Read Full Report

Date: July 2, 2002
Contacts: Christine Stencel, Media Relations Officer
Chris Dobbins, Media Relations Assistant
(202) 334-2138; e-mail <>


Publication Announcement

Social Security Disability Programs Need Fundamental Change

For more than 50 years, the Social Security Administration's (SSA) disability programs have provided a financial safety net for Americans unable to work because of disabling conditions. However, changes in the demographics of claimants over time and a rapid, unexpected surge in the beneficiary rolls have seriously strained the agency's staff and resources, causing backlogs in the processing of claims and appeals, and contributing to inconsistencies in eligibility decisions. Recognizing that the situation will only worsen as baby boomers reach ages at which disabilities are more likely, SSA in the mid-1990s embarked on a major effort to manage the programs more effectively. Its principal goals were to re-engineer the claims system, including redesigning the eligibility determination process, and to estimate the current and potential numbers and characteristics of people with work disabilities through a national survey.

If SSA is to continue to adequately serve the ever-growing rolls of beneficiaries, it desperately needs to fundamentally rethink its systems and services, says a new report from the National Academies' Institute of Medicine and National Research Council. The agency should create a long-term research program to explore what is needed to address increasing demands and to provide the basis for improvements in the disability determination process. In addition, an ongoing monitoring system, rather than a single survey, is essential to understand the changing population of people with work-related disabilities and predict their likelihood of applying for benefits.

The report presents the results of an expert committee's review of SSA's plans for redesigning the eligibility determination process and developing a national survey of disability. It provides feedback on the design and content of SSA's proposed survey, including sample size and distribution, data collection and response rates, and clarity and validity of questions. The agency should undertake research to develop a full understanding of work disability, including factors in both the social and physical work environments that affect people's ability to work. Also, adequate time and resources should be devoted to research, develop, and field-test SSA's proposed complex national survey. However, because analysts and policy-makers need continuous, up-to-date information to manage and adapt the programs to the changing needs of claimants, the agency should develop a permanent work-disability monitoring system consisting of regular national surveys and a smaller set of core measures to be used between surveys, the report says.

In reviewing SSA's plan for improving the disability determination process, the committee called for establishing objective criteria to measure the performance of the existing system and whether proposed changes would lead to improvements. It also pointed out the need to evaluate how certain factors such as age, work experience, and education may influence a person's ability to work or adapt to disabilities. SSA also should initiate a research program to test models that emphasize rehabilitation and return to work in the context of providing benefits. However, without the infusion of new resources -- of both dollars and qualified and diverse researchers -- SSA will not be able to make the changes necessary to address the needs of Americans with disabilities.

A committee roster follows. The study was sponsored by the Social Security Administration. The Institute of Medicine and the National Research Council are private, nonprofit organizations that provide advice on science and health policy issues under a congressional charter granted to the National Academy of Sciences.

Read the full text of The Dynamics of Disability: Measuring and Monitoring Disability for Social Security Programs for free on the Web, as well as more than 1,800 other publications from the National Academies. Printed copies are available for purchase from the National Academy Press Web site or by calling (202) 334-3313 or 1-800-624-6242. Reporters may obtain a pre-publication copy from the Office of News and Public Information (contacts listed above).

[This announcement and the report are available at]

Board on Health Care Services


Division of Behavioral and Social Sciences and Education

Committee to Review the Social Security Administration's Disability Decision Process Research

Dorothy P. Rice (chair)
Professor Emeritus
Department of Social and Behavioral Sciences
Institute for Health and Aging
University of California
San Francisco

Monroe Berkowitz, Ph.D.
Professor of Economics, Emeritus, and
Disability and Health Economics Research
Rutgers University
New Brunswick, N.J.

Ronald S. Brookmeyer, Ph.D.
Professor of Biostatistics
Bloomberg School of Public Health
John Hopkins University

Marshal F. Folstein, M.D.
Chairman and Professor of Psychiatry
Tufts University School of Medicine, and
New England Medical Center

Robert M. Groves, Ph.D.
Survey Research Center
University of Michigan
Ann Arbor, and
Senior Research Scientist
Joint Program in Survey Methodology
University of Maryland
College Park

Alan M. Jette, Ph.D.
Professor and Dean
Sargent College of Health and Rehabilitation Sciences
Boston University

William D. Kalsbeek, Ph.D.
Professor of Biostatistics and Director
Survey Research Unit
University of North Carolina
Chapel Hill

Jerry L. Mashaw, L.L.B., Ph.D.
Sterling Professor of Law and Management, and
Institute for Social and Policy Studies
Yale University
New Haven, Conn.

Catherine Maslow, Ph.D.
Initiatives on Managed Care and Acute Care
Alzheimer's Association
Washington, D.C.

Donald L. Patrick, Ph.D., M.P.H.
Professor of Health Services, and
Social and Behavioral Sciences Program
School of Public Health and Community Medicine
University of Washington

Harold A. Pincus, M.D.
Executive Vice Chairman
Department of Psychiatry
School of Medicine
University of Pittsburgh, and
Senior Scientist

Edward H. Yelin, Ph.D.
Professor of Medicine and Health Policy
Department of Medicine and Institute for Health Policy Studies
University of California
San Francisco


Gooloo Wunderlich, Ph.D.
Study Director

Nicole Amado
Research Associate