Showing papers on "Disability insurance published in 2003"

The Rise in the Disability Rolls and the Decline in Unemployment

Abstract: Between 1984 and 2001, the share of nonelderly adults receiving Social Security Disability Insurance income (DI) rose by 60 percent to 5.3 million beneficiaries. Rapid program growth despite improving aggregate health appears to be explained by reduced screening stringency, declining demand for less skilled workers, and an unforeseen increase in the earnings replacement rate. We estimate that the sum of these forces doubled the labor force exit propensity of displaced high school dropouts after 1984, lowering measured U. S. unemployment by one-half a percentage point. Steady state calculations augur a further 40 percent increase in the rate of DI receipt.

Option Value and Dynamic Programming Model Estimates of Social Security Disability Insurance Application Timing

Abstract: This paper develops dynamic structural models - an option value model and a dynamic programming model - of the Social Security Disability Insurance (SSDI) application timing decision We estimate the time to application from the point at which a health condition first begins to affect the kind or amount of work that a currently employed person can do We use Health and Retirement Study (HRS) and restricted access Social Security earnings data for estimation Based on tests of both in-sample and out-of-sample predictive accuracy, our option value model performs better than both our dynamic programming model and our reduced form hazard model

Tracking the household income of ssdi and ssi applicants

Abstract: Using panel data from the Survey of Income and Program Participation linked to Social Security Administration disability determination records we trace the pattern of household income and the sources of that income from 38 months prior to 39 months following application for Social Security Disability Insurance (SSDI) and Supplemental Security Insurance (SSI). We find that the average applicant’s labor earnings declines dramatically beginning six months before application but the average applicant’s household income drops much less dramatically both in the months just before or just after application and over the next three years, and does so even for those denied benefits. However, we also found substantial heterogeneity in household income outcomes in both the SSDI and SSI applicant population. Our quantile regressions suggest that higher income households experience greater percentage declines in their post-application income. Such results are consistent with the lower replacement rate for higher earners established in the SSDI program and the low absolute level of protection provided to all SSI applicants regardless of income prior to application.

Disabled Rights: American Disability Policy and the Fight for Equality

Abstract: Acknowledgments IntroductionDemographics of DisabilityUnderstanding Disability PolicyA Word about Language Chapter 1: Disabled Policymaking/Disabled PolicyThe Paradigm ShiftOverview of the Policymaking ProcessKey Stakeholders Chapter 2: History of Segragation and Stereotypes"The Problem of Feeblemindedness"Assistance and TreatmentThe Stereotypes Continue Chapter 3: Compensation and RehabilitationHistorical Basis of CompensationIndustrial-Related DisabilitiesSocial SecurityThe Disability Insurance CrisisVocational Education1973 Rehabilitation ActEducation for Disabled ChildrenDisability as a Business/Rehabilitation as an IndustryTicket to Work and Work Incentives Improvement Act of 1999 Chapter 4: Social and Political ActivismDisability Rights as a Social MovementDisability Interest GroupsBerkeley and the Independent Living Movement"The Splintered Universe"Coalition Building and Cross-Disability ActivismDemonstrations and ProtestsLitigation Chapter 5: The ADA and the Vision of EqualityDeveloping a Naitonal Policy: Early InitiativesOpening the Policy WindowPolicy EnvironmentLegislative Building BlocksUnited We StandFriends in High PlacesLegislative ProcessStealth CampaignOpposition Forces Chapter 6: The ADA as PolicyProvisions of the LawImplementation and RulemakingEnforcementLitigationKey Litigation IssuesFusion of Positive and Negative Rights Chapter 7: Life beyond the ADA: Policy Hot ButtonsReproductive Rights and TechnologyNot Dead YetJerry's Kids and TelethonsChristopher Reeve and the Myht of the SupercripDeaf Culture and Cochlear ImplantsThe Intergration MandateViolence against People with DisabilitiesInvisible Disabilities Chapter 8: Status Report on EqualityAttitudes and Public OpinionEmploymentSocial IntegrationBarriers to IndependenceTransportationHealth CareHousingOverall Analysis Epilogue AppendicesAppendix A: Suggestions for Further ReadingAppendix B: Selected Disability Periodicals and MediaAppendix C: Annotated Guide to Nongovernmental Disability OrganizationsAppendix D: Chronology of Important Events in the History and Development of American Disability Policy Notes Index

