Selected Research & Analysis: Disability Insurance (DI) Program
Work-Related Overpayments to Social Security Disability Insurance Beneficiaries: Prevalence and Descriptive Statistics
In this article, the authors estimate the prevalence, duration, and amount of work-related benefit overpayments accrued by Social Security Disability Insurance beneficiaries from January 2010 through December 2012. The authors also estimate the association between beneficiary and program-related characteristics and the likelihood of a work-related overpayment.
Congress established the Social Security Disability Insurance (DI) program in 1956, after more than 20 years of debate. From the outset of the debate, however, there had been general agreement that the DI program should be for workers with substantial work histories, be funded through payroll taxes, include stringent disability criteria, provide modest benefit levels, and require return-to-work supports. Using administrative data on current DI beneficiaries, this issue paper examines how the program reflects those original tenets as it nears its 60th anniversary.
The authors present an overview of the Benefit Offset National Demonstration project and the opportunities it provides to participants. They also share the experiences of three individuals who are successfully reaching their return-to-work goals as they participate in this project.
We find that three factors—(1) population growth, (2) the growth in the proportion of women insured for disability, and (3) the movement of the large baby boom generation into disability-prone ages—explain 90 percent of the growth in new disabled-worker entitlements over the 36-year subperiod (1972–2008). The remaining 10 percent is the part attributable to the disability “incidence rate.” Looking at the two subperiods (1972–1990 and 1990–2008), unadjusted measures appear to show faster growth in the incidence rate in the later period than in the earlier one. This apparent speedup disappears once we account for the changing demographic structure of the insured population. Although the adjusted growth in the incidence rate accounts for 17 percent of the growth in disability entitlements in the earlier subperiod, it accounts for only 6 percent of the growth in the more recent half. Demographic factors explain the remaining 94 percent of growth over the 1990–2008 period.
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.
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.
This article analyzes the effect of longitudinal interactions between the Disability Insurance (DI) and Supplemental Security Income (SSI) programs in providing access to Medicare and Medicaid, using a sample of administrative records spanning 84 months. Our study is the first effort to link and analyze record data on participation in all four of these major, and highly interrelated, public benefit programs in the United States. We find that SSI facilitates high levels of Medicaid coverage for SSI awardees overall and provides access to Medicaid for many DI awardees during the 24-month Medicare waiting period. Many people who exit SSI retain their Medicaid coverage, but the gap in coverage between continuing SSI participants and those who leave the program increases over time. After Medicare kicks in, public health insurance coverage is virtually complete among awardees with some DI involvement, including dual Medicaid and Medicare coverage for some.
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.
Data from administrative records of the Social Security Administration allow us to examine patterns of initial entitlement to Old-Age Insurance benefits as well as Disability Insurance benefits. We follow cohorts born in different years over their lifetimes to identify changes in entitlements by age over time. Breaking out single birth cohorts shows close adherence in entitlement ages to rule changes as well as increasing shares of cohorts relying on the Disability Insurance program in middle age.
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 Statistics on Work Activity and Use of Employment Supports for New Social Security Disability Insurance Beneficiaries
Longitudinal statistics on the employment activities of Social Security Disability Insurance beneficiaries offer a different perspective than the Social Security Administration's published statistics, which are based on annual data, and have important policy implications.
Approximately 4 percent of the aged population will never receive Social Security benefits. This article examines the prevalence, demographic characteristics, and economic well-being of these never-beneficiaries. Most never-beneficiaries do not have sufficient earnings to be eligible for benefits, and most of these insufficient earners are either late-arriving immigrants or infrequent workers. About 44 percent of never-beneficiaries are in poverty, compared with about 4 percent of current and future beneficiaries.
Expanding Access to Health Care for Social Security Disability Insurance Beneficiaries: Early Findings from the Accelerated Benefits Demonstration
The Accelerated Benefits (AB) demonstration project provides health benefits to Social Security Disability Insurance beneficiaries who have no health insurance during the 24-month period most beneficiaries are required to wait before Medicare benefits begin. This article describes the project and presents baseline survey results on health insurance coverage among newly entitled beneficiaries and the characteristics of those without coverage. A 6-month follow-up survey provides information on the effects of the AB health benefits package on health care utilization and on reducing unmet medical needs. The article also reports the costs of providing the health benefits package during the 24-month Medicare waiting period.
