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Social Security Today
March 2000 Issue
Filing New Case when a Case is Pending at the Appeals Council
Ticket to Work Act
President Clinton recently signed the "Ticket to Work and Work Incentives Improvement Act of 1999." The major features of this new law are to provide improved health insurance to people with disabilities, create new work incentives and enhance existing incentives for recipients of disaility benefits, and to create a "ticket to work and self-sufficiency" structure to assist disability benefit recipients in achieving their goal of self-sufficiency.
One significant provision of this bill extends premium-fee Medicare Part A coverage for an additional four and a half years for people with disabilities who return to work. Under current law, Medi-Care benefits continue for four years when a person returns to work. The new provision will extend coverage to a total of eight and a half years. It is hoped that this provision will encourage people to attempt to return to work without fear of being left without medical coverage. This provision will go into effect on October 1, 2000. The law also contains provisions that will permit the state more flexibility to provide Medi-Cal coverage to people with disabilities who work.
The actual "ticket to work" portion of the law directs the Commissioner of Social Security to establish a program whereby SSDI and SSI disability beneficiaries are provided with a ticket they may use to obtain vocational rehabilitation, employment, and other support services from a employment network of their choice. The Commissioner will select and enter into agreements with organizations that will act as an employment netwrok and provide services. The employment networks are charged with developing and implementing an individual work plan in partnership with each beneficiary that includes a statement of vocational goals and identification of servics necessary to reach those goals; and with coordinating and delivering the services identified. This program is to begin on January 1, 2001, and should be up and running nationally by January 1, 2004.
Social Security is also re-instituting the "transfer of assets penalty" for SSI benefits. After December 14, 1999, if resources are transferred for less than fair market value within 36 months o fthe application for SSI benefits for the purpose of qualifying for SSI, there will be a reduction in SSI benefits. There are a number of exceptions to application of the penalty, including if application of the benefit would work an "undue hardship."
The new law has multiple other provisions that could affect an SSI or SSDI beneficiary who is interested in attempting to return to work.
Filing New Case when a Case is Pending at the Appeals Council
When a claim is denied after a hearing in front of an Administrative Law Judge, a claimant's next step is to file a Request for Review of the Hearing Decision with the Social Security Appeals Council in Falls Church, Virginia. The average Appeals Council case currently takes two years or longer before an appeal is ruled upon, and the processing time continues to get longer.
Until recently, Social Security would not process a new application for benefits while a claim was pending at the Appeals Council, on the theory that a claimant may have only one claim active before the Administration at any given time. However, in response to the delays at the Appeals Council level, Social Security now allows a claimant to file a new application while simultaneously appealing an unfavorable hearing decision at the Appeals Council. Ideally, the new claim will be granted quickly so that the claimant has an income while awaiting the outcome of the appeal (which becomes purely an issue of retroactive benefits once payment has begun).
New Ninth Circuit Case
The Ninth Circuit recently rendered a decision in the case of Silveira v. Apfel. The issue in this case had to do with application of the Medical Vocational Guidelines to non-English speaking claimants without transferable skills to other jobs.
The court resolved a conflict in the medical-vocational rules in favor of disability claimants, and also allowed the issue to be raised for the first time on appeal. The new issue was "a pure question of law" and Social Security was not "unfairly prejudiced."
New Partner at Law Firm
Olson, Hagel, Waters and Fishburn, LLP, is pleased to announce that Elizabeth L. Gade became a partner with the firm on March 1, 2000. She continues to practice exclusively in the area of Social Security disability and SSI.
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