What makes genetic discrimination exceptional

Abstract: I. INTRODUCTION Recent advances in understanding the genetic basis of disease has inspired hope but also fear. While establishing a link between a person's genetic makeup and a propensity to disease may lead to better treatment, many scientists, physicians and genetic counselors also worry that it may lead to discrimination. Although access to health insurance is the primary concern, people also fear discrimination in life and disability insurance, employment and other contexts, such as child custody decisions or adoption. In response to this concern, many state legislatures have passed laws forbidding genetic discrimination.1 While most of these laws focus on health insurance,2 some also prohibit genetic discrimination in employment3 or in life or disability insurance coverage.4 These laws have been the subject of both praise and criticism. Defenders of the laws see them as important and necessary, though arguably incomplete.5 Critics view them as unjustified and unwarranted.6 However, the question that dominates current literature is whether genetic discrimination is meaningfully different from discrimination on the basis of general health status; or as the debate is often framed, whether anti-discrimination laws ought to be genetic or generic.7 In fact, this is one point on which there is some convergence between the critics and supporters of anti-discrimination laws. Critics of the current laws that target genetic discrimination argue that genetic discrimination is no different from discrimination on the basis of health status and, additionally, that such discrimination is necessarily at the heart of the proper administration of insurance.8 Therefore, these critics argue, the current laws are both unwise and unjust. Some supporters of anti-discrimination protection acknowledge that there is no good reason to differentiate between those with a genetic predisposition to disease and those who already suffer from disease. However, rather than concluding that no anti-discrimination laws are necessary, these commentators see the current laws as merely a first step in the right direction. The second step, then, would be a generic law that protects people from discrimination on the basis of health status. This Article also addresses the question of whether special genetics legislation is warranted. In other words, why treat discrimination on the basis of genetic variation differently from discrimination on the basis of health? Although scholars offer a myriad of arguments in support of laws prohibiting genetic discrimination, most of these arguments fail to justify the need for genetic (as opposed to generic) legislation. There are, however, two reasons for specifically targeting genetic discrimination that warrant further exploration. The first of these-that legislation prohibiting genetic discrimination is needed in order to safeguard the health benefits that the new genetic science offers-is powerful and important. But, it is more complex than has been thus far recognized. This Article will examine that argument in depth, and argue that the strength of the argument depends on the answers to several empirical questions that require further study. The second argument that warrants a closer look-which implicitly underlies many of the arguments in the literature on genetic discrimination-has neither been teased out nor examined explicitly. Genetic discrimination may be meaningfully different (and worse) than health status discrimination because of what it expresses. This claim rests on the more general claim that the expressive dimension of action matters morally and legally.9 In arguing for protection from genetic discrimination, commentators commonly refer to the history of eugenics both in this country and in Europe, particularly Nazi Germany. However, this reference is made in a cursory fashion without any articulation of why that history matters or what part it plays in building an argument for legislation prohibiting genetic discrimination. …

Alternatives for Welfare Policy: Pathways to retirement and retirement incentives in Sweden

Abstract: We use a large panel data set (LINDA) to describe retirement behaviour in Sweden. The importance of different pathways to retirement is analysed. Survival functions for labor force participation of several groups in the labor force are estimated. We then provide a detailed analysis of economic incentives for additional work of older workers in Sweden inherent in the social security system, occupational pension schemes, labor market insurance programs, income taxes and housing allowances. The analysis shows the importance of these components of the income security system in forming the incentives.

Designing optimal disability insurance

Abstract: In this paper we describe how to optimally design a disability insurance system. The key friction in the model is imperfectly observable disability. We solve a dynamic mechanism design problem and provide a theoretical and numerical characterization of the social optimum. We then propose a simple tax system that implements an optimal allocation as a competitive equilibrium. The tax system that we propose includes only taxes and transfers that are similar to those already present in the U.S. tax code: a savings tax and an asset-tested transfer program. Using a numerical simulation, we compare our optimal disability system to the current disability system. Our results suggest a significant welfare gain from switching to an optimal system.

The cost-effectiveness of short-term dynamic psychotherapy.

Abstract: Short-term dynamic psychotherapy is a group of well-researched brief treatments with over 50 published controlled trials testing its effectiveness against a range of treatment and nontreatment controls. Studied samples are often high users of medical services, hospital services, mental health services and disability insurance. If short-term dynamic psychotherapy is effective, it should translate into demonstrable reductions in medical and social system costs. This review examines whether or not short-term dynamic psychotherapy is a cost-effective treatment.

Disability payments, drug use and representative payees: an analysis of the relationships.

