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Handicapped by Social Security Agency ill-equipped to evaluate clients, get them back to work

THE BALTIMORE SUN

WASHINGTON -- Mary Jane Owen is blind, partially deaf and uses a wheelchair. Robbed of the feeling in her fingers, she can't even read Braille. But she goes to work every day.

A writer, lecturer and administrator, she is one of the thousands of workers with conditions that would qualify them for Social Security disability checks if they quit their jobs.

Indeed, Ms. Owen was on the rolls until she concluded the agency was impeding her return to work. She told Social Security to keep the money, but the checks kept flowing anyway, piling up uncashed for nearly five years.

Though unusual, Ms. Owen's case illustrates a flaw in the $66 billion disability programs, which were created to replace income for people unable to work: Social Security offers little aid or encouragement to recipients to return to work, even when they want to.

What's more, the program's eligibility standards allow thousands who do work to receive benefits should they choose to give up their jobs and apply for disability. This suggests that the standards themselves may be out of date in light of medical advances.

These problems intensified in recent years as Social Security virtually stopped monitoring the condition of recipients to see if they qualified for benefits. Saddled with a cut of nearly 20 percent in its staff when applications were soaring toward 3 million annually, the agency has done little more than process applications.

Recently, under pressure from Congress, it has stepped up its reviews of recipients, along the way providing fresh evidence that many disability recipients are now able to work.

In the year that ended Sept. 30, the agency re-examined 240,440 recipients -- only 2.7 percent of the total. It found that 41,790 -- more than one in every six -- had improved and should be dropped from the rolls.

The programs date from the 1950s, when Congress created Disability Insurance (DI) to extend Social Security benefits to disabled workers not yet eligible for old-age pensions.

In 1972, it added Supplemental Security Income, a program for the disabled poor and elderly who were not eligible for DI. Originally intended for worn-out middle-aged manual laborers, the programs in recent years have awarded an increasing percentage of benefits to younger applicants with mental and emotional problems.

SSI pays an average of $390 a month to 4.9 million disabled recipients; DI pays an average of $665 a month to 4 million disabled workers. Most SSI and DI recipients also receive free government medical insurance through Medicaid or Medicare.

To be eligible for either disability program, a person must -- as the result of a medically verifiable physical or mental ailment -- be unable to engage in what the law calls "substantial gainful activity" for at least a year. It is, say the program's administrators and defenders, a strict standard.

They "have a limitation that's so severe that our definition says that we don't expect them to work," says Susan Daniels, who is in charge of disability policy at the Social Security Administration.

Yet she acknowledges that many who could qualify for benefits do work, because, in cases like Ms. Owen's, they have found a way to overcome their disabilities and find jobs.

In many cases, Social Security doesn't even evaluate whether an applicant can work. If the applicant's condition is on the agency's list of those considered disabling, then benefits are awarded.

No one even asks

They "are pretty severely impaired," says Jane L. Ross, the former Social Security research chief who now supervises the General Accounting Office's scrutiny of the agency. "But a severe impairment does not mean you can't work. If you meet the medical listing, no one even asks about your capacity to work."

The agency does evaluate some applicants to see if they can work -- but only those whose condition isn't on the list.

One problem, many experts agree, is that the programs are mired in the 1950s, outpaced by medical and technological advances that have opened the way to survival -- and to gainful employment -- for the disabled.

"In the 1950s, when the disability program was first designed," says Social Security's Ms. Daniels, "there was a common belief -- and it was reasonable -- that if you had a disability, you couldn't work."

Now, she says, "enormously good treatment also makes people functional with disabilities."

But such factors as poverty, education, motivation and one's employment before becoming disabled have muddled the picture -- so that, of two equally disabled people, one might work while the other doesn't.

Often, says Ms. Daniels, the incentives to stay on the rolls outweigh the advantages of leaving -- a certain, if meager, income and full health coverage for remaining on the rolls vs. the uncertain prospects of slim income and no health insurance for leaving.

