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Statement by Kenneth S. Apfel

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For Immediate Release
December 17, 1997
John Trollinger/Rich Hensley
410-965-8904   FAX 410-966-9973

Social Security Administration

News Release

Statement by Kenneth S. Apfel

Commissioner of Social Security

on SSI Childhood Disability Reviews


Good afternoon. Upon assuming office, I directed the Social Security Administration to conduct a "top-to-bottom" review of the implementation of the childhood disability provisions of the welfare reform law. I believed that this review was needed because the Congress, the President and the American public deserved to know whether the law and the regulations were being applied fairly.

Today, I am releasing a report of the Social Security Administration's review of cases of children who were affected by changes in the law.

For the past two months, SSA has been examining quality assurance data, developing case profiles, reviewing adjudicators' instructions and conducting other oversight activities with this goal: to ensure that our implementation process permitted every child who is eligible for disability benefits to receive them.

Before discussing the results of the report, I think it is important to note that there are approximately one million children receiving SSI disability benefits. Of those one million children, only about 288,000 were subject to redetermination under the new law.

Our review found that overall SSA and the States did a good job in the implementation of the childhood disability provisions of the law; but we did find problems with the manner in which certain redeterminations were made.

Most importantly, I want to emphasize that our review has not been just about numbers--it has been about children. And because of that, SSA is taking steps above and beyond normal action to assure that every child receives a fair assessment of his or her benefit eligibility. Today, I am directing the Agency and the State Disability Determination Services to review approximately 45,000 of the SSI childhood disability cases which were ceased during this process.

In addition, families of all children whose eligibility for SSI has been ceased under the new law and who have not appealed will receive another opportunity to do so.

Let me now outline the specific actions to be taken, and the reasons for each.

The problems we identified generally fall into three areas: (1) the status of children classified as having mental retardation; (2) the actual case processing in some areas; and (3) confusion regarding appeal rights.

Eighty percent of the children with mental retardation on the SSI disability rolls were not subject to this review. Of the 80,000 children who were, over half were ceased. The question that needs to be answered is why.

Part of the answer can be attributed to the fact that historically some children who do not have mental retardation were actually coded as having mental retardation. But we also found that some redetermination decisions in mental retardation cases were wrong. In particular, we were concerned that some children with mental retardation may have been inaccurately ceased.

Therefore, I have directed that all benefit cessation cases showing the mental retardation code be reviewed, as well as all denials of initial applications filed on or after August 22, 1996. In addition, for those children with the code for mental retardation and an IQ score of 75 or below, we will reopen their case, develop it as needed, and provide a new redetermination if their benefits were ceased or their applications were denied. For those children with the code for mental retardation and an IQ score above 75, we will review their case and, if deficiencies exist, we will reopen it, develop as needed, and provide a new redetermination.

Before these reviews begin, SSA will provide additional training to its adjudicators on the mental retardation evaluation issues raised in the report.

A second area of concern relates to the quality of our case processing in some areas. Our quality reviews found that in most cases, the case development practices were adequate and the decisions to either continue or deny benefit payments were correct. However, there were variations in accuracy rates. The review found that in some instances, SSA did not follow or fully document all required contacts with beneficiary families to enlist cooperation in processing the claim.

Also, while the accuracy of decisions has been above the regulatory threshold for accuracy nationally, the Agency's quality assurance data show that accuracy varies by state and by impairment.

Therefore, to ensure that each child's case was handled correctly, I have directed the following action. In addition to the review of all cases with the code for mental retardation, we will review a portion of the cessation cases in those areas which have been found to have the greatest likelihood of errors.

SSA will continue to monitor for quality assurance throughout the review of these cessation cases.

The third area of concern focuses on confusion regarding our appeals process and requests for benefit continuation. Concerns were also voiced that beneficiaries did not receive information about the availability of free legal services.

We found evidence which suggests that some beneficiaries and their families who were ceased did not receive full information and did not fully understand their rights. Because of that, I believe these families deserve a second chance.

Therefore, I have directed the Agency to send special notices to those families who were notified that a child had lost SSI eligibility but who did not file an appeal. These families will be given another opportunity to do so. And, if they should choose to appeal, they will be given a new 10-day period to request benefit payments to continue during the appeals process.

Families who did file an appeal but did not request continuation of their benefit payments will also be given a new 10-day period in which to request that benefit payments continue.

Also, SSA is making a concerted effort to ensure that families are aware of available legal assistance by providing toll-free numbers in our field offices, teleservice centers, our Internet site and on the notices we send. We will include the numbers in our notices in those States in which they are available.

Given the results to date of our initial redeterminations and the actions outlined here today, I believe that the Agency's initial estimate of 135,000 children losing benefit eligibility must be modified. We now believe that about 100,000 children, approximately 10 percent of those who were receiving SSI benefits based on a disability, will be impacted by the new law.

As I said at the beginning of my remarks, this review has been about children. During the review we sampled 151 cessation cases to help us answer the question "who are these children?" We found that the children affected do have limitations in functioning, but by and large, their conditions are not as severe as those of the 900,000 children who will continue to receive benefits. The majority of cases in which children came off the rolls involved learning problems, such as attention deficit hyperactivity disorder and conduct disorders. A third of the children sampled had demonstrated medical improvement.

This was an exhaustive process that received input from many people--advocates, service providers, members of Congress and the public. We could not have conducted this review without their support and I want to personally thank them. I also want to take this opportunity to say that this agency is doing all that it can to protect the rights of disabled children.

Finally, let me say that I ordered this review because I wanted a higher level of assurance that children are given every chance to receive the benefits for which he or she is eligible under the new law, and that is why I have announced these actions today. I believe the actions will leave little doubt that the Social Security Administration is committed to providing fair, thorough and equitable reviews for all SSI childhood disability claimants and beneficiaries.

Thank you. I'll now take your questions.

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