Action needed on 4 impairment-specific SSA notices

[Guest guest]

Action needed by 6/13 on four impairment-specific SSA notices – please see

if one or more affect your members

SSA issued four “advanced notices of proposed rulemaking” on April 13th,

seeking comments related to three sections of the current Listing of

Impairments and the possibility of creating a new listing. In each case,

both ADULT and CHILD listings are under review. Each notice is

impairment-specific and comments from medical experts and consumers will be

very important. Please consider sharing this message with your

organization’s medical (and other) experts for review. The notices cover

the following four areas:

1. Neurological impairments ­ Listing sections 11.00 and 111.00 (In

addition to general questions, there is a specific question about criteria

SSA should use to define disabling epilepsy at the listing level; there

also is a question about whether the neurological listings “should continue

to include functional criteria that consider all aspects of listed

neurological impairments such as motor and sensory deficits,

cognitive/behavioral abnormalities, speech/language limitations, and

vision/hearing losses.” And, there is specific reference to a publication

on criteria for determining disability related to multiple sclerosis.)

2. Language and speech disorders ­ Here, SSA is asking whether they should

create a new body system in the listings that covers language and speech

disorders.

3. Respiratory impairments ­ Listing sections 3.00 and 103.00 (In addition

to general questions, there are specific questions about criteria that SSA

may want to incorporate to define disabling asthma at the listing level and

also disabling bronchopulmonary dysplasia (BDP) at the listing level.)

4. Hearing impairments and disturbance of labyrinthine-vestibular function

­ Listing sections 2.00 and 102.00 (Here, SSA asks whether they should

continue to have these listings and, if so, whether changes are needed.

Also, are there criteria that are not included now but should be? SSA asks

whether there should be separate criteria for individuals who have had

cochlear implants? Should there be a listing for disturbance of

labyrinthine-vestibular function in children?)

In addition, for each of these four notices there are questions related to

how SSA could better help people with these specific impairments who want

to return to work or remain working. (See discussion below.)

Background

The Listing is a very important part of the disability determination

process for Social Security and SSI because if a person can establish that

his/her condition meets the requirements of a listed impairment (and the

person is not working and earning over $830 per month in 2005), SSA will

find the person eligible for benefits. Others whose conditions are found

not to meet the listing are not denied at that stage but instead have to go

on to prove that their condition is medically equivalent to the listed

impairment or that, even though they don’t meet or equal the listing, based

on their age, education and work experience, their medical condition(s)

makes it impossible for them to engage in substantial gainful activity.

SSA is in the process of reviewing and updating the various listings. This

process of issuing advanced notices of proposed rulemaking is relatively

new to SSA and one that CCD applauds ­ it gives the public a chance to

weigh in about concerns with specific listings before SSA staff issue the

notice of proposed rulemaking. In 2003-2004, SSA issued an advanced notice

of proposed rulemaking on the mental impairment listings and another on

immune disorders. It is important to take these notices seriously and to

see them as an important opportunity to inform SSA about concerns with a

particular listing and whether it currently works, where the problems are,

and to answer other questions SSA asks in the notices.

What information is SSA looking for?

* In each of the ANPRMs, SSA explains that it is seeking views on how

the current listing is working, whether changes are needed, and, if so,

what changes are proposed and why. (See the first section above for a few

more details about each notice.) This is a great chance to urge your

medical experts to provide thoughtful comments to SSA.

* In addition to the focus on the specific listing in each of the

advanced notices, SSA has included a paragraph asking for information that

goes beyond the listing, seeking information and recommendations about how

Social Security and SSI could be better designed to help people with the

specific impairment who would like to return to work or remain in their

jobs. SSA asks how their regulations (and the statute, should the

commenter want to suggest statutory changes) affect people with the

impairment who would like to work, full-time or part-time, with supports.

Our suggestions:

1. If your organization has strong ties to medical and other

health experts who are at the cutting edge of work related to one or more

of the impairments that are the focus of these notices, please consider

contacting them and asking them to review the current listing. They

could either submit their own comments or you could submit a comment on

their behalf. Your organization also should submit your own

comments.

2. If your organization has a membership base and/or listserv, please

urge your members and others to look at the relevant listing and

comment. It is very easy to submit a comment on SSA’s website. (See

directions below.)

3. It is important to stress that the deadline is June 13, 2005, less

than three weeks from now.

4. If we can be of assistance to you as you think about working on this,

please contact any of us.

Commenting on SSA’s website

It is easy to submit a comment directly on SSA’s website. Also, because

SSA posts all of the comments on the SSA website, it is possible for you to

get a sense of whether others are commenting on the notice you are

concerned about and who you may want to call to urge to submit a

comment. And, by submitting your comment early, you may help to enlighten

other potential commenters.

To file a comment on SSA’s website: go to

<http://policy.ssa.gov/pnpublic.nsf/LawsRegs>http://policy.ssa.gov/pnpublic.nsf/\

LawsRegs,

then click on the section on notices that are open for comment. The list

of notices will come up. Click on the relevant notice. When you get to

the page with the relevant notice, at the very bottom on the left, there is

a little triangle ­ if you click on it, it will point down and you can then

view below it any comments that have been filed. On the same page, there

is a place to click to submit your comment as well.

As of today, very few comments have been filed on any of these four notices.

Links to the four notices in the April 13, 2005 Federal Register:

1. Neurological impairments: 70 Federal Register 19356 (April 13, 2005)

<http://a257.g.akamaitech.net/7/257/2422/01jan20051800/edocket.access.gpo.gov/20\

05/05-7357.htm>http://a257.g.akamaitech.net/7/257/2422/01jan20051800/edocket.acc\

ess.gpo.gov/2005/05-7357.htm

http://a257.g.akamaitech.net/7/257/2422/01jan20051800/edocket.access.gpo.gov/200\

5/pdf/05-7357.pdf

2. Language and speech disorders: 70 Federal Register 19351 (April 13, 2005)

<http://a257.g.akamaitech.net/7/257/2422/01jan20051800/edocket.access.gpo.gov/20\

05/05-7356.htm>http://a257.g.akamaitech.net/7/257/2422/01jan20051800/edocket.acc\

ess.gpo.gov/2005/05-7356.htm

http://a257.g.akamaitech.net/7/257/2422/01jan20051800/edocket.access.gpo.gov/200\

5/pdf/05-7356.pdf

3. Respiratory impairments: 70 Federal Register 19358 (April 13, 2005)

<http://a257.g.akamaitech.net/7/257/2422/01jan20051800/edocket.access.gpo.gov/20\

05/05-7358.htm>http://a257.g.akamaitech.net/7/257/2422/01jan20051800/edocket.acc\

ess.gpo.gov/2005/05-7358.htm

http://a257.g.akamaitech.net/7/257/2422/01jan20051800/edocket.access.gpo.gov/200\

5/pdf/05-7358.pdf

4. Hearing impairments and disturbance of labyrinthine-vestibular function:

70 Federal Register 19353 (April 13, 2005)

<http://a257.g.akamaitech.net/7/257/2422/01jan20051800/edocket.access.gpo.gov/20\

05/05-7355.htm>http://a257.g.akamaitech.net/7/257/2422/01jan20051800/edocket.acc\

ess.gpo.gov/2005/05-7355.htm

http://a257.g.akamaitech.net/7/257/2422/01jan20051800/edocket.access.gpo.gov/200\

5/pdf/05-7355.pdf