Pain and disability under Social Security: time for a new standard

Some degree of pain is a part of every individual's life. Many people, however, live in chronic debilitating pain. This Article examines concepts of pain and its treatment and implications for victims of pain under the Social Security system. The Article discusses inconsistencies within the Social Security Administration and in the courts when attempting to set standards for evaluating pain and determining disability.     

Supplemental Security Income: determining disability for a child under age 18. Social Security Administration. Final rules

On February 11, 1997, we published interim final rules with a request for comments to implement the Supplemental Security Income (SSI) childhood disability provisions of sections 211 and 212 of Public Law (Pub. L.) 104-193, the Personal Responsibility and Work Opportunity Reconciliation Act of 1996. We are now publishing revised final rules in response to public comments. We are also conforming our rules to amendments to Public Law 104-193 made by the Balanced Budget Act of 1997, Public Law 105-33. Finally, we are simplifying and clarifying some rules in keeping with the President's goal of using plain language in regulations.     

Determining disability and blindness; substantial gainful activity guides. Social Security Administration. Final rules

We are revising our rules to reflect amendments to the Social Security Act (the Act) concerning the trial work period and the disability insurance reentitlement period. We are also clarifying certain standards we use to determine whether work is substantial gainful activity and whether an individual is entitled to a trial work period, thereby further explaining how we determine disability under titles II and XVI of the Act.     

Social Security benefits; disability insurance benefits; deductions, reductions, and nonpayments of benefits--SSA. Final rules with comment period

These regulations amend the existing regulations under which Social Security benefits payable to a disabled worker and his or her family may be reduced because of the worker's concurrent entitlement to workers' compensation benefits. They provide that entitlement to certain other public disability benefits may reduce the disability benefits paid by Social Security; that the reduction applies to the first month of concurrent entitlement regardless of the month in which we are notified of entitlement to the public disability benefit; and that the reduction applies to all months of concurrent entitlement until the disabled worker attains age 65. These regulations also provide that where a public disability law or plan provides for reduction of the public disability benefit on the basis of entitlement to Social Security disability insurance benefits that provision will preclude reduction of the Social Security benefits but only if it was in effect on February 18, 1981. These regulations implement section 2208 of the Omnibus Budget Reconciliation Act of 1981 (Pub. L. 97-35).     

Federal old-age, survivors, and disability insurance; earnings test: Social Security Administration. Interim regulations

The Social Security Administration is issuing interim regulations to implement sections 1, 3, and 4 of Pub. L. 96-473 (enacted October 19, 1980) that make a number of changes in the application of the earnings test for retirement purposes. The provisions are designed to eliminate some unintended and harsh effects of the limitations on the use of the monthly earnings test imposed by the Social Security Amendments of 1977. Section 1 permits the use of the monthly earnings test by those beneficiaries entitled to child's benefits, young wife's and young husband's benefits (entitled only by reason of having an entitled child in their care) or mother's and father's benefits, in the year that entitlement terminates, if termination is for a reason other than death and the beneficiary is not entitled to another type of Social Security benefit for the month following the month of termination. Section 3 excludes from gross income, for purposes of the annual earnings test, self-employment income which is received in a year after the initial year of entitlement to insurance benefits under title II (other than disability benefits and childhood disability benefits) and is not attributable to services performed after the month of entitlement. Section 4 provides for all beneficiaries the use of the monthly earnings test in the first taxable year after 1977 in which a beneficiary has a non-service month in or after the month of entitlement to benefits.     

Modifications to the disability determination procedures; disability claims process redesign prototype. Social Security Administration. Notice of a prototype involving modifications to the disability determination procedures

The Social Security Administration (SSA) is announcing a prototype involving a combination of modifications to the disability determination process. Before proceeding to national implementation, we expect that this prototype will provide a body of information about what impact these modifications may have on agency operations, notice and other procedures, as well as the resulting quality and timeliness of decisions for the public.     

Coercion and justification: a global public reason perspective on Security Council reform

The Security Council is the only international body capable of authorizing the use of force in cases other than self-defence. Its main mission is to protect international peace and security, and this has been reinterpreted in recent decades to include the protection of human rights in situations of grave humanitarian emergencies as well as to allow it to exercise legislative powers. Given this extraordinary range of functions, it is worth asking whether the Security Council is justified in their exercise. Should the international community entrust such power to an institution with the authority, structure, and decision-making process of the Security Council? This article explores the implications of a distinctive tradition in political philosophy – namely, the public reason tradition – for judging the adequacy of some of the proposals for reform of the Security Council. I show that the scope of authority of the Security Council, as well as some of the proposals for reform, can be challenged on the basis of an emerging global public culture.     