During its 75-year history, the Social Security Administration (SSA) has faced many administrative challenges. This article depicts some of those challenges—involving legislative demands, staffing and workloads, infrastructure and technology, logistics and procedures, emergency response operations, and other matters—and the steps that SSA has taken to deal with them.
This article discusses the advantages and limitations of using administrative data for research, examines how linking administrative data to survey results can be used to evaluate and improve survey design, and discusses research studies and SSA statistical products and services that are based on administrative data.
Provided here are the absolute and relative poverty status of 2002 elderly Supplemental Security Income (SSI) recipients. Official poverty estimates are generated from the Current Population Survey's Annual Social and Economic Supplement (CPS/ASEC). The poverty study presented here differs from previous studies in that it is based on CPS/ASEC income and weight records conditionally adjusted by matching Social Security administrative data. This effort improves the coverage of SSI receipt and the accuracy of SSI estimates. The adjusted CPS/administrative matched data reveal lower 2002 poverty rates among elderly persons (with and without SSI payments) than those generated from the unadjusted CPS/ASEC data.
The Social Security Protection Act of 2004 (SSPA), with its administrative remedies and program protections, can be seen as another incremental step in the development of a social insurance program that best meets the evolving needs of American society. This article discusses the legislative history of the SSPA in detail. It also includes summaries of the provisions and a chronology of the modification of these proposals as they passed through the House and Senate, and ultimately to the president's desk.
It is widely known that about three-fourths of the working-age population is insured for Disability Insurance (DI), but the substantial role played by the Supplemental Security Income (SSI) program in providing disability benefit coverage is not well understood. Using data from the 1996 panel of the Survey of Income and Program Participation (SIPP) we find that over one-third (36 percent) of the working-age population is covered by SSI in the event of a severe disability. Three important implications follow: (1) SSI increases the overall coverage of the working-age population; (2) SSI enhances the bundle of cash benefits available to disabled individuals; and (3) interactions with other public programs—most notably the SSI path to Medicaid coverage—also enhance the safety net. Ignoring these implications could lead to inaccurate inferences in analytic studies.
The Effect of Welfare Reform on SSA's Disability Programs: Design of Policy Evaluation and Early Evidence
Recent legislation has affected the populations served by the Social Security Administration's (SSA's) disability programs. The Contract with America Advancement Act of 1996 mandated that persons whose disability determination was based on drug addiction or alcoholism be removed from the Supplemental Security Income and Social Security Disability Insurance rolls. The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (later amended by the Balanced Budget Act of 1997) tightened the SSI eligibility criteria for children and converted the Aid to Families with Dependent Children program into a block grant, Temporary Assistance for Needy Families. This article describes the design of three related studies evaluating the direct and indirect effects of these policy changes on SSA's disability populations. It describes the methodological challenges of the studies and the strategies used to overcome them. It also presents early evidence from the three studies and discusses future directions.
This article reports research and analysis undertaken by a very successful collaborative, federal interagency work group on disability, convened by the Office of Management and Budget and charged with the development of a short set of disability questions for Census 2000. The process that culminated in the final disability questions on Census 2000 is described, along with a discussion of the complexities of defining and measuring disability.
This article describes the development of SSA's administrative records database for the Project NetWork return-to-work experiment targeting persons with disabilities. The article is part of a series of papers on the evaluation of the Project NetWork demonstration. In addition to 8,248 Project NetWork participants randomly assigned to receive case management services and a control group, the simulation identified 138,613 eligible nonparticipants in the demonstration areas. The output data files contain detailed monthly information on Supplemental Security Income (SSI) and Disability Insurance (DI) benefits, annual earnings, and a set of demographic and diagnostic variables. The data allow for the measurement of net outcomes and the analysis of factors affecting participation. The results suggest that it is feasible to simulate complex eligibility rules using administrative records, and create a clean and edited data file for a comprehensive and credible evaluation. The study shows that it is feasible to use administrative records data for selecting control or comparison groups in future demonstration evaluations.
