Selected Research & Analysis: Impairments Analysis (Primary/Secondary, Comorbidity)
See also related Extramural Projects.
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.
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.
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.
Outcome Variation in the Social Security Disability Insurance Program: The Role of Primary Diagnoses
This article investigates the role that primary impairments play in explaining heterogeneity in disability decisions. Using claimant-level data within a hierarchical framework, the author explores variation in outcomes along three dimensions: state of origin, adjudicative stage, and primary diagnosis. The findings indicate that the impairments account for a substantial portion of claimant-level variation in initial allowances. Furthermore, the author finds that the predictions of an initial and a final allowance are highly correlated when applicants are grouped by impairment. In other words, diagnoses that are more likely to result in an initial allowance also tend to be more likely to receive a final allowance.
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.
This note provides data on the changes in the primary diagnosis codes of Supplemental Security Income (SSI) youth resulting from age-18 redeterminations from 2005 through 2009. It also provides information on the percent of youth continuing on or leaving the SSI program at age 18 by primary diagnosis. Although there is some movement between primary diagnosis codes, most youth remain in the same overall diagnostic group even if program eligibility ceases.
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.