Abstract: Aims This study attempted to determine: if US federal cash disability payments increase the use of cocaine or opiates among those requalifying for supplemental security income (SSI) disability benefits compared with those who lost benefits; if drug use peaks at the beginning of the month after the receipt of the disability cash disbursement; and if money management by representative payees of requalifying SSI recipients suppresses drug use. Design A multi-site, prospective, 2 year longitudinal design was used with follow-up interviews conducted every 6 months. Urine samples were collected at the final three follow-up interviews. Setting Data were collected in Chicago, IL, Los Angeles, CA, and Seattle, WA, USA. Participants This study used a randomly selected sample of 740 former recipients of SSI who had received disability benefits for drug addiction and alcoholism (DA&A) in 1996, were between the ages of 21 and 59 years, had not received concurrent social security disability insurance and provided testable urine samples and complete self-report data for at least one follow-up interview. Measurements Independent variables included demographics, SSI status at follow-up, representative payee status, drug treatment participation and income. Time of drug testing was operationalized as the first 10 days of the month versus the last 20–21 days based on when the urine sample was collected. The dependent variables were cocaine and opiate use, determined by urinalysis results. Findings Participants were 28% more likely to test positive for cocaine use in the first 10 days of the month than later in the month. This effect was general across all subjects and was not restricted to those receiving SSI benefits. No such effect was found for opiate use. Receiving SSI benefits did not increase cocaine or opiate use generally, nor did having a representative payee suppress use. Conclusions The findings do not support the contentions that federal cash benefits appreciably increase drug use or that representative payees discourage use, at least when use is defined dichotomously. The ‘check effect’ for cocaine use appears to be general and not confined to those receiving federal cash benefits. The lack of a ‘check effect’ for opiate use is probably the result of the difference between a relatively steady state of opiate use associated with addiction and a binge pattern of cocaine use triggered by suddenly flush resources.

The Gender Impact of Pension Reform: A Cross-Country Analysis

Abstract: Pension systems may have a different impact on gender because women are less likely than men to work in formal labor markets and earn lower wages when they do Recent multipillar pension reforms tighten the link between payroll contributions and benefits, leading critics to argue that they will hurt women In contrast, supporters of these reforms argue that it will help women by the removal of distortions that favored men and the better targeted redistributions in the new systems To test these conflicting claims and to analyze more generally the gender effect of alternative pension systems, James, Edwards, and Wong examine the differential impact of the new and old systems in three Latin American countries-Argentina, Chile, and Mexico Based on household survey data, they simulate the wage and employment histories of representative men and women, the pensions they are likely to generate under the new and old rules, and the relative gains or losses of men and women because of the reform The authors find that women do accumulate private annuities that are only 30-40 percent those of men in the new systems But this effect is mitigated by sharp targeting of the new public pillars toward low earners, many of whom are women, and by restrictions on payouts from the private pillars, particularly joint annuity requirements As a result of these transfers, total lifetime retirement benefits for women reach 60-80 percent those of men, and for "full career" women they equal or exceed benefits of men Also as a result, women are the biggest gainers from the pension reform For women who receive these transfers, female/male ratios of lifetime benefits in the new systems exceed those in the old systems in all three countries Private intra-household transfers from husband to wife in the form of joint annuities play the largest role This paper is a product of the Gender Division, Poverty Reduction and Economic Management Network

Characteristics of third-party money management for persons with psychiatric disabilities.

Abstract: OBJECTIVE: The study examined different types of third-party money management arrangements for persons with psychiatric disabilities and consumers' perceptions of their finances in the context of these arrangements. METHODS: Clinical and demographic data were collected through structured interviews and record reviews for 240 persons with a diagnosis of a psychotic or major affective disorder who had been involuntarily hospitalized and were awaiting discharge on outpatient commitment in North Carolina. All consumers were receiving Supplemental Security Income or Social Security Disability Insurance. RESULTS: Third-party money management arrangements were reported by 102 (41 percent) of the study participants. A majority (77 percent) of these consumers had their finances managed by a family member. Consumers with third-party money managers were more likely to have a median annual income below $5,000, to have a diagnosis of a primary psychotic disorder, and to have substance use problems. Most participants w...

What rehabilitation counselors should know to assist Social Security beneficiaries in becoming employed.

