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PubMed1999

Old-age, survivors, and disability insurance and supplemental security income for the aged, blind, and disabled; substantial gainful activity amounts. Social Security Administration. Final rules.

We are revising the rules for determining when earnings demonstrate the ability to engage in substantial gainful activity (SGA). This rule change applies to Social Security disability benefits provided under title II of the Social Security Act (the Act) and Supplemental Security Income (SSI) benefits based on disability under title XVI of the Act. (Eligibility for benefits under titles II and XVI also confers eligibility for related Medicare and Medicaid benefits under titles XVIII and XIX of the Act.) Specifically, we are raising from $500 to $700 the average monthly earning guidelines used to determine whether work done by persons with impairments other than blindness is SGA. We are raising this level as part of efforts to encourage individuals with disabilities to attempt to work, and to provide an updated indicator of when earnings demonstrate the ability to engage in SGA. This increase reflects our assessment of the amount that roughly corresponds to wage growth since the last increase in 1990.

Eligibility Determination↗
PubMed1995

Cross-coding from the Swiss Disability Insurance listing to the ICIDH.

It has been suggested that converting, via a process of cross-coding, the listing used by the Swiss Disability Insurance (SDI) for their statistics into codes of the International Classification of Impairments, Disabilities, and Handicaps (ICIDH) would improve the quality and international comparability of disability statistics for Switzerland. Using two different methods we tested the feasibility of this cross-coding on a consecutive sample of 204 insured persons, examined at one of the medical observation centres of the SDI. Cross-coding is impossible, for all practical purposes, in a proportion varying between 30% and 100%, depending on the method of cross-coding, the level of disablement and the required quality of the resulting codes. Failure is due to lack of validity of the SDI codes: diseases are poorly described, consequences of diseases (disability and handicap, including loss of earning capacity), insufficiently described or not at all. Assessment of disability and handicap would provide necessary information for the SDI. It is concluded that the SDI should promote the use of the ICIDH in Switzerland, especially among medical practitioners whose assessment of work capacity is the key element in the decision to award benefits or propose rehabilitation.

Adult↗
PubMed1998

Supplemental Security Income (SSI), Disability Insurance (DI), and substance abusers.

Federal legislation repealed Supplemental Security Income (SSI) and Disability Insurance (DI) for alcohol and drug abusers as of January 1997. This article outlines the context in which the legislation was passed and summarizes concerns resulting from the legislation. We discuss the effects of the legislation on treatment participation, financing, and availability, and the legislation's impact on individuals with dual mental health and substance abuse problems. We also consider the individual and societal implications of substance abusers' loss of monthly income and health insurance.

Adult↗
PubMed2000

How raising the age of eligibility for Social Security and Medicare might affect the disability insurance and Medicare programs.

The normal age of retirement is scheduled to increase to 67 by 2022, and several proposals to increase it to age 70 are being considered. The Medicare eligibility age is not scheduled to increase under current law, but proposals to raise it in step with the retirement age were recently considered by the National Bipartisan Commission on the Future of Medicare (1999). This article examines how raising both the normal retirement age and the Medicare eligibility age would affect Social Security Disability Insurance (DI) eligibility, Medicare eligibility, and Medicare expenditures under two hypothetical policy scenarios. The first (the 2022 age-67 scenario) assumes that the eligibility age is raised to 67 by 2022, in step with the scheduled increase in the normal retirement age. The second (the 2040 age-70 scenario) assumes that the eligibility ages are increased to 70 by 2040. The findings are based on a summary of two reports. The earlier one (Wittenburg and others 1999) describes a series of microsimulation models developed from data in the Survey of Income and Program Participation (SIPP) and the Medicare Current Beneficiary Survey (MCBS). The base simulations in that report assume that the normal retirement and Medicare eligibility ages had already been increased in 1993, when the SIPP and MCBS respondents were observed. In the later report (Wittenburg, Stapleton, and Scrivner 2000), adjustment factors were developed to reflect future increases in Medicare expenditures, population growth, and increased participation in DI. The base simulations were then adjusted by those factors, yielding a final set of annual projections under the two policy scenarios. The hypothetical policy scenarios illustrate that the major cost reductions from jointly raising the Medicare eligibility age and the normal age of retirement would not be realized until after 2020, when the increases are fully phased in and a large portion of baby boomers have reached age 65. Although the projections provide important cost estimates, the equity and efficiency of those policies must be studied before the desirability of any specific proposal can be evaluated fully.