Federal old-age, survivors, and disability insurance and supplemental security income for the aged, blind, and disabled; evaluating opinion evidence. Social Security Administration. Final rules

We are revising the Social Security and Supplemental Security Income (SSI) regulations concerning the evaluation of medical opinions to clarify how administrative law judges and the Appeals Council are to consider opinion evidence from State agency medical and psychological consultants, other program physicians and psychologists, and medical experts we consult in claims for disability benefits under titles II and XVI of the Social Security Act (the Act). We are also defining and clarifying several terms used in our regulations and deleting other terms.     

Old-age, survivors, and disability insurance and supplemental security income for the aged, blind, and disabled; substantial gainful activity amounts. Social Security Administration. Final rules

We are revising the rules for determining when earnings demonstrate the ability to engage in substantial gainful activity (SGA). This rule change applies to Social Security disability benefits provided under title II of the Social Security Act (the Act) and Supplemental Security Income (SSI) benefits based on disability under title XVI of the Act. (Eligibility for benefits under titles II and XVI also confers eligibility for related Medicare and Medicaid benefits under titles XVIII and XIX of the Act.) Specifically, we are raising from $500 to $700 the average monthly earning guidelines used to determine whether work done by persons with impairments other than blindness is SGA. We are raising this level as part of efforts to encourage individuals with disabilities to attempt to work, and to provide an updated indicator of when earnings demonstrate the ability to engage in SGA. This increase reflects our assessment of the amount that roughly corresponds to wage growth since the last increase in 1990.     

Social Security and Taxation: A Note on Some Intellectual Foundations of Social Security and Taxation

This note offers a short summary of intellectual roots of social security and taxation as institutions. The emphasis is on very basic ideas, spanning a bridge from the German historical school to recent French thought. The purpose is, of course, to show the breadth of intellectual options.     

Social Security Ruling, SSR 98-1p; Title XVI: determining medical equivalence in childhood disability claims when a child has marked limitations in cognition and speech--SSA. Notice of Social Security Ruling

In accordance with 20 CFR 402.35(b)(1), the Commissioner of Social Security gives notice of Social Security Ruling, SSR 98-1p. This Ruling results from the "top-to-bottom" review of the implementation of changes to the Supplemental Security Income childhood disability program necessitated by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (Pub. L. 104-193). It provides a policy interpretation that children who have a "marked" limitation in cognitive functioning and a "marked" limitation in speech have an impairment or combination of impairments that medically equals Listing 2.09. It also provides guidance for determining when a child has a "marked" or an "extreme" limitation in each of these areas.     

The new Israeli health care reform: an analysis of a national need

This paper describes the current situation of health care services in Israel. Major problems are discussed and analyzed in terms of the dualism of the main health organizations (the Ministry of Health and the General Sickness Fund), the multiplicity and discontinuity of health care delivery, quality-of-care problems, and the uneven geographical distribution of facilities. A proposal for a reform of the health care system is outlined, and its principles enumerated. This reform, suggested by the Ministry of Health, reflects a new approach of separating the direct provision of care from the executive functions of planning and control of services. The Ministry's proposal is analyzed, and its implications are discussed in relation to the American health care system.     

养老社会化的社会类型与社会结构差异

养老模式与社会类型和社会结构密切相关。从社会类型看,居家养老是机械团结型社会的核心乃至唯一养老模式,而社会养老是分工协作型社会家庭保障功能外移的结果。养老社会化进程与工业化进程总体上是正向相关关系,即工业化程度越高,养老社会化的程度越高;工业化程度越低,养老社会化的程度越低。从社会结构看,社会养老服务的需求与供给存在显著的社会分层差异,如贫富差异、区域差异和城乡差距等。这些差异是不同社会分层生存需求层次差别、政治话语权差异及其利益博弈的结果,并经由国家福利政策将其制度化。养老社会化的社会类型和社会结构分析的意义在于:特定国家的养老社会化进程应与其政治、经济、文化和社会条件相适应,以期获得坚实的道德支撑和制度保障。     

Revised medical criteria for evaluating mental disorders and traumatic brain injury. Social Security Administration. Final rules

These rules revise our regulations for evaluating mental impairments. They also change some of the provisions of our Listing of Impairments (the Listings) that we use to evaluate mental disorders in adults. We also are adding guidance to the adult neurological listings regarding the evaluation of traumatic brain injury. In addition, the rules make technical changes to the adult digestive listings and the childhood mental disorders listings. We expect that these rules will clarify the intent and purpose of the listings for evaluating mental disorders, and will simplify our adjudication of claims involving mental impairments. These rules also recognize the sometimes unpredictable course of traumatic brain injury, and will improve our adjudication of claims involving traumatic brain injuries.     

