned for medical treatment?? but shockingly! the vast majority haven't been to a single doctor since they got on the roll.

Anonymous said...

@10:16

Actually a bit more than half stay on benefits at age 18 re-determination. See table 1 at:

http://www.socialsecurity.gov/policy/docs/ssb/v69n4/v69n4p1.html

It's not that strange that a bit more than 40% lose benefits at age 18 re-determination, considering a different disability standard applies and, as we would hope, some severely disabled kids do medically improve to where they can work in competitive employment.

Some that lose benefits at that point lose them properly. However, many thousands are still found disabled. Even amongst those who lose there are some that still have disabling impairments. In that sub-group, some claims are mis-adjudicated, and some may be legitimately disabled but not able to properly document it at the time of re-determination.

I see no need to cut the SSI Kids program. There's clearly room for improvements and efforts to improve accuracy in decision making are fine. However, cutting the program out would deny much needed assistance to one of the most vulnerable and needy groups in our society, impoverished disabled children. There's not many things in our government budget I would place above helping disabled kids in need, and I suspect a majority of Americans would agree.

To those who clamor for cuts in government spending, I would suggest leaving help for disabled kids alone. Any politician who advocates for that will come across as heartless, and will lose credibility with large segments of the public.


Anonymous said...

Good point Anon 11:09 about needing to be "marked" or "extreme" in the domains. I am training my attorneys on SSI child disability this week. Below is an excerpt from this training.

Bottom line it is MUCH harder to gain child SSI disability than adult SSD/SSI.

Necessary considerations

I treat child SSI disability claims almost like an adult but a little different. I see 2 main ways to gain child SSI.

1. Meet or equal one of the child’s listings.
2. The child is marked in 2 of the 6 domains or extreme in 1 of the domains.

There are obviously other case law, CFRs, SSRs, Hallex, etc. that go into more detail. But those are the basics. SSA.gov is a tremendous resource on all the substantive law.

I treat all cases for adult disability trying to get around Step 5 (other work). If I can get any claimant under 62 around step 5, then the claimant wins. Period. I understand there other areas like the listings and Grids. But if I can get a physical or psych RFC below sedentary, then the claimant wins (or should).

Anonymous said...

I have read the article and some of the blog statements. What stands out is the lack of organization of the article. I am not a lawyer, know little about SSI, and do not have a dog in this fight. However, just reading the article left me with lots of unknowns that were not addressed or sketchy comparisons. For instance, I was confused with the comparisons to TANF. As most know, the cost of living is cheaper in Mississippi than in California. No surprise that remunerations might depend on the state in which a distressed family might reside...a Mississippi family might feel wealthy if they were paid by CA standards. The families have no control over this. However, they do have control over where they might look for help. No surprise, again, that families might gravitate to SSI or TANF depending on which program gives them more money in their pockets. They are taking care of children that most of the bloggers say must be verifiably disabled in order to qualify. If they are not checked and rechecked by the funders, what are poor parents supposed to do? Call someone to stop their payments?

I found the article a bit all over the place with difficult-to-compare stats. At first the $9.7 billion seemed high when comparing the SSI for children vs "welfare" (defined only as 'nation's welfare programs'). In other words the children received $.7 billion more than all of the nation's welfare programs spent? Where does this fit in with the $32 billion of TANF (Federal and state funds)? Help me out here. If we are going to compare apples, compare apples. Don't bring in the oranges without some more explanation.

It appears that I am supposed to be upset that children...CHILDREN... receive $ 0.7 billion more money from the federal government than adults. Sorry. I don't get it. I was lucky to have healthy children and now healthy grandchildren. I cannot imagine how a single mother with a child who requires full-time care--can cope with her life. I prefer to think she needs some help and I cannot try to nickel and dime her into a downward spiral. Help her child and help her family. We'll all be better for creating functioning families.

Anonymous Grandmother