Age Factors↗
PubMed1981

Evaluation of disability insurance savings due to beneficiary rehabilitation.

This article uses individual vocational rehabilitation case data and disability insurance (DI) benefit histories from the master beneficiary record file to compare the costs and savings to the DI trust fund associated with the beneficiary rehabilitation program. Using cost-benefit procedures and varying assumptions as to the impact of vocational rehabilitation services, the savings to the trust fund were found to range between $1.39 and $2.72 per $1.00 of cost for DI beneficiaries who completed their vocational rehabilitation service period in fiscal year 1975. Calculating savings according to the length of the savings period revealed that expenditures for vocational rehabilitation services to these beneficiaries would be fully repaid within 10 years after closure. It was also discovered that the loss of savings due to return to the DI rolls substantially exceeds the increased payroll tax revenue accruing to the trust fund from post-vocational rehabilitation employment.

Age Factors↗
PubMed1994

The HIV-positive physician and disability insurance.

Occupational exposure to HIV is becoming a daily hazard in many emergency departments. Emergency physicians who are protected by disability insurance policies are likely to believe that if they are unable to continue working because of HIV-positive status, their disability policies will provide them with a source of income. Unfortunately, analysis of case law regarding claims under disability policies shows that the law is unlikely to consider an asymptomatic, HIV-positive physician disabled for purposes of payments under disability policies. Therefore, it is necessary for emergency physicians to make sure this issue is resolved before buying and relying on a disability policy so that an anticipated safety net will be operative over the full range of hazards that emergency physicians face.

Data Collection↗
PubMed1995

Medicare and the Social Security Disability Insurance program.

This DataWatch traces changes over time in the age and health characteristics of persons awarded Social Security Disability Insurance (SSDI) benefits. SSDI beneficiaries are increasingly younger and more likely to be incapacitated by health conditions that at any age lengthen spells of disablement. These changes have had a significant impact on SSDI operations; they also have important implications for financing the Medicare program.

Adult↗
PubMed1984

The effect of disability insurance on health care demand.

This paper examines the incentive effects of the growth in the Social Security Disability Insurance (DI) system in terms of its impact on individual health care demand. A simple model predicts that DI benefits will reduce the individual's demand for preventive health care (in order to increase their probability of acceptance) while the demand for acute care is not affected. Estimates of health care demand equations for males aged 58-63 confirm the non-effect of DI benefits on acute care, while significant (but small) negative effects of benefits on preventive care are found.

Health Services Needs and Demand↗
PubMed1996

Quality of work incapacity assessment in the Swiss disability insurance system.

Quality of medical assessment of work incapacity has been poorly investigated, despite the enormous costs engendered by transient incapacity of work and permanent disability. This study examined some indices of quality from a stratified, random sample (n = 120) of assessments performed by expert assessors of the Swiss disability insurance. The distribution of work incapacity (WI) percentages over a 100% scale showed a clustering around key values significantly associated with financial disability benefits. The precision of WI, expressed as the level of quantitative exactness, was found to be high in 74% (95% CI: 66-82%) of current WI assessments, and in 62% (95% CI: 53-71%) of maximal WI assessments. Disagreement was observed in 17% of cases when comparing two ways of expressing WI by the same physician (95% CI: 10-23%). This exploratory study is limited by the general lack of objective criteria and standards. Further theoretical and empirical developments are needed to determine standardized criteria and clear guidelines for medical assessments of WI, as well as for evaluating their quality.

