ADA. Insurance coverage for disabilities doesn't have to be equal.
Explore the source record for details and available documents.
AIDS Serodiagnosis↗
SEARCH · Search PubMed
Results for “Insurance, Disability”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
[The mentally ill and disabled-stepchildren of rehabilitation].
The institutions traditionally catering for the mentally ill and disabled are more and more turning into Psychiatric Hospitals (Clinification). Efforts are being concentrated on treatment and therapy, while a majority of the chronically ill and disabled are placed in nursing homes for their long-term care (and are pensioned prematurely). Though an extensive network of rehabilitation facilities has been developed in the Federal Republic of Germany, and although social legislation has provided for equal status of the mentally ill and disabled with other ill or disabled persons, only a negligibly small number of patients from psychiatric facilities are given the opportunity for participating in rehabilitative measures. This arises from the fact that the present range of facilities has in the fist line been developed according to the rehabilitational needs of people with physical disability, and from a reluctance on the part of the agencies financially responsible for rehabilitation services and benefits (with the exception of social welfare) to honour this social legislative title of their mentally ill or disabled insured (except for patients with dependence problems and neuroses). As the official disability statistics, too, usually negate the specificity of mental illness and disability the problematic issue does not emerge openly.
Persons with Disabilities↗
Disability patterns among SSI recipients.
In December 1993, about 3.8 million persons under age 65 received Supplemental Security Income (SSI) payments because of a disability. More than half of these recipients had some form of mental disorder. In recent years, the number of disabled SSI recipients has climbed sharply. At the same time, there has been a change in the disability patterns among these recipients. The proportion of recipients with mental disorders, particularly those with psychiatric illness, is increasing steadily. Many of these recipients enter the SSI program in their youth and may stay in the program for many years. Similar increases and disability patterns in the Social Security Administration's Disability Insurance (DI) program imply program related causes, including recent changes to the disability requirements and outreach efforts. These changing disability patterns have implications for the size and shape of future SSI caseloads.
Adolescent↗
Disability benefits: what is the Social Security Administration thinking?
This article briefly describes decision-making standards and procedures used by the Social Security Administration in adjudicating disability insurance benefits claims. Correlatively, the article addresses and dispels some of the myths surrounding various outcomes of disability claims. It also describes the role of the treating physician and how a treating physician who wants to help his or her patient obtain disability benefits should respond to Social Security's requests for medical records and written reports.
Adult↗
Social Security Disability Benefits Reform Act of 1984: legislative history and summary of provisions.
This article describes the legislative history of the Social Security Disability Benefits Reform Act of 1984 (Public Law 98-460), and contains a summary of the provisions in the new law. Major provisions include: standards for continuing disability reviews (CDR's) of disability insurance (DI) beneficiaries and supplemental security income (SSI) recipients who get payments based on disability or blindness; the right of a DI beneficiary or an SSI recipient to have payments continued during appeal of a CDR decision to an administrative law judge that disability or blindness has ceased; and suspension of CDR's of mentally impaired persons until the evaluation criteria for mental impairments are revised. The new law was enacted in response to problems that arose as a result of the implementation by the Social Security Administration (SSA) of a provision in the 1980 disability amendments that required periodic CDR's. In enacting the new law, Congress intended to assure more accurate, consistent, and uniform disability decisions at all levels and equitable and humane treatment not only to beneficiaries who must undergo CDR's but also to new applicants for DI benefits or SSI payments based on disability or blindness.
Blindness↗
[Fibromyalgia (generalized tendomyopathy) in expert assessment. Analysis of 158 cases].
MEDAS-agencies are medical institutions within the Swiss Disability Insurance, which specialize in assessing the working capacity of candidates who apply for a disability pension. Degenerative and other chronic pain disorders of the musculoskeletal system form the majority of cases that we investigate. Fibromyalgia is one of our most frequent diagnoses (8.6%). We become involved in cases on average 8.5 years after the first onset of painful symptoms and on average 2.5 years after the patients have ceased to work. Our experience, tells us that fibromyalgia is usually associated with psychological disturbances; thus our psychiatrists have found important psychological problems in 86.7% of applicants. They found mainly neurotic and depressive syndromes. Our investigations have shown that psychological disturbances precede the onset of musculoskeletal pain in about 70% of patients. Therefore, we don't consider fibromyalgia syndrome as an entity of its own, but regard it as a pain syndrome in which there are underlying psychological problems in most cases.
