The commissioner of the Social Security Administration for the first time publicly acknowledged yesterday that there are major flaws with the $10 billion children’s disability program his agency oversees and said he was aggressively seeking congressional approval to conduct an independent scientific study of the program’s weaknesses.
In an extensive interview at the Globe, Michael Astrue said that such a study, which would cost about $10 million, could provide a dispassionate, scientific basis for changing aspects of the children’s Supplemental Security Income (SSI) program, which can be overhauled only by congressional decree.
The best organization to identify problems within the swiftly growing program, he said, is the Institute of Medicine, the nonprofit health research wing of the National Academy of Sciences. ...
“Too much of legislation happens by sound bite and anecdote,’’ Astrue said. “It’s one of the things I worry about in this area. When you see how shrill the advocates are, and then you see what we are getting from the other side of the fence, too, what kind of legislation is this going to look like if we’re not careful?’’ ...
The commissioner was careful not to say that parents were deliberately cheating the system. Rather, he said the law makes the SSI program, by statute, vulnerable to being manipulated by families, lawyers, and others with financial incentives to gain SSI benefits. ...
He said he has a strong suspicion that many children who are deemed troubled do not warrant a disability label, as given by the SSI program. In many instances, he said, the children do not qualify under stricter adult SSI standards once they turn 18.
“I think that’s a sign that there’s a certain percentage of them there that shouldn’t have been there in the first place,’’ he said.
Let me say that in the area where we practice, most attorneys avoid the SSI child's cases. My firm takes a few of them but many attorneys, perhaps most, avoid them altogether. We mostly avoid ADHD, seizures and asthma as the primary basis for a child's disability claim since these types of SSI child's cases are particularly problematic. My guess is that most Social Security attorneys across the country either do not take the SSI children's cases or take only a select few. In general, the SSI child's cases are just tough to win at the hearing level. Everybody who deals with them says the same thing -- often the mother has more serious problems than the child. It can be tough to separate how how much of the child's problems are due to the mother's own psychiatric problems and how much is innate to the child. This is not every case but there are enough cases like this to be very noticeable.
Still, there are cases that cry out for SSI child's benefits. I remember one case I had where the child had severe hearing problems from birth. Tragically, even though the child had good parents, the problem was not recognized until too late. There is a time period in a child's life during which it must be able to hear spoken speech. If the child is not able to hear speech during this time period, the child will never be able to understand spoken speech or be able to speak effectively. Social Security denied the child since by the time the claim was filed the child had a hearing aid and could hear sound but the sound was meaningless to the child and would remain so. The child was approved by an Administrative Law Judge.
19 comments:
While the example you give is an unfortunate situation, how would child SSI have helped the child? If the child's family met the income restrictions for SSI, then the child was already eligible for Medicaid and therefore had access to the same medical services that SSI child disability would provide. You stated that the family did not recognize the problem in time to implement the early intervention needed, so winning child SSI benefits at a later date would not rectify that issue.
While it is possible that the parents would have used the monthly cash benefit to obtain speech therapy or sign language training or some other service to help this child cope with his hearing loss, the odds are that the money would have been spent on things that did not address the child's disability.
There are very few situations where child SSI benefits would serve a meaningful purpose since the child already has access to Medicaid by virtue of the family's low income and if the child is school-age, the school has to provide special education services for intellectual, communicative, or behavioral disabilities.
Any restructuring of the SSI program for children MUST include some stipulation about how the money is spent.
In my area, parents use children collecting SSI as a substitute for a paycheck. Sad.
The commissioner should discover the legal age to work gainfully in each state and ask congress to amend the child disability program accordingly.
Way way overdue. If the commissioner manages to get legislation passed to change SSI for children, again, we in the field offices will be ecstatic. Every day we see that SSI for children has become a way of improving living conditions for welfare families with parents who see SSI as their personal spending money. Legislation about how the money should be spent will have no effect if the law doesn't have some real "teeth", unlike dedicated accounts. Getting money back from people who have none is impossible, even if they misapply or misuse.
Any legislation that tries to control how the money is spent will quickly create huge, meaningless workloads - the parents will try to circumvent the rules, and SSA will try to catch them. See Dedicated Accounts. If you want to eliminate those cash payments, that would be great - with all their free time, the SSI claims reps could learn Title 2, and we would solve many of our staffing problems. I won't be holding my breath though. Congress is much more likely to create more rules, which will only complicate an overly complicated program further.
I work for a law firm that represents SSD/SSI claimants. One of my children has severe, multiple congenital disabilities and bcs of that I feel that I can understand the special needs of a disabled child. That said, I'm very much bothered by the calls we get from parents who are filing appeals for disabled children. With a very few exceptions, the impairment cited is ADHD and the callers cannot cite any special needs that the child has. It's extremely unusual to rec a call regarding a child who has what seems to be a severe impairment. We take perhaps one SSI child's claim every couple of yrs.
I am saddened by the comments in the main article and by the comments here. You paint with way too wide a brush. There can be reasoned debate about disability for children as a public policy issue as there can be about ANY public policy issue. But to brand all or even most SSI claimants as liars or cheats is mean spirited and hateful.
