Social Security Disability

STATEMENT BY CAROLYN W. COLVIN DEPUTY COMMISSIONER FOR PROGRAMS AND POLICY SOCIAL SECURITY ADMINISTRATION DECEMBER 1, 1997

PLANS FOR ACHIEVING SELF-SUPPORT

I am announcing, today, a series of actions that the Social Security Administration (SSA) is taking with respect to Plans for Achieving Self-Support, or PASS. PASS is a provision of the Supplemental Security Income program that is intended to assist highly-motivated people with disabilities in their efforts to join or rejoin the workforce. The actions I'm sharing with you today will enhance its ability to do so.

In April 1996, SSA revised its guidelines for administering PASS and created a new process for handling PASS applications and reviews. The main purpose of these changes was to ensure proper stewardship of the provision, amid mounting evidence and criticism that it was being misused. The changes were largely successful in that regard, but we have learned that they also had unintended consequences, with respect to the application of the policy guidelines, the physical processing of cases, and communications with PASS customers and stakeholders.

Social Security had informed certain advocates and members of the Congress that it would assess the impact of the new guidelines when it had gained experience with them. That assessment began in March of this year, accelerated by expressions of concern from PASS participants and advocates about the guidelines and how they were being applied. SSA field staff and diverse segments of the disability community, including individual PASS participants and advocates, have contributed invaluable input during the assessment process, helping us to identify causes for a number of the concerns we heard.

Today's actions affect PASS policies, the procedures for applying PASS policies, and the overall process for handling the work associated with PASS applications and reviews. From now on:

PASS evaluations and notices will make a clear distinction between the feasibility of the goal, based on an individual's reasonable expectations to perform the work, and the viability of the plan for achieving it, based on the steps necessary to achieve the goal.
Unless we have evidence to the contrary, SSA's PASS Specialists will presume an occupational goal to be feasible, and the plan for achieving it to be viable, if a Vocational Rehabilitation agency develops the PASS. If the PASS Specialist cannot approve a PASS, he or she will discuss the matter with the individual as well as with any Vocational Rehabilitation professional involved with developing the plan.
Instructions regarding the limit on occupational goals will make it clear that this limit is not the strict "entry level" limit that many, both in and outside of SSA, perceive it to be. Our policy is that, within the business, trade, or profession the individual has chosen, the occupational goal cannot exceed the earliest point on the career path that would generate sufficient earnings to enable the individual to pay for his or her own living expenses, uncovered medical expenses, and work-related expenses.
Allowable expenses for major purchases will not be limited to down payments. Funds set aside for installment payments will be excluded to the extent that the expense remains related to and supportive of an approved occupational goal, and earnings do not negate the need to continue the exclusion.
The PASS Specialist will play an earlier and expanded role in the PASS application or review, and he or she and the customer will be able to communicate directly with each other throughout the process.

In addition, anyone whose PASS was terminated or denied after March 1996 will be contacted, informed of these changes, and invited to submit a new PASS.

Emergency instructions regarding these actions are being sent today to all SSA regional and field offices. The instructions related to feasibility determinations, the limit on occupational goals, and down payments will be implemented immediately. Implementation of the changes to the process for working on PASS applications and reviews will begin after a brief transition period.

These actions may not resolve all the concerns that have been raised regarding SSA's administration of PASS, but they eliminate the underlying causes of many of them. We will continue the dialog we have established with PASS customers and stakeholders, both to assess the impact of these actions and to identify further changes that may be warranted. We believe that PASS can be an unusually effective tool for assisting people with disabilities in their efforts to work, and we are committed to the success of those efforts.

A summary sheet with more background information on these actions follows.

Note: This announcement and the accompanying summary sheet will be available on SSA's Internet Site, Social Security Online, at http://www.ssa.gov.

