Index

A

Activities of daily living, 58, 61, 187, 192-193, 195-196, 227-232, 247, 253, 265, 292, 296

Activity limitation concept, 193, 196, 197, 201, 202, 204-205, 208, 261, 264, 286

Administration and processing of claims.

See also Disability decision process

definitional issues, 4, 55

file linkages for monitoring work disability, 5, 93, 94, 95, 96, 97, 106-108, 290-291, 293

growth issues, 2, 10, 19-20, 37, 38, 39, 40

research recommendations, 172-173

Age

and ability to work, 10, 135, 242

and growth of disability programs, 1-2, 35, 18-19, 42, 43, 44-45, 46

labor force participation, 306-308, 320-321, 325, 326

Agency for Healthcare Research and Quality, 110, 143, 294, 297

Aid to the Blind, 37

Aid to the Permanently and Totally Disabled, 37

AIDS/HIV infection, 41

Aliens, qualified, 43-44

Allowances. See Awards and allowances

American Community Survey, 99-101, 109, 295, 297, 298

American Housing Survey, 100-101, 295, 300-301

American Institutes for Research (AIR), 122, 133

American Medical Association (AMA), Guides to Evaluation of Permanent Impairment, 55-56, 203-204

American Psychiatric Association, 241, 242, 245, 250-257, 268, 269, 272-273, 274, 279

American Psychological Association, 245-246

Americans with Disabilities Act of 1990 (ADA), 4, 31, 51, 54, 60, 194, 213, 262, 310, 328, 329

Assistive devices and accommodations, 62, 84, 116, 187, 202, 207, 208, 283-284, 310

Awards and allowances

growth of, 1, 18, 33-42, 46, 47

replacement rate caps, 39

review requirements, 39

minimum benefits, 39

variations in, 136-137



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The Dynamics of Disability: Measuring and Monitoring Disability for Social Security Programs Index A Activities of daily living, 58, 61, 187, 192-193, 195-196, 227-232, 247, 253, 265, 292, 296 Activity limitation concept, 193, 196, 197, 201, 202, 204-205, 208, 261, 264, 286 Administration and processing of claims. See also Disability decision process definitional issues, 4, 55 file linkages for monitoring work disability, 5, 93, 94, 95, 96, 97, 106-108, 290-291, 293 growth issues, 2, 10, 19-20, 37, 38, 39, 40 research recommendations, 172-173 Age and ability to work, 10, 135, 242 and growth of disability programs, 1-2, 35, 18-19, 42, 43, 44-45, 46 labor force participation, 306-308, 320-321, 325, 326 Agency for Healthcare Research and Quality, 110, 143, 294, 297 Aid to the Blind, 37 Aid to the Permanently and Totally Disabled, 37 AIDS/HIV infection, 41 Aliens, qualified, 43-44 Allowances. See Awards and allowances American Community Survey, 99-101, 109, 295, 297, 298 American Housing Survey, 100-101, 295, 300-301 American Institutes for Research (AIR), 122, 133 American Medical Association (AMA), Guides to Evaluation of Permanent Impairment, 55-56, 203-204 American Psychiatric Association, 241, 242, 245, 250-257, 268, 269, 272-273, 274, 279 American Psychological Association, 245-246 Americans with Disabilities Act of 1990 (ADA), 4, 31, 51, 54, 60, 194, 213, 262, 310, 328, 329 Assistive devices and accommodations, 62, 84, 116, 187, 202, 207, 208, 283-284, 310 Awards and allowances growth of, 1, 18, 33-42, 46, 47 replacement rate caps, 39 review requirements, 39 minimum benefits, 39 variations in, 136-137

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The Dynamics of Disability: Measuring and Monitoring Disability for Social Security Programs B Baby boom generation, 2, 11, 43, 46, 51, 89, 141, 145, 307, 308 Behavioral Risk Factor Surveillance System, 95, 100-101, 290, 295, 299-300 Bias, defined, 214 Black Lung Program, 35, 37 Boston College, 143 Bureau of Justice Statistics, 282, 298-299 Bureau of Labor Statistics, 133, 282, 299, 310, 314, 315, 316, 317, 324, 326 Bureau of the Census, 94, 297-298, 300 C California Work and Health Survey, 324-326 Canadian Health and Activity Limitation Survey, 77, 207, 298 Cardiovascular disease, 46 Centers for Disease Control and Prevention, 192, 299-300 Centers for Medicare and Medicaid Service, 143 Classification of disabilities. See also International Classification of Functioning, Disability and Health by disabled persons, 218-219, 225-227 fuzzy logic in, 225 mental, 245-250, 253-254 SSA Listings of Impairments, 48, 55, 63, 124, 129-132, 203-204, 245-250 in work disability monitoring system, 6, 296, 298 Clinical Disability Severity Rating, 252 Cognitive considerations interviewing, 224-225 in survey measurements of disability, 223-225, 236-237, 238, 298 Cognitive theory, 223-225 Composite International Diagnostic Interview, 267 Conceptual issues. See Definition of work disability Consultative Examiner, 250 Content Reinterview Survey (CRS), 228-231, 234-235 Continuing disability reviews (CDRs), 39, 40 Continuous Work History Sample, 107 Cost containment, 34 Cost-of-living adjustments, 35 Court decisions and class action suits and definitions of disability, 213 and growth of disability programs, 2, 10, 40, 45, 48, 90, 127 Coverage error, 75-78, 85, 95, 104, 171, 215, 220, 223, 227, 284, 285, 290, 292 Cross-sectional design for monitoring work disability, 95, 96, 105-106, 291, 293-294 for survey measurement of disability, 96, 219, 291, 293-294 Current Population Survey, 51, 95, 100-101, 104, 106, 206, 234, 290, 295, 298, 299, 318, 324 D Data collection modes for monitoring work disability, 95, 97, 102, 106, 110, 291-292, 294, 295 for survey measurement of disability, 69, 70, 72, 74, 78-79, 82, 83-84, 86, 87, 95, 106, 212, 216, 218, 219-220, 223, 228-229, 284, 285, 291-292, 301 Decennial Census, 206, 228-229, 230, 234-235, 236-237, 298 Definition of work disability. See also Disability decision process activity limitation concept, 193, 196, 197, 201, 202, 204-205, 208, 261, 264, 286 biopsychosocial model, 260, 285-286 conceptual issues, 4, 53-56, 59, 184-195 cultural perspective, 54, 193 duration or chronicity considerations, 62-63, 202-203 dynamic nature of disability and, 4, 60, 62-63, 84, 198-200, 202-203, 213 enabling-disabling process, 7-8, 74, 190, 191, 213, 281 environmental factors, 4, 7, 54, 57-58, 59-60, 61, 62-64, 83-84, 185-186, 188-190, 191, 194, 196, 198, 204-205, 208, 211, 213, 261-262, 283, 285-286 functional limitation, 4, 30, 54, 58, 59, 186-187, 193, 196, 197, 202, 204, 208, 212, 283

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The Dynamics of Disability: Measuring and Monitoring Disability for Social Security Programs and growth of awards and allowances, 35, 37, 40, 41 handicap concept, 193, 194, 195, 259 