Changes to Social Security unlikely to have major impact on people served by boards

A rule change set to be filed this year by the U.S. Social Security Administration (Social Security) could increase the frequency at which people receiving Supplemental Security Income (SSI) must take part in disability eligibility reviews. After reviewing the proposed rule, OACB believes the change’s impact on people served by county boards would be minimal except in rare cases.

Regulatory Background

Social Security announced in November that it plans to revise when and how often it conducts continuing disability reviews (CDRs), which determine SSI recipients’ continued eligibility for the program based on their disability status. The agency plans to do this by creating a new category of SSI recipients that will be required to undergo CDRs more often. If Social Security concludes from a CDR that a person’s condition has improved past the point of them needing SSI, their benefits can be revoked.

Download the Proposed Rule

Currently, disability benefit recipients are placed in one of three categories when they become eligible for SSI. These are Medical Improvement Expected (MIE), which requires CDRs every 6-18 months; Medical Improvement Possible (MIP), which requires CDRs every 3 years; and Medical Improvement Not Expected (MINE), which requires CDRs every 5 to 7 years. The rule change would create a fourth category, Medical Improvement Likely (MIL), that would require CDRs every 2 years.

Social Security estimates that the increased frequency of CDRs following the introduction of the MIL category will lead to more than 1 million additional CDRs being conducted between FY2020 to FY2029. According to estimates published with the proposed rule, this increase will be the result of thousands of beneficiaries being moved from “Medical Improvement Possible” to new and stricter categories, giving the federal government more chances to review the disability claims of nearly 2 million Americans.

Impact on People Served by County Boards of DD

Social Security does not expect any of these new CDRs to be the result of people shifting from the MINE (Medical Improvement Not Expected) category, which is the category to which people with developmental disabilities, autism, cerebral palsy, and similar conditions are most often assigned. People who were granted SSI due to the diagnosis of a developmental disability are not likely to be moved to a stricter category as a result of this rule change. Those receiving benefits, however, will be required to submit to CDRs every six years (as opposed to every five to seven).

When the rule change was announced, disability advocates expressed concern that it would be used to strip benefits unfairly from people with disabilities. Broadly speaking, the rule change would, in fact, require thousands of Americans with disabilities to submit to more frequent CDRs, giving the federal government more opportunities to reassess and potentially invalidate their disability status. Furthermore, the Trump administration has regularly stated its goal of decreasing federal spending on Medicaid, Social Security, and other programs, and the proposed rule change makes several mentions of how this shift will help control costs. Based on this, OACB believes is it reasonable to conclude that the goal of this rule change is to decrease the number of people receiving federal disability benefits. The proposed rule language does not suggest, however, that Social Security plans to target SSI beneficiaries with developmental disabilities to achieve that aim.

While the risk appears to be very low, there could be some instances in which SSI beneficiaries served by county boards are reassigned to different categories and required to submit to more frequent CDRs. For board staff guiding new applicants through the process, it should be noted that Social Security will no longer assign cases to the MINE category automatically.

In addition, the agency states that it intends to include some childhood disability claims in the new “Medical Improvement Likely” category for children who are approaching “a chronological age with key developmental activities, for example, age 6 with a transition into formal education, and at age 12 with a transition into adolescence.” The agency also states that it will provide guidance for what conditions meet those criteria, but that guidance is not likely to be available until after the rule goes into effect.

In light of this rule change, OACB advises that SSAs or EI service coordinators guiding the parents of children with developmental disabilities through the SSI application process set reasonable expectations regarding Social Security categorization and CDR frequency.

Regulatory Next Steps

The public comment period on the rule change closed January 31, 2020. The next step in the rule change process is for Social Security to submit the new rule to the White House Office of Management and Budget, which will review its potential financial impacts.

OACB has requested additional information from Social Security and will provide more updates if/when the agency responds. Members with questions about this topic should contact Erich Bittner (ebittner@oacbdd.org).