[Congressional Record Volume 143, Number 116 (Friday, September 5, 1997)]
[Extensions of Remarks]
[Page E1670]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                         PRESUMPTIVE DISABILITY

                                 ______
                                 

                        HON. FORTNEY PETE STARK

                             of california

                    in the house of representatives

                       Friday, September 5, 1997

  Mr. STARK. Mr. Speaker, today, I am introducing legislation that 
incorporates the Supplemental Security Income's presumptive disability 
system into the Social Security Disability Insurance [SSDI] program.
  The Social Security Administration [SSA] is still confronted with a 
backlog of nearly 1 million cases waiting for disability determination. 
In fiscal years 1994-96, administration requested additional funds for 
disability investment funding in order to help SSA handle the 
exorbitant amount of disability claims. The administration requested 
$534 million for disability investment funding as part of the regular 
administrative budget for fiscal year 1996. These funds were 
specifically earmarked for processing disability related workloads. 
Congress appropriated disability investment funding in the amount of 
$387.5 million for fiscal year 1996. I supported these past efforts, 
but we must do more to help these people in their time of urgent need.
  Social Security currently has over almost 1 million pending 
applications for disability benefits. Social Security realizes the 
challenge it faces in processing an overwhelming number of disability 
cases. It has made efforts within the past 2 years to reengineer the 
disability determination process. In 1995, a disability applicant had 
to wait an average of 5 months to get an initial decision. Today, a 
disability applicant can expect to wait an average of 3.5 months. I 
commend the Social Security Administration for their work in reducing 
the time a needy person must wait for a determination. However, there 
is still the need to deliver assistance quickly.
  In recent years, Congress has heard complaints of deserving 
applicants waiting months before receiving desperately needed funds, 
and in some cases, dying before a decision is made. For example, in 
Arizona a 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 specialized in such 
cases. These kinds of long delays are repeated in anecdote after 
anecdote.
  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 then 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 problem 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 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 however, in the final determination, a claimant's impairment does 
not meet SSA's definition of disability, they and their dependents 
shall not be responsible for returning 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 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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