Even though I’m a lawyer, receiving a letter in the mail from the Social Security Administration still triggers a panic attack. My heart races, I get nauseous, and my hands shake.
Lately it’s gotten worse. A letter earlier this month made me feel suddenly lightheaded as my vision started to fade. As I sat on the floor, my mind raced through all of the potential bad news the envelope could contain for a disabled Supplemental Security Income recipient like myself.
Many more people could soon be in the same position, more often. A new proposal from the Social Security Administration would cut $2.6 billion dollars over the next decade from the two core programs it runs that comprise the disability safety net: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). The cuts would start with letters — 2.6 million more of them.
A letter is the first notice a disabled recipient of SSDI or SSI gets that they’ve been selected by Social Security to undergo a “continuing disability review” (CDR). As the agency puts it, CDRs are used to “determine if disabled beneficiaries still meet the medical requirements for eligibility.” In other words, a CDR is a kind of “are you still disabled enough for SSI or SSDI” audit.
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After the audit, if Social Security believes a beneficiary’s medical condition has improved such that they no longer meet Social Security’s stringent criteria for disability, their benefits are terminated. It is now much easier for Social Security to say that a disabled person has medically improved thanks to a 2017 rule change that allows the agency to disregard medical evidence from a beneficiary’s own doctors. Benefits are also terminated if the disabled person does not respond to the CDR.
The Social Security Administration is proposing a dramatic ramp up in the number of CDRs it conducts, adding an additional 2.6 million of them over the next decade. And that’s not the only change Social Security wants to make to the CDR process.
When an applicant is approved for disability benefits, Social Security assigns them to a category that determines how often they must go through a CDR. If Social Security thinks a disabled person’s medical condition is expected to improve, they set a CDR for every 6 to 18 months. If it’s possible the medical condition will improve, they set a CDR for every three years. And if the person’s medical condition is not expected to improve, they set a CDR for every 5 to 7 years.
Social Security officials want to create a new category, “medical improvement likely,” that will get a CDR every two years. And they propose to move hundreds of thousands of people from less frequent CDR categories into the new category.
The vast majority of disabled people receiving SSDI and SSI are not represented by counsel through the CDR process. The maximum amount that SSI will provide to a disabled beneficiary is just 74 percent of the federal poverty level — currently $12,490 for an individual. As of November 2019, the average SSDI benefit was just $14,855 per year. Most SSDI and SSI beneficiaries simply do not have the money to hire someone to help them navigate the CDR process. Instead, they find themselves facing the byzantine, and all too often hostile, bureaucracy of the Social Security Administration on their own — something that I find daunting even with the benefit of a law degree.
– Kathleen Romig
Social Security is also proposing to focus the targeting of those CDRs on disabled children, people with certain medical conditions such as leukemia, and disabled older adults. Under the new rule, many disabled children would face a mandatory CDR at six years old and another mandatory CDR at 12 years old.
In both adults and children, the rule would change the category of certain mental health conditions including anxiety-related disorders, depressive, bipolar and related disorders, attention-deficit hyperactivity disorder, and impulse control disorders to a CDR every two years.
But Social Security has not provided estimates of how many disabled people from each of those groups will be impacted. In fact, Social Security hasn’t released any estimates of how many people will be impacted, period, only the number of CDRs it expects to undertake. (A single person could face multiple CDRs in that time period.)
Kathleen Romig, a senior policy analyst at the Center on Budget and Policy Priorities, explained by email that “SSA provides no estimates of the number of people who would be affected. No number of people who will be subject to additional reviews. No number of people who will be terminated.”
Instead, Social Security just published the projected cuts of $2.6 billion. That leads Romig to believe the agency has data it isn’t releasing: “They DO have a number of program dollars saved — in fact, two numbers, one for SSDI and one for SSI. I think it stands to reason that SSA has estimated how many disability beneficiaries would be cut off and they are withholding it. I’ve never seen the estimated number of people left out of a proposed rule; it’s a vital piece of information.”
The rule is open for public comment on regulations.gov until January 31, 2020.