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Project Information

Project Information

Identifying Disabling Medical Conditions Likely to Improve with Treatment

Project Scope:

In response to a request from the Social Security Administration (SSA), the Health and Medicine Division (HMD) of the National Academies of Sciences, Engineering, and Medicine (the National Academies) will conduct a study to identify disabling medical conditions that are likely to improve with treatment. Of particular interest, for this study, are those long-lasting conditions (12 months or more) in the categories of mental disorders, cancers, and musculoskeletal disorders only.

Specifically, the National Academies will convene a committee to:

1.    Identify and define the professionally accepted, standard measurements of outcomes improvement for medical conditions noted in #2 below;

2.    Identify specific, long-lasting (12-month duration or longer) medical conditions for adults in the categories of mental disorders (such as depressive disorders, anxiety disorders, attention-deficit/hyperactivity disorder), cancers (such as breast, skin, thyroid), and musculoskeletal disorders (such as disorders of the back, osteoarthritis, other arthropathies), that are disabling for a length of time, but typically (for most people with the condition) do not result in permanently disabling limitations, are responsive to treatment, and, after a specific length of time of treatment, improve to the point at which the conditions are no longer disabling; and

3.    For the conditions identified in Objective 2 (above): 
a.    Describe the professionally accepted diagnostic criteria, and the average age of onset and the gender distribution, for each condition; 
b.    Identify the types of medical professionals involved in the care of a person with the condition;
c.    Describe the treatments used to improve a person’s functioning, the settings in which the treatments are provided, and how people are identified for the treatments; 
d.    Describe the length of time from start of treatment until the person’s functioning improves to the point of which the condition is no longer disabling and specific ages where improvement is more probable;
e.    Identify the laboratory or other findings used to assess improvement and, if patient self-report is used, identify alternative methods that can be used to achieve the same assessment; and 
f.     Explain whether pain is associated with the condition and, if so, describe the types of treatment prescribed to alleviate the pain (including alternatives to opioid pain management such as non-pharmacological and multi-modal therapies).

Status: Current

PIN: HMD-HCS-18-12

Project Duration (months): 21 month(s)

RSO: Fulco, Carolyn


Board on Health Care Services


Health and Medicine

Geographic Focus:

Committee Membership

Committee Post Date: 01/09/2019

Judith G. McKenzie - (Chair)
Judith McKenzie is Professor, Division Chief, and Residency Program Director in the Department Emergency Medicine, Division of Occupational and Environmental Medicine, at the University of Pennsylvania Perelman School of Medicine where she is active in clinical practice, research, education, and administration. She is also a senior fellow of the Leonard Davis Institute for Health Economics, the Graduate Program in Public Health Studies and the Prevention Research Center. Dr. McKenzie graduated from Princeton University where she was awarded the Frederick Douglass Prize for leadership and scholarship. She went on to study medicine at Yale University School of Medicine where she was selected to be a Commonwealth Fellow. Dr. McKenzie completed her Internal Medicine training at New York University/Bellevue Hospital and her subsequent Occupational Medicine Fellowship training at the Johns Hopkins School of Hygiene and Public Health where she also earned her Masters of Public Health degree and completed the Epidemiology Research Track. She was a recipient of one of the first resident research awards given at the American College of Occupational and Environmental Medicine (ACOEM) national meeting.

Dr. McKenzie is a diplomate of the American Board of Preventive Medicine, Occupational Medicine, and became a diplomate of the American Board of Internal Medicine in 1993. She was honored by ACOEM, an international medical society, when it bestowed upon her its 2015 Kehoe Award for Excellence in Education or Research in Occupational and Environmental Medicine, a lifetime achievement award recognizing an individual who has shown distinction in and made significant contributions to academic excellence or research in the disciplines of occupational medicine (OM), environmental medicine, and/or environmental health. She was recognized in particular for her work and accomplishments as a distinguished educator, specifically for her outstanding leadership as Director of UPenn’s OEM Residency Program, which has resulted in the development of a unique train-in-place program, an innovative model of post-graduate medical education.