Abstract: The 1999 Ticket to Work and Work Incentive Improvement Act (TTWWIIA) has opened new employment opportunities for vocational rehabilitation professionals The legislation minimized longstanding disincentives in the return to work efforts of beneficiaries collecting Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) Although some of these key disincentives have been eliminated, rehabilitation counselors working with this population will find some interesting new challenges posed by this population This article will outline the Social Security Administration's SSI/SSDI programs and process for applying; characteristics of beneficiaries; and information regarding the psychological and physiological aspects of beneficiaries with psychiatric disabilities and musculoskeletal disorders

Why has Employment Recently Risen Among Older Workers in Britain

Abstract: From late 1998 to late 2002, employment among those aged 50 and over increased by 650,000. Their employment rate also rose, by 2 percentage points. This is in sharp contrast to the downward trend in the two decades prior to the mid-1990s. This growth was disproportionately concentrated among people in their 50s rather than their 60s, women rather than men and, on balance, among more highly educated workers. The buoyant economy of the period is a major reason for the upturn — there is a particularly strong association between the growth of GDP and the employment rate of people aged in their 50s (relative to older workers). On the demand side, demographic change and the shift to a service sector-based economy may reduce the likelihood of future precipitate falls in employment of older workers of the kind that was experienced in the early 1980s. On the supply side, falling equity markets and tighter regulations concerning ill-health related retirement in public pension programmes may have led people to postpone retirement. There is no clear evidence that reforms to the public disability insurance programme have had any effect on employment rates. Other policies, such as the voluntary code of practice on age diversity and New Deal 50 Plus may have had small effects on employment but mostly serve to keep the issue of employment of older workers on the public agenda.

The fraction of disability caused at work.

Abstract: Disability has high societal and personal costs. Various disparate federal and state programs attempt to address the economic and social needs of people with disabilities. Presumably workplace injuries and accidents are an important source of disability. Yet separate public policies and research literatures have evolved for these two social problems-disability and workplace injuries-despite their relatedness. This article seeks to document the overlap between these two phenomena in estimating the proportion of the disabled population whose disability was caused by workplace injury, accident, or illness using the Health and Retirement Study of 1992. The results point toward the need for initiatives to reduce disability that focus on work-related causes, which are a common pathway to disability, and that may result in substantial savings in federal programs. Summary Studies of the economic and social consequences of disability among adults have documented the disadvantages that confront individuals with disabilities. A separate literature has focused on the economic and social consequences of workplace injuries and illnesses, which have been shown to lead to lower employment rates for years after the injury and significant losses in income. The public policies for these two social problems-disability and workplace injuries-are distinct, as are the associated research literatures, and yet the phenomena are related. In this article, we seek to document the overlap between these phenomena to improve public policy for both. Specifically, our goal is to estimate the proportion of the disabled population whose disability was caused by work. Using the 1992 Health and Retirement Study, a nationally representative study of the U.S. population of people aged 51 to 61, we find that among those whose health limits the amount or kind of work they can do 36 percent became disabled because of an accident, injury, or illness at work. Among people of this age group who are receiving Social security Disability Insurance, 37 percent are disabled because of an accident, injury, or illness at work. The workplace is a more common source of disability for men than it is for women: among Disability Insurance recipients, 45 percent of men and 26 percent of women are disabled because of workplace accidents, injuries, or illnesses. The annual cost of workplace injuries to Medicare and Social security Disability Insurance is roughly $33 billion. The results imply that one focus of initiatives to reduce disability should be work-related causes, because occupational injuries and illnesses are a common pathway to disability. Workplace injury prevention and rehabilitation may have far greater social benefits than previously realized, because of the substantial savings to Social security Disability Insurance and Medicare. Introduction Studies of the economic and social consequences of disability among adults have documented the disadvantages that confront individuals with disabilities. Among these consequences are lower employment and earnings (Burkhauser, DaIy, and Houtenville 2001 ) and higher medical expenditures (Trupin, Rice, and Max 1995). Noneconomic consequences include increased social isolation and higher rates of entry into nursing homes (Freedman and others 1994). Much of this literature is cited as motivation for antidiscrimination policies and income-support programs for the disabled, such as the Americans with Disabilities Act of 1990, which provided disabled individuals with the right to sue for discrimination and for accommodations in public places, and the Social security Disability Insurance program, which provided $55 billion of income support for the disabled in 2000 (Thompson Williams, Reno, and Burton 2003). A separate literature has focused on the economic and social consequences of workplace injuries and illnesses, which have been shown to lead to lower employment rates for years after the injury and significant losses in income (Berkowitz and Burton 1987; Biddle, Boden, and Reville 2001; Reville and Schoeni 2001). …