Adult↗
Uncovering the health challenges facing people with disabilities: the role of health insurance.
Americans with disabilities have wide-ranging health care needs and face serious challenges in the health care system. This 2003 survey of 1,505 nonelderly adults with disabilities finds relatively large shares of people with disabilities reporting cost-related barriers to care. The study also reveals marked differences in cost-related experiences both between those with and without health insurance and across sources of coverage. These findings suggest the need for additional research, along with policies to provide health insurance to people with disabilities who lack coverage, to fill gaps in coverage among those with Medicare and private insurance, and to maintain coverage for Medicaid enrollees amid rising costs and state budget shortfalls.
Adolescent↗
[ON DISABILITY EVALUATION, STATE INSURANCE SERVICE AND STATE INSURANCE SERVICE PHYSICIANS].
Explore the source record for details and available documents.
Disability Evaluation↗
Paying for the Medicare program.
Although the hospital insurance (HI) trust fund acted as a source of strength for the old-age, survivors, and disability insurance program during its recent financial crises, projections by HCFA and CBO reveal that the Medicare program will experience financing problems of its own within the next decade. No one would argue that Medicare's financing problems should be solved simply by raising more money. However, the prospect of insolvency in the HI trust fund and the increasing strain on general revenues from the Supplementary Medical Insurance trust fund require policymakers to survey the options for increasing Medicare revenues while cost-control devices are being developed. Indeed, even if cost-control efforts are completely successful, additional revenues may be needed in the future to finance new initiatives in the Medicare program. Therefore, this paper will look briefly at current efforts to regain control of soaring hospital and physician costs and then examine some of the more feasible options for increasing Medicare revenues.
Aged↗
The functional IME: A linkage of expertise across the disability continuum.
Disability assessment remains a significant challenge especially in welfare systems like workers' compensation and disability insurance. Many of today's managed care strategies do not impact on the seminal issue of return to gainful employment. Employers, insurers, attorneys and case managers routinely request independent medical examinations (IMEs) as a means of determining degree of disability, functional limitations, work restrictions and "estimated" physical capacities. However, this approach is limited because physicians are not trained in the functional model of disability assessment. IMEs address pathology and impairments which represent a portion of the disability continuum described by the World Health Organization, Nagi, Guccione and others [e.g. pathology-impairment-disability-handicap]. Functional capacity evaluations or FCEs are often performed by physical and occupational therapists who are trained in a function-based model of disability assessment. Unlike an IME physician who completes "Estimated Physical Capacities", therapists measure actual physical functioning. The value of both IMEs and FCEs can be enhanced through a "functional IME" that combines both models; medical-based examination and a function-based disability evaluation. This combination enhances the assessment of the relationship of pathology to impairment and impairment to disability status especially, in musculoskeletal disorders which tend to drive costs in workers' compensation.
Humans↗
Does U.S. federal policy support employment and recovery for people with psychiatric disabilities?
Evidence suggests that a high percentage of people with a psychiatric disability can recover--find meaningful work, develop positive relationships, and participate fully in their communities. Evidence also suggests that work is an essential component of recovery. However, few people with a serious psychiatric disability are actually employed and most of those who are employed work only part-time at barely minimum wages. To assess the impact of federal programs such as Social Security Disability Insurance, vocational rehabilitation, medical insurance, and psychiatric services upon employment, we conducted a qualitative study of 16 employed and 16 unemployed individuals with psychiatric disabilities. All of our participants had disabilities severe enough to qualify them for Social Security Disability benefits. They told us that current federal policies and practices encouraged employment and integration of only a few participants, in a particular stage of their recovery, and placed significant barriers in the employment path of others.
Adult↗
Is early intervention worth it?
