Dr. James Perrin, professor of pediatrics at Harvard Medical School, was on the Here and Now radio program talking about the Institute of Medicine study on Supplemental Security Income (SSI) benefits for children disabled by mental disorders. Perrin was one of the researchers for the study. The main takeaway from Dr. Perrin: the biggest problem with SSI child benefits for mental disorders is that there are many children who should be on benefits who aren't receiving them.
18 comments:
That statement, by itself, doesn't really mean much. It's no different then a treating physician who states in his/her records nothing more than, "I believe the patient to be completely and totally disabled."
No news here, but first of all, the issue of disability is one that is reserved to the Commissioner to determine. Second, each case succeeds or fails on its individual medical records. If the opinion is supported by the treating physician's own treatment notes and the weight of the record, as a whole, or at least is not inconsistent with other substantial evidence, then the child is disabled, as long as all other criteria are met.
Even a professional researcher in the field of childhood mental illness has no basis for the opinion that many children are improperly denied benefits without first also establishing that he understands the benefit program rules/regulations and has reviewed, or is aware of, a significant sampling of adjudicated cases that were improperly denied.
The SSI they deserve? Not sure anyone deserves welfare. Having said that, they should just quit the word games and call SSI what it really is: federal welfare. I'm not contending that children on the program are or are not medically disabled. If my child needed SSI, I couldn't get it. Does that mean he or she isn't medically disabled? Of course not - what it means is the government is handing out welfare in the disguise of a "disability benefit". How many children get ceased at age 18? Are they healed?
I am always amused at the far right’s knee jerk opposition to the term “welfare.” Welfare basically means doing well. The founding fathers urged us to “promote the general welfare” in the preamble to the Constitution. Major religions exhort their followers to do things like helping impoverished disabled kids. You would think it would take the devil’s own ad man to convince anyone decent that “doing well” in such a manner was somehow worthy of scorn and derision. What convinced you, Anon 12:04?
My main issue is that I do not feel it is right that it is easier to get your child on disability if they have behavior problems than if they have cystic fibrosis or a missing limb.
A missing limb may be easier to deal with than a long term mental illness that causes severe behavior problems in a child. A child with such a mental illness typically cannot make friends and learn well. They quickly fall behind their peers. Parents of such a child in an impoverished family often cannot find child care due to the difficulties caused by the mental illness (even if they could afford it, which they usually cannot). As a result, it's difficult or impossible for the parents to work because their hands are full with they extremely difficult task of caring for a mentally disabled child. I don't begrudge those families help through the SSI program.
Besides, kids with missing limbs and CF are likely to meet listings, and get approved fairly easily.
Perhaps someone read the whole 394 pages. I couldn't bring myself to do so. Is there any recommendation about how the parents should spend the SSI money? Or any studies done on the number of parents and families who rely on their disabled child's money to be the main source of cash income for a family? It is my observation that it happens enough to be statistically significant. This week I spoke with the father of a disabled child. Mother is paid as the care provider of the disabled child; dad says he can't work because he has four other children to take care of. So the disabled child provides all the money to a household of seven.
Deserve SSI. Deserves... No doubt there are many disabled children who are not getting cash benefits but there are also parents who don't meet the income/resource rules. Did these parents apply and get denied for excess income or denied due to medical reasons? Did the writer of this tome ever do any studies on how many children on SSI turn 18 with federal debt because of parental income?
Why not advocate for vouchers for respite care, therapy, equipment, other special needs and make them dependent upon the diagnosis. At least then, there would be some correlation between the condition and how the money was spent. And parents would have to find another way to support themselves and whatever lifestyle they choose.
Guess I am confused. Children can meet listing and not be on rolls due to parental income. Child's SSI is for disabled children whose parents are low income. Just because a child is truly disabled, doesn't mean they should receive SSI. This whole piece seems a waste of time.
@ 1:38 and @ 7:21...thank you for your wise comments. The system is broken, too many families use child SSI as a primary means of support. Right now, it's the default "welfare" system in our country (along with food stamps, section 8, Medicaid, cash assistance, etc.). I support helping those in need, but couching this help under the guise of "disability" is a joke. Time to reform the system to provide needed healthcare, therapy, medication, etc. but remove the huge incentive for parents to have a "disabled" kid.
1:38 AM and 7:21 AM comments was not wisdom. There is a system already in place for free respite, therapy, and equipment, and that is called "State Division of Developmental Disabilities".
There are already forms in place for parents to complete- to account for the spending of SSI assets for the child. They are called "SSA Payee Accounting Forms"
As for the paid caregiver mom, that sounds suspect because they do not allow moms and dads to be paid caregivers. That violates rules for federal funding.
