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1984 DISABILITY AMENDMENTS

Medical Improvement Standard

One of the basic purposes of the 1984 legislation was to reemphasize the congressional intent that there be national uniformity in the disability programs under standards established by Congress and authoritatively interpreted in the regulations of the Secretary. Therefore, most of the major provisions of the 1984 Disability Benefits Reform Act involved the establishment of statutory standards for evaluating disability. Perhaps the most important of these is the amendment setting forth the standard of review for termination of disability benefits. In general, the amendment provides that, with certain exceptions, the Secretary may terminate benefits based on disability only if there is substantial evidence which shows that the individual's impairments have medically improved and the individual can now perform substantial gainful activity. The new regulations implementing this change were published in the Federal Register on December 6, 1985.

Multiple Nonsevere Impairments

The 1984 Disability Benefits Reform Act also changed the established policy concerning the evaluation of disability in cases involving non-severe impairments. Prior to the amendments, by regulation a case could not proceed through the sequential evaluation process unless the individual had a least one severe impairment. Thus, an individual with two or more impairments, each of which was a non-severe impairment, could not be found to be under a disability. However, the statute now requires that in determining whether a person's impairment or impairments are of sufficient medical severity to be considered the basis for eligibility, the Secretary must consider the combined effect of all of a person's impairments. This provision is reflected in interim regulations published on March 5, 1985.

Evaluation of Pain

In addition, the 1984 legislation codifies, through 1986, SSA's policy concerning the evaluation of pain and other symptoms in adjudicating disability. The amendment makes explicit that an individual's subjective complaints shall not alone be sufficient to establish disability, and that there must be medical signs and findings which show the existence of a medical impairment which could reasonably be expected to produce the pain or other symptoms alleged. The 1984 Amendments also require the appointment of a Commission to conduct a study on the evaluation of pain in determining disability. This study is currently underway and a report is due by the close of this year.

Personal Appearance Demonstration Projects

Another provision of the 1984 Amendments requires the Secretary to implement demonstration projects with several States in which applicants for disability benefits and beneficiaries undergoing continuing disability review are provided an opportunity far a personal appearance prior to an initial determination of ineligibility. Under the demonstration projects the opportunity for a face-to-face meeting at the initial level of adjudication takes the place of the reconsideration level of review. The purpose of the demonstration projects is to test whether a face-to-face interview will result in a better evaluation of the individual's condition and simplify and expedite the decision-making process. A report on the projects, together with recommendations, is due to the Congress by the end of 1986.

Revised Mental Evaluation Criteria

Of further note is the provision in the 1984 Amendments which placed a temporary moratorium on periodic reviews of all mental impairment cases pending the issuance of revised criteria for evaluating such impairments. A thorough and complete reevaluation of the mental listings has been a major administrative goal since June 1983. As the result of the Department's commitment to this initiative, revised criteria are now in final regulations, appearing in the Federal Register on August 28, 1985.

SUMMARY

The disability programs are of vital importance to millions of Americans whose lives are disrupted by the onset of disability. Currently, the disability insurance program provides replacement income to more than 2.6 million disabled workers and their families. In addition, more than 2.3 million disabled or blind needy individuals receive benefits under the SSI program. A combined total of approximately 2 million disability applications are filed each year. The problems associated with administering these enormous and highly complex programs are often difficult to comprehend. As was observed by the Supreme Court in Heckler v. Day, the task of managing these programs effectively and efficiently is an extremely difficult one. Yet, the Department is committed to ensuring that the disability programs are administered both fairly and responsibly, as demonstrated by its many initiatives these past 2 years. It is the Department's goal to ensure that there is consistent and equitable treatment of all those who are served by these national programs. As their history demonstrates, the disability programs are dynamic programs, undergoing continuous examination, change, and refinement.