Workers' Compensation: A Background for Social Security Professionals

Abstract: This article provides a brief history and background of workers' compensation programs for occupationally injured and ill workers in the United States. It presents the basic principle involved in workers' compensation and briefly discusses the disability benefits to which workers are generally entitled. It also discusses why there are settlements in this disability program and the availability of information about the amounts paid in workers' compensation cases for obtaining an offset for Social Security Disability Insurance benefits paid to the worker. Finally, the article explains the rationale behind the public policy on coordination of Disability Insurance and workers' compensation in the new paradigm of disability and return to work. Summary Workers' compensation programs in the United States are state regulated, with laws determined by each state legislative body and implemented by a state agency. The programs provide the payment of lost wages, medical treatment, and rehabilitation services to workers suffering from an occupational injury or disease. These programs were being adopted in the early 190Os-a time when the federal government considered social insurance and welfare to be the purview of the states and there was no discussion of a federal occupational injury or disease program other than the one created in 1908 to cover federal workers. Ultimately, the agreements made in all states upon the adoption of workers' compensation statutes had a few common principles and similar categories of benefits, although the details concerning the level of benefits provided and the administrative mechanisms used to deliver the benefits varied dramatically from state to state-and still do. The basic principle underlying workers' compensation programs was that benefits would be provided to injured workers without regard to fault and, in return, employers would face limited liability. In other words, workers would be entitled to benefits if the injury was caused by their employment, regardless of who caused the injury, and employers would be responsible for specific benefits itemized in the statute in exchange for the elimination of lawsuits for negligence. Determining the appropriate amount of these benefits can be difficult, because most jurisdictions are attempting to calculate a future wage loss for an individual who has permanent physical residuals that are likely to affect his or her future earning capacity. Estimating future wage losses is not an exact science. The process often involves litigation, which quite often resolves through negotiated agreements and the payment of a lump sum to the injured worker. Furthermore, not all occupational injuries and diseases are paid for under workers' compensation systems. Coverage exceptions in each jurisdiction and differences in compensability rules eliminate some injuries and illnesses that may be work related. Therefore, some claims are denied; they may also be litigated and settled with lump-sum payments. In recent years, a new paradigm of disability has emerged that considers disability as a natural and normal part of the human experience. With this new approach comes a greater responsibility for disability benefit programs to help people with disabilities gain access to the labor market and return to work after a permanently disabling occurrence, whether it was work related or not. The focus on return to work also requires greater coordination between disability programs. For example, an individual receiving workers' compensation benefits may also be entitled to benefits under Social security Disability Insurance. In most states, there is an offset that reduces Disability Insurance benefits because of workers' compensation benefits paid; in other states, the offset works the other way. Calculating offsets requires an understanding of each workers' compensation law, agency, and rules; obtaining appropriate authorizations for release of information from their applicant or beneficiary; and obtaining the record of payments or settlement agreements from the workers' compensation agency or payer. …

Changes in the Demographic and Economic Characteristics of SSI and DI Beneficiaries Between 1984 and 1999

Abstract: During the past 20 years, legislative and judical actions have affected Supplemental Security Income and Disability Insurance beneficiaries. This article compares important changes in demographics, income sources and amounts, and poverty status of beneficiaries of both programs between 1984 and 1999, using data from the Survey of Income and Program Participation matched to administrative data from the Social Security Administration. The average age of both groups has decreased, while their education levels increased. In 1999, Disability Insurance beneficiaries and their families relied less on Social Security, while their poverty rate remained fairly constant. The Supplemental Security Income population had a lower poverty rate, while beneficiaries were slightly more reliant on Social Security for personal income. Summary Social Security has paid benefits to persons insured for disability since 1956 under its Disability Insurance program and, since 1974, to the low-income aged, blind, and disabled under its Supplemental Security Income program. Over time major demographic, economic, and societal changes have affected the underlying populations who are eligible for these programs, and legislation and court decisions have affected the programs themselves. This article capitalizes on the availability of data collected by the U.S. Census Bureau in its Survey of Income and Program Participation that go back to 1984 and that have been linked to Social Security administrative records. It examines changes in the Disability Insurance and Supplemental Security Income beneficiary populations between 1984 and 1999, the latest year for which Survey of Income and Program Participation data linked to administrative records are available. Both the Disability Insurance and Supplemental Security Income populations have experienced marked growth and compositional changes in that 15-year period. * The average age of both groups decreased. The Supplemental Security Income population is much more likely to be working-aged and less likely to be aged. The Disability Insurance population is much more likely to be under the age of 55. * Marital status has shifted for both groups as a result of underlying trends in the population and the types of beneficiaries on the rolls. The Disability Insurance population is more likely to be divorced and less likely to be married. The Supplemental Security Income population is more likely to be never married and less likely to be widowed. * Both groups are on average more educated in 1999 than they were in 1984, although half of the adult Supplemental Security Income population has not graduated from high school. In 1999, the Disability Insurance population had about the same level of average personal and family income (almost $13,000 and $30,000, respectively, in 1999 dollars) and a similar poverty rate (about 22%) as it had in 1984. However, Disability Insurance beneficiaries and their families were less dependent on Social Security and relied more heavily on family earnings and a range of other sources of income in 1999. Disability Insurance beneficiaries had relied on Social Security for over 70 percent of their own income and over 50 percent of their family income in 1984. In 1999, reliance on Social Security was about 15 percentage points lower: 58 percent of personal income and 36 percent of family income. The Supplemental Security Income population in 1999 had slightly higher average income (personal and family) and a lower poverty rate than it did in 1984. The poverty rate among beneficiaries declined from 47 percent in 1984 to 42 percent in 1999. In 1999, Supplemental Security Income beneficiaries were slightly more reliant on the program for personal income (64 percent of income on average compared with 58 percent in 1984) but had about the same level of reliance for their family income (40 percent). The families of Supplemental Security Income beneficiaries in 1999 are relying more on earnings and less on Social Security benefits received by the Supplemental Security Income recipient or other family members. …