Federal old-age, survivors and disability insurance and Supplemental Security Income for the Aged, Blind, and Disabled; medical and other evidence of your impairment(s) and definition of medical consultant. Social Security Administration. Final rules

We are revising the Social Security and Supplemental Security Income (SSI) disability regulations regarding sources of evidence for establishing the existence of a medically determinable impairment under title II and title XVI of the Social Security Act (the Act). We are doing this to clarify and expand the list of acceptable medical sources and to revise the definition of the term "medical consultant" to include additional acceptable medical sources.     

Representing the healthcare organization in a post-Sarbanes-Oxley world: new rules, new paradigms, new perils

The Sarbanes-Oxley Act (Act) significantly changed the expected corporate behavior of public companies. The Act governs the relationship between corporate organizations and their in-house or outside counsel. Under Section 307 of the Act, the Securities and Exchange Commission initially proposed expansive rules regarding counsel's duties. After comments and criticism from much of the bar, a final, narrower, version of rules under Section 307 (Final Rule) was adopted. The Final Rule contains alternative reporting procedures, attorney responsibilities, and sanctions for violations. In addition to the Act, the American Bar Association's (ABA) Task Force on Corporate Responsibility(Task Force), which was itself a reaction to Enron, reported on the importance of counsel's role in a corporate setting (Cheek Report). The ABA adopted amendments to its Model Rules of Professional Conduct (Model Rules) 1.6 and 1.13 as proposed in the Cheek Report. The Final Rule and amended Model Rules together suggest that attorneys may owe duties beyond those owed to their clients.     

The new institutionalist approaches to health care reform: lessons from reform experiences in Central Europe

This article discusses the applicability of the new institutionalism to the politics of health care reform in postcommunist Central Europe. The transition to a market economy and democracy after the fall of communism has apparently strengthened the institutional approaches. The differences in performance of transition economies have been critical to the growing understanding of the importance of institutions that foster democracy, provide security of property rights, help enforce contracts, and stimulate entrepreneurship. From a theoretical perspective, however, applying the new institutionalist approaches has been problematic. The transitional health care reform exposes very well some inherent weaknesses of existing analytic frameworks for explaining the nature and mechanisms of institutional change. The postcommunist era in Central Europe has been marked by spectacular and unprecedented radical changes, in which the capitalist system was rebuilt in a short span of time and the institutions of democracy became consolidated. Broad changes to welfare state programs were instituted as well. However, the actual results of the reform processes represent a mix of change and continuity, which is a challenge for the theories of institutional change.     

Social Security benefits and supplemental security income; disability termination hearings at the reconsideration level--SSA. Notice of proposed rulemaking

We are proposing regulatory changes to carry out a requirement of Pub. L. 97-455 (enacted on January 12, 1983). That legislation requires several changes in the procedures used by the Social Security Administration (SSA) to conduct periodic reviews of disability cases for continuing eligibility. The proposed regulations would implement Sections 4 and 5 of the new law, which require SSA to make a face-to-face evidentiary hearing available in connection with the reconsideration of any initial determination that an individual receiving disability benefits under title II of the Social Security Act (the Act) is not now disabled. We also propose to make the new reconsideration procedure available in blindness and disability termination cases in the Supplemental Security Income (SSI) program under title XVI of the Act, pursuant to the Secretary's broad rulemaking authority in the SSI program. Although Congress has not specifically required that we do so, it is customary to extend legislative improvements in the title II disability program to comparable SSI cases, since the medical eligibility requirements in both programs are quite similar. Moreover, the proposed inclusion of SSI blindness and disability termination cases would promote effective program administration by providing a uniform appeal procedure in the two programs. We believe that this new procedure will make the reconsideration level more meaningful in blindness and disability termination cases, that beneficiaries affected by these termination decisions will be better served and that the overall quality of the decisionmaking process will also be improved.