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Federal old-age, survivors, and disability insurance; listing of impairments--mental disorders--SSA. Proposed rules.

These proposed amendments revise the medical evaluation criteria for mental disorders for the disability program in title II and title XVI of the Social Security Act. No substantial revisions have been made to these criteria since 1979. The proposed revisions reflect advances in medical treatment and in methods of evaluating certain mental impairments, and will provide up-to-date medical criteria for use in the evaluation of disability claims based on mental disorders.

Disability Evaluation↗

Experiments and demonstration projects under the disability insurance and supplemental security income programs--Social Security Administration. Proposed rule.

The Social Security Administration (SSA) is proposing to amend its regulations to implement section 505 of the Social Security Disability Amendments of 1980 (Pub. L. 96-265). That section requires the Secretary to conduct experiments and demonstration projects to test alternative conditions and limitations for stimulating the return to work of disabled title II beneficiaries and to otherwise improve the administration of the title II disability program. To the extent necessary to thoroughly evaluate these alternative methods, the Secretary may waive compliance with benefit requirements under titles II and XVIII of the Social Security Act. Section 505 also authorizes the Secretary to waive or add to the requirements, conditions, or limitations in title XVI of the Act to the extent necessary to conduct experimental, pilot, and demonstration projects which are likely to promote the objective or improve the administration of the SSI program.

Eligibility Determination↗

[Degree of disability of demented patients as judged by relatives and experts (disability insurance)].

Health insurance companies commission medical expert opinions rating the severity of clinical improvement in order to provide adequate nursing support. We compared these ratings on 28 demented patients with the ratings from carers and with our own examination. The results indicate that the expert opinions underestimated the severity of improvement and adequate support in some of the cases. We discuss whether these discrepancies may be due to the peculiarities of dementia.

Aged↗

Work while receiving disability insurance benefits: additional findings from the New Beneficiary Followup Survey.

From the foregoing analyses, the following picture emerges about persons who work after award of DI benefits: Almost one-quarter of the sample population attempted to reenter the labor force in the 10-year NBS-NBF period. The higher the level of education, the greater the proportion of persons who worked. Younger beneficiaries were more likely to work than older beneficiaries. About half of the beneficiaries who worked did so on a full-time (40-hour-or-more per week) basis. Most beneficiaries worked because of financial need. The profile of reasons for working did not vary across demographic groups and aspects of the first job held. Most beneficiaries began working without attributing this decision to an improvement in their health. Individuals pursued different methods of job search. No single approach emerged as the most successful. Job search modes did not vary for different groups and different jobs. Four activities were most likely to lead to job offers: persons checking where they had worked before, asking a friend, answering an ad, and following up a vocational rehabilitation lead. These findings were not conclusive because small numbers of persons engaged in these activities. Thirty percent of DI workers returned to their preentitlement employer. The beneficiaries' first postentitlement jobs had less exertion, fewer hours, and lower pay than did their job held prior to award. The likelihood of working was the same across a broad range of disabling health conditions. In terms of work return policy, formal work return programs aimed at young beneficiaries and those with higher levels of educational attainment would produce the greatest number of job placements. It appears that no targeting of programs is necessary along gender lines. The anomalous finding of an absence of the relationship between improvement in health and labor-force reentry requires further investigation. Any followup in this area of inquiry should plan to have the data collected close to the time of postentitlement job entry.

Adolescent↗

[Medical rehabilitation of disability insurance--determination of the status and future perspectives].

The legal prerequisites for medical rehabilitation offered by the pension insurance institutions are described. The definition of position includes the attitude towards applying for rehabilitation and its repercussions on the selection of rehabilitation, specific questions with regard to expert opinion, the indications for general medical rehabilitation measures and the changes within the concept of rehabilitation. Future possibilities are shown. Some examples of rehabilitation measures relating to specific indications are chosen to demonstrate successes and problems in this regard. Finally, the present state of research in rehabilitation and its future development are considered.

Chronic Disease↗

[Treatment and glycemic control of 1200 diabetic patients enrolled at the National Institute of Disease-Disability Insurance diabetes convention].

We have studied the characteristics of insulin therapy and home blood glucose monitoring of 1.200 diabetic patients (590 males, 610 females), mainly type I adults (age: 43 +/- 19 years, mean +/- 1 SD), attending a licensed diabetes center in Belgium which benefits from a National Health Service convention system for providing education and home blood glucose monitoring kits and disposables to diabetic subjects. 50% of these patients were treated with 2 daily insulin injections, while 22% were treated with 3 and 24% with 4 daily injections. 4% of the subjects were treated with a continuous subcutaneous insulin infusion. Patients treated with four daily injections were younger than those treated with other insulin schemes (p < 0.001). Home blood glucose monitoring strip consumption was 2.2 patient-1 day-1. The mean HbA1C level was 8.63 +/- 1.55% [8.54 +/- 1.46 in males and 8.72 +/- 1.62% in females (NS)]. In more than one third of the subjects treated with injections, HbA1C was lower than 8% HbA1C was also below 8% in 50% of patients using 1100-1200 strips year-1.

Adolescent↗

Federal Old-Age, Survivors, and Disability Insurance benefits annual earnings test--Social Security Administration. Proposed rule.

These proposed regulations reflect recent statutory amendments which delay for one year (from January 1982 until January 1983), for all except a very small number of individuals who file their tax returns on a fiscal year basis, full-implementation of section 302, Pub. L. 95-216, the Social Security Amendments of 1977. Section 302 reduced from 72 to 70 the age at which social security beneficiaries are no longer subject to an earnings test.

Age Factors↗

Federal old-age, survivors and disability insurance computation of benefits under totalization agreements--SSA. Notice of proposed rulemaking.

Section 233 of the Social Security Act (the Act) authorizes the President of the United States to enter into Social Security agreements with foreign countries which permit the establishment of entitlement to benefits under title II of the Act by combining periods of coverage under the United States (U.S.) system and the system of the foreign country with which the U.S. has such an agreement. This process is called "totalization." We have gained a considerable amount of experience under the rules (Section 404.1918) for computing a totalization benefit while implementing the three agreements now in effect. That experience has shown that those rules are difficult to administer and that they can cause some undesirable results for benefit applicants. The rules also make it difficult to negotiate and implement additional agreements. In order to avoid administrative problems and other undesirable results we are proposing a new U.S. totalization benefit computation method which uses neither foreign earnings nor foreign coverage.

Eligibility Determination↗

Federal Old-Age, Survivors, and Disability Insurance; coverage of employees of private nonprofit organizations--SSA. Proposed rules.

These proposed rules implement sections 102, 321, 322 and 323 of Pub. L. 98-21 (the Social Security Amendments of 1983). Generally, these provisions: (1) Mandatorily cover for Social Security purposes employees of private nonprofit organizations; (2) Provide additional Social Security coverage for certain work performed outside the United States (U.S.); (3) Provide coverage under the Social Security program for certain foreign earned income; (4) Provide special Social Security insured status requirements for certain nonprofit organization employees covered as a result of these amendments; and (5) Provide Social Security coverage for employment and self-employment that is identified as "covered" for purposes of title II of the Social Security Act (the Act) by the provisions of a totalization agreement between the U.S. and another country.

Organizations, Nonprofit↗