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Old 03-22-2011, 02:40 PM   #1 (permalink)
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Social Security Disability: Going Broke Fast

NationalJournal.com - WSJ: State Flexibility Pushing Disability Program to Insolvency - Tuesday, March 22, 2011

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Puerto Rico has emerged in recent years as one of the easiest places in the U.S. to get payments from the Social Security Disability Insurance program, created during the Eisenhower administration to help people who can't work because of a health problem. In 2010, 63% of applicants there won approval, four percentage points higher than New Jersey and Wyoming
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Old 03-22-2011, 03:03 PM   #2 (permalink)
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I find the story a little confusing because it makes it sound like the disability program is independently funded. Doesn't it come out of the general social security tax?

All the Fed has to do to ensure social security is sufficiently funded is to raise the social security wage base. Doing this doesn't affect anyone who makes less than the current base (right now it's $106K/year), and raising this threshold is partly how they've managed to keep the fund going this long. But if states are somehow doling out the payouts indiscriminately that seems like a leak that needs to be patched.
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Old 03-22-2011, 04:46 PM   #3 (permalink)
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And stop playing shell games with the trust once it's properly funded.
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Old 03-22-2011, 05:57 PM   #4 (permalink)
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I thought it was all the same fund. Until today I didn't realize it was a different fund, but I guess it does make sense. When they send you the letter of your benefits each year the disability amount is listed separately from the retirement or death benefits.

I guess one thing is that if it is a Federal program and everyone is paying into it on a Federal level, the rules should be set by the Fed not the states and applied the same way across the board.
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Old 03-22-2011, 07:10 PM   #5 (permalink)
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One thing the article does not mention is there are two very similar federal disability programs, SSDI and SSI.

Both are administered through the Social Security Administration. SSDI does come out of the SS Trust Fund, which is in actuality two trust funds: Old-Age and Survivors Insurance and Disability Insurance. SSI does not come out of either of those two SS trust funds. The eligibility criteria for both programs are exactly the same as far is being disabled is concerned, and those are rules are set by the Social Security Administration, not by the States.

It seems the difference in Puerto Rico's case is that there is a higher approval on the second (out of 3 total) chances for appeal: about 2/3 of all people get turned down on initial application, which one can appeal to a Reconsideration phase, of which roughly 10 percent win approval. If one is not successful at Reconsideration, one can appeal to a hearing in front of an Administrative Judge, where the success rate there is roughly 50/50. The article says Puerto Rico's rate of approval at the ALJ level has risen to 80 percent. So it seems that is where the difference is.

Also, at each stage (initial application, Reconsideration, Administrative Judge, or Board Review) the case is being handled through the Social Security Administration, not a State or any other agency.
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Old 03-22-2011, 08:23 PM   #6 (permalink)
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I'm on SSI. For Asperger, of all things. A lot of it is how a doctor chooses to word their appraisal of you. I've aided other people with similar diagnoses in getting by giving them a copy of the letter my doctor wrote to bring to theirs.
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Old 03-22-2011, 08:36 PM   #7 (permalink)
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Thanks, Autumn - that basic explanation tells me a great deal - NOT that so many are being aproved, per se, but that there is a difficult set of hurdles standing between a claimant and approval. If you want to criticize those hurdles one way or the other (too lenient or too stringent), then do so. But don't imply, as I think the OP article does, that getting approval is "easy".

I'm biased, but I am growing tired of wild claims that people can "easily" just ride the social safety net like it just ain't no big thang.

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Old 03-22-2011, 08:58 PM   #8 (permalink)
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Originally Posted by Bard Jameson View Post
Thanks, Autumn - that basic explanation tells me a great deal - NOT that so many are being aproved, per se, but that there is a difficult set of hurdles standing between a claimant and approval. If you want to criticize those hurdles one way or the other (too lenient or too stringent), then do so. But don't imply, as I think the OP article does, that getting approval is "easy".

I'm biased, but I am growing tired of wild claims that people can "easily" just ride the social safety net like it just ain't no big thang.

