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PubMed2000

Federal old-age, survivors and disability insurance and Supplemental Security Income for the Aged, Blind, and Disabled; medical and other evidence of your impairment(s) and definition of medical consultant. Social Security Administration. Final rules.

We are revising the Social Security and Supplemental Security Income (SSI) disability regulations regarding sources of evidence for establishing the existence of a medically determinable impairment under title II and title XVI of the Social Security Act (the Act). We are doing this to clarify and expand the list of acceptable medical sources and to revise the definition of the term "medical consultant" to include additional acceptable medical sources.

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↗
PubMed2000

Federal old-age, survivors, and disability insurance and supplemental security income for the aged, blind, and disabled; evaluating opinion evidence. Social Security Administration. Final rules.

We are revising the Social Security and Supplemental Security Income (SSI) regulations concerning the evaluation of medical opinions to clarify how administrative law judges and the Appeals Council are to consider opinion evidence from State agency medical and psychological consultants, other program physicians and psychologists, and medical experts we consult in claims for disability benefits under titles II and XVI of the Social Security Act (the Act). We are also defining and clarifying several terms used in our regulations and deleting other terms.

Expert Testimony↗
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↗
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↗