May 16, 2012

American Exceptionalism Must Prevail -- Don't Follow Foreign Practices, Especially Those Likely To Cause Chaos

     According to a report from The Telegraph, the British government has decided that it is paying disability benefits to too many people. The government's plan is to cut a half million Britons off disability benefits. This would be a quarter of those drawing the most important type of British disability benefits, the Disability Living Allowance. Reviews are already underway in the other type of British disability benefit, the Incapacity Benefit, and 60% of those recipients are being cut off benefits. 
     The government minister responsible for the changes in disability benefits says it is "scaremongering" to allege that the British government is "slashing" disability benefits.


Anonymous said...

This is a wonderful idea and the US would be wise to take similar steps to get the undeserving off the disability roles. The most sensible changes would to eliminate child SSI unless a listing is met or medically equaled (which was Congress intended anyway) and to eliminate the idiotic and inappropriate age-based presumptions. A person who is fifty and capable of sedentary work or fifty-five and capable of light work is NOT disabled and should not be considered disabled. Those two changes would greatly reform the system and focus the awards of benefits on those who are truly disabled.

Any representative who cares about the integrity and viability of the disability system, instead of the size of their bank account, would agree with me.

Anonymous said...

Agreed. Child SSI should go. Age-based GRID rules are silly and should go as well.

Anonymous said...

Anon 3:11,

I didn't get the same take as you did when I read the linked article. The only two "reforms" the article mentions appear to be concepts similar to what SSA already has, e.g. a more functionally based approach to disability determination, and a continuing disability review. The Brits seem to be playing catch up to SSA there.

Reasonable folks agree on most things. Beneficiaries who get better and are legitimately able to work should go off the rolls and that means doing more and better CDRs. Those who legitimately can't work should stay on.

What I am suspicious of are proposals that would have the effect of excluding people who genuinely can't work from the disability program, in the guise of supposed "cost-saving reforms." Examples: 1. proposals to only give benefits to people who meet listings 2. changing the rules to exclude consideration of the legitimate effects of pain and non-exertional limitations.

Lots of babies are thrown out with the bath water there (translation: people who genuinely can't work are excluded and left in a desparate situation with no means of support). Where will you find those people? Destitute and in your local emergency rooms, hospitals, homeless shelters, jails, etc. Who ultimately pays for that? Check the nearest mirror.

These "reform" proposals shift the public cost around, but I doubt that they reduce it. The image of a shell game comes to mind.

Anonymous said...

Anon 4:00, I think that pain and non-exertional considerations are legitimate and ought to be an aspect of the adult disability analysis. I also believe that the listings should not be the stopping point for adult disability.

However, for children, SSI benefits should only go to the worst children -- profound mental retardation, severe JRA, severe cerebral palsy, etc. While these children are rightly granted benefits, there are many children who get benefits because they found a sympathetic ALJ or found a doctor willing to say the child was markedly functionally limited, when that is often not really the case. Outside of severe (in the real sense of the word, not the SSA "a hangnail is severe" sense) physical conditions such as those mentioned above or severe intellectual disabilities, often the problem the child faces is a dysfunctional living situation. The family does not need an extra $600 a month to help out Junior, but rather needs services from other agencies to address the sources of dysfunction (poor education by parents, drugs/alcohol, mental illness of parents, abusive relationships, etc.).

Besides restricting child SSI to listing level impairments and eliminating age-based presumptions [you still have the adverse vocational categories, such as the so-called "mule rule"], the only two major changes I would advocate in the disability program itself are mandating that CDRs be performed as scheduled (every 3, 5, or 7 years) and that inability to speak English not be used as a potentially disabling factor in Spanish-speaking Puerto Rico.

There are other changes that could be made, such as making work incentives and rules clearer, simplifying the non-disability requirements for SSI, doing a better job of explaining overpayments to beneficiaries, and requiring more from representatives, but these would not affect who is disabled or not disabled directly.

ANON 3:11 (and now 5:01)

Anonymous said...

Committee Reports from the 104th Congress 1995-1996; Senate Report 104-096 (The Family Self-Sufficiency Act of 1995):

For example, there is an ongoing controversy over the purpose of the children's SSI program. According to history of the original SSI legislation, the House Ways and Means Committee included children with disabilities in the SSI program to assist families with the extra expenses associated with their child's disability (see H. Rpt. 92-231 at 147-148). The Senate Finance Committee did not agree, believing the needs of children with disabilities were generally only greater for health care, and that most children would qualify for Medicaid (see S. Rpt. 92-1230 at 385). The Senate receded in conference.

The Committee urges those who seek changes in eligibility standards or other program features to resolve such matters directly with Congress. As a general matter, it is impossible for Congress to properly oversee any program, especially an entitlement program, when rules are reinterpreted by a court and unilaterally implemented by an agency. The Committee is also deeply concerned about the false hopes such behavior creates for individuals who then expect to benefit from a program.

The Committee believes this is an important issue that needs to be revisited. It is easy to imagine extra expenses for a child with a disability, and helping families with such expenses is an appropriate rationale for this program. However, the best data available indicate that for many children receiving SSI their families do not incur extra disability-related expenses on their behalf, and that SSI is often used for general household expenses. Moreover, there is a small percentage of children who incur huge disability-related expenses barely touched by the SSI payment. These data raise fundamental questions of fairness and equity.

The Committee also believes there are many unmet needs for children with disabilities, and is aware of the controversy over whether some children would be better served by services, such as mental health treatment or purchase of items of assistive technology, rather than by cash payments. In the 23 years since the SSI program was created, substantial new programs have been created to assist children with disabilities, including Federal funding for special education and expansion of Medicaid. The impact of these programs on cash needs of children with disabilities merits careful evaluation as well.

The Committee is determined to treat fairly those current recipients affected by the rules changes, and has included explicit protection for appeal and due process procedures and a partial grandfathering (until January 1, 1997), with a hold harmless provision for any overpayments. The Committee expects the Social Security Administration to be mindful of its experience with the hazards of large scale continuing disability reviews and urges it to conduct these reviews in an orderly fashion.