Amy Bernstein
Amy Bernstein is currently a health policy and data consultant. She has held various positions in the federal government over the past 40 years. Her last federal position was Policy Director and Contracting Officer at the Medicaid and CHIP Payment and Access Commission (MACPAC). She was also Chief of the Analytic Studies Branch in the Office of Analysis and Epidemiology at the CDC/National Center for Health Statistics. Her education includes a B.A. from Swathmore College, a Master of Health Services Administration from the University of Michigan, and a Doctorate of Science from Johns Hopkins School of Public Health.

Amy Bernstein is currently a health policy and data consultant. She has held various positions in the federal government over the past 40 years. Her last federal position was Policy Director and Contracting Officer at the Medicaid and CHIP Payment and Access Commission (MACPAC). She was also Chief of the Analytic Studies Branch in the Office of Analysis and Epidemiology at the CDC/National Center for Health Statistics. Her education includes a B.A. from Swathmore College, a Master of Health Services Administration from the University of Michigan, and a Doctorate of Science from Johns Hopkins School of Public Health.
Charles H. Bombardier
Charles Bombardier is a board certified clinical psychologist at the Rehabilitation Medicine Clinic at Harborview, head of the Clinical and Neuropsychology Department at UW Medicine and a UW professor of Rehabilitation Medicine.

Dr. Bombardier treats psychological and substance use problems in people with brain or spinal cord injury, multiple sclerosis and other disabilities. He strives to create active partnerships with his patients to achieve the best possible outcomes.

Dr. Bombardier earned his M.S. and Ph.D. from Washington State University. His clinical interests include improving mental, physical and cognitive health, treating depression, pain and physical inactivity and addressing substance abuse in people with physical and cognitive disabilities. His research interests include treating major depression with exercise, counseling or medication and promoting healthy behaviors and reducing substance use in people with physical and/or cognitive disabilities.
Joseph A. Buckwalter, IV
Dr. Joseph A. Buckwalter is professor of Orthopedics and Rehabilitation and Arthur Steindler Chair of Orthopaedics at the University of Iowa. He served as Head of the Department for 14 years and as senior editor of the Journal of Orthopaedic Research for more than 25 years. His clinical practice includes treatment of patients with osteoarthritis, joint injuries and tumors of the skeleton and musculoskeletal soft tissues. He has served as chairman of the American Academy of Orthopaedic Surgeons Council on Research and president of the Orthopaedic Research Society, the American Board of Orthopaedic Surgery, and the American Orthopaedic Association. His research awards include the Kappa Delta Award, the Cabaud Award for Research in Sports Medicine, the American Orthopaedic Association Award for Distinguished Achievement in Orthopaedic Research, the Orthopaedic Research Society and American Orthopaedic Association Alfred Shands Award for Research, and the Orthopaedic Research Society-Orthopaedic Research and Education Foundation Distinguished Investigator Award. He is a member of the Royal College of Surgeons of Edinburgh and the National Academy of Medicine, National Academies of Sciences. His current research involves study of the pathogenesis of post-traumatic osteoarthritis and methods of preventing osteoarthritis following joint injuries. His most recent work shows that mechanically induced chondrocyte metabolic dysfunction has a critical role in the onset and progression of mechanically induced osteoarthritis and that preventing this chondrocyte dysfunction in animal models that simulate human joint injuries minimizes or prevents cartilage erosion following joint injury.
Andrea L. Cheville
Andrea L. Cheville is a Professor of Physical Medicine and Rehabilitation at the Mayo Clinic. Dr. Cheville focuses on the deliver of supportive care services yo optimize the functionality of quality-of-life for patients with cancer in all disease stages. Her research goals are identifying novel strategies to protect critical elements of the lymphatic system during primary cancer treatments and facilitating lymphatic healin in order to reduce risk of developing secondary lymphedema, developing novel models for the delivery of supportive cancer care that overcome traditional logistic, geographic and cost barriers, and clarifying the physiologic mechanisms by which symptom burden physical functioning and stress reciprocally interact in order to develop improved treatment approaches. Dr. Cheville has been an election member of the National Academy of Medicine since 2016.
Lisa Dixon
Lisa Dixon is a Professor of Psychiatry at the Columbia University Medical Center and the director of the Division of Behavioral Health Services and Policy Research within the Department of Psychiatry. She also directs the Center for Practice Innovations (CPI) at the New York State Psychiatric Institute.