Summary Sheet Plans for Achieving Self-Support (PASS) Policies and Procedures December 1, 1997

1. Feasibility of Occupational Goals

a. Background

POMS criteria for determining the feasibility of an occupational goal currently include criteria that pertain not to whether the goal itself is feasible (i.e., to whether the individual has reasonable expectations of doing the work considering the nature of the impairment and any limits imposed by it), but to whether the plan for achieving the goal is viable. As a result, a denial can be based on poor plan design, but the notice to the individual about the denial can characterize the issue as one of "feasibility," suggesting that SSA considers the individual incapable of doing the work.
SSA's PASS Specialists sometimes find that, despite a PASS having been developed by a Vocational Rehabilitation (VR) professional, its occupational goal is not feasible or the plan for achieving it is not viable. There is currently no procedure in place for resolving such differences of opinion before denying the PASS.
There is, in most cases, an absence of direct communication between the PASS applicant and the PASS Specialist who makes determinations in his or her case.

b. Actions

SSA will revise its operating instructions to make a clear distinction between the feasibility of the occupational goal that a PASS specifies and the viability of the plan for achieving that goal. Notices to PASS applicants will make the same distinction.
Unless there is evidence to the contrary, SSA's PASS Specialists will presume the occupational goal specified in a PASS to be feasible, and will presume the plan for achieving it to be viable, if a Vocational Rehabilitation agency develops the PASS. If these presumptions do not apply, and the PASS Specialist believes that the goal is not feasible or the plan is not viable, he or she will discuss this with the plan's preparer. If, the PASS Specialist continues to believe that the goal is not feasible or the plan is not viable, he or she will document the file regarding the discussion and the reason for his or her position.
PASS Specialists will communicate with PASS applicants and participants directly during the application and review processes. Before denying a PASS on the basis that it is not a viable means of achieving the occupational goal, SSA will contact the PASS applicant, explain why the plan is not viable, and discuss with the applicant modifications that would make the plan viable.

2. Limit on Occupational Goals

a. Background

Current POMS instructions describe the limit on occupational goals as an "entry-level" limit, to which an exception is possible. They define entry level as the initial rung on the career ladder of a business, trade, or profession. The exception to this limit applies if the entry-level position would not generate sufficient income to cover the individual's living expenses (as they exist during the PASS), uncovered medical expenses, and work-related expenses. Often, this exception is overlooked and the policy is misunderstood by both SSA staff and the public.

b. Action

SSA will revise its operating guidelines to describe the limit on occupational goals as follows:

Within the business, trade, or profession the individual chooses, his or her occupational goal must be the earliest point on the career path at which earnings can reasonably be expected to cover his or her living expenses (as they exist during the PASS), uncovered medical expenses, and work-related expenses.

3. Allowable Expenses for Major Purchases

a. Background

Allowable expenses for major purchases under a PASS have been limited to down payments.

b. Action

In the future, funds set aside for a major purchase will be excluded to the extent that the expense is reasonable, related to and supportive of an approved

occupational goal, and until earnings negate the need to continue the exclusion. Funds set aside for installment payments now will be able to be excluded.

4. Process for Handling PASS Applications and Reviews

a. SSA will implement a process for handling PASS applications and reviews that is based on a pilot conducted by its PASS cadre site in St. Paul, Minnesota. The St. Paul model provides for significantly greater direct communication than now occurs between the PASS Specialists, who are the decision-makers, and PASS applicants and participants. To facilitate this communication, toll-free access to the PASS Specialists will be provided for case discussion as soon as possible.

b. PASS reviews will continue to include current stewardship requirements, but will be more proactive and supportive. The PASS Specialists will augment these reviews with periodic telephone calls. These calls will help the PASS Specialist and the individual identify and remedy actual or potential problems before they affect the integrity of the PASS, and should improve chances for successful completion of the PASS.

c. Emphasis will be placed on flexibility in amending a PASS retroactively when changes have occurred that do not compromise the integrity of the plan.

5. Additional Training and Resources for PASS Specialists

The Social Security Administration will provide its cadre of PASS Specialists with training on these changes, and additional vocational training, beginning in January 1998. It will provide the PASS Specialists with vocational assessment tools, including access to vocational assessment resources available on the internet. It also will work to improve communications with Vocational Rehabilitation agencies, at both the national and local levels, regarding PASS.