Schedule for rating disabilities; AL amyloidosis (primary amyloidosis). Final rule

The Department of Veterans Affairs (VA) is amending its Schedule for Rating Disabilities by updating the schedule of ratings for the hemic and lymphatic systems to include AL amyloidosis. This regulatory action is necessary to add AL amyloidosis as one of the disease conditions and establish criteria for disability evaluation to fully implement the decision by the Secretary of Veterans Affairs to grant presumptive service connection based on herbicide exposure for this disease. The intended effects are to provide consistency in disability ratings and to ease tracking of AL amyloidosis for statistical analysis.

[Analysis of job retraining rulings issued by evaluating doctors and medical comissions of the social insurance institution]

BACKGROUND

Training pension was introduced into the Polish social security system on September 1, 1997. It is granted to a person who has permanently lost the ability to work in his or her current vocation, but after an appropriate retraining may do another profession. The aim of this study was to assess the compatibility between ruling of job retraining and medical certification rules. An effort was also made to evaluate the "effectiveness" of issued recommendations expressed by the number of retrained people.

MATERIAL AND METHODS

In total, 300 cases of retraining ruling issued by an evaluating doctor or medical commission, registered in 2009, were analyzed. Retraining pension was granted to 219 persons.

RESULTS

Of the 300 rulings under study, over 35% were found groundless. In 52 cases (23.74%) (219 of them were awarded a retraining pension) there is information about completed retraining (training) and in 24 (10.95%) about referral to a specific course and its duration, but there is no information whether the insured person has completed the training course. In 2 (0.91%) cases the insured persons continued to collect retraining pension (from 21 and 30 months). 141 people were not retrained even though they had been granted a training pension.

CONCLUSIONS

A significant percentage (over 35%) of rulings were issued improperly. It is caused by the ignorance of the rules of medical certification and binding regulations in this area. The number of training courses on the principles of issuing retraining rulings and current laws should be increased.

Extension of statutory period for compensation for certain disabilities due to undiagnosed illnesses and medically unexplained chronic multi-symptom illnesses. Interim final rule

The Department of Veterans Affairs (VA) is issuing this interim final rule to amend its adjudication regulation regarding compensation for disabilities suffered by veterans who served in the Southwest Asia Theater of Operations during the Persian Gulf War. This amendment is necessary to extend the period during which disabilities associated with undiagnosed illnesses and medically unexplained chronic multi-symptom illnesses must become manifest in order for a veteran to be eligible for compensation.

Revisions to rules of conduct and standards of responsibility for representatives. Final rules

We are revising our rules of conduct and standards of responsibility for representatives. These revisions further clarify our expectations regarding representatives' obligations to competently represent their clients and constitute official notice concerning our requirements and procedures. We are also updating other rules about the representation of parties. These changes are necessary because our current regulations are insufficient to address some representative conduct that is inappropriate, but has technically fallen outside the scope of our regulations. These changes will allow us to better protect the integrity of our administrative process, ensure that claimants receive competent and effective representation, and further clarify representatives' responsibilities in their dealings with us and with claimants.

The European influence on workers' compensation reform in the United States

Workers' compensation law in the United States is derived from European models of social insurance introduced in Germany and in England. These two concepts of workers' compensation are found today in the federal and state workers' compensation programs in the United States. All reform proposals in the United States are influenced by the European experience with workers' compensation. In 2006, a reform proposal termed the Public Health Model was made that would abolish the workers' compensation system, and in its place adopt a national disability insurance system for all injuries and illnesses. In the public health model, health and safety professionals would work primarily in public health agencies. The public health model eliminates the physician from any role other than that of privately consulting with the patient and offering advice solely to the patient. The Public Health Model is strongly influenced by the European success with physician consultation with industry and labor.

