The Dynamics of Disability Measuring and Monitoring Disability for Social Security Programs (2002) / Chapter Skim
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2. Dynamics of SSA's Disability Programs
2. Dynamics of SSA's Disability Programs
Pages 33-52
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From page 33... ...
This chapter reviews the historical development and growth of the disability programs administered by the Social Security Administration (SSA) for the working age population in the 45 years since the inception of the Social Security Disability Insurance (SSDI)
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From page 34... ...
The Act gave states responsibility for initial disability determination, acting under contract with the federal government. Reflecting the concerns about containing costs, it limited disability benefits to individuals 50~4 years old and did not extend benefits to me dependents of disability beneficiaries.
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From page 35... ...
The program grew rapidly in the early 1960s and through the middle of the 1970s. Several amendments to the Social Security Act extended the qualifying requirements for disability benefits.
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From page 36... ...
SOURCE: SSA, 2001d. TABLE 2-1 Disabled Workers: Number of SSDI Applications, Awards, Ratio of Awards to Applications, and Applications per 1,000 Insured Workers for Selected Years, 1960-2000 Number of Number of Awards as a Applications Awards per Applications Awards Percentage of per 1,000 1,000 Year (thousands)
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From page 37... ...
During 1972-1974, processing disability redeterminations for continuing eligibility of former state welfare recipients for SSI disability payments and for new disability claims under the new SSI program resulted in additional workloads for processing disability claims. The SSI program requires applicants under the age of 65 to apply first for benefits from all other programs, including SSDI, that may partially or fully offset SSI benefits.
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From page 38... ...
The legislative changes, increased benefit levels, changes in program administration, and the economic downturn of the early 1970s probably contributed to the sharp increase in the disability incidence rate (number of new SSDI benefit awards per 1,000 workers insured in case of disability) from 4.8 in 1970 to a high of 7.1 in 1975 (Table 2-1~.
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From page 39... ...
In 1981, Congress eliminated the ~ innum Social Security benefit for new beneficiaries (DHHS, 1992; Mashaw, 1997~. 3For a detailed discussion of the experience of disability benefit terminations, the reader is referred to Social Security Disability Insurance Program Worker Experience (SSA, l999c)
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From page 40... ...
Congress enacted the Social Security Benefits Reform Act of 1984. Its provisions included more liberal standards for mental impairments that emphasized the indiviclual's ability to perform substantial gainful work, consideration of combined effects of multiple impairments in the absence of a single severe impairment, requirement for proof of medical improvements before termination of benefits, and use of SSA's regulatory standards to evaluate the effect of pain on disability.
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From page 41... ...
The termination rates also declined significantly as a result of SSA's moratorium on CDRs and their subsequent reinstatement under new and less stringent standards (see Table 2-2~. During the latter half of the 1980s, after the brief increase in the late 1980s associated with adjudicating a large number of cases under the new regulations for mental impairments, applications and incidence rates for disability benefits remained fairly stable.
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From page 42... ...
However, because relatively few persons leave the SSI rolls, the total number of recipients has risen steadily since the 1980s, with the exception of a slight decline in He late 1990s. FACTORS CONTRIBUTING TO RECENT GROWTH As stated above, applications and awards for disability benefits in both the SSDI and the SSI programs increased significantly in 1989 and into the 1990s.
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From page 43... ...
. The working age eligible population is projected to increase in the coming years as the baby boom generation ages and reaches 40-50 years of age, when chronic disease and disabilities are more likely to occur.
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From page 44... ...
This growth is due, at least in part, to an increase in the number of persons in the relatively younger ages entering the disability programs with fewer life-threatening impairments, resulting in increasing the duration of entitlement. As shown in Figure 2-3, the average age of persons awarded disability insurance benefits has been declining for both men and women, with a consequent increase in the duration of benefits.
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From page 45... ...
In recent years, as a result of legislative changes and court decisions, an increased number of awards have been based on impairments that occur much earlier in life such as mental disorders, including mental retardation. As shown in Figure 2-4, in 1981, 11 percent of SSDI disabled worker beneficiaries 18~4 years of age were awarded benefits on the basis of mental disorders including mental retardation compared with 24 percent in 2000,
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From page 46... ...
The proportion of persons awarded benefits on the basis of musculoskeletal conditions increased by 41 percent between 1981 and 2000. By 2000, musculoskeletal conditions had eclipsed circulatory conditions as the most common set of conditions associated with the award of SSDI benefits.
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From page 47... ...
Welfare agencies routinely refer persons to SSA's disability programs. During 1989-1992, such cost shifting may have contributed to the acceleration of applications and awards particularly in the SSI programs (Rupp and Stapleton, 1995~.
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From page 48... ...
In 1984, Congress required SSA to review and update the Listings of Impairments and related regulations resulting in significant increases in awards of benefits for mental impairments in the late 1980s. The 1996 legislation dropped drug abuse and alcoholism as a contributing factor material to finding disability.
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From page 49... ...
Lack of training, unavailability of adequate alternative employment, and prospects of losing medical coverage lead to increased applications for disability benefits. In the 1980s, despite poor economic conditions at the time, applications and awards declined as a result of programmatic changes in the SSDI and SSI Programs.
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From page 50... ...
Labor Market for Persons with Disabilities Although among all working age persons, including men (and even extending to men 55 to 64 years of age) , labor force participation rates have increased in the last few years, two recent studies indicate that persons win disabilities have not shared in this increase (Bound and Waidmann, 2000; Burkhauser et al., 2000)
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From page 51... ...
Consistent with Ws observation, during the slack labor markets in the 1970s and late 1980s, there were substantial increases in the number of people applying for Social Security Disability Insurance benefits. CONCLUSION The impact of any one factor on the demand for and provision of disability benefits is difficult to determine.
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From page 52... ...
(2001) , "no studies have been able to satisfactorily disentangle the impact of demand side factors related to the passage of the ADA or changes in the mix of jobs in the economy in the 1990s from supply side factors related to changes in the ease of access to SSDI and SSI benefits or to a deduction in the share of jobs that provide private health insurance, which would discourage work among the population with disabilities." Research is needed to delineate the magnitude of the various effects in order to understand the causes of recent declines in employment among people with disabilities.
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