Dr. Dixon is an internationally recognized health services researcher with over 25 years of continuous funding from the National Institute of Mental Health and the VA. As CPI director, she oversees activities for the New York State Office of Mental Health in implementing evidenced based practices for persons diagnosed with serious mental illness. She is leading the innovative program, OnTrackNY, a statewide initiative designed to improve outcomes and reduce disability for the population of individuals experiencing their first episode of psychosis.

Dr. Dixon's grants have focused on improving the quality of care for individuals with serious mental disorders with a particular emphasis on services that include families, reducing the negative impact of co-occurring addictions and medical problems, and improving treatment engagement and adherence. Dr. Dixon's work has joined individuals engaged in self-help, outpatient psychiatric care, as well as clinicians and policy makers in collaborative research endeavors. In addition, Dr. Dixon is the current editor of a column in Psychiatric Services dedicated to Public-Academic partnerships. She has published more than 200 articles in peer-reviewed journals and received the 2009 American Psychiatric Association Health Services Senior Scholar Award, as well as the Wayne Fenton Award for Exceptional Clinical Care. In 2014, she received the National Alliance on Mental Illness annual Scientific Research Award.

Annette Fitzpatrick
Annette L. Fitzpatrick, PhD, is an epidemiologist and Research Professor in the Departments of Family Medicine, Epidemiology and Global Health and a former Associate Dean in the School of Public Health at the University of Washington, Seattle. She has been working in the field of aging for over 28 years with a focus on cardiovascular disease (CVD) and its risk factors as well as in dementia and cognitive function. She has been Principal Investigator of 18 studies funded by the NIH or CDC as well as co-investigator in an additional 15 studies. She was the first Program Director for the “Cardiovascular Health Study” (CHS), a multi-site cohort developed to understand risk factors of heart disease and stroke in older adults and is a co-investigator for the “Multi-Ethnic Study of Atherosclerosis” (MESA) designed to assess subclinical CVD in adults of White, African-American, Hispanic and Chinese ethnicity. In 2013 she worked with colleagues at Kathmandu University to begin collection of cardiovascular risk factors in the town of Dhulikhel, Nepal, in the “Dhulikhel Heart Study” (DHS). She has published over 170 papers in peer-reviewed journals.
Jaimie L. Gradus
Jaimie L. Gradus is an Associate Professor Epidemiology at Boston University School of Public Health and an Associate Professor of Psychiatry at Boston University School of Medicine. She received her BA in psychology from Stony Brook University, her MPH with a concentration in epidemiology and biostatistics and DSc in epidemiology at Boston University and her DMSc at Aarhus University. Dr. Gradus’s research interests are in the epidemiology of trauma and trauma-related disorders, with a particular focus on suicide outcomes. She was the winner of the 2009 Lilienfeld Student Prize from the Society for Epidemiologic Research for her paper on the association between PTSD and death from suicide in the population of Denmark. Dr. Gradus has been the recipient of multiple National Institute of Mental Health and foundation grant awards to conduct psychiatric epidemiologic research in both veterans and the general population.
Stephen S. Grubbs
Dr. Grubbs joined the American Society of Clinical Oncology (ASCO) in July 2015 as Vice President of the Clinical Affairs Department after 31 years as a practicing medical oncologist in Newark, Delaware at the Helen F. Graham Cancer Center. He served as managing partner of his independent medical practice, Medical Oncology Hematology Consultants, PA.

The ASCO Clinical Affairs department supports practicing oncologists both domestically and internationally through ASCO quality programs, practice business intelligence and support, value-based care consulting, and practice education.

He is a chemical engineering graduate of Purdue University and graduate of the Thomas Jefferson University Medical School. Medical postgraduate training in Internal Medicine was completed at the Medical Center of Delaware and Hematology and Oncology at the Dartmouth Hitchcock Medical Center.

He served as the Principal Investigator of the Delaware Christiana Care NCORP and Board member of the NCI sponsored Alliance cooperative research group. He remains a member for the Alliance Foundation Board and Executive Committee. He is a member of the state of Delaware Cancer Consortium Council and is chair of the Early Detection and Prevention Committee. He is a past member of the ASCO Board of Directors as well as the Ethics, Finance, Research, and Government Relations Committees and past president of the Medical Society of Delaware.

