Congress does.

7.2 What is the maximum amount of money a disabled person on Social Security disability benefits can earn per month, without getting removed from the benefit rolls?

Under Social Security, a disabled beneficiary may have a trial work period of nine months during any 60-month period without limit on the amount of earnings, and yet have benefits continue during this time.

7.3 Can the process to get disability be simplified? Many are turned down, then appeal, and eventually are approved and paid back.

SSA has embarked on a long term project to improve its disability claims process from the claimant's initial contact through the final administrative appeal. This initiative, the Disability Process Redesign Project, is expected to provide claimants with accurate disability decisions that are easier, faster, and more cost-efficient. The specific objectives of the Project include:

Approving claims that should be allowed as early in the process as possible;

Ensuring that claimants entering the process are more informed about the requirements for disability benefits and the nature of the decision-making process;

Streamlining and consolidating the number of appeals steps while providing for more personal interaction with the decision makers;

and

Providing claimants with decisions that are based on more fully developed evidence and are written in clearer and more understandable language.

SSA is currently testing disability process changes in various locations throughout the country, and expects to begin to implement major process changes nationwide next year.

7.4 How can addicts qualify for benefits?

Under Social Security, to receive disability benefits, an individual must have an impairment that is severe enough to make them unable to engage in any substantial gainful activity (defined as earnings of $500 or more per month) and that impairment must be a medically determinable physical or mental condition expected to last at least 12 months or result in death. Last year, legislation was enacted which eliminated drug addiction and alcohol abuse as eligibility factors for Social Security disability benefits.

7.5 Why are persons who work part time while receiving Social Security Income benefits penalized?

SSI is a program for low income persons. It has income and asset limits so that it reaches those most in need. There are work incentives for SSI-disabled persons to help ease the transition to work and self support.

7.6 What options for saving money does a disabled person receiving SSI benefits have for saving, given the $2000 assets cap?

Entitlement to Social Security benefits is an earned right. People can receive Social Security disability, retirement, or survivors' benefits without regard to their resources.

A claimant's resources are considered under the SSI program, which is also administered by SSA. Unlike the Social Security program, SSI is a means-tested income maintenance program for aged, blind and disabled people whose incomes and resources, are below the levels established by law. SSI-which is paid from general revenues, rather than from earmarked employer and employee payroll taxes-is designed to help needy individuals meet the basic costs of food, clothing and shelter.

For purposes of SSI eligibility, resources cannot exceed $2,000 for an individual or $3,000 for a couple. Congress established the resource limit as a reserve to meet emergencies and other expenses that are not covered by other public assistance programs. In figuring the amount of resources, the following are not counted:

7.7 What does the Social Security Administrative plan to do to increase participation in work incentive programs for the disabled community?

Many people with disabilities want to work, and the Social Security Administration wants to help them find jobs.

SSA is developing a comprehensive and cost-effective employment strategy for people with disabilities. This strategy includes proposals to study and improve work incentives through the regulatory, research, and legislative processes, and through improving our delivery of employment services and information to people with disabilities. Key elements of the strategy include:

Developing innovative policy changes designed to promote employment and lessen dependence on public benefits.

Updating and modernizing the way SSA treats work and earnings of people with disabilities, including consideration of raising the monthly earnings amount used to determine if work and earnings for non-blind people with disabilities is substantial gainful activity.

Improving service delivery, information activities and other employment support provisions, and access to services by SSA's beneficiaries with disabilities to promote employment and lessen dependence on public benefits.

Providing employment assistance through Project ABLE, a national resume bank that provides employers with an applicant pool of qualified, job-ready individuals with disability who are ready, willing and interested in working.

7.8 Why does a disabled person have to wait two years for Medicare when they need it the most and cannot get coverage from private companies?

Medicare coverage was extended to the disabled by the 1972 Social Security Amendments. Studies done for Congress had shown that disabled workers receiving cash benefits under Social Security used about seven times as much hospital care and about three times as much physicians' services as the non-disabled population. These facts accounted for both the need for and substantial costs of providing Medicare coverage to the disabled. The two year wait for coverage was designed to help keep costs within reasonable bounds, avoid overlapping private health insurance protection, and minimize certain administrative difficulties that might otherwise arise due to the sometimes lengthy disability determination process. Moreover, it was felt that this approach would better target those whose disabilities have proven to be severe and long lasting.

7.9 If a third of all benefits go to disabled persons, and if we consider the disabled to be deserving, why don't we subsidize the benefits given to the disabled?

Actually, only about one-eighth of total benefit payments go to disability beneficiaries and their dependents. The social insurance aspect of Social Security does, in effect provide a "subsidy" from those who never become disabled and draw benefits to those who do become disabled and need benefits. The amount of the disability benefit is determined from the individual's lifetime average earnings covered by Social Security (after indexing to allow for wage inflation in the past, before age 60).

7.10 What is the fraud level in the Disability Insurance program?

Actually, there is relatively little fraud-but even that is too much.

The Commissioner of Social Security has established as one of the top goals of the agency, "to make SSA program management the best in business, with zero tolerance for fraud and abuse." We are committed to ensuring the integrity of SSA programs through the elimination of wasteful practices that erode public confidence in our programs, by vigorously prosecuting individuals or groups who damage the integrity of our programs and by changing our programs, systems and operations to reduce the likelihood of fraud.

Specific actions aimed at reducing fraud in our programs, including the disability program include:

Increased investigative resources, including additional investigative personnel.

A new fraud telephone hotline to handle allegations of fraud, abuse and mismanagement of SSA programs (1-800-269-0271).

