Selected Research & Analysis: Demographic Characteristics > Disabled
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How Does Mortality Among Disability-Program Beneficiaries Compare with That of the General Population? A Summary of Actuarial Estimates
Using period mortality estimates from Social Security Administration actuarial studies published over the period from 1977 to 2015, this article compares the long-term mortality trends of Disability Insurance (DI) beneficiaries aged 25 or older with those of the general population. The author finds substantial longevity gaps between the groups. Mortality rates among DI beneficiaries are highest in their first year on the DI rolls; rates are lower among those with longer durations on the rolls. Although period mortality for DI beneficiaries improved significantly over the study period, it remains today at levels similar to those experienced by the general public in the early years of the 20th century.
Changing Stays? Duration of Supplemental Security Income Participation by First-Time Child Awardees and the Role of Continuing Disability Reviews
This article provides new evidence of the changing role of the Supplemental Security Income (SSI) program for low-income children since 1997. The authors use administrative records from the Social Security Administration to identify new SSI awardees and track their histories in SSI and in the Social Security Disability Insurance program. SSI participation lasted much longer for 2007 and 2012 awardees than for their 1997 counterparts. However, the authors also find that the volume of continuing disability reviews, which determine continuation or cessation of SSI eligibility and were conducted more frequently for 1997 awardees than for subsequent cohorts, strongly affects length of program participation. The trend toward longer periods of program participation therefore might not continue, given that the number of continuing disability reviews has risen substantially since 2015.
This article examines the geographic, demographic, socioeconomic, and program-participation characteristics of initial Supplemental Security Income (SSI) and Social Security Disability Insurance (DI) applicants who faced homelessness during 2007–2017. Using Social Security Administration data, the authors chart the distribution of homeless SSI/DI applicants and beneficiaries across county-equivalent areas in the contiguous United States. They also use a text-mining method to identify 162,536 potentially homeless disability-program applicants, in addition to the 647,790 applicants identified using the standard homeless-status indicators in the administrative data. They find that homelessness among disability-program applicants was largely an urban phenomenon, with almost half (42.1 percent) of applicants living in one of 25 urban areas. Relative to their domiciled counterparts, homeless disability-program applicants were far more likely to be male, aged 18–64, and without a high school or general equivalency diploma.
The Time Between Disability Onset and Application for Benefits: How Variation Among Disabled Workers May Inform Early Intervention Policies
This article examines how much time typically passes between disability onset and application for disability-program benefits, by age at onset and diagnosis. Among eventual applicants, certain subgroups might be suitable targets for employment-support interventions. Using Social Security administrative data, the authors find that the median period from onset to application is 7.6 months. Younger applicants tend to have waited longer, particularly those diagnosed with back impairments or arthritis. Among both younger and older applicants, individuals diagnosed with intellectual disability or other mental disorders are potential targets for early intervention programs because those groups wait the longest to apply and are the most likely to continue working in the interim.
Social Security Disability Insurance and Supplemental Security Income Beneficiaries with Multiple Impairments
This article uses data from the Social Security Administration's National Beneficiary Survey and agency administrative records to estimate the number and examine the characteristics of adult disability-program beneficiaries with multiple impairments. In the survey, most beneficiaries report conditions in more than one impairment category. Beneficiaries with multiple impairments tend to have more activity limitations and poorer health than those reporting one impairment. They also tend to be older and to have higher household incomes than those with one impairment, and are less likely to have work-related goals and expectations. Administrative data contain fewer impairments per beneficiary and do not necessarily reflect the condition(s) that the beneficiary considers most limiting. Administrative data are complete for their purpose, but they may underrepresent the totality of disability that beneficiaries experience, and thus may be less predictive of employment and other outcomes than survey data.
Correlation Patterns between Primary and Secondary Diagnosis Codes in the Social Security Disability Programs
This paper addresses impairment comorbidity among participants in programs that provide disability benefits. Comorbidity in this context is defined as the simultaneous presence of a primary and a secondary medical diagnosis. The author fits a high-dimensional Bayesian multivariate probit model with a 10% random sample of 2009 initial claimants (disabled workers, including individuals concurrently applying for Disability Insurance and Supplemental Security Income). The resulting correlation estimates provide evidence of strong impairment comorbidity patterns at the initial-claim level. Many of the findings mirror the epidemiological evidence, such as associations of diabetes with chronic renal failure, open wounds of a lower limb, peripheral neuropathies, and blindness/low vision. Other results are surprising. For instance, the correlation estimates defy the presumption of high positive association between mental and musculoskeletal-system diagnoses.
Using Survey of Income and Program Participation data linked to Social Security administrative files, the authors examine the preapplication employment patterns of Social Security Disability Insurance (DI) applicants for periods of varying lengths up to 24 months before application. The employment histories of about half of the applicants are characterized by stable employment in well-paying jobs; most policy proposals related to workforce retention or DI diversion target this type of worker. The other half of the applicants have either intermittent or no work experience in the preapplication period. Proposals that focus on DI applicants with recent or long-term attachments to the workforce are therefore likely to miss this other half of eventual DI applicants. Future policy proposals should consider outreach to people who lack a strong labor force attachment and who might need a broader array of supports to remain in or return to the workforce.