Historically, the largest components of costs associated with rheumatoid arthritis (RA), the most common inflammatory rheumatic disease, were hospitalizations, principally for joint replacement surgery, and work loss. Thus, for expensive interventions such as biological agents to be "worthwhile," they must reduce the prevalence of joint replacement and assist persons with RA in maintaining employment. However, joint replacement surgery and work losses tend to occur at least several years after onset of disease, even in severe cases. Assessing the cost-effectiveness of expenditures becomes computationally and politically difficult when the expenditure and the outcome are separated in time. The computational issue concerns the translation of future benefits--surgeries avoided and jobs held onto years from now--into present monetary values. The computational issue may be even more complex when the benefits are less tangible than surgery and wages; for example, when measured by quality-adjusted life-years. The political issue concerns the disjuncture between the agents making the expenditures--provincial health insurance in Canada or an employer's health plan in the US--and the agents reaping the benefits, a private disability insurance company or provincial or state workers' compensation fund. In addition, there is an ethical dilemma. In the US, many of the advances in the care for RA such as the biological agents derive, at least in part, from federal research expenditures. Such expenditures are financed by increasingly regressive taxes. Yet the individuals bearing an increasing share of the tax burden find themselves relegated to more restrictive health insurance plans less likely to provide access to those agents. Thus, whether expenditures for early interventions are worthwhile may turn on such issues as how long the expenditure and the benefits are separated in time, how well the interests of the agent making the expenditure and the agent reaping the rewards are aligned, and how equitable the financing of the benefit and the access to it.
Arthritis, Rheumatoid↗
A longitudinal perspective on entitlement income among homeless adults.
OBJECTIVE: Sources of entitlement income were examined in a sample of homeless adults to determine whether certain subgroups more consistently obtain entitlement income and are more likely to continue receiving it over time. METHODS: From a baseline sample of 564 homeless residents of Alameda County, California, 397 were interviewed at both five- and 15-month follow-ups. Information was obtained on income received from public sources in the 30 days before each interview, including general assistance, Aid to Families With Dependent Children (AFDC), Supplemental Security Income, or Social Security Disability Insurance. Data were also obtained on psychiatric diagnosis, race, marital status, education, duration of homelessness in adulthood, household status, and reported disability. RESULTS: At baseline fewer than half of the respondents were receiving any entitlement income. The benefits of almost half of the AFDC and general assistance recipients were terminated during the 15-month period. Respondents who continued receiving entitlement income over the 15-month period were more likely to be black, to be women alone or with children, to have a family history of receiving welfare, and to report a disability. Respondents with dual disorders were six times more likely than others to have their benefits terminated. CONCLUSIONS: Entitlement income is tenuous for many homeless adults, particularly those with dual diagnoses.
Adult↗
Postrecovery experience of disabled-worker beneficiaries.
This study followed a 1972 cohort of newly entitled beneficiaries from January 1, 1981, when they left the Disability Insurance program because of a recovery, to June 1986. This recovery group represents about 11 percent of the cohort of disabled-worker beneficiaries entitled in 1972. Three outcomes or next events were of specific interest: Return to the DI program, death, and attaining age 62 (considered retirement for the purposes of this study). The tendency toward reentitlement and the tendency toward death were modeled and then combined with retirement age to project the percentages of recovered beneficiaries who end the postrecovery period by reentitlement, death, or retirement. About 43 percent of these recovered beneficiaries are expected to become reentitled some time after leaving the program, and 52 percent are expected to reach retirement age before dying or becoming reentitled. Of the 43 percent projected too return to the program, 23 percent are expected to become reentitled within the first 5 years of recovery. The tendency to return to the DI program drops sharply at the fifth year of the postrecovery period. There may be program-based reasons for this pattern. The Social Security Amendments of 1980 may provide incentives to return to the DI program within 5 years. When covariates were examined, the covariate PIA had a strong effect on the reentitlement tendency. For those in the high PIA group ($500 or more), it is projected that 65 percent will return to the DI program. This projection is considerably higher than the 34 percent projection for those in the low PIA group (less than $500). Projected median time to reentitlement is quite different for the two PIA groups. The median time to reentitlement is 10 years for the low PIA group and only 3 years for the high PIA group. The PIA was also important in modeling the death tendency as the next event in the postrecovery period. For those in the low PIA group, death is the next event projected for 3 percent of the individuals; in the high PIA group, the projected proportion is 11 percent. It is suspected that the PIA may be acting as a proxy for the severity of the disabling condition, but this hypothesis cannot be tested with the available data. These descriptions of the reentitlement and death tendencies and the project percentages provide a global picture of the DI program reentitlement process. Further research will continue by comparing this pre-1980's cohort with a later cohort and studying the causal mechanisms underlying the recovery and reentitlement processes.