Amendments to procedures for certain determinations and decisions. Final rules

We are revising the procedures for how claimants who receive fully favorable revised determinations based on prehearing case reviews or fully favorable attorney advisor decisions may seek further review. We are also revising our procedure to provide that we will notify claimants who receive partially favorable determinations based on prehearing case reviews that an administrative law judge (ALJ) will still hold a hearing unless all parties to the hearing tell us in writing that we should dismiss the hearing request. These changes will simplify our administrative review process and free up scarce administrative resources that we can better use to reduce the hearings-level case backlog.

Requiring use of electronic services by certain claimant representatives. Final rules

We are revising our rules to require that claimant representatives use our electronic services as they become available on matters for which the representatives request direct fee payment. In the future, we will publish a notice in the Federal Register when we require representatives who request direct fee payment on a matter to use our available electronic services. We are also adding the requirement to use our available electronic services on matters for which the representative requests direct fee payment as an affirmative duty in our representative conduct rules. These revisions reflect the increased use of technology in representatives' business practices. We expect that the use of electronic services will improve our efficiency by allowing us to manage our workloads more effectively. These rules do not require claimants to use our available electronic services directly; they only require their representatives to use the services on matters for which the representatives request direct fee payment.

[Integration of psychological tests into clinical expert reports on mental disorders]

Norm-referenced psychological tests may provide crucial information that cannot be derived from non-standardised assessment techniques. However, little is known about the use of psychological tests in medical expert reports. Based on 90 medical expert reports from private invalidity insurances, the use of psychological tests and the appropriateness of test-score interpretation was analysed. About 60% of the reports included test-related data. Two-third of these reports revealed deficits of either test description or interpretation or utilisation of test results. It was recommended how to interpret test results appropriately. Psychological tests should be used to validate diagnostic findings. Tests should be integrated into a multi-method assessment strategy.

[Neurorehabilitation: social-professional integration in light of the Federal disability insurance (IV/AI) 5th revision]

The new measures introduced as part of the 5th revision of the Federal invalidity insurance (IV/AI) stress social-professional integration. Thus, when work ceases for a lengthy period, AI offices rapidly organize early intervention measures and professional reinsertion in collaboration with the patient and medical team. These measures are especially well adapted to accompany and support neuro-rehabilitation so as to place or maintain patients in the labour market.

Eliminating the Decision Review Board. Final rules

We are eliminating the Decision Review Board (DRB) portions of part 405 of our rules, which we currently use as the final step in our administrative review process for adjudicating initial disability claims in our Boston region. As of the effective date of this regulation, we will replace the DRB step with review by the Appeals Council. The Appeals Council will follow most of the rules in parts 404 and 416 that we use in the rest of the country to adjudicate disability claims at the Appeals Council level, with some differences needed to accommodate the rules that govern administrative law judge (ALJ) hearings in the Boston region. We will also authorize attorney advisors in the Boston region to conduct certain prehearing proceedings and make fully favorable decisions as they do in the rest of the country. We are making these changes to improve service to claimants and to increase consistency in our program rules.

Revised medical criteria for evaluating endocrine disorders. Final rules

We are revising the criteria in the Listing of Impairments (the listings) that we use to evaluate claims under titles II and XVI of the Social Security Act (Act) involving endocrine disorders in adults and children. The revisions reflect our adjudicative experience, advances in medical knowledge, information from medical experts, and comments we received from the public in response to an advance notice of proposed rulemaking (ANPRM), a notice of proposed rulemaking (NPRM), and at an outreach policy conference.

Court of Appeal reaffirms long-term income support for alcohol and drug dependence

On 16 September 2010, the Ontario Court of Appeal upheld a decision of the Social Benefits Tribunal that found discriminatory the exclusion from long-term income support of people suffering from alcohol or drug dependency.

Employment of individuals in the Social Security disability programs

The articles in this special issue present findings from research on the employment and work-related activities of individuals receiving benefits through the Social Security Disability Insurance and Supplemental Security Income programs, and on the factors that hinder their efforts to work at levels that lead to exiting the disability rolls. This article introduces the other articles, highlights their important findings, and discusses the implications for ongoing efforts to increase the earnings and self-sufficiency of these beneficiaries, such as the Ticket to Work program and the Benefit Offset National Demonstration.