Vol. 6, No. 2 March/April 1998 |
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Community Legal Aid Society, Inc. Establishes Children's SSI Project
Daniel Atkins, Esquire, Disabilities Law Program (DLP) of CLASI
SSI Reform
As previously reported in The AT Messenger (Jan/Feb 1998 article by Ron Sibert), the Welfare Reform Act of 1996 has dramatically changed the landscape of the Children's Supplemental Security Income (SSI) program. SSI is a federal needs-based program administered by the Social Security Administration (SSA) that provides a monthly financial benefit and Medicaid insurance to eligible children who are disabled.
Prior to the enactment of the Welfare Reform Act on August 22, 1996, the Social Security Act provided that children under the age of 18 were disabled if they had an impairment, or combination of impairments, of "comparable severity," which would prevent an adult from performing substantial gainful activity. "Comparable severity" was defined in the SSI regulations as medically-determinable physical and/or mental impairments that so limit a child's ability to function independently, appropriately, and effectively in an age-appropriate manner that the impairments and their resulting limitations are comparable to those which would disable an adult.
After the Welfare Reform Act (the "Act"), disability for children has been redefined to require medically determinable physical and/or mental impairment(s) that result in marked and severe functional limitations. As with the prior standard, the impairments must last or be expected to last 12 months or result in death. The new law eliminates the individual functional assessment (IFA) at Step 4 of the sequential analysis of disability for children. And, among other things, the Act also removes "maladaptive behavior" from the listings of possible childhood mental disorders, and requires continuing disability reviews at least once every three years for most children, at which time children could see their benefits terminated.
Social Security Administration Renotices Families
Since passage of the Act, approximately three hundred thousand of the one million children on SSI were reevaluated and about one hundred thousand were cut off from receiving benefits. However, the SSA has acknowledged that it may have terminated a few too many children in its haste to implement the Act, and due process rights might have been breached in the process. As a result:
(1) Children whose eligibility for SSI has been terminated and who have not appealed will be notified by the SSA of their right to appeal and will be provided with a new period of 60 days in which to appeal and 10 days to request benefit continuation during the appeal. Benefit continuation permits children to receive benefits while the appeal of their termination is pending. So long as benefit continuation is requested in good faith the SSA will not seek to recoup benefits should the appeal ultimately fail. It is also interesting to note that 45 states are sending families notices of the right to appeal, in addition to the notices being sent by the SSA. Delaware should consider doing the same since the state stands only to gain by having more children eligible for a federal program that provides essential monetary and health insurance benefits to children with disabilities.
(2) Children whose eligibility for SSI has been terminated (redetermination cases) and who have requested reconsideration but who have not requested benefit continuation will be notified by the SSA of their right to request benefit continuation and will be provided a new 10-day period in which to request benefit continuation during the appeal.
(3) All "failure to cooperate" cessations/denials who have not appealed will be rereviewed. These are cases in which children and families have not provided appropriate information to SSA or have failed to respond to notices.
(4) All cessations of childhood redeterminations and all denials of initial childhood determinations filed on or after August 22, 1996 that show a primary or secondary diagnosis code of mental retardation or speech and language disorder and who have not appealed will be returned and rereviewed.
(5) Additional numbers of both childhood initial denials and redetermination cessations are expected to be rereviewed on a selective basis.
Community Legal Aid Society, Inc. Children's SSI Project
To address the heavy volume of terminations of reevaluated children under the new SSI rules, the DLP of CLASI has made children's SSI cases a priority in 1998. The DLP began the year by presenting a three-hour workshop on children's SSI for private attorneys who are interested in handling cases on a 'pro bono' basis. The DLP, along with Delaware Volunteer Legal Services (DVLS), will continue to recruit volunteers throughout the State, and will serve as a clearinghouse/support center for volunteer attorneys. Available at the three DLP offices are binders for SSI advocates/or parents that include among other items:
(1) A guide to the new children's SSI program rules;
(2) The new children's SSI rules;
(3) Sample forms, letters, case preparation materials, and
(4) Question and answer guides.
The DLP considers these cases a priority, and as a result, each attorney and at least three paralegals in the program will be handling cases. While the DLP will do its best to meet the needs of as many children as possible, it will be impossible to represent every child terminated from the SSI program. As a result, DVLS is recruiting more volunteers and the DLP is providing self-help materials to as many parents as possible. Parents and advocates should contact the DLP:
New Castle County 575-0690
Kent County 674-8500
Sussex County 856-0038
or
Delaware Legal Help Link 478-8850
in order to consult with an advocate, or to pursue the possibility of acquiring representation.
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