Adult↗
PubMed1982

Federal Old-Age, Survivors, and Disability Insurance; revised medical criteria for the determination of disability--Social Security Administration. Proposed rules.

These proposed amendments revise the medical evaluation criteria for both the title II and title XVI disability programs. These criteria were last revised in 1979. The proposed revisions reflect advances in the medical treatment of some conditions and in the methods of evaluating certain impairments. These proposals will provide up-to-date medical criteria for use in the evaluation of disability claims.

Disability Evaluation↗
PubMed1997

[Use of the International Classification of Diseases for disability insurance in Switzerland: study of reproducibility].

The International Classification of Diseases (ICD-10) was introduced in a pilot phase for coding of diagnoses in a sample of cases encountered in the Swiss Disability Insurance (SDI), as a substitute for the SDI codes, judged unsuitable for the description of disability. The goal of this study is to evaluate the reliability of use of these codes, by studying the coding reproductibility between the Medical Observation Centers (MOC) and the Evaluation and Coordination Center. A second goal was to evaluate the feasibility of coding by non-physicians. Reliability of diagnoses was examined by level of precision: chapters, groups, categories and subcategories. The agreement between the two coding Centers varies from 78%, at the chapter level, to 29% at the most detailed level. This agreement is improved if taking into account the three main diagnoses for the comparison, reaching 91%. The results of the physician coder, concerning the precision and reliability of coding, are significantly superior to those of an economist coder and a medical secretary coder. To improve coding agreement, it is proposed to train coding professionals, provide coding tools, clarify which diagnosis is the main one, and seek a consensus for cases of systematic disagreement. The ideal level of precision should not be so high as to produce diagnostic codes with low reliability. It should, however, be precise enough to give a satisfactory description of the problems encountered.

Adult↗
PubMed1988

The psychiatrist and the Social Security Disability Insurance and Supplemental Security Income programs.

As psychiatrists become more active in the care of the chronic mentally ill, they are taking a greater role in relation to the entitlement programs of Social Security Disability Insurance and Supplemental Security Income. In a review of the application and appeals processes of the disability determination system, the author focuses on areas in which psychiatrists are likely to be involved, such as identifying patients qualified to receive benefits, providing reports on their own patients for disability determination, and examining other patients as a consultant. Psychiatrists should be knowledgeable about the Social Security entitlement programs, the author believes, and should increase their linkages with the Social Security Administration.

Disability Evaluation↗
PubMed1998

Historical redistribution under the Social Security Disability Insurance Program.

This study uses Social Security administrative data on historical taxes and benefits by year, age, gender, and race for an ex post analysis of redistribution under the Disability Insurance (DI) program. The relationship between the taxes paid and benefits received to date under the program is described for successive cohorts as a whole and for specific race and gender groups both within cohorts and across time.

Aged↗
PubMed1983

Social Security benefits; disability insurance benefits; deductions, reductions, and nonpayments of benefits--SSA. Final rules with comment period.

These regulations amend the existing regulations under which Social Security benefits payable to a disabled worker and his or her family may be reduced because of the worker's concurrent entitlement to workers' compensation benefits. They provide that entitlement to certain other public disability benefits may reduce the disability benefits paid by Social Security; that the reduction applies to the first month of concurrent entitlement regardless of the month in which we are notified of entitlement to the public disability benefit; and that the reduction applies to all months of concurrent entitlement until the disabled worker attains age 65. These regulations also provide that where a public disability law or plan provides for reduction of the public disability benefit on the basis of entitlement to Social Security disability insurance benefits that provision will preclude reduction of the Social Security benefits but only if it was in effect on February 18, 1981. These regulations implement section 2208 of the Omnibus Budget Reconciliation Act of 1981 (Pub. L. 97-35).

Social Security↗