[Medical assessment of disability for Swiss disability insurance].
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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.
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.
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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).
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These proposed regulations, which are based on Pub. L. 96-473, place certain restrictions on the payment of benefits based on disability and student status to persons who have been convicted of a felony and are imprisoned and restrict the use of certain impairments in determining disability. These proposed rules specify the conditions under which benefits will not be paid to these individuals and how a finding of disability may be affected when an impairment, or the aggravation of a preexisting impairment, arises during the commission of a felony or imprisonment. Before the enactment of Pub. L. 96-473, there were no restrictions upon the payment of benefits or the making of disability determinations for these persons.
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In a deregulated market characterised by increasing competitiveness and improved conditions, care in assessing proposals in additional disability benefits will take on an even more significant role. The assessment has to be based on overall analysis of the moral and objective risk. This entails risk assessment of financial, professional, economic and medical factors, and should also include experience gained from the specific area of benefits involved. In terms of getting closer to our clients, the possibilities of limiting risk should be offered to an increasing extent on an individual, transparent and differentiated basis. Despite every effort to exercise caution, the time factor, i.e. the speed required to issue policies, should not be forgotten.
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