Monday, November 8, 2010

Proposed Social Security Administration Rules Threaten the Ability of Persons With Mental Illnesses to Obtain Benefits

The Social Security Administration (SSA) has proposed changes to the way decisions are made for awarding disability benefits based on a mental impairment. These changes will threaten the ability of people with serious mental illnesses to obtain benefits.The SSA will not revise these proposed changes unless it hears a large outcry from consumers, providers and experts on mental health and disability.The changes appear in a regulation that would amend the "Medical Listings" –the standards that SSA uses to determine eligibility for Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) benefits. While the proposed new Listings include some very good features, these are undermined by a provision that could limit the number of people with mental illnesses who can qualify to only one or two percent of the nation's population. This is far below even the most conservative estimate of the number whose mental health disability makes them unable to work and who therefore need this monthly income.To qualify under the proposed Listings, individuals must have more than one "marked" impairment in functioning or one "extreme" functional limitation. These functions include the ability to get along with co-workers and others, to maintain concentration, persistence and pace, and to understand, remember and apply information. These standards are similar to current rules and pose no problem. The trouble lies in the process disability examiners would use in deciding how an individual meets them.

What's Bad About the Proposed Rule?The specific problem, for both children and adults, lies in a reference in the Listings to standardized test results and the scores a person must have on those tests in order to meet the new standard. The definitions of the minimum scores are arbitrary and exclusionary. First, there are no suitable tests that validly measure ability to work, nor is there any research showing a link between the tests of mental functioning that do exist and the ability to work that needs to be measured for the SSA process. Nonetheless, SSA would encourage its disability examiners to use "standardized tests."If a test is used, under the proposed rule an individual's score must be two standard deviations below the mean for the level of functioning to be considered "marked," and it must be three standard deviations below the mean for the level of functioning to be considered "extreme." So in addition to encouraging the use of tests that cannot measure what needs to be measured, SSA has created a stringent and flawed standard in terms of the score required to qualify. This change would drastically reduce the number of children and adults with serious mental disorders who qualify for disability benefits.SSA needs to hear about the problem from advocates, consumers and experts.What You Can DoPlease ask SSA to revise its proposed mental impairment Listings; and please circulate this alert widely. The deadline for comments is November 17.The message to SSA should be as follows: The proposed use of standardized tests to measure the functioning of people with serious mental illnesses is a flawed approach, with no scientific basis. SSA should drop all reference to standardized tests in the mental illness sections of the proposed mental impairment Listings, especially the requirements for people to score so low on such tests in order to qualify for benefits. Under the proposed rule, every year thousands of people who cannot work would be unable to qualify for federal disability benefits.When you submit your comments, refer to Docket No. SSA-2007-0101 so your comments are connected to this particular regulation.To send your message, use one of these methods: Internet: go to and search for docket number SSA-2007-0101 and follow directions. Fax: send your comments to 410-966-2830 begin_of_the_skype_highlighting              410-966-2830      end_of_the_skype_highlighting. Mail: Office of Regulations, Social Security Administration, 137 Altmeyer Bldg., 6401 Security Blvd, Baltimore, MD 21235-6401.To read SSA's proposed changes, download

Thanks to the Bazelon Center for Mental Health Law for this information.

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