Agreed. I don't think "easier" was the right way to explain it in the WSJ article. Basically the journalist noticed that there is a higher percentage of people getting approved in Puerto Rico at the stage in the appeals when the claimant actually gets in front of a live person (the Administrative Judge). Why that is? I don't know. I think exploring that more fully would've made for a better article.

What would also be interesting to know is: how many people actually stick out the appeals process all the way to the Administrative Judge, as it can take easily a year if not two to finally make it to that round of appeal.

Another thing the article does not mention is that it's not just medical records that are used in the process; the SSA factors in age and education and work history too (how much or little those factor in I don't know).

And maybe it's just me, but I couldn't help wondering if there wasn't some bias in that it was an article written by the WSJ, focusing on Puerto Ricans and "easy welfare."
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Old 03-22-2011, 09:32 PM   #9 (permalink)
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Well I don't have a premium Wall Street Journal account, so I have no idea about the article in its entirety is about. What I can see from what I have found is that states are setting their own rules. Which State you live in should not affect your ability negatively or positively for benefits from a federal program. It should be the same for everyone.

The Wall Street Journal is rather conservative so I don't doubt they would have a bias about what they are writing, but even so, reading between the lines and ignoring that bias, some people are getting benefits easier than others based on where they live and everyone should be equal.
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Old 03-22-2011, 10:04 PM   #10 (permalink)
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About ten years ago, the national average for a claimant winning on appeal was about 75%. The main reason is that the staff handling the claims at the first two stages didn't make a lot of effort in making the determinations.

I never really understood the funding exactly, honestly, but the local staff who would make decisions on the Initial Application and the Reconsideration were paid from a different pot than the ALJ who handled the appeal. The local offices seemed to be tight with the money, and the ALJ's seemed to have more resources. The ALJs were knowledgeable, gave you a full hearing, and appointed their own experts (doctor, psychiatrist, employment analyst) to review the cases and give testimony. Those experts were particularly helpful for those claimants who couldn't afford to go to doctors to get great documentation of their conditions, or the ability to sort through their own medical records to find what is relevant.

Also, getting an attorney usually isn't an option until appeal. Attorneys can take a 25% contingency over the back award a claimant wins (the amount of money the government owes the claimant since the time the claimant filed until the time of determining disability). Since the initial application and Reconsideration are done in months, there is no significant back award. Waiting two years for an appeal, the government is going to owe one to two years of back benefits, and that creates a pot of money for a lawyer to get paid. (Hopefully you don't starve to death or die waiting that year or two).
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Old 03-22-2011, 10:05 PM   #11 (permalink)
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I don't have a subscription either, but when I goggled the title of the article, a WSJ link via google let me see the whole thing. You might be able to find it that way too (or I just go lucky).

States don't set their own rules though. The rules are set by the Social Security Administration. I'm not sure why there would be a large variance by state in who finally gets approved. I do think when it finally gets in front of an Administrative Judge, they have a lot more leeway in approving or denying a case, however.

I'm also wondering if the article is conflating "approval," too (I'd have to go back and try to re-read it). There are different stages where one can be approved or denied. I think what would be good to see is some chart on total approval percentage based on all applicants, broken down by state or territory. I'm sure the SSA has some stats on that. Maybe tomorrow I can look through their website to see if I can find a report.

Moderately OT: I did find this stat from the Council for Disability Awareness website which shows the approval rate declining in the past 15 years:


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Old 03-24-2011, 11:09 PM   #12 (permalink)
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The SSDI fund first started to pay out more than it was making back in 2005. Considering that almost half a million new Social Security recipients went on the dole last year, the impending problem is magnified. This has led experts to predict that Social Security Disability Insurance will exhaust surplus funds in four to 7 years, states the Wall Street Journal. I think, the company must do something. They may revise some documents to attend to the needs of the beneficiaries. Anyway, I guess one thing is that if it is a Federal program and everyone is paying into it on a Federal level, the rules should be set by the Fed not the states and applied the same way across the board.
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