[Congressional Record Volume 141, Number 82 (Wednesday, May 17, 1995)]
[Extensions of Remarks]
[Pages E1061-E1062]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


   SOCIAL SECURITY PRESUMPTIVE DISABILITY FOR THE SEVERELY DISABLED 
                               INTRODUCED

                                 ______


                        HON. FORTNEY PETE STARK

                             of california

                    in the house of representatives

                         Wednesday, May 17, 1995
  Mr. STARK. Mr. Speaker, today I am introducing legislation that 
incorporates the Supplemental Security Income's [SSI] presumptive 
disability system into the Social Security Disability Insurance [SSDI] 
Program.
  One of the largest continuing problems faced by the Social Security 
Administration [SSA] is the backlog of more than 1 million cases 
waiting for a disability determination. In 1995 President Clinton asked 
for disability investment funding in the amount of $280 million as part 
of the regular administrative budget. These funds were specifically 
earmarked for processing disability related workloads. Congress 
appropriated disability investment funding in the amount of $320 
million for fiscal year 1995. I support this move but we need to do 
more and to act more quickly.
  Social Security expects to receive nearly 3 million applications for 
disability benefits through 1995, 70 percent more than it received 5 
years ago. Social Security admits that its complicated decision process 
has changed little in 40 years and offers an ``unacceptable'' level of 
service to the public. An announced ``re-engineering'' of the 
increasingly complex disability determination system is expected to 
stabilize the workload but not to result in an appreciable reduction in 
the backlog.
  On the average, it now takes a disability applicant 5 months to get 
an initial decision. If benefits are denied, the applicant waits 
another 18 months to get an administrative law judge's decision on the 
appeal. Congress has heard complaints in recent years of deserving 
applicants waiting months for desperately needed funds and, in some 
cases, dying before they get a decision.
  For example, in Arizona a recent disability applicant was forced to 
leave her secretarial job due to injuries resulting from a serious auto 
accident. She applied to the Social Security Administration for 
disability benefits to offset the loss of her income. She did not 
realize that she was venturing into an understaffed, underfunded 
Federal program that often forces disabled people to wait months to 
learn whether they qualify for benefits. After a year wait, she was 
successful in obtaining the benefits to which she was entitled only
 after hiring an attorney who specializes in such cases. These kinds of 
long delays are repeated in anecdote after anecdote.

  For many severely disabled, there should be a faster way.
  The SSI program makes an initial determination that presumes a person 
to be disabled if they fit certain severe disability criteria. These 
people begin to receive SSI benefits immediately and the SSA has a 6 
month period to make the final determination of eligibility using the 
SSA's definition of disability.
  Being able to receive SSI benefits on the basis of a presumptive 
disability determination provides the disabled person with much needed 
money immediately. However, for a worker who has paid into Social 
Security and becomes disabled, there is no comparable process to 
identify the people that would most likely qualify for DI benefits. My 
legislation would remedy this by providing for determinations of 
presumptive disability under title II of the Social Security Act in the 
same manner and to the same extent as is currently applicable under 
title XVI of such act.
  This means that if a person is found to be presumptively disabled 
under title II and meets the requirements for entitlement to benefits 
the person will begin to receive benefits, after the initial 5 month 
waiting period required before DI benefits can be paid, for up to 6 
months while the final determination is being made. If the person is 
presumed eligible to receive DI benefits, then their dependents shall 
also begin to receive benefits.
  If, in the final determination, a claimant's impairment does not meet 
the Social Security Administration's definition of disability, they and 
their dependents shall not be responsible to return the money they 
received during the presumptive eligibility determination period.
  In some instances a person may be presumed eligible for SSI benefits 
before being found to be presumptively disabled under title 
[[Page E1062]] II. In this case, the person will still be entitled to 
only 6 months of presumptive disability benefits. In most States, while 
receiving SSI benefits, a person is eligible for Medicaid. Under this 
proposal, claimants who would have been eligible for SSI benefits, were 
it not for their receipt of DI presumptive disability benefits, would 
be deemed eligible for SSI, making them eligible for Medicaid in those 
States where SSI eligibility triggers Medicaid eligibility. When the 
final determination for DI benefits is made, the claimant loses the 
Medicaid eligibility. Medicare will be provided to disabled workers and 
their dependents after they have been receiving disability benefits for 
24 months, including the time they were receiving presumptive 
disability payments.


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