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Tuesday, April 9, 2024 | Back issues
Courthouse News Service Courthouse News Service

Agency Clarifies Total Disability Benefit Criteria

WASHINGTON (CN) - The Social Security Administration has completed revisions to its criteria for evaluating congenital physical disorders under which individuals may be eligible for benefits.

People suffering from mental and physical disorders are often eligible for benefits under the Social Security Administration (SSA), which uses a set of criteria to determine if a person's impairments are seriousness enough to merit total disability payments.

The agency has finalized its criteria for congenital disorders, particularly for Down Syndrome, and has proposed revisions for criteria concerning respiratory and genitourinary disorders.

The SSA made comprehensive revisions to the criteria for impairments that affect multiple body systems in adults and children in 2005. The revisions came under Titles II and XVI of the Social Security Act and are due to expire on Oct. 31, 2013. The SSA said in its initial proposal that "most of the rules are substantively the same as the current ones. We propose to clarify and reorganize them."

Specifically, the finalized rule, which has not changed from its initial proposal, revises the name of the body system listing from "Impairments That Affect Multiple Body Systems" to "Congenital Disorders That Affect Multiple Body Systems."

The congenital disorders listing is now revised to included different methods for establishing the existence of non-mosaic Down Syndrome, versus "mosaic" Down Syndrome, and other congenital disorders that affect multiple body systems.

"We do not expect any decisional differences due to the revisions in this body system," the SSA said.

The agency said revisions are meant "to clarify that we consider only certain congenital disorders in this body system. We evaluate other disorders that affect more than one body system under the listings that address their specific effects. We evaluate congenital disorders with single effects under other body systems."

Revisions concerning respiratory disorders were last made in 1993, according to the SSA, which is now considering revising and expanding the introductory text to the respiratory system listings for both adults and children to reflect medical advances in the evaluation of respiratory disorders.

Revisions concerning genitourinary disorders were last made in 2005, with an expiration date of Sept. 6, 2013. The proposed revisions include changing the body system listing from genitourinary "impairments" to "disorders" and the introductory text for adults and children listings, among other changes being considered. The SSA also proposes adding a listing criterion for evaluating chronic kidney disease with impairment of kidney function in adults and children.

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