Dr. Grubbs has served as a member of the National Cancer Institute Clinical Trials Advisory Committee, co-chair of the Clinical Trials Subcommittee of the NCI Community Cancer Centers Program (NCCCP), and the Institute of Medicine Committee on Cancer Clinical Trials and the NCI Cooperative Group Program.

He has been an active community based clinical trial investigator with the NCI sponsored CALGB, ECOG, NSABP, and Alliance Cooperative Groups since 1984 and is the recipient of the 2007 Association of Community Cancer Centers David King Community Clinical Scientist Award.

Erin E. Krebs
Erin E. Krebs, MD, MPH is a Core Investigator at the Minneapolis VA Center for Care Delivery and Outcomes Research and Associate Professor of Medicine at the University of Minnesota Medical School. Her research addresses clinical questions related to chronic pain and opioid analgesics, informed by her practice as a primary care physician. She has expertise in comparative effectiveness research and pragmatic trials and has received funding as principal investigator from VA, PCORI, and NIH. Her current research focuses on clinical care and delivery models for patients prescribed long-term opioid therapy for chronic pain. Dr. Krebs completed medical school and internal medicine residency at the University of Minnesota and received her MPH from the University of North Carolina, where she was a Robert Wood Johnson (RWJ) Foundation Clinical Scholar. She completed a VA Career Development Award/RWJ Physician Faculty Scholars Award focused on improving the quality and safety of opioid prescribing in primary care.
Knashawn H. Morales
Knashawn H. Morales is an Associate Professor of Biostatistics in the Department of Biostatistics, Epidemiology, and Informatics at the Perelman School of Medicine at the University of Pennsylvania. Dr. Morales was trained at Harvard School of Public Health, where she earned a doctoral degree in Biostatistcs in 2001. She joined Penn in 2003 after working for the New England Research Institutes. Her methodological research interests include longitudinal data analysis, latent variable modeling, and categorical data analysis. Dr. Morales has extensive collaborative experience in mental health services and clinical trials research. In addition, she has participated in studies involving behavioral modification interventions for asthma, insomnia, HIV/STD risk reduction and weight management. Dr. Morales is the Co-PI of the Penn Mental Health Biostatistics Training Grant and Director of the Penn Mental Health and AIDS Research Center, Biostatistics and Data Management Core. She has produced over 80 collaborative publications including those in high-profile journals such as the Journal of the American Medical Association, Annals of Internal Medicine, the British Medical Journal, and the Journal of the American Statistical Association.
Patricia M. Owens
Ms. Owens has over 30 years of experience in health and disability related programs and policy. She has an unusual set of qualifications having held executive, policy development and administrative positions in both the public and private disability sectors. Her experience serves as the basis for in-depth understanding of the multidimensional and interactive nature of health and disability for individuals and populations in policy formation and risk management. Ms. Owens consults with both public and private organizations on health and disability policy and programs. She is currently a member of the National Academies of Science, Academy of Medicine Standing Committee of Experts on Disability Policy, .

From September 2007 to September 2011, Ms Owens was the senior disability expert for the Government Accountability Office.

1989 -1999 UNUM INSURANCE COMPANY - Senior Disability Advisor, Vice President; President, Integrated Disability Management (IDM) Division , Vice President, Disability Programs. Provided internal and external consulting and direction on workplace health and disability issues, products and programs. Designed; implemented UNUM’s extensive disability research program including the much-cited research on the Total Cost of Work Disability and Predictors and Descriptors of Psychiatric Disability. Served as President of experimental Integrated Health and Disability Division that developed and tested models that integrated coverage and administration of health, Workers Compensation and short term and long term disability.

1987 - 1989: THE PAUL REVERE INSURANCE GROUP - Vice President, Disability Programs; Vice President of Underwriting. Executive responsibilities included budget, strategic planning, design and implementation of life & disability risk assessment policy; evaluation of experience, development and maintenance of' an expert system for underwriting and customer service. Served as a member of the CEO’s Executive Management Committee that set and monitored company strategic planning

1962 - 1986: THE SOCIAL SECURITY ADMINISTRATION – Associate Commissioner of Disability. As Chief Executive Officer of' the Social Security Disability Program was responsible for all policy, research, operations, administration and evaluation of the Social Security Disability Programs. Played a central role in formulating and lobbying for massive reforms in the program including return to work efforts in cooperation with private employers and insurers. Negotiated cooperative agreements with the American Psychiatric Association, The American Medical Association and various disability advocacy groups. Joined SSA in 1962 and progressed through successively more responsible positions in the field and central office. From late 1979, experience was primarily in the disability programs.