Adult↗
Geographic patterns of disability in the United States.
Geographic patterns of county prevalence rates of disability benefit receipt are shown for the Social Security Administration's Disability Insurance (DI) and Supplemental Security Income (SSI) programs. Prevalence rates were calculated by dividing each county's December 1990 DI and SSI disability caseloads by the population aged 18-64 for that year in that county. Separate maps were also constructed for men and women recipients. Areas with the highest overall DI prevalence rates included Appalachia, the Southeast Coastal Plains, the Mid-south, northwestern Montana, the coastal counties of Washington, and isolated counties of the Southwest. Areas with the highest SSI prevalence rates included the Mississippi Delta, scattered counties in Oklahoma, the Missouri "Boot Heel," parts of Appalachia, isolated counties in South and North Dakota, the "Four Corners" regions of the Southwest, the Sacramento and San Joaquin Valley regions of California, isolated parts of the upper Great Lakes States, northern Maine, and the coastal region of southwestern Alaska. Disability prevalence rates were also calculated for the overall population and by sex for each of the 10 U.S. Department of Health and Human Services administrative regions.
Adult↗
[Degenerative diseases of the spine and their effect on work capacity].
The most frequent diseases of the locomotive system encountered in assessing the ability to work are discussed. From 1981 to 1982, the investigation was carried out on insured persons with pathologic changes in their locomotive system. The subjects belonged to three different environments, thus, making three representative samples. The clinical data on the insured persons of sample N1 were supplied through the past medical history, clinical examinations of the insured persons and from the survey of the medical documentation. The data on the sample N2 and N3 were obtained from the Central Service Information Centre of the Community for Pension and Disability Insurance of Croatia, Zagreb. Degenerative changes in the locomotive system (70%), primarily in the spine (90%), appeared most frequently in all the three samples, and were practically on the same percentage level. After analysing the assessments of the ability to work of all the insured persons with degenerative spine changes, it was found out that there were significant qualitative and quantitative differences in the disability evaluations for all the three samples. The author concludes that significant deviations in the scale of the ability to work assessment are considerably due to various assessment criteria.
Female↗
International trends in disability program growth.
The steep growth in the number of beneficiaries under the U.S. Social security Disability Insurance program during 1966-77 has aroused interest in learning whether programs abroad experienced similar expansion. This article presents the gross rate of disability incidence in five European programs and explores termination rates (for recovery and death) in three of those programs. Factors underlying growth patterns are also discussed. Findings show that the gross disability incidence rate increased in the Belgian and Finnish programs from the late 1960's and in the programs of the Federal Republic of Germany, the Netherlands, and France From the early 1970's, tapering off in all five countries studied by the mid-1970's. Gross recovery- and death-termination rates declined continuously in the Dutch and the Finnish programs. For all countries in this study, changes in the definition of statutory disability and changes in other program provisions, economic conditions, demographic patterns, and public awareness and attitudes were the major causes of expansion. Adequate explanations to account for the recent slackening off in program growth, however, are lacking.
Belgium↗
Disability and welfare--who wants it?
Over 4 million people under the age of 65 currently receive Social Security Disability Insurance (DI) benefits or Supplemental Security Income (SSI). Research on these groups is limited. The charts of 284 patients referred for psychiatric evaluation by Disability Determination were examined. Of this group, 148 (52%) were psychotic: 61 (41%) had schizophrenia, 37 (25%) depression, 27 (18%) undiagnosed psychosis, and 23 (16%) mania. Chronic medical illness was present in 27 (73%) of the depressives, but only 9 (8%) of the other three groups. Implications of these findings are discussed.
Bipolar Disorder↗