The Law and Economics of Disability Accommodations

Abstract: The Americans with Disabilities Act provides a clear mandate that disabled workers be provided with “reasonable” accommodations, but does not meaningfully articulate the standards by which reasonableness ought to be measured. Until now, neither courts nor commentators have provided a systematic model for analyzing accommodation claims. This Article articulates an initial law and economics framework for analyzing disability-related accommodations. In doing so, it demonstrates how accommodations span a cost continuum that can be divided into areas of Wholly Efficient and Semi-Efficient Accommodations to be funded by private employers, Social Benefit Gain Efficient Accommodations where the costs should be borne by the public fisc, and Wholly Inefficient Accommodations that ought not be provided. It also delineates the boundaries between each category, and explains why the entities designated should bear the accommodation costs assigned to them. The analysis of disability accommodations uses, questions, and at times goes beyond the neoclassical economic model of the labor market, and also engages arguments from the jurisprudence of social justice. By utilizing both these fields, this Article stakes out a unique perspective on disability accommodations, and provides an avenue for continued discussion and debate over how disability accommodations ought to be measured.

Mild traumatic brain injury: Impairment and disability assessment caveats.

Abstract: Mild traumatic brain injury (MTBI) accounts for approximately 80% of all brain injuries, and persistent sequelae can impede physical, emotional, social, marital, vocational, and avocational functioning. Evaluation of impairment and disability following MTBI typically can involve such contexts as social security disability application, personal injury litigation, worker's compensation claims, disability insurance policy application, other health care insurance policy coverage issues, and the determination of vocational and occupational competencies and limitations. MTBI is still poorly understood and impairment and disability assessment in MTBI can present a significant diagnostic challenge. There are currently no ideal systems for rating impairment and disability for MTBI residua. As a result, medicolegal examiners and clinicians must necessarily familiarise themselves with the variety of disability and impairment evaluation protocols and understand their limitations. The current paper reviews recommended procedures and potential obstacles and confounding issues.

The Methodology of the Multi-site Study of the Termination of Supplemental Security Income Benefits for Drug Addicts and Alcoholics

Abstract: In March 1996 federal legislation (P.L. 104-121) rescinded Supplemental Security Income (SSI) and Social Security Disability Insurance (DI) benefits to recipients with disabling impairments "materially related" to drug addiction or alcoholism. Benefits based on these impairments ceased as of January 1, 1997. This paper details the methodology employed in a multi-site longitudinal panel study (the SSI Study) that aimed to evaluate the impact of this policy change on former recipients, known as drug addiction and alcoholism (DAA there was wide variation among the sites in terms of the availability of social services, including substance abuse treatment and funding for things like housing subsidies, medical coverage, and state and/or local welfare. There were also significant differences in general population characteristics and employment opportunities. Although funding expedience and other exigencies played substantial roles in site selection, CSAT selected many of the sites because of their relatively large number of DA&A recipients. …

Is Life Insurance a Human Capital Derivatives Business

Abstract: Life and disability insurance, as well as annuities, traditionally have been analyzed as products providing protection against random losses This article proposes that these products can be viewed as derivative instruments created to address the uncertainties and inadequacies of an individual’s human capital, if human capital is viewed as a financial instrument In short, life insurance (including disability insurance and annuities) is the business of human capital securitization

Reassessing the Relationship between Disability Insurance and Workers' Compensation