I am an attorney and I take kid's cases. They certainly are not a money maker and I agree that these are among the most difficult cases to win. When I read of attorneys who will not take these cases because they are difficult, I respond that these are the claimants that need you the most. Please note well that I am NOT speaking of claims without arguable merit. I am speaking about cases with merit that may be difficult to prove. These are the folks that need experienced counsel.
Welfare medicaid and SSI medicaid are NOT the same thing. State medicaid programs cover less and less each day. It is about to get much worse. These children are in desperate need for every service imaginable. To say that school districts provide all of the necessary services is to believe in the tooth fairy.
Undoubtedly some will point to some individual who has defrauded the system and say "See, they are all liars and cheats! Abolish SSI!" Well, I read a story last week about an SSA employee stealing benefits and selling fake SSN's. Should I allow the reputations of the overwhelming majority of dedicated public servants to be diminished by a few of their coworkers? Of course not.
How we treat the least fortunate of our society is how we will be judged.
The "mother's own psychiatric problems???" - recommend you reconsider to reflect "Parents psychiatric problems, economic conditions, or cultural acceptability in certain low-income communities." Agree you have painted with a broad brush to suggest the child SSI population is due to mothers in general.
Wow, 10 million to just conduct a study? This smells corruption. The consultant will get paid, what $1000 an hour?
Claims lead for this week: mother applying for SSIDC. She's on SSI. Child's disability: asthma and eczema. Won't get approved, but gives you a glimpse of the mindset...so much generational welfare....
If the children have true special needs that cannot be covered by regular Medicaid, then there could be SSI entitlement similar to 1619b entitlement for the working SSI recipients who cannot afford to pay for their medical care or other services. They still have to meet all SSI requirements but rather than providing the parents of children with cash, the parents get a voucher or ticket or stamp that allows them to purchase the services they need from a variety of private providers. There could also be a stipend for living expenses, similar to the amount that one extra TANF child would get if added to a grant; $100 per month plus food stamps rather than $674 per month.
Of course, this sort of system takes away some of the choices available to those with cash to spend. Just like food stamps that don't cover everything a person wants to buy at the grocery store. But this is a public assistance program. Designed to provide for basic necessities. And those who are willing to commit fraud will find a way to do it.
And of course the advocates will trot out the obviously disabled poster child and use them to pull heartstrings and the naysayers will find those egregious parents who do teach their children how to act disabled and who put them on drugs instead learning how to parent. But then there is the vast majority in the middle of those two extremes that may need a little extra help that SSI can provide. But a disabled child's money should NEVER be a way to improve the financial well-being of a family and too often it is.
"Congress is much more likely to create more rules, which will only complicate an overly complicated program further."
The problem is not Congress, it is SSA. Congress intended child SSI to only go to children who met or medically equaled a listing. SSA created functional equivalency to get around Congress and keep paying large numbers of children who should not qualify. SSA can fix the problem it has created by doing what Congress intended.
Anon of 10:40:
How feeble are our memories! And to think that Zebly came down from the SCOTUS only 20 years ago. Seems just like yesterday.
Is there any such thing as a neutral historical fact? I came across a delicious anecdote in a George Orwell essay. Trusting to my own feeble memory of how Orwell told this story, Clemenceau was asked at the 1919 Paris peace conference what historians would say about who started WWI. “Whatever they say,” he growled, “they will not say that France invaded Belgium.”
To see what Justice Blackmun said about congressional intent, see SSR 91-07c.
http://www.ssa.gov/OP_Home/rulings/ssi/01/SSR91-07-ssi-01.html
JOA
Right you are, JOA. Why, heavens to Betsy, Congressional intent is always clear as a bell. Just as the looming rapture is clear as a bell....
One might note, probably in vain, that "Congress" is a body of some 535 souls, the singular intent of which just ain't all that simple, folks.
give SSI back to the states and let the states make the rules. way cheaper for the taxpayers. the entire SSI program is a shambles. eight million recipients, 48 billion dollars a year, and virtually uncontrolled and unmonitored.
I hope this bogus ADHD is the first thing to be deleted. What a joke.
Lack of parenting skills/ability should never lead to a finding of disability for the child...but it does.
I see lots of cases where the mom (never the dad, he's out of the picture) claims oppositional defiant disorder and says something along the lines of "he won't listen" and "he won't do chores like I tell him to."
Welcome to the world of parenting, learn to act like an adult and there's a chance your child might listen to and respect you.
I have a memory too,
While not directly stated in Zebly , at the hearing level, the problem was ALJ who tried to circumvent the "medical equivalence> provision in applying the Listings by not using a ME/MA at hearings. They were just trying to be cheap and save hearing room time.
I have seen paying and non-pay ALJ winging-it with no ME input for equally shallow decisions.
Also, I should add that most had no idea that the child disability regulations required use of Listings' Part B for childhood illness AND Part A for adults, not just Part B.
It is still another question why SSA should be paying children, plus the 'fraudulent' parenting and how many of the children ever benefit for the added SSI check coming into the household (and ... the live-in boy friend's habit ... ). Sorry for the stereotype, but this is the real world.
@ Anon above:
stereotypes exist because they are at LEAST in part based on some truth.
Don't be sorry for highlighting the truth.
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