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Rethinking SSI: Insider urges more inclusive disability system

As I read the concerns expressed over the recent changes in Supplemental Security Income (SSI) regulations for children, I feel the need to give a bit of an insider's view.

About 20 years ago, I was offered the opportunity to do disability determination exams for the state. These patients added much to what we all know can be rather routine in a pediatric practice. I have been able to see conditions I had only read about previously. Some years later, as "medical expert" for the Office of Hearings and Appeals of the Department of Health and Human Services, I began reviewing records, attending hearings and rendering medical opinions on previously denied pediatric SSI cases. I don't determine whether a child receives SSI benefits; I state in a hearing or written report whether a child "meets a listing" or otherwise qualifies as being disabled. An administrative law judge usually finds it difficult to deny benefits if I state otherwise.