Abstract: I am pleased to join with Jerry Mashaw, president of the National Academy of Social Insurance, to introduce this policy research seminar on the relationship between Social security Disability Insurance and workers' compensation. I would like to express our appreciation to the staff of Social security and the Academy who put together this excellent program. The Social security Administration (SSA) and the National Academy have worked together for many years to improve our knowledge and understanding of workers' compensation. Since 1997 the National Academy has compiled much of the basic national data on workers' compensation that was previously prepared by our agency. The Social security Administration has provided both financial and analytical support to this effort, which is part of the Academy's larger research initiative on workers' compensation. Thus, this seminar continues a longstanding partnership. The relationship between Social security Disability Insurance (DI) and workers' compensation is important to my agency for many reasons. And it is also of personal interest as I have worked in companies that have been a buyer, broker, insurer, and reinsurer of workers' compensation as well as being a banker to several workers' comp companies. Disability Insurance and workers' compensation are the country's two largest disability programs. In 2002, the DI program paid $66 billion in benefits to 5.5 million disabled workers and their dependents. In the same year, workers' compensation paid out $53 billion-$29 billion in wage-loss compensation and $24 billion in medical benefits. It is vital that these two big programs work in tandem. Because Disability Insurance and workers' compensation are so large and have overlapping goals, it is not surprising that many people receive benefits from both. In some cases, however, overlapping benefits can create excessive wage replacement rates and the resulting disincentives for achieving self-sufficiency. For this reason, the Social security Amendments of 1965 established the workers' compensation offset. The offset assures that the combined amount of a disabled worker's and family's benefit from Social security and workers' compensation (or another public disability benefit) will not exceed 80 percent of the worker's average current earnings. Although the issue of excessive wage replacement remains salient today, many things have changed in the past 40 years. For example, in 1965, total cash benefits paid by workers' compensation were three-fourths of those from Disability Insurance. Today, they are less than half as large. Since 1993, up to 85 percent of Social security benefits have been subject to federal income taxation, while benefits from workers' compensation have remained taxexempt. This disparate tax treatment can create horizontal inequities. …

Current trends in workersʼ compensation stress claims

Abstract: Purpose of review This paper seeks to update the reader in this area and features a notable recent development relating to the approach to treatment and rehabilitation of those suffering from work-related stress-induced illnesses. This may represent one of few successful therapeutic efforts to deal somewhat broadly with this socially problematic group of conditions. Work-related stress issues have been addressed in a number of publications since the early 1990s. Those publications, reporting clinical and epidemiological findings, have been quite illuminating as to the incidence and the degree of disability resulting from mental illness arising within work settings. However, the major interventions have been political, as urged by many seeking a reduction in economic costs to the workers' compensation system of stress claims. The result has been legislation that has reduced access to the workers' compensation system for those who may be suffering from work-related stress illnesses. This trend may continue for political reasons. Recent findings The past 2 years have seen few relevant clinical developments in the area of disability due to work stress. Most recent publications have concerned topics addressed in earlier years. These include significant factors influencing recovery, comprehensive reviews of work-related stress, and a review of readiness for return to work as it relates to the interpersonal impact of healthcare, workplace and insurance factors. Summary Patients receiving treatment for injuries compensated for by the workers compensation system, as well as those involving tort litigation or disability insurance claims, have historically had poorer outcomes than those with injuries for which compensation cannot be provided. The theory has been that this rests on various factors primarily within the claimant. Newer research looking at readiness to return to work from the perspective not only of the claimant but also of the interpersonal impact of various factors in the environment may shed considerable light on this topic and provide a new framework for dealing with such claims.

Stochastic Models of the Social Security Trust Funds

Abstract: Each year in March, the Board of Trustees of the Social Security trust funds reports on the current and projected financial condition of the Social Security programs. Those programs, which pay monthly benefits to retired workers and their families, to the survivors of deceased workers, and to disabled workers and their families, are financed through the Old-Age, Survivors, and Disability Insurance (OASDI) Trust Funds. In their 2003 report, the Trustees present, for the first time, results from a stochastic model of the combined OASDI trust funds. Stochastic modeling is an important new tool for Social Security policy analysis and offers the promise of valuable new insights into the financial status of the OASDI trust funds and the effects of policy changes. This Research and Statistics (R&S) Note demonstrates that several stochastic models deliver broadly consistent results even though they use significantly different approaches and assumptions. However, the results also demonstrate that the variation in trust fund outcomes differs as the approach and assumptions are varied. Which approach and assumptions are best suited for Social Security policy analysis remains an open question. Further research is needed before the promise of stochastic modeling is fully realized. Despite this caveat, stochastic modeling results are already shedding new light on the range and distribution of trust fund outcomes that might occur in the future. The stochastic model used in the Trustees’ Report was recently developed by the Office of the Chief Actuary (OCACT) of the Social Security Administration to illustrate the uncertainty surrounding projections of the financial future of the Social Security system over the next 75 years. The stochastic results are intended to augment the traditional demonstrations of uncertainty used in past Trustees' Reports. The standard method of demonstrating uncertainty is to present three alternative sets of deterministic projections. The intermediate (Alternative II) projections are intended to reflect the best estimates of future experience. The low-cost (Alternative I) and high-cost (Alternative III) projections are based on more optimistic and more pessimistic assumptions about the future, respectively. The three alternatives indicate a possible range for future experience. The stochastic model also relies on the assumptions underlying the intermediate (Alternative II) projections. Time constraints dictated that the stochastic results in the 2003 Trustees’ Report be based on the assumptions from the 2002 report.