Rethinking Disability Policy: The Role of Income, Health Care, Rehabilitation, and Related Services in Fostering Independence
Disabled-Worker Beneficiaries and Disabled SSI Recipients: A Profile of Demographic and Program Characteristics
Statistical Methods for the Estimation of Costs in the Medicare Waiting Period for Social Security Disabled Worker Beneficiaries
This paper presents the statistical methods used to estimate Medicare costs in the waiting period that were presented in text tables 2–3 of Bye and Riley (1989). The first part describes the development of Medicare utilization equations for each Social Security Disability Insurance (DI) program status group. The second part describes how these equations were used to predict expected costs per month and how the monthly estimates were aggregated to yield estimates of costs in the full 2-year waiting period and in the second year only. Finally, there is a brief discussion of the accuracy of the predictions.
Social Security Disability Benefits Reform Act of 1984: Legislative History and Summary of Provisions
To be awarded Disability Insurance benefits, an individual must have an objectively determinable, severe medical condition or impairment that, according to Social Security regulations, is serious enough that it can be presumed to keep the individual from working. We know, however, that some people who have medical conditions serious enough to qualify them for disability benefits are nevertheless able to continue working, while others who consider themselves unable to work do not have a serious enough impairment to qualify them for benefits. Whether or not a seriously impaired individual files for Social Security Disability Insurance benefits (SSDI) will depend, in part, on his or her own self-assessment of his ability to work, i.e., whether he considers himself to be severely disabled. This self-assessment depends upon many factors in addition to the actual severity of the individual's medical condition. These factors, therefore, become important elements in the decision to apply for SSDI benefits. This report examines how the relationship between measures of actual individual functional capacity and individual self-assessments of work capacity vary by age and other important job-related attributes.
A Note on Maximum Likelihood Estimation of Discrete Choice Models from the 1978 Survey of Disability and Work
This paper demonstrates an alternative maximum likelihood procedure for estimating discrete choice models in retrospective samples, such as a model of SSA disability beneficiaries or application status in the 1978 Survey of Disability and Work.
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.
In 1971, 44 percent of workers who had been currently entitled to social security disability insurance benefits (SSDI) for 1 year or more received benefits from at least one income source in addition to SSDI. These recipients of multiple benefits (RMB's) were found to have average benefits from SSDI which were greater than the average SSDI benefit for those who did not receive income from these additional sources. On the average, total benefits to RMB's were double the benefits paid to those who received only SSDI. The combined benefits for overlappers produced median replacement rates for nonoverlappers. The rate of receipt of replacement rates in excess of 80 percent of predisability earnings was 70 percent larger for persons who were RMB's than for those who were not.
Based on the present research, consideration of replacement rates based solely on SSDI benefits substantially understates the extent to which benefits from public and private programs actually replace predisability earnings. Since replacement rates based solely on SSDI benefits are generally higher for persons receiving only SSDI than for persons who receive multiple benefits, employing policies which cap replacement rates based only on SSDI benefits may only serve to increase the differential in the total replacement of predisability earning which exists between those who receive multiple benefits and those who do not. Increasing this differential could be considered undesirable from both the adequacy and equity viewpoints.
The role of time as an input into the utility maximization process has long been recognized in the labor/leisure decision. Expanded research has dealt with this input in a family context. Assuming a joint utility maximization model, the resulting labor supply functions can be determined for both spouses.
The model presented here is an extension of previous models by its incorporation of the effects of disabling conditions of the husband on the labor supply decisions of both spouses.
Because hours worked takes on a lower limit of zero, the standard simultaneous equation techniques would yield estimates lacking the ideal properties. Instead, the model is estimated using a simplification of a simultaneous TOBIT technique, which yields consistent estimates.
This paper presents the social and demographic characteristics of those disability claimants whose cases go to hearing. Particular attention is given to how these characteristics may be related to (1) the individual decision to contest a denial or accept it; (2) the general increase in disability claims and contested applications in recent years; and (3) the high proportion of reversals in hearings.
In recent years, the number of workers awarded disability insurance benefits has rapidly increased, while there has been no corresponding increase in the numbers leaving the rolls for recovery. Concern has been expressed that cash benefit payments may be leading to disincentives to beneficiaries to return to work after medical improvement
To examine this question, a comparative analysis was made of the demographic, disability, and benefit characteristics of a sample of disabled workers who left the benefit rolls for recovery in contrast to the characteristics of those who remained on the rolls after award of disability benefits in 1972. Characteristics related to greater recovery included younger age, higher education, disability due to traumatic injury, residence in western states.