David Hatfield Comment

As you may know, I recently testified before the Social Security subcommittee of the House Ways and Means Committee regarding Social Security disability policy. I referenced and endorsed ACUS' recommendation to eliminate the treating physician controlling weight standard. I also discussed in my testimony the idea of "term benefits" for some applicants found disabled, which has been mentioned in a draft ACUS paper. I would like to mention briefly some of the points I made that differ and/or amplify your discussion. First, instead of relying on an individual adjudicator's judgement as to whether a term benefit should be given, I would convene a panel consisting of experts in the fields of medicine and vocational rehabilitation to establish a matrix of guidelines that would, if met, decide the length of disability in each case. These guidelines would be applied after the decision, and not made by the individual adjudicator. Administrative notice would be taken, similar to the Medical Vocational Guidelines used in step 5 adjudications. This approach would provide consistency and uniformity, and would be supported by expert opinions. For example, the guidelines might state that a 25 year old individual with a traumatic leg injury that should improve with treatment would be given a two year term of disability. At the expiration of that term, the individual could reapply if he believed the injury continued to prevent him from engaging in substantial gainful activity. This would be a new application, however, and no medical improvement standard would apply. Second, because these "term" beneficiaries are likely to improve and return to work, they would be allowed to go back to work within the term with no penalty. This would encourage those individuals to get back in the workplace as quickly as possible, which is the overriding goal. The current work activity rules are cumbersome, confusing, and in the end discourage an individual's desire to return to work. It is time to recognize that many disabled individuals are unable to engage in work for at least a year, but are not permanently disabled. The current continuing disability review (CDR) process has shown over time that it does not work well, as it is detrimentally affected by outside forces, such as budget and workload.