An Assessment of the Representativeness of the SSI DA&A Study Panels

Abstract: The purpose of this paper is to assess the representativeness of the longitudinal surveys of Drug Addiction and Alcoholism (DA&A) Supplemental Security Income (SSI) recipients collected by various grantees commissioned by the Center on Substance Abuse Treatment (CSAT) CSAT commissioned grantees in seven catchment areas (in five states) to survey representative samples of DA&A SSI-only recipients (ie, DA&A SSI recipients who did not receive additional disability benefits from Social Security Disability Insurance)

Redistribution under OASDI: How Much and to Whom?

Abstract: In one of the most comprehensive, intergenerational studies on Social Security's redistribution of lifetime income, the authors find that (1) Social Security, or Old Age, Survivors, and Disability Insurance (OASDI), is slightly progressive in that persons with high lifetime earnings on average receive lower rates of return than persons with low lifetime earnings; (2) For most generations, the retirement component (OASI) by itself achieves little if any redistribution across income groups, while Disability Insurance (DI) is progressive, it is a relatively small program, and so does not affect overall redistribution under OASDI, except for key groups; and (3) The groups who benefit most when DI is added to OASI are men, workers in the bottom earnings quintile, high school dropouts, and minorities. [© Brookings Institution]

Option Value and Dynamic Programming Model Estimates of Social Security Disability Insurance Application Timing

Abstract: This paper develops dynamic structural models - an option value model and a dynamic programming model - of the Social Security Disability Insurance (SSDI) application timing decision. We estimate the time to application from the point at which a health condition first begins to affect the kind or amount of work that a currently employed person can do. We use Health and Retirement Study (HRS) and restricted access Social Security earnings data for estimation. Based on tests of both in-sample and out-of-sample predictive accuracy, our option value model performs better than both our dynamic programming model and our reduced form hazard model.

Disability insurance eligibility criteria and the labor supply of older men

Abstract: I estimate the effect of allowing individuals to use socioeconomic conditions to qualify for disability benefits on the labor supply of older men in Canada. I obtain my estimates using a difference-in-difference approach and I also adjust my standard errors to properly account for the sampling variability in the data. I find that this policy change led to a 1.5 percentage increase in the nonparticipation of older men (aged 45 to 64) in the CPP provinces, relative to Quebec where there was no change in eligibility requirements.

The Dutch Disability Insurance Act (WAO) and the role of research in policy change

Abstract: In the Dutch welfare state social policy research always has been an essential tool in policy development. Much public money has been spent on explanatory research and research that has to be supportive to policy design, policy improvement and the evaluation of social policies. A significant field in this respect is social security and more in particular the Dutch disability problem. Since the onset of the at the time fundamentally changed public disability insurance legislation in the second half of the sixties of the last century, disability has become one of the biggest problems of the Dutch working population. The number of disabled workers increased rapidly after the introduction of the Disability Insurance Act (WAO) in 1967 from about 200.000 to almost one million in the nineties (about 10% of the whole Dutch working population) and remained at this unusual high level until today. To be able to tackle this problem Government and the administrative organizations carried out and funded several hundreds of research projects since the seventies. In this paper we investigate the impact of this research on policy-making. The main question to be answered is to what extent the results of research have been used in policy-making regarding the WAO. On the basis of three more specific case studies we conclude that this impact has been very modest. More in particular, by means of detailed document studies and complementary interviews with the relevant stakeholders we investigated three important and far-reaching corrective legal reforms in the nineties and the role policy research played in this respect. Various aspects explain the under-utilization of research, but one of the most important ones is the complicated political context in the Netherlands. Many institutional actors, that are interdependent and locked into permanent negotiation over such a sensitive societal issue, are involved. Therefore, consensus on the basis of particular research results or recommendations is difficult to envision.This paper has primarily been composed in behalf of a project under the auspices of the UNESCO-MOST Programme on knowledge utilization of social policy research in various countries. We presented the first results at the conference One Hundred Years of Social Security in the Netherlands in The Hague in June 2001 (De Gier & Vijgen, in: Berghman et al. 2003: 139-156).