Exhibit No. 10 [FACSIMILE] MR ROBERT BYNUM'S STATEMENT THE ROLE OF AGE AS A FACTOR IN THE REFERRAL OF DISABILITY APPLICANTS FOR VOCATIONAL REHABILITATION This statement describes the Social Security Administration's policy on vocational rehabilitation and information and referral. Social Security's interest in referring applicants to State vocational rehabilitation agencies for possible services goes back to the earliest days of the disabiity cash benefits program. The 1956 Social Security Amendments contained a referral provision. Congress specified that referrals would be made to State vocational rehabilitation agencies. To stress rehabilitation in the disability program, Congress further specified that whenever possible the State vocational rehabilitation agency should be the contracting agency to make disability determinations for social security. Moreover, benefits could be withheld if the disability beneficiary refused rehabilitation services without good cause. In the Social Security Amendments of 1965, Congress provided that disability insurance trust fund money could be used to reimburse the States for the cost of rehabilitation services to selected disability beneficiaries. When the Supplemental Security Income program was authorized in 1974, Congress included a provision authorizing payment out of general revenues for the cost of vocational rehabilitation services provided to Supplemental Security Income disability/blindness recipients. A referral mechanism, linking social security and its contracting State Disability Determination Services with State vocational rehabilitation agencies similar to that in the regular social security disability insurance program, was created. Social Security Administration Referrals and Vocational Prior to the 1956 Amendments, there was a disability "freeze" program with a vocational rehabilitation referral provision, but referral was not mandatory at that time. The vocational rehabilitation referral experience during that period was unfavorable. The vocational rehabilitation agencies were inundated with referrals and the mass of paperwork in these agencies undermined every attempt at serious vocational rehabilitation consideration. When the disability benefit program was established with mandatory referrals and sanctions for refusal of vocational rehabilitation services, a more productive referral system was needed. It was obvious that some kind of screening was necessary to assure that vocational rehabilitation counselors would not continue to be flooded with referrals, most of which involve poor candidates for vocational rehabilitation. The system adopted was as follows: The Social Security Administration would refer every disabiity applicant to the vocational rehabilitation agency for vocational rehabilitation consideration. However, the Social Security Administration's referral would be transmitted to the State office responsible for making Social Security Administration disability determinations. In most States, this State office was a component of the vocational rehabilitation agency and would conduct a screening of all disability claims for vocational rehabilitation in conjunction with determining disability. In those few States where the State office was not a component of the vocational rehabilitation agency, the vocational rehabilitation agency would be expected to out-station staff to conduct a screening. Screen-ins by the State office or out-stationed staff would be referred further into the vocational rehabilitation pipeline, eventually reaching counselors in the field. It is this screening process which is most commonly called the referral process. The Social Security Administration does not dictate to the screeners in the State offices whom to screen-in. In most States, a set of national criteria are used. These criteria were developed by a task force composed of the Rehabilitation Services Administration, Social Security Administration, and State vocational rehabilitation agency representatives and the first version was issued in 1970. A revised version was issued in 1974 and new versions are being developed. The vocational rehabilitation agencies in 18 States are using modified national criteria or special criteria developed by the vocational rehabilitation agency. The vocational rehabilitation agency decides which criteria are to be used. Their objective is to assure that only those persons with vocational rehabilitation potential are referred to the counselors. National Screening Criteria: As previously indicated, the national criteria were developed by a Federal/State task force. The stated purpose of the screening criteria was to provide guides for increasing productive referrals to vocational rehabilitation agencies to insure that all disability applicants with rehabilitation potential were given the opportunity to receive services. It was also decided that the vocational rehabilitaton agency in collaboration with the State Disability Determination Services should refine and adjust the screening criteria to the individual State's situation. Therefore, the age factor as well as any other factor used in determining vocational rehabilitation portential can be raised, lowered, or excluded depending upon the combination of services and jobs available to disabled persons who have been rehabilitated. The Social Security Administration does not impose any limits on the kind of screen-ins. However, limitations are occasionally imposed by the State vocational rehabilitation agency usually due to a shortage of funds or unmanageably high caseloads. The point is that the State vocational rehabilitation agency is virtually autonomous in determining the profile of disability applicants who could be expected to derive the most benefit from the vocational rehabilitation counselor's time, funds, services, and the rehabilitation facilities available. Perhaps it would be useful to take a closer look at the screening criteria especially as they relate to questions raised concerning the possibility of an inherent age bias. The national screening guidelines used by the Disability Determination Services in determining whether to refer social security and supplemental security income disability applicants to State vocational rehabilitation agencies for possible services are divided into three categories: A. Automatic Screen-In (Referral) Criteria: There are 10 "screen-in" criteria. An analysis shows that nine of these criteria may be met, and the applicant screened in for vocational rehabilitation services, regardless of the applicant's age. For example, an applicant whose condition has a favorable prognosis or can be corrected or substantially reduced with the aid of physical restoration or other medical treatment automatically meets the criteria whether that applicant is 20 or 60 years of age. (Age is mentioned in only one criterion which calls for the automatic screen-in of applicants between age 15 and 45, unless, of course, vocational rehabilitation screen-in is contraindicated by information elsewhere in the file.) B. Automatic Screen-Out Criteria: There are seven automatic "screen-out" criteria. Reflecting the considered judgment of rehabilitation professionals over the years, these criteria are indicative of relatively poor vocational rehabilitation potential and, when present in an applicant's profile, may serve as grounds for screen-out. In the application of these "screen-out" criteria, age alone is not a consideration. Two criteria do refer to age, but only in conjunction with other factors. One screens out applicants of advanced age, who have "such severe organ and system impairment that potential to adjust to or sustain work is doubtful." The other screens out the older applicant of advanced age, who "has a significant impairment and also presents a sparse work record or has a markedly limited education and a 35-year work history confined to arduous, unskilled labor." |