Statement of Paul Seifert, Co-Chair, Social Security Task Force
and Work Incentives Implementation Task Force, Consortium for Citizens with Disabilities,
and Director of Government Affairs, International Association of Psychosocial Rehabilitation Services

Before the Subcommittee on Social Security,
House Committee on Ways and Means

Hearing on Social Security Disability Programs' Challenges and Opportunities

July 11, 2002

Chairman Shaw, Mr. Matsui and Members of the Subcommittee, thank you for the opportunity to testify today in this third of a series of hearings on challenges facing the Social Security disability program.  I am Paul Seifert, Director of Government Affairs for the International Association of Psychosocial Rehabilitation Services.   I am testifying today in my role as a Co-Chair of the Consortium for Citizens with Disabilities (CCD) Task Forces on Social Security and Work Incentives Implementation.  CCD is a coalition of nearly 100 national organizations advocating on behalf of people with physical, mental, and sensory disabilities.

Today’s hearing focuses on one of the most critical and difficult issues facing the disability program: the definition of disability.  In Social Security, the definition is tied in part to work because the disability program is meant to replace income lost due to the inability to work because of a disability.  To be eligible for benefits in the Title II and Supplemental Security Income disability programs, a person must satisfy two criteria—they must have a medically determinable physical or mental impairment which is expected to result in death or has lasted or is expected to last more than twelve months; and they must be unable to perform any substantial gainful activity in the national economy. Section 223(d) of the Social Security Act

The Social Security Administration uses a five-step process to make the disability determinations that operationalize the statutory definition.  SSA has established a “Listing of Impairments” whereby a person who satisfies the requirements of the listing is eligible for benefits.  For those applicants who do not meet the listings, SSA has established additional tests that take into account functional limitations, age, education, and work experience.

It is widely held that the definition of disability for SSDI and SSI is one of the strictest standards in the western industrialized world.  It requires a high level of severity of disability combined with a very low level of functioning in order for a person to become eligible for, and remain on, benefits.  We believe that there are several issues that should be addressed regarding the current definition.

While medical and technological advances are making it increasingly possible for some individuals despite severe disabilities to be successful in the work place, we should be very cautious when contemplating any changes to disability criteria, whether statutory or regulatory, based on such advances.  Medical and technological advances have had a powerful impact on the lives of some fortunately-placed individuals with disabilities and, recognizing this, Congress worked with the disability community to develop policies and reduce barriers to employment for persons with disabilities.  We thank you Chairman Shaw, Mr. Matsui, and all the members of the Subcommittee for your leadership in passing the landmark Ticket-to-Work and Work Incentives Improvement Act of 1999.  However, these medical and technological advances are clearly not universally or uniformly available to all who need them.  For example, an individual with a severe spinal cord injury may need personal assistance services to get out of bed in the morning, eat, bathe, dress, and get to work.  These services may cost more than $20,000 a year and are not fully covered under Medicare and Medicaid, and almost never available through private health insurance.

Therefore, it would be wrong to base eligibility for disability benefits using the assumption that medical or technological advances would be available to mitigate the functional impact of a disability.  In fact, many of the services and supports people with significant disabilities need to work, such as personal assistances services, prescription medications, or durable medical equipment, are available to them only through Medicare and Medicaid.   As you know, a primary way people with disabilities access Medicare and Medicaid is through the Title II and SSI disability programs.

Obviously, it is impossible at this time to ensure that all the technology, medications, and support services necessary are available to all people with every type of disability. Until that point comes, we have several recommendations:

First, as mentioned above, when considering any changes in disability eligibility criteria, whether to the statutory definition, the five-step disability determination process, or the listings, Congress and the Social Security Administration should not assume that mitigating supports are available.

Second, the definition of substantial gainful activity (SGA) must be addressed.  Granted the SGA level is now indexed for inflation.  However, the base, now $780 per month, should be re-examined in relation to what it defines: substantial gainful activity.  If $780 per month is all a person is able to earn, we find it hard to call that amount “substantial.”  In this economy, you cannot pay rent or utilities and buy food for a month at that level of earnings.  The issue may lie with the implementation of the SGA standard, rather than the concept of SGA.  Further, there is a different SGA level for non-blind persons with disabilities than for blind individuals.  We support raising the SGA level for non-blind disabled individuals to the same level as for those who are blind.

Finally, the federal disability programs were created assuming that people with disabilities would remain unable to work throughout their lives. This static view of disability meant that little thought was given to what might happen if people returned to work after receiving benefits.  Consequently, in Title II disability programs, the same requirements must be met to stay on the program as it took to qualify.  This has the perverse effect of forcing people to diminish their work.

For example, under the Title II disability rules a person can earn only $780 a month.  Earning even one dollar above that amount (after the nine-month trial work period) means a person loses every dime of their disability cash assistance.  For example, a person could have a monthly Title II disability benefit of $700 and a monthly paycheck of $771.  But if they receive a two dollar and fifty cent a week raise, fifty extra cents a day or ten dollars a month, they lose all of their $700 monthly SSDI check.  Clearly, it is not a very attractive trade-off.  This policy is known in the disability community as the cash-cliff. 

A far more reasonable approach to earnings is found in the SSI program where a person loses one dollar in benefits for every two dollars they earn.  The latest data from SSA indicate that from 1987 to 2001 the number of working SSI beneficiaries doubled.  Ironically, one-fifth of working SSI beneficiaries earn above the SGA level compared to hardly anyone in the DI program; a fact made all the more stark considering that SSI beneficiaries typically have weaker employment records, are typically less well educated, and are far poorer than their DI counterparts.  Yet, under the SSI rules where work is rewarded, the accumulation of even a small amount of savings is penalized.  Asset and resource restrictions ensure that people on SSI will remain an economic underclass. 

We have long advocated for a sliding scale cash benefit offset in the Title II disability programs and we again urge Congress to remove this barrier to work.  We recognize that SSA is required to study a benefit offset in Title II.  Until such a policy is enacted we believe that a disconnect will remain between desire of beneficiaries to work the reality of work.

Again, on behalf of the CCD Task Forces on Social Security and Work Incentive Implementation, I thank the Chairman and Members of the Subcommittee for the opportunity to testify and I look forward to any questions you may have.

On behalf of:

American Congress of Community Supports and Employment Services
American Council of the Blind
American Network of Community Options and Resources
Association for Persons in Supported Employment
International Association of Psychosocial Rehabilitation Services
NAMI—National Alliance for the Mentally Ill
National Association for Developmental Disabilities Councils
National Multiple Sclerosis Society
National Organization of Social Security Claimants’ Representatives
National Senior Citizens Law Center
NISH
Research Institute for Independent Living
The Arc of the United States
United Cerebral Palsy Associations, Inc.