Supplemental Security Income and Social Security Disability Insurance Beneficiaries with Intellectual Disability
This article uses nationally representative survey data on working-age Supplemental Security Income (SSI) and Social Security Disability Insurance (DI) beneficiaries to present a profile of the characteristics, employment, and income sources of beneficiaries with intellectual disability and to compare them with those of other working-age SSI and DI beneficiaries.
Social Security administrative data show that the earnings of individuals who apply for Disability Insurance benefits decline rapidly in the years prior to application. This article presents statistics on the average “decline period”—the time from the year of maximum earnings to the year of application—by general and specific primary diagnosis, sex, and age for individuals who filed applications during 2004–2013. The analysis compares decline periods for applicants whose claims were allowed with those for applicants whose claims were denied. Understanding decline-period variations may enable policymakers and service providers to target and customize preapplication support services to specific population subgroups.
State Medicaid Eligibility and Enrollment Policies and Rates of Medicaid Participation among Disabled Supplemental Security Income Recipients
In addition to providing income-maintenance payments to eligible participants, the Supplemental Security Income (SSI) program provides automatic Medicaid enrollment for applicants upon SSI award in most states. Other states require applicants to file a separate Medicaid application. Some use the SSI eligibility criteria for both programs; others use Medicaid eligibility rules that are more restrictive. The authors use matched monthly longitudinal administrative records to test whether automatic enrollment has a positive effect on Medicaid coverage. Using logistic regression with a combination of repeated cross-section and regression discontinuity approaches, they find positive effects of automatic enrollment on Medicaid coverage relative to other policies. The differences are attributable to a discontinuous increase in Medicaid coverage shortly after the final disability determination decision. The time lag arising from the often-lengthy disability determination process reduces the effectiveness of automatic enrollment, which depends critically on timeliness of the final award decision.
This article evaluates the Homeless with Schizophrenia Presumptive Disability pilot, which provided Supplemental Security Income application assistance and presumptive disability payments to homeless applicants in selected California communities who alleged schizophrenia or schizoaffective disorder. The findings show that, relative to the comparison groups, the intervention led to improved application outcomes.
This study examines workers who had physical or mental impairments that prevented continued work in their pre-onset occupation but did not qualify for Disability Insurance (DI) benefits. More specifically, we examine workers who experienced the onset of such impairments, applied for DI once, were denied benefits on the basis of residual ability to work in other occupations, and did not appeal the decision. In contrast to allowed claimants, this group of individuals continued to participate in the labor market at comparatively high rates. We describe their post-onset labor market experience, including employment rates and earnings losses by type of impairment.
Employment, Earnings, and Primary Impairments Among Beneficiaries of Social Security Disability Programs
This article examines the employment and earnings of Disability Insurance beneficiaries and working-age Supplemental Security Income recipients across detailed primary-impairment categories. The authors use 2011 data from linked Social Security administrative files to identify which beneficiaries and recipients are most likely to have earnings and to have higher levels of earnings. They find substantial heterogeneity in these outcomes across primary impairments.
Veterans Who Apply for Social Security Disabled-Worker Benefits After Receiving a Department of Veterans Affairs Rating of “Total Disability” for Service-Connected Impairments: Characteristics and Outcomes
This article examines the experiences of veterans with service-connected disabilities who encounter the disability compensation program of the Department of Veterans Affairs (VA) and the Social Security Administration's Disability Insurance (DI) program. The authors use matched administrative records from both agencies to track the characteristics and experiences of veterans who received VA ratings of “totally disabled” during fiscal years 2000–2006, focusing on the timing and outcomes of their applications for DI benefits and the prevalence of the primary diagnoses identified by both programs. The authors pay special attention to diagnoses of posttraumatic stress disorder and traumatic brain injury.
Using Health and Retirement Study data, the authors examine three groups of adults aged 51–56 in 1992 with different disability experiences over the following 8 years. Our analysis reveals three major findings. First, people who started and stayed nondisabled experienced stable financial security, with substantial improvement in household wealth despite substantial labor force withdrawal. Second, people who started as nondisabled but suffered a disability shock experienced a substantial increase in poverty rates and a sharp decline in median incomes. Average earnings loss was the greatest for that group, with public and private benefits replacing less than half of the loss, whereas the reduction in private health insurance coverage was more than alleviated by the increase in public health insurance coverage. Third, people who started and stayed disabled were behind at the baseline and have fallen further behind on most measures. An important exception is substantial improvement in health insurance coverage because of public safety nets.