For the poor in that situation, leaving the rolls "is not a rational choice," she says.

Like Ms. Owen, Ms. Daniels has seen the disability system in personal terms. Because of childhood polio, she uses a wheelchair and spent several years on DI as a graduate student. She could still qualify if she chose not to work.

Ms. Daniels argues that she and Ms. Owen -- and thousands of others who work -- have advantages that most disability recipients don't have.

"Mary Jane Owen is like me," she says. "She's well-educated, she's smart, she has good experience she knows people, so she knows where to get jobs.

"A person with my disability with no education is extremely disadvantaged in the workplace -- extremely."

Ms. Owen now gets reduced Social Security retirement checks even though she works. She has been on the disability rolls twice and doesn't like what she's seen.

In 1989, two years after an accident and surgery left her unable to walk, she wasn't up to returning to full-time work but told Social Security she wanted to begin a business as a consultant, writer and lecturer.

She was repeatedly discouraged by calls from a caseworker, who told her she risked her monthly checks if she engaged in "substantial gainful activity."

Her frustration boiling over, she finally told the caseworker to stop the checks and followed that up with a letter.

No way to stop the checks

"I never got any more calls," she says, but the checks kept coming -- for nearly five years.

Two years ago, she made a third attempt to get them stopped, only to encounter a sympathetic Social Security employee who insisted that she probably qualified for at least some money, even though she was working by then.

And he couldn't find her file.

The disability checks finally stopped when Ms. Owen turned 65 in mid-1994, to be replaced by retirement checks that are reduced because she works.

Last March, she returned 42 of the uncashed checks -- $17,146 -- to the government, handing them over to Sen. William S. Cohen, a Maine Republican, during a hearing he called to criticize Social Security's disability programs.

Ms. Owen's protest was an expensive cry in the wilderness from someone living on the financial edge, a cry in keeping with the dominant Republican view on Capitol Hill.

"The average individual with a disability doesn't want a handout," says Sen. Bill Frist, a Tennessee Republican who heads the Senate disability policy subcommittee. "They want a hand up."

Ms. Daniels, the Social Security disability policy chief, says, "Many of our beneficiaries tell us they can't work and want to work. We want to help them get there."

But, according to the General Accounting Office, the agency does pitifully little.

For every $100 that Social Security sends out in disability checks, it spends only a dime on getting recipients back to work, the GAO says. Only about 6,000 recipients return to work each year, about one-sixteenth of 1 percent.

"We are not satisfied," Ms. Daniels admits, saying the agency is exploring ways of increasing its efforts.

Beyond Social Security's periodic reviews of a small percentage of recipients, there has been no systematic study to determine how many of them could work.

Nor has there been much study of the other side of the coin -- how many who qualify for benefits, like Ms. Owen and Ms. Daniels, actually do work.

Louis P. Enoff, who spent 30 years at Social Security and was acting commissioner before he retired in 1993, estimates that they number in the hundreds of thousands -- perhaps a million.

The Journal of Aging Studies reported in 1988 that many participants in a long-term heart study in Framingham, Mass., worked even though their conditions would qualify them for disability benefits.

Social Security is just now beginning its own five-year study aimed at refining its medical criteria and its list of ailments so they reflect the current state of medicine and medical practice.

The aim, says Ms. Daniels, is to "make sure we are using the right criteria, specific medical criteria that discriminate between people who can and cannot work."

For Ms. Owen, a more radical change would be preferable -- one that aims the program toward helping people to work. Currently, she says, the program focuses on the applicant's obligation to prove, sometimes repeatedly, an inability to work.

That, she says, is "training people to be victims."

The applicant has "to affirm and keep reaffirming that 'I can't do anything, I can't do anything, I can't do anything.' "

Then, she says sadly, "there comes a time when you can't. You have worked yourself into such a state that you can't."

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