U.S. to Resume Benefits Review for Disabled

The federal government announced Thursday that it will resume a controversial review of 2.6 million disabled people to determine if they should continue receiving monthly Social Security disability checks.

The eligibility review was suspended in 1984 after complaints from Congress and the public that recipients were being removed arbitrarily from the benefit rolls.

The new review will begin next month with 55,000 cases and eventually will include all cases. Individuals will lose benefits only if it is determined that their medical condition has improved since the last review and that they are now able to work.

More ‘Compassionate’

The revised screening program will be “more humane and compassionate” than the earlier one, Health and Human Services Secretary Margaret M. Heckler pledged in a statement. The new standards, which will be officially published today, reflect amendments to the disability law made last year.

But although federal officials “have done a really good job of consulting with people on this issue,” the new medical improvement standard is “removed from reality and open to abuse” because it considers only pre-existing health problems, said Eileen Sweeney, an attorney with the Senior Citizen Law Center in Washington.

Thus, Sweeney warned, some of those Congress sought to protect still may lose their benefits.

In a hypothetical case, she said, a person who suffered from diabetes, high blood pressure and fainting spells might have begun receiving benefits in 1982. In deciding whether that person’s condition had improved, the government would review only the old ailments, ignoring any health problems that had developed since then.

At the same time, the chairman of the House panel that oversees Social Security accused the Reagan Administration of a “rush” to review cases and warned against “pressures to turn out decisions too quickly, sacrificing careful review for speedy termination of benefits.”

Panel Hearings ‘Soon’

Rep. James R. Jones (D-Okla.) noted that, because the new rules are being published today, there will be only three weeks, including the Christmas and New Year’s holidays, in which to train the workers who will be processing the cases. Jones said his House Ways and Means subcommittee on Social Security will conduct hearings on the issue “as soon as possible” next year.

Angered by the Administration’s effort to cut off benefits for 491,000 people, Congress last year decided to order a strict new standard for declaring a person ineligible. Now, the government must demonstrate with medical evidence that a disabled person has become healthier before benefits can be taken away.

Under the new system, someone who is ruled ineligible has several opportunities for appeal, in a process that may take as long as a year. And, ultimately, the person can sue the government.

$469 Per Month

The disability program provides average monthly benefits of $469 to 2.6 million Americans who are considered incapable of performing any work for at least a year. The diverse group ranges from accident victims who may recover and be able to resume employment to those who are permanently and totally disabled.

Another 1.7 million dependent spouses and children also receive benefits under the program. The average family benefit is $872 a month.

The first 55,000 people whose cases are being reviewed will receive letters in January that ask them to visit Social Security offices, bring medical records or provide the names of doctors and hospitals familiar with their medical problems. If a new medical examination is required, Social Security will pay for it.

Special Training

Personnel handling the cases will be given special training in applying the new standard of medical improvement ordered by Congress. In addition, the regulations for considering mentally ill individuals have been rewritten in an attempt to keep up with current views among mental health professionals, Heckler said.

If a person is ruled ineligible, he first may ask the Social Security Administration for reconsideration of the decision. If this appeal is rejected, another appeal can be made to an independent administrative law judge. The monthly benefit check would not be stopped unless the judge issued an adverse decision.

However, the individual still could carry the case further, to a Social Security appeals council and ultimately to the federal courts.

1.2 Million Cases

In its first series of reviews, the Social Security Administration studied 1.2 million cases and ruled that 491,000 people were ineligible for benefits. But 214,000 were restored to the rolls after appeals, and many of the 277,000 ruled ineligible have initiated court cases. The review program was suspended in April, 1984.

“We have worked diligently with all segments of the public in developing regulations that ensure a consistent disability program nationwide,” Heckler said.

The original drive to review disability cases began in 1981, after a General Accounting Office study asserted that 500,000 recipients of disability benefits were healthy enough to work.