Selected Research & Analysis: Disability Determination Process (for DI and SSI)
See also related Extramural Projects.
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.
The Benefit Receipt Patterns and Labor Market Experiences of Older Workers Who Were Denied Social Security Disability Insurance Benefits on the Basis of Work Capacity
In this article, the authors use linked survey and administrative data to identify Social Security Disability Insurance applicants who received a denial at steps 4 and 5 of the Social Security Administration's sequential evaluation process for disability determination. The authors document the denied applicants' demographic characteristics and the characteristics of the occupations they held before application and track their postdenial benefit receipt, employment, and earnings patterns.
Public disability benefit programs in the United States and other countries consider, as a condition for benefit eligibility, the claimant's ability or inability to resume or find work because of a health impairment. Many countries use an applicant's vocational factors (VFs)—age, education, and work experience—in assessing disability claims. As such, VFs play an important role in determining who qualifies for disability and related benefits. This article offers a comprehensive examination of the disability assessment processes in 11 developed countries and highlights the use and relevance of VFs in those processes.
Childhood Continuing Disability Reviews and Age-18 Redeterminations for Supplemental Security Income Recipients: Outcomes and Subsequent Program Participation
This note presents statistics on child Supplemental Security Income (SSI) recipients whose eligibility had ceased because of a finding of medical improvement in a childhood continuing disability review (CDR) or an age-18 redetermination. We present the numbers and percentage distributions of children and youths who received a CDR or age-18 redetermination between 1998 and 2008, the resulting cessation rates, and the estimated percentages that returned to Social Security Administration (SSA) disability programs, all by selected personal and programmatic characteristics. These statistics provide context for policy proposals calling on SSA to conduct more childhood CDRs.
The authors document the steps used by the Social Security Administration (SSA) and state Disability Determination Service (DDS) agencies to make initial determinations about eligibility for Disability Insurance and Supplemental Security Income. For both adults and children, SSA/DDSs record the basis for initial disability determinations using codes that correspond to the steps of the process. The resulting data element, the Regulation Basis Code, permits researchers to distinguish allowances based on the Listings from those based on medical/vocational factors for adults (or functional factors for children). It can also be used to identify denials based on severity, residual functional capacity, or other reasons.
Factors Affecting Initial Disability Allowance Rates for the Disability Insurance and Supplemental Security Income Programs: The Role of the Demographic and Diagnostic Composition of Applicants and Local Labor Market Conditions
Various factors outside the control of decision makers may affect the rate at which disability applications are allowed or denied during the initial step of eligibility determination in the Social Security Disability Insurance (DI) and Supplemental Security Income (SSI) programs. This article, using individual-level data on applications, focuses on the role of three important factors—the demographic characteristics of applicants, the diagnostic mix of applicants, and the local unemployment rate—in affecting the probability of an initial allowance and state allowance rates. A random sample of initial determination administrative records for the 1993–2008 period is used for the analysis in a fixed-effects multiple regression framework. The empirical results show that the demographic and diagnostic characteristics of applicants and the local unemployment rate substantially affect the initial allowance rate. An increase in the local unemployment rate tends to be associated with a decrease in the initial allowance rate. This negative relationship holds for adult applicants in both the DI and SSI programs and for SSI childhood applicants.
This article examines fast-track procedures in long-term public disability programs in the United States and several other countries. Such procedures share a common goal of accelerating applicants—generally for those with severe disabilities, blindness, or facing terminal illness—through the disability determination process.
This article describes the outcomes of the redetermination of Supplemental Security Income (SSI) eligibility when a child recipient reaches age 18. Statistics on the characteristics of youth whose eligibility is redetermined are presented using 8 years of administrative data, and the relationship between these characteristics and both an initial cessation decision and a successful appeal or reapplication for SSI are discussed.
This paper analyzes the predisability earnings of Social Security Disability Insurance (DI) applicants using yearly pools of applicants from 1977 through 1997 constructed from SSA program data that are matched to multiple panels of the Survey of Income and Program Participation (SIPP). Results of this study show that the predisability earnings of workers denied DI benefits are significantly lower, by $4,518 per year, than the earnings of those allowed and that the influx of workers with low predisability earnings coincides with the recent rapid growth in applications for DI benefits. Average predisability earnings are the highest for applicants during 1981–1983 (when benefit eligibility was tightened) and are the lowest for applicants during the 1990–1994 period, which included the 1990–1991 recession.