Nina A. Sayer
Nina A. Sayer is the deputy director for the Center for Care Delivery and Outcomes Research at the Minneapolis VA Healthcare System and professor of Medicine and Psychiatry at the University of Minnesota. Dr. Sayer is also a clinical psychologist and a health services researcher whose work focuses on post-deployment health including PTSD, disability, combat-related polytrauma and unmet service needs. Dr. Sayer recieverd her B.A. from Cornell University, her M.A. from New York University, and her Ph.D. in Clinical Psychology also from New York University.
Tisamarie Sherry
Tisamarie Sherry is an Associate Physician Policy Researcher at the RAND Corporation and a practicing general internist with expertise in health economics, health policy and health services research. Her research evaluates the impacts of public policy and health care system design and financing on health disparities, with a special focus on improving health and economic outcomes for individuals with substance use disorder, psychiatric illness and disabilities. Her recent work examines how chronic illness, pain and opioid use influence health status and functional outcomes. Prior to joining RAND, Sherry worked with the Office of the Assistant Secretary for Planning and Evaluation in the U.S. Department of Health and Human Services, and with the Centers for Disease Control's Global AIDS Program. She is also a practicing primary care physician at Brigham and Women's Hospital (BWH), and an instructor at Harvard Medical School. Sherry obtained her A.B. in molecular biology and public policy from Princeton University, her M.D. from Harvard Medical School, and Ph.D. in Health Policy from Harvard University. She completed residency training in internal medicine at BWH.
Michael Stubblefield
Michael D. Stubblefield is a nationally and internationally recognized leader in the field of cancer rehabilitation. His clinical expertise is in the identification, evaluation and rehabilitation of neuromuscular, musculoskeletal, pain and functional disorders resulting from cancer and its treatment, particularly those caused by radiation and neurotoxic chemotherapy. He is an expert electromyographer and performs procedures such as botulinum toxin (Botox) injections for the relief of pain and spasm in cancer survivors.

Dr. Stubblefield graduated with honors from Brown University in Providence, RI, where he double majored in biology and philosophy. He received his medical degree from the Columbia University College of Physicians and Surgeons and completed a combined residency in internal medicine and physical medicine and rehabilitation (PM&R) at Columbia Presbyterian Medical Center in New York City. He is triple board certified in (PM&R), internal medicine, and electrodiagnostic medicine (EMG).

Dr. Stubblefield worked at Memorial Sloan Kettering Cancer Center for nearly 14 years and was the Chief of the Rehabilitation Medicine Service. He joined Kessler Institute as Medical Director of Cancer Rehabilitation in 2015. He also serves as the National Medical Director of ReVital Cancer Rehabilitation for Select Medical where he oversees the development of comprehensive cancer rehabilitation programs across the organization’s national network of rehabilitation facilities.



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Contact Phone:  (202) 334-1819

Supporting File(s)
Disability 101

Is it a Closed Session Event?
Some sessions are open and some sessions are closed

Closed Session Summary Posted After the Event

The following committee members were present at the closed sessions of the event:

Judith Green-McKenzie
Amy Bernstein
Charles H. Bombardier
Joseph A. Buckwalter
Andrea L. Cheville
Lisa B. Dixon
Annette Fitzpatrick
Stephen S. Grubbs
Jaimie L. Gradus
Erin E. Krebs
Knashawn H. Morales
Patricia M. Owens
Nina A. Sayer
Tisamarie Sherry
Michael Stubblefield
Nanette Wenger (Consultant)

The following topics were discussed in the closed sessions:

Statement of task, report outline. Committee formed working groups and discussed approach to the task and needed literature.

The following materials (written documents) were made available to the committee in the closed sessions:

Briefing book with draft outline, draft chapters, and background materials.

Date of posting of Closed Session Summary:
February 13, 2019
Publication(s) resulting from the event:



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