Disability News

Social Security Reform Proposal To Improve Disability Process

Jo Anne Barnhart, Commissioner of Social Security, today announced that Social Security will publish a proposed regulation to improve the disability determination process. The improvements, which build upon Social Security’s new electronic disability claims process, would shorten decision times and pay benefits to people who are obviously disabled much earlier in the process.

The Proposed Regulation:

• Establishes a quick disability determination process for those who are obviously disabled. Appropriate claims would be identified and referred directly to special units in the State agencies for expedited action.
• Establishes a Federal Expert Unit comprised of State and Federal experts to provide medical and vocational expertise for adjudicators at each level of the disability determination process.
• Eliminates the reconsideration step of the appeals process and establishes a Federal Reviewing Official level of review. The Reviewing Official would review initial State agency denials if the claimant requested such review. The Reviewing Official would not conduct a hearing but would issue a decision based on a review of the record.
• Retains the de novo hearing before the Administrative Law Judge (ALJ). The ALJs would be required to explain in their decisions why they agree or disagree with the rationale of the written decision of the Reviewing Officials.
• Closes the record after the ALJ issues a decision. However, new and material evidence would be considered after a decision is issued under certain limited circumstances.
• Establishes a Decision Review Board (DRB) to select and review both favorable and unfavorable ALJ decisions and to handle dismissals. Other review functions currently performed by the Appeals Council would eventually shift to the DRB when the new process is phased in.
• Strengthens in-line and end-of-line quality review mechanisms at the state agency, Federal Reviewing Official, hearings and DRB levels of the disability determination process. Pre-effectuation review at the initial claims level would continue while quick disability decisions would be subject to expedited pre-effectuation review as well. The current Disability Quality Branch review of State agency claims would be replaced with a new centrally-managed quality assurance system that would perform independent end-of-line reviews of targeted cases, perform a random sample of all cases, and provide for an in-line quality process performed by State agencies.
• Provides that Social Security plans to implement the new disability determination process on a phased-in basis, allowing the Agency to make adjustments as necessary.

Please contact us if you or any qualified individual with a disability you know in New Jersey has been discriminated against. Do not let anyone get away with violating the ADA.

	Did You Know?
	SHMO means Social Health Maintenance Organization A managed system of health and long-term care services geared toward an elderly client population. Under this model, a single provider entity assumes responsibility for a full range of acute inpatient, ambulatory, rehabilitative, extended home health and personal care services under a fixed budget which is determined prospectively. Elderly people who reside in the target service area are voluntarily enrolled. Once enrolled, individuals are obligated to receive all SHMO covered services through SHMO providers, similar to the operation of a medical model health maintenance organization (HMO).