The National Association of Disability Examiners (NADE), an organization of the personnel who make initial and reconsideration determinations on disability claims for the Social Security Administration, has posted its Winter newsletter.
Here's an excerpt that concerns something I haven't yet seen in my office but probably will, eventually:
For more than a year, analysts across the nation have seen a huge influx in CDB cases [Childhood Disability Benefits, also known as Disabled Adult Child or DAC cases] cross our desks, with people filing for Childhood Disability Benefits years or even decades after they were approved for SSI. A 38-year-old applying for Childhood benefits? Why now?The OIG’s office conducted an audit last year, summarized in a report submitted in December entitled, “Follow-up on Dis-abled Supplemental Security Income Recipients Potentially Eligible for Childhood Disability Benefits.” ...
OIG recommended that SSA instruct their staff in the importance of following up on potential leads to other benefits and assessing eligibility for other programs during redetermination and initial claims. They renewed their recommendation that SSA establish an automated solution that identifies SSI recipients who may be entitled to CDB. ...
Also, with baby boomers hitting retirement age or dying, a lot of their disabled kids are now now eligible for CDB when they were only able to get SSI before.
ReplyDeleteActually every rep should ask every client about this. There are many families who have children with congenital issues that just took care of them and never sought benefits. A lot of these children are now older and their parents are no longer able to take care of them or have died. It can be hard to prove these cases but not impossible. Pitfalls include that the adult child is now married to a non-disabled spouse. Even more common is where the parents wanted their child to be as independent as possible and managed to get them a job through friends but the job was really an unofficial sheltered workshop. The rep will need to prove this some how. Also they will need to track down old medical and school records. It is a lot of work but rewarding when you manage to get one of these cases paid.
ReplyDeleteYES. I can explain.
ReplyDeleteIt is largely a result of the change in mental listings and SSA's response to that.
Before the change, the field offices approved these cases (receiving SSI often since before age 22; now technically eligible for T. II on parent's account death; disability; retirement), using long established rules on collateral estoppel.
Beginning February 2019, SSA "changed" (sort of) how it handles collateral estoppel.
1. Collateral Estoppel decisions going forward NOT to be made by FO but instead DDS.
2. Applied longstanding (?) but little noticed policy that collateral estoppel DOES NOT APPLY WHERE THERE HAS BEEN A SIGNIFICANT CHANGE IN THE LISTINGS. E.g. 2017 new Mental Listings e.g. elimination of 12.05C.
Same problem where there has ben a relevant change in Vocational Rules (e.g. if elimination of literacy was material).
Sooooo, what happens. DDS makes a brand new decision on these cases applying current listing. And lo and behold, are we the least bit surprised that they fail to get the SSI file while at the same time telling the claimant that part of the reason the claim is being denied is that they haven't shown that the disability began before age 22 (yes, even though SSA has that very evidence hidden away in the SSI file). Yes, I am bitter, angry and frustrated. And then conclude not disabled under current mental listing. Same would apply to obesity case etc.
Here are the POMS that apply -- DI 27515.000 through .055. There are also two other documents that I believe are now incorporated in the current POMS and are difficult to get. AM 18029 from Feb. 2019 and EM 110344
That's the story.
I never knew about CDB benefits until I read about it in 2013 and said to myself, I could qualify for that. First problem I encountered was my mother applied for me in 1994 and it was quickly rejected simply because she had no idea how to medically describe my condition or submit evidence. Eventually after 6 years I was awarded back to 1994. To wind on CDB you really need substantial medical evidence going back before age 21, so it is more difficult then usual disability filings. Just about every attorney declined to take my case except one special one.
ReplyDeleteLike that has worked sooo well the last 30 years (including multiple rounds of special disability workloads).
ReplyDeleteI'm sure the agency will just jump right on doing that.
Sometimes parents don't answer the question correctly. If the disabled adult child is not living with the parent is one example. I know of parents who were payees for their adult children on SSI who answered no to the question. There are so many questions that frequently have "no" answers that the parents may not really be listening to the questions closely. That's not to excuse CRs that don't ask the question or don't pursue an answer when the answer is not clear.
ReplyDeleteSeems like enrollment should be handled automatically for children on SSI who pass the adult redetermination and otherwise qualify. I'm hard-pressed to see any (innocent) reason for not handling it that way, and trying to fix this sort of thing when the "disabled kids" are middle-aged adults just doesn't work.
ReplyDeleteA lot do not want CDB benefits for their child because it reduces the amount their other kids get.... there is a family maximum...except for divorced people....for Title II... But not for SSI Thus they do not list all their kids when they apply for their own RIB/DIB
ReplyDelete7:40 pm. The parent was likely not retired, disabled or deceased at the time of the age 18 re det. That would be one reason
ReplyDelete