A residency verification pilot program which resulted in program savings of $824,000. This program is being expanded to 12 offices in=20 California and Texas.

Computer matching programs with more Federal, State and local penal institutions to identify prisoners who are illegally collecting disability benefits. SSA estimates that this effort will result in the suspension of about 60,000 prisoners each year, saving $500 million annually.

Pilot programs in five states which provide investigative support to the State Disability Determination Services, which making disability decisions on behalf of SSA.

Our anti-fraud efforts are addressed through aggressive use of criminal prosecution and civil penalties.

7.11 All the emphasis seems to be on retirement, but there seem to be a lot of problems with who receives disability. It seems that those who aren't really disabled have no problem getting disability while those who really need it either can't get it or have great difficulty. What is being done to look at and improve this system?

And

How is disability determined?

Under Social Security Disability an individual must have an impairment that is severe enough to make them unable to engage in any substantial gainful activity (defined as earnings of $500 or more per month) and that impairment must be a medically determinable physical or mental condition expected to last at least 12 months or result in death. The Supplemental Security Income (SSI) disability program, which is not part of Social Security and is financed by general revenues, uses the same medical standard for determining eligibility. SSI is also a program for the low-income and uses both income and asset tests to determine eligibility. The Congress recently tightened restrictions under both programs for drug addiction and alcoholism as contributing factors to disability, placing strict treatment requirements on recipients and limitations on benefits. The childhood disability program under SSI was also recently reformed by Congress due to concerns that court decisions had brought in children who were not intended to be covered.

7.12 What is the likelihood of raising the amount ($500.00 gross per month) that a disabled individual may earn? Many benefits and supports (subsidized housing, food stamps, energy assistance, etc.) are pegged on income. When income goes up, benefits drop or are discontinued. Most importantly, Medicare is lost, and there is almost no affordable health care available.

SSA currently is studying the issue of raising the monthly earnings amount used to determine if work and earnings for non-blind people with disabilities is substantial gainful activity (SGA). (SGA is a concept prescribed by law to be used in determining initial and continuing entitlement to Social Security Disability Insurance (SSDI) benefits and initial eligibility for Supplemental Security Income (SSI) disability benefits.) This study includes considering if increasing the $500 amount would strengthen the concept of SGA as a reasonable and meaningful criterion for evaluating work as a component of disability.

SSDI beneficiaries who return to work and complete their 9-month trial work period are entitled to up to 39 consecutive months of Medicare, if their impairments continue to be disabling. This provides up to 48 months of Medicare coverage. If they continue working and perform work at the SGA level, beneficiaries may purchase Medicare coverage after the 39-month period.

Also, the Balanced Budget Act of 1997 allows States to extend Medicaid coverage to certain people with disabilities. SSA is working with the Health Care Finance Administration to assure maximum State participation in this program to assist SSDI and SSI disability beneficiaries continue their health care coverage at a reasonable cost.

In addition, legislation pending in Congress, the Ticket to Work and Self-Sufficiency Act of 1998, would continue Medicare benefits for up to 2 years longer. This legislation contains provisions similar to legislation proposed by SSA last year.

7.13 Are drug addiction and alcohol abuse being treated as a disability and are Social Security benefits being paid in such cases and if so, why?

Under Social Security disability, individuals must have an impairment that is severe enough to make them unable to engage in any substantial gainful activity (defined as earnings of $500 or more per month) and that impairment must be a medically determinable physical or mental condition expected to last at least 12 months or result in death. Last year, legislation was implemented which eliminated drug addiction and alcohol abuse as eligibility factors for Social Security disability benefits.

7.14 I understand the need for raising the retirement age for Social Security recipients. However, what happens to people who have received benefits because of disability but return to the workforce? They lose the benefits but have to maintain a job till the age of 67 or greater even with a disability. This surely does not aid the statistic that life expectancy is greater. Disabilities hinder the ability to work at full capacity. Why must these people be subjected to more wear on their bodies to ensure they receive full benefits?

If the disability continues, and if they can no longer work substantially, the disability benefit can be reinstated. Many of the proposals to raise the retirement age would not change the current early retirement age of 62. However, benefits would be reduced further than the reduction which occurs under current law when early retirement is taken. There are some proposals which would also raise the age for early retirement to 65 years.

7.15 Why can't the disabled person enjoy the benefit of working and making $14,500 per year or more?

Under Social Security disability, a disabled beneficiary may have a trial work period of nine months during any 60-month period and, as the disability continues earn any amount and yet have benefits continue during this time.

7.16 If we are spending $43 billion on the disabled, how are you hearing from that group about their concerns? Who is that group?

Disability Insurance benefits were about $46 billion in 1997. The Social Security Administration hears from disability beneficiaries and their organizations in various forums throughout the country, in congressional hearings, through correspondence and in comments from the public on any proposed changes in regulations.

7.17 What if a 25 year old becomes permanently disabled before they hav= e contributed to Social Security for ten years. Will they be able to draw benefits?

A 25 year old does not need 10 years to be insured for disability benefits. The insured status requirements for Disability Insurance benefits are less stringent for persons disabled at younger ages. In general, the worker would have to have worked in at least half the period since age 21, but not less than 1 1/2 years.

7.18 Why do Social Security offices that serve rural areas seem to have their own set of rules for disability determination?

They do not have their own rules. Social Security is a nationwide program and the same rules apply throughout the country.

7.19 What percentage of claims are automatically denied initially, and on reconsideration, forcing appeals, which usually requires an attorney?

No one is AUTOMATICALLY denied benefits. The test of disability in the Social Security Act is strict, and many who apply don't meet that strict test.