Counting the Disabled: Using Survey Self-Reports to Estimate Medical Eligibility for Social Security's Disability Programs
This paper develops an approach for tracking medical eligibility for the Social Security Administration's (SSA's) disability programs on the basis of self-reports from an ongoing survey. Using a structural model of the disability determination process estimated on a sample of applicants, we make out-of-sample predictions of eligibility for nonbeneficiaries in the general population. This work is based on the 1990 panel of the Survey of Income and Program Participation. We use alternative methods of estimating the number of people who would be found eligible if they applied, considering the effects of sample selection adjustments, sample restrictions, and several methods of estimating eligibility/ineligibility from a set of continuous probabilities. The estimates cover a wide range, suggesting the importance of addressing methodological issues. In terms of classification rates for applicants, our preferred measure outperforms the conventional single variable model based on the "prevented" measure.
Under our preferred estimate, 4.4 million people—2.9 percent of the nonbeneficiary population aged 18–64—would meet SSA's medical criteria for disability. Of that group, about one-third have average earnings above the substantial gainful activity limit. Those we classify as medically eligible are similar to allowed applicants in terms of standard measures of activity limitations.
We estimate a multistage sequential logit model reflecting the structure of the disability determination process of the Social Security Administration (SSA), as implemented by state Disability Determination Services (DDS) agencies. The model is estimated using household survey information exactly matched to SSA records on disability adjudications from 1989 to 1993. Information on health, activity limitations, demographic traits, and work is taken from the 1990 Survey of Income and Program Participation. We also use information on occupational characteristics from the Directory of Occupational Titles, DDS workload pressure, and local area economic conditions from unpublished SSA sources. Under the program provisions, different criteria dictate the outcomes at different steps of the determination process. We find that without the multistage structural approach, the effects of many of the important health, disability, and vocational factors are not readily discernible. As a result, the split-sample predictions of overall allowance rates from the sequential model performed considerably better than the conventional approach based on a simple allowed/denied logit regression.
We model the Social Security Administration's (SSA's) disability determination process using household survey information exact matched to SSA administrative information on disability determinations. Survey information on health, activity limitations, demographic traits, and work are taken from the Survey of Income and Program Participation (SIPP). We estimate a multistage sequential logit model, reflecting the structure of the determination procedure used by State Disability Determination Services agencies. The findings suggest that the explanatory power of particular variables can be appropriately ascertained only if they are introduced at the relevant stage of the determination process. Hence, as might be expected by those familiar with the process, medical variables and activity limitations are major factors in the early stages of the process, while past work, age, and education play roles in later stages. The highly detailed administrative information on outcomes at each stage allows clarification of the roles of particular variables. Planned future work will include policy estimates, such as the number of persons in the general population eligible for the disability programs, as well as analysis of applications behavior in a household context.
A Comparison of the Recovery Termination Rates of Disabled-Worker Beneficiaries Entitled in 1972 and 1985
Estimation of Disability Status as a Single Latent Variable in a Model with Multiple Indicators and Multiple Causes
In this paper, we are concerned with the underlying structure of self-definitions of disability. Our purpose is to identify the contribution of exertional and nonexertional impairment and the contributions of such nonmedical factors as age, sex, and education to the individuals' assessment of their own situations. On a statistical level, we seek to accomplish a substantial reduction of a large number of data items into a form that can be used conveniently in subsequent behavioral analyses.
This report examines the impact of local labor market characteristics on three steps in the disability process: The perception of oneself as disabled; the decision to apply for benefits under the social security disability insurance program (SSDI); and the determination of disability status under SSDI. The research attempts to determine whether the elements of an individual's local economic environment play a role in the various steps of the disability process specifically above and beyond his or her own demographic characteristics and economic motivations. Among the key variables used to measure the local economic environment are the unemployment rate, the percent of families below the low income (poverty) level, rural location, occupational diversity and the percent of the unemployed exhausting their unemployment benefits. With the exception of the last variable, which is measured on a statewide basis, all variables pertain to the county of residence.
The results contradict earlier findings which were based on aggregated data. No significant effect on any of the three elements in the disability process was found for either variable measuring the dimensions of the unemployment problem. With few exceptions, results from the other labor market variables were sketchy at best. One surprising result is noted with respect to the benefit replacement ratio, the variable intended to measure the relative attractiveness of SSDI benefits.