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PubMed1982

Medical ramifications of the federal regulation of the Social Security Disability Insurance program: Social Security and medicine.

Social Security Disability Insurance is a federally created and regulated insurance plan. The definition of disability as it relates to work capacity is exclusively the purview of government administrators. The primary physician's opinion has little, it any, impact on decision. Administering this insurance scheme requires the quantification of illness as it relates to work capacity (disability). What has evolved is a program that insures for the amount of "disease." The assumption is that with more disease, there is a greater likelihood of illness, even illness manifest as work incapacity. Leaving this underlying assumption tacit is responsible for the adversary climate that envelops the physician, the patient-claimant, and the administrators. It is also responsible for the paucity of clinical investigations into the critical issue of the amount and form of illness a diseased person will have.

Arthritis, Rheumatoid↗
PubMed1996

Occupational disease surveillance using disability insurance at an automotive stamping and assembly complex.

Sickness and accident-insurance (sick leave) claims at an automotive stamping and assembly complex were analyzed using Poisson regression over a 4-year period to identify occupational health problems. The incidence of lower-respiratory disability (excluding asthma) was higher in painting operations (rate ratio [RR] = 2.9, 95% confidence interval [CI] = 1.2 to 6.8), and final assembly and processing areas (RR = 2.7, 95% CI = 1.0 to 7.4) at the assembly plant, and in metal assembly (welding) areas (RR = 2.8, 95% CI = 1.4 to 5.7) at the stamping plant. Disability rates for upper-extremity musculoskeletal disorders were statistically significantly higher (RR = 3.1 to 3.8) in major assembly plant production areas, as were back disability rates (RR = 1.5). During the first 6 months of new work assignments in painting or final assembly, respiratory problem rates were four times higher than in other areas. Upper-extremity musculoskeletal rate ratios ranged from 4.4 to 5.7 for new assignments in body, hard trim, and chassis areas. Higher rates in new assignments appeared to result from assignment changes precipitated by developing health problems, or from routine assignments to new tasks, some of which conferred high risk and were tolerated for less than 6 months. Musculoskeletal disability was consistent with known ergonomic hazards and paralleled that reported on the Occupational Safety and Health Administration log. Work-related musculoskeletal and other problems can be readily identified from disability insurance claims without dependence on plant medical visits or workers' compensation records. Disability insurance appears to absorb considerable work-related medical and absence costs.

Accidents, Occupational↗
PubMed1996

[Variations in referral to specialized medical centers of the Swiss disability insurance: role of the referring party].

The Commissions of the Swiss Disability Insurance (CDI), in order to evaluate the degree of disability which determines the right to benefits, can call upon Medical Observation Centers (MOCD) for a pluridisciplinary examination. The utilization rate of the MOCD, by the 28 CDI, varies by a factor of 1 to 50. The goal of this study is to identify the causes of this variation related to the differences in CDI practice. The CDI answered a mail survey. For analysis, they are allocated into 3 groups of equal size: Low, medium and high users of MOCD. There is no association between the use of the official and non-official criteria for referral to MOCD and utilization rate of the MOCD. The CDI have a false perception of their MOCD use; 40% of them underestimate it. Considering together the utilization rate of the substitutes and of the MOCD, variation still persists from 1 to 9 among the CDI. There is no difference in the reasons for non-referral to the MOCD according to the level of utilization. This study failed to identify the causes of the utilization differences of the MOCD by the CDI. Other factors should be examined.

Eligibility Determination↗
PubMed1976

[Minimal early-childhood brain damage in the pediatric practice and disability insurance].

In modern practice the pediatrician is called upon daily to take preventive, curative and rehabilitative action in children with cerebro-organic and psychosocial risk factors: 1. Eearly diagnosis of handicaps by POLTIBAC on the occasion of individual vaccinations and infectious diseases. 2. Fitness programs for infants to improve the mother-child relationship and reduce frustrations in children's homes and day nurseries. 3. Psychohygiene and mini-psychotherapy of ambivalent mothers during every pediatric consultation. The pediatrician's second patient is the mother. 4. The self-help mentality in pediatrician, parents and educationists assumes increasing importance as economy cames to rule pediatric practice in view of the cost explosion in the health sector. 5. In the Canton of St. Gall increasing numbers of children with cerebral lesions have been registered with the Disablement Insurance since 1970: in 1972 12%, in 1973 14% and in 1974 19% of first-registered minors. Since 1961 all definitely cerebral motor disorders have been registered with the Disablement Insurance, and since 1971 the infantile psychoorganic syndrome and questionable minimal "dyskinesias" have also been registered. The diagnostic and therapeutic costs for infantile minimal brain lesions according to Disablement Insurance tariffs are computed.

Adolescent↗
PubMedDate not supplied

Increased physician disability claims causing 'crisis'. High utilization of disability insurance may leave physician groups fewer options in the future.

With physician claims on the rise, disability insurers are adjusting rates, provisions and benefit plans that are offered to those in the medical field. Physicians are being hit the hardest, experiencing premium increases, benefit reductions and stricter qualifications for coverage. There are only a few carriers who have not changed their rate structures and benefit plans. Now is the time to review the quality of your disability programs and establish how your carrier is reacting to this trend.

Disability Evaluation↗
PubMed1991

An intergenerational policy proposal for the 1990s: applying the temporary disability insurance model to family caregiving.

This paper proposes a new policy initiative to assist family caregivers at a time when major demographic shifts in both the family and the workplace have taken place. Women especially are in the position of having to balance both work and family responsibilities without proper assistance. The initiative is based on an expansion of the Temporary Disability Insurance (TDI) model, to include care of family members of all ages by providing an adequate wage replacement. The shifting dependency ratio, resulting in a shrinking caregiver pool, is discussed as well as existing policies and their short-comings. For example, no current policies provide paid leave. The evolution of TDI, including resistance to it, is examined. Finally, Massachusetts' abortive attempt at a comprehensive plan for employment-leave insurance is discussed in detail and policy recommendations are outlined.

Adult↗
PubMed1999

Industry, occupation, and disability insurance beneficiary work return.

This article uses the New Beneficiary Data System to describe the first job held after award of Disability Insurance benefits, in terms of occupation and industry. It examines work activity within sectors of employment, and looks at the issues of whether work return in certain industries and occupations varies according to the demographic characteristics of the beneficiaries. The article also presents data on sector-specific employer accommodations that can aid in sustained work return. Postentitlement work was fairly evenly distributed across occupational and industrial sectors. Persons with higher levels of educational attainment were found to be in white-collar employment sectors. There were noticeable differences in the availability of employer accommodations across postentitlement occupations and industries.

Adolescent↗