Nov 12, 2020

Final Musculoskeletal Listings Changes Approved

      The Office of Management and Budget (OMB) has approved final regulations to modify Social Security's Listing of Impairments on musculoskeletal disorders. This proposal had been pending at OMB since last December, an extraordinary length of time. We don't know what's in the approved final regulations, although it's unlikely to be much different from the proposal. Expect to see these published in the Federal Register in the near future.

     The proposal was extremely controversial. Musculoskeletal disorders produce a lot of disability. There's no doubt that the proposed regulations would have a significant effect upon who gets approved for disability benefits and that the intention was to sharply reduce the number approved. My opinion is that these regulations will prove to be the most enduring legacy of the Trump Administration as far as Social Security is concerned and that it will be a harsh legacy.

     In theory, these regulations could be reviewed under the Congressional Review Act. It would only take a majority vote in both Houses of Congress plus the incoming President's approval to ditch these. No filibuster is allowed. However, these may seem too technical to get voted down. Also, if regulations get voted down under the Congressional Review Act, it takes Congressional approval to ever revive them. That could make it difficult for Social Security to ever modify the musculoskeletal Listings.

     I would say that under normal circumstances Social Security would like to have considerable lead time in order to implement something of this magnitude and might make them effective further out in the future than the minimum 30 days notice. However, I don't think that those behind these regs expect to be around for the implementation or care much about proper implementation. For them, it's smash and grab time.

     Below is a side by side comparison of the proposed regulation and the current regulation. Click on each to view full size. There was also an extensive preamble to the proposed regulations.

Click on each image to view full size










14 comments:

Anonymous said...

1.21(c) would exclude anyone who won't benefit from further treatment (i.e. maximum benefits from therapy has been achieved)...that seems backwards.

Anonymous said...

"1.21(c) would exclude anyone who won't benefit from further treatment (i.e. maximum benefits from therapy has been achieved)...that seems backwards."

This makes perfect sense.

Once you achieve maximum benefit, you can comfortably settle into your new career as surveillance system monitor without interference from workplace absences due to therapy.

Anonymous said...

@10:02

Ha!

Anonymous said...

The SSA usually is very slick when they change the listings. On its face, it sometimes looks like it may help claimants. But in reality, it may give ALJs or MEs more ways to not meet a listing.

Anonymous said...

I don't think 1.21 is a problem. Its really no different than the current listing that requires continuing surgical management. Under either the old or the potential new listing, if you are not receiving continuing surgical treatment (because the maximum benefits of therapy have been achieved) then the listing no longer applies. That's not to say that you are no longer disabled.
Whatever residual functional limitations remain would be considered.

I haven't reviewed all of the new ones but I am assuming we will have much bigger problems than 1.21.

Anonymous said...

@10:02

Those with conditions like Degenerative Disk Disease which usually is accompanied by nerve compression, cannot sit for very long, stand for very long, or walk for very long. Some can only sit for 5-20 minutes. One can't "comfortably settle into" hardly anything. Chair, walking, standing, even laying flat... most employers are unable to accommodate the constant movement required, and even then, it's painful. Even after surgery, a lot of people still feel pain. Nerves don't always heal. They have memory, but if pinched for too long, they can become permanently damaged and cause excruciating nerve pain even with the best of surgeons. Be more compassionate. Do some research. This is a big deal for those with musculoskeletal diseases and deformations. Your post is quite cold toward those in constant pain.

Anonymous said...

@4:45

9:42/10:42 here.

I'm 99% sure 10:02 was joking. SSA has been insisting for years that the job of "surveillance system monitor" still exists in the national economy when it objectively does not.

Anonymous said...

just for the unaware...whether an impairment "meets a listing" is not determinative of whether an individual is disabled. The impairment can be found to "not meet" or "not medically equal" and the claimant can still be found disabled. In my experience, the "meets" or "equals" decisions are already very rare.

Anonymous said...

@4:45

10:02 here.

As 9:42/10:42 noted, I was joking.

I was making fun of what appears to be Social Security's consistently more punitive approach to disabled people when it comes to automatic disability awards based solely on the medical records (the listings).

When you are under 50, and you do not meet a listing, "surveillance system monitor" is a common (and by common, I mean common during the 1970s) job that is often provided by a Vocational Expert at disability hearing if you are found to be limited to sedentary work. There are many other potential fake jobs, but "surveillance system monitor" is really the current gold standard for non-existent jobs.

Anonymous said...

@12:45

Don't forget microfilm document processors and seed sorters!

Anonymous said...

@10:02

4:45 here. Glad you were joking! I took an advocate approach at your post, rather than knowing about that. That's great to hear. Wow. I was wondering about that. HAHA @ 12:45 microfilm doc processors and seed sorters. Ok, gotcha. Yes, I can see them doing that. Thanks for the clarification, like I said, I wrote it as an advocate seeing it rather than seeing the sarcasm/joke behind it. I thought Surveillance System Monitor sounded a bit fishy for a job. HAHA. Certainly never seen that job available. Sounds like a cushy, boring, money collecting job tho! Another LOL for microfilm.

Anonymous said...

It seems many forget SSA began to tighten the screws starting in about 2010. No longer able to file an AC request and file a new claim at the same time. Yes, there are exceptions. ALJ pay rates started declining by no later than '12 or '13 and at the same time the AC started to deny review in a greater percentage of cases. Not hard to tell new ALJs were being trained in such a way so as to pay fewer cases.These things happened while Mr. Obama was president. Doubtful the president even is aware when such changes are made, and maybe not the COSS depending on circumstances. Mr. Biden and his adminstration are unlikely to hurt the disabled, but also unlikely to make SSA all that much more disability claimant friendly.

Anonymous said...

I didn't know there were so many microfilm document processors and order callers. Like more than 100,000 in the national economy! At least I haven't heard anymore about silver wrappers since the pandemic. It amazing how much your health can be compromised and you can still do these things.

Anonymous said...

Don’t forget silverware wrapper!