Subsequent Program Participation of Former Social Security Disability Insurance Beneficiaries and Supplemental Security Income Recipients Whose Eligibility Ceased Because of Medical Improvement
This article examines subsequent participation in the Social Security Disability Insurance and Supplemental Security Income programs by individuals whose eligibility for those programs ceased because of medical improvement. The authors follow individuals whose eligibility ceased between 2003 and 2008 and calculate rates of program return for up to 8 years after the cessation decision. They also explore how return rates vary by certain personal and programmatic characteristics.
Profile of Social Security Disabled Workers and Dependents Who Have a Connection to Workers' Compensation or Public Disability Benefits
This note provides a comprehensive profile of the characteristics of disability beneficiaries with a connection to workers' compensation or public disability benefits (PDBs). The 8.3 percent of disabled workers who have this connection tend to be economically better off, more frequently middle aged, male, afflicted with a musculoskeletal and connective tissue disorder, and tend to wait longer to apply for social security disability benefits after onset than the general disabled-worker population. In our analysis, we have included a special focus on California, as this state represents a large portion of the PDB workload, and its experience has a substantial effect on the national picture.
Workplace injuries and illnesses are an important cause of disability. States have designed their workers' compensation programs to provide cash and medical-care benefits for those injuries and illnesses, but people who become disabled at work may also be eligible for Social Security Disability Insurance (DI) and related Medicare benefits. This article uses matched state workers' compensation and Social Security data to estimate whether workplace injuries and illnesses increase the probability of receiving DI benefits and whether people who become DI beneficiaries receive benefits at younger ages.
Using data from the 2004–2006 National Beneficiary Surveys matched to Social Security administrative data, this study follows a cohort of disability beneficiaries participating in the Ticket to Work program for several years to assess changes in their service use, health status, employment, and income.
This study uses survey and administrative data to analyze the characteristics of working-age Social Security Disability Insurance and Supplemental Security Income beneficiaries who report having work goals or expectations, and the extent to which these beneficiaries become employed and leave the disability rolls during a 4-year period.
Using linked administrative data from program and earnings records, we summarize the 2007 employment rates of working-age (18–64) Social Security disability program beneficiaries at the national and state levels, as well as changes in employment since 1996. Substantial variation exists within the population. Disability Insurance beneficiaries and those younger than age 40 were much more likely to work relative to other Social Security beneficiaries. There are also strong regional differences in the employment rates among disability beneficiaries of working age, and these differences are persistent over time.
Longitudinal Patterns of Participation in the Social Security Disability Insurance and Supplemental Security Income Programs for People with Disabilities
We analyze longitudinal interactions in benefit eligibility between the Disability Insurance and Supplemental Security Income programs and the lags arising from processing time in receiving the first payment, based on Social Security administrative records. We find that longitudinal interactions enhancing the bundle of cash benefits available for awardees over a 60-month period is much more common than apparent from cross-sectional data and identify distinct patterns of longitudinal interactions between the two programs. SSI plays an especially important role in providing benefit eligibility during the 5-month DI waiting period. Transition to nonbeneficiary status is more prevalent among SSI awardees because of exits attributable to the SSI means test. We also find that there is substantial variation in the lag in receiving the first disability payment.
How Post Secondary Education Improves Adult Outcomes for Supplemental Security Income Children with Severe Hearing Impairments
This article uses a unique longitudinal dataset based on administrative data from the National Technical Institute for the Deaf (NTID) linked to Social Security Administration (SSA) microdata to conduct a case study of Supplemental Security Income (SSI) children who applied for postsecondary education at NTID. The authors estimate the likelihood that SSI children who apply to NTID will eventually graduate relative to other hearing impaired applicants, as well as the influence of graduation from NTID on participation in the SSI program as adults and later success in the labor market. Findings indicate that SSI children are substantially less likely to graduate from NTID than their fellow deaf students who did not participate in the SSI program as children, but that those who do graduate spend less time in the SSI adult program and have higher age-earnings profiles than those who do not graduate.
A Profile of Children with Disabilities Receiving SSI: Highlights from the National Survey of SSI Children and Families
This article, based on interviews from the National Survey of SSI Children and Families conducted between July 2001 and June 2002, presents a profile of children under the age of 18 who were receiving support from the Supplemental Security Income program. The topics highlighted provide information of SSI children with disabilities and their families not available from administrative records, including demographic characteristics, income and assets, perceived health and disabilities, and health care utilization. While virtually every child in the SSI program is covered by some form of health insurance, primarily Medicaid, the data indicate substantial heterogeneity on other variables. This is true on many different dimensions, such as the perceived severity of the child's disabling conditions, health care utilization and service needs, the presence of other family members with disabilities, family demographics, and access to non-SSI sources of incomes.
This article summarizes several different methods used to measure the adequacy of wage replacement in state workers' compensation systems in the United States. Empirical research casts serious doubt on benefit adequacy, especially in the case of more serious disabilities.
This article looks at the history of earnings in covered employment for the 300,000 disabled SSI beneficiaries who were working in December 1997. It provides background information on beneficiaries essential to SSA's efforts to help them return to work.