"Legally responsible persons, defined as a parent of a minor child, or the individual’s spouse, may not be paid to provide services to an individual." http://tinyurl.com/pacwent
The link below shows the income limits for Child SSI. It is quite generous. Maybe dad is unaware that he CAN work, and not loose Child SSI.
https://www.socialsecurity.gov/ssi/text-child-ussi.htm
I see too many comments from people who THINK they know what is best. However, what you are reading is coming from a person who is receiving child SSI for my own child.
Children have milestone markers that they should meet as they get older. When a child is not meeting those markers, something is wrong. I'm not talking about a few milestones, but MANY milestones that is detrimental for a person to be a functional member of society. I don't wish this on my worst enemy.
A few things SSI pays for is doctors not covered by Medicaid. SSI helps pay for damages done by the disabled child (ex. breaking a doorknob). SSI pays for dietary needs not paid for by insurance.
I am so sick of these poor people myths(its welfare, parents misspend the money, ad nauseam....) It is not an incentive to have a disabled child.
Ummm 10:42, I am 7:21, my comments were 100% true, and, I am well in the know on both sides of this issue due to my career in the dib field, and due to the fact my child was born with a genetic disability that does meet listing. Therefore I am well aware of the rules regarding this. Thank you for your comments, however, if my income were lower he/she would qualify, since it isn't, he/she does not. Therefore, SSI is needs based and just because a child is born disabled does not mean that child does or should qualify for Child's SSI.
"I am so sick of these poor people myths(its welfare, parents misspend the money, ad nauseam....) It is not an incentive to have a disabled child."
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I can understand your frustration, but SSI is welfare, even if you disagree with the negative connotations of that word. Anecdotes about parents misspending the money are not "myths" -- abuse of the system is very real, albeit somewhat overblown. Perhaps a few bad apples shouldn't spoil the bunch, but there's no point denying that such apples exist.
I think some of the backlash against child SSI comes from a much broader political/philosophical point of contention: whether SSI recipients should continue having children, and whether the public should subsidize that choice. You're unlikely to get people to switch camps on that issue.
@10:42
I realize that my post is anecdotal, but it is all true. In California, the In Home Supportive Services does pay money to some parents as their child care's provider. This is considered non-covered wages and the parents are not paying FICA taxes, but they are wages and the parents get a W-2 form.
Not all SSI children qualify as developmentally disabled and do not have the ability to access developmentally disabled funding.
And, IMO, many payee accounting forms are a joke. Some payees keep meticulous records. Too many other payees add the SSI funds to the family pot and really cannot truly account for how they spend the money. And seriously, how can a parent of one disabled child and several non-disabled child (who are not on any benefit program) tell the non-disabled children that there is enough money to buy new clothes, new shoes, entertainment for the disabled child but there is not enough money from the parents' own income to pay for the same things for the non-disabled children. These parents know that the money is spent, they know that their children (all of them) are fed and clothed, but there is no way they can prove how much is spent on food and shelter and how much is spent on personal needs.
My experience is 28 years as an SSI claims rep. It is not a myth that there is a significant amount of fraud and whole families being supported by SSI. It is not the norm, but it is also not insignificant. I don't know of a good solution.
@10:14 A child with one missing limb usually does not mete a Listing and many with cystic fibrosis do not either. This is especially so if they are given the proper treatment and therapy by their parent.
@ 1:20 AM Im 10:42, thanks for explaining that to me. I didn't know California had different laws pertaining to that. Sorry I said that your post didn't have wisdom. Now that you explained more detail, it makes a lot of sense what you said.
@9:50
True, not all with one missing limb or CF meet listings, but they can still get approved by proving marked impairments in two functional domains. In such physical disability cases it properly comes down to the degree of functional limitation, just as it should for cases of mental disability.
@11:30 you are right. They can. However it is far easier for the behavior problems to have marked in multiple domains. The disruptive behavior may mean he is rated as marked in acquiring and using info because even if he is of average i or borderline intellect and achievement it can be argued he is not using his intellect. Since he is not doing what his teachers tell him and not doing his homework or is being sent to detention or is habitually absent or tardy he can be given a marked in contraction, persistence and task completion. Since h may cuss or be verbally or physically aggressive he may be given a marked for social interactions with others. Then he may be give a marked for taking care of himself because these same behaviors can be considered as emotional days regulation. I am not talking here of children with classical autism who cannot control their behaviors but of those who may cuss, steal and bully because they can. This is a minority of those allowed under SSI. However I have seen difficulties trying to give those with physical impairments marked under other domains even when their therapy or condition disrupts their classroom routine or ability to socialize outside the classroom .
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