Supplemental Security Income:

Review of SSA Regulations Governing Children's Eligibility for the Program

HEHS-97-220R: Published: Sep 16, 1997. Publicly Released: Sep 16, 1997.

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Jane L. Ross
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Pursuant to a legislative requirement, GAO reviewed the eligibility criteria in the new Supplemental Security Income (SSI) program regulations to determine their consistency with the law, focusing on: (1) the provisions describing how severe a child's impairment must be in order for the child to qualify for benefits; and (2) public comments on the regulations and interviews with Social Security Administration (SSA) officials.

GAO noted that: (1) Public Law 104-193 enacted several provisions that made the eligibility criteria for disabled children more restrictive; (2) to implement the new law, SSA issued interim final regulations that defined an impairment that results in "marked and severe functional limitations" as one that meets or medically or functionally equals one of SSA's medical listings; (3) for a child to be determined eligible for benefits under this new and stricter standard of severity, his or her impairment must generally result in marked functional limitations in two areas of functioning, such as social and motor skills, or an extreme limitation in one area; (4) during the public comment period for the draft regulations, SSA received more then 175 written comments from individuals and organizations, many of which expressed the view that the new eligibility standard in the regulations is more severe than the law requires; (5) more recently, media reports have criticized the stringency of the new regulations; (6) in its regulatory analysis, SSA gave several reasons for concluding that the law and legislative history made clear that the Congress meant to establish a stricter level; (7) GAO found the interim final regulations to be consistent with the law; (8) SSA was well within its authority in establishing the new level of severity, and its rationale for doing so was well supported; (9) the new eligibility criteria also apply to children already receiving SSA benefits; (10) through September 6, 1997, SSA has reviewed the eligibility of 246,211 children, and of these 116,670 were found eligible to continue to receive benefits and 129,541 were found ineligible; and (11) because the number of children deemed to be ineligible by this review does not yet reflect the results of all appeals, GAO does not yet know what the final outcome on all these cases will be.

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