The National Academies Press

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Pages 17-32

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From page 17... ... . inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or expected to last for a continuous period of not less than 12 months . Read the entire page →
From page 18... ... The DHEIS study found that although the increases in applications for adult disability benefits cannot be explained definitively, many factors may have contributed to the growth in the number of people receiving Social Security disability benefits. These factors include the economic downturn in the late 1980s and early l990s in the United States; structural changes in the labor market; demographic trends such as changes in the size, composition, and characteristics of the working age population; changes in public policies and the types of disabling impairments that are recognized and diagnosed for disability cash benefits; and a decrease in the average age of new beneficiaries with a resulting increase ? Read the entire page →
From page 19... ... The decision-making standards and procedures used by the ALIs are not always the same as those followed by the DDS adjudicators. The subjective element in the disability decision process also contributes to the differences in disability decisions made at different levels of the application process and among different states (DHHS, 1982; GAO, 1994, 1997b; Hu et al., 1997~. Read the entire page →
From page 20... ... A number of research projects were initiated, including staff analyses and contracts to undertake econometric analyses of the causes of disability growth using cross-sectional data; a survey of field office managers undertaken by SSA as part of the research effort to understand the changes in the application behavior of individuals who are potentially eligible for disability benefits; and the Disability Evaluation Study (DES) , later renamed by SSA the National Study of Health and Activity (NSHA) Read the entire page →
From page 21... ... 46~. DISABILITY DETERMINATION STRUCTURE AND PROCESS Disability Claims Process 1 The Social Security disability claims process starts at the state Disability Determination Service where most disability decisions are made for SSA at the initial and reconsideration levels. Read the entire page →
From page 22... ... Evaluation of Eligibility for Disability Benefits The Current Decision Process for Initial Claims The disability decisions process for initial claims involves five sequential decision steps (SSA, 1994a) Read the entire page →
From page 23... ... ^~.x ,..~. Claimant reacts SSA Claim developed Decision sent Claimant requests & hearing to claimant hearing conducted Claimant contacts SSA Claimant requests Appeals Council Review Decision sent to claimant Appeals Council reviews decision ...., _ :_: ._: ~.~,~,~ : its Decision sent Initial claim is taken, to claimant developed, and decision made i~i ~ Decision sent to claimant Hearing conducted Claimant requests hearing Claim developed and issues narrowed FIGURE 1-1 The Social Security Administration's current and proposed disability claims process. Read the entire page →
From page 24... ... Proposed Redesigned Decision Process As stated above, the redesign of the disability decision process is only one of the many process changes proposed in the reengineered disability claims process. SSA has stated that such a redesigned decision process should � be simple to administer; � facilitate consistent application of rules at each decision level; � provide accurate and timely decisions; and � be perceived by the public as straightforward, understandable, and fair. Read the entire page →
From page 25... ... 21~. According to SSA, in the proposed redesigned disability decision process the presence of a medically determinable impairment will remain a necessary requirement for eligibility, as required by the current law. Read the entire page →
From page 26... ... THE NATIONAL ACADEMIES STUDY The Committee's Charge In response to the Commissioner's directive, SSA launched a multiyear research effort to develop and test the feasibility, validity, reliability, and practicality of a redesigned disability determination process. SSA developed what it referred to as the research plan for the redesign of the disability decision process and a time line for its completion (SSA, 1996, 1997~. Read the entire page →
From page 27... ... It reviewed and analyzed an extensive body of research literature, published and unpublished, and other documents including planning documents, internal papers, requests for proposals, relevant internal documents and unpublished papers related to the redesign and SSA's research plan, and other material provided by SSA and other government officials during the course of the study, as well as historical documents and publications relating to the subjects under consideration. Published literature on survey design and methods, evaluation and research on labor market trends, disabilities caused by physical and mental impairments, functional measures, and other relevant topics also were reviewed. Read the entire page →
From page 28... ... The committee made no attempt in that report to comment on the content of the questionnaires, specific measures of functional capability, or the content of the medical examinations and medical and diagnostic tests proposed for the survey. The second interim report was a preliminary assessment of the adequacy of SSA's research plan for developing a new disability decision process and the time line for its completion. Read the entire page →
From page 29... ... To avail itself of expert and detailed analysis of some of the key issues beyond the time and resources of its members, the committee commissioned five background papers listed below from experts in areas of concept and measurement of disability, survey design and method, mental impairments, and disability and the labor market: 1. "Conceptual Issues in the Measurement of Work Disability," by Alan lette, Ph.D. Read the entire page →
From page 30... ... as inability to engage in any substantial gainful activity anywhere in the national economy by reason of any medically determinable physical or mental impairment that can be expected to result in death or that has lasted or is expected to last for a continuous period of not less than 12 months. An individual's physical and mental impairments must be of such severity that he or she not only is unable to do the previous work but cannot, given the person's age, education, and work experience, engage in any other kind of substantial gainful work that exists in the national economy, regardless of whether such work exists in the immediate area in which the person lives, or whether a specific job vacancy exists, or whether they would be hired if they applied for work. Read the entire page →
From page 31... ... The research plan for the redesign of the disability decision process and the scope, statistical design and methods, and content of the NSHA represent separate, and yet related, subject areas of study with different issues. For the most part, therefore, they are discussed separately in the report. Read the entire page →
From page 32... ... The chapter discusses the need for and elements of such a system, a brief description of possible survey partners in the development and use of the data, the essential principles for such a system, a needed advisory structure, and a suggested development and implementation strategy. Chapter 6 summarizes the committee's preliminary assessment undertaken early in the study of SSA's research plan to redesign the disability decision process (IOM, 1998) Read the entire page →

From page 17...

... . inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or expected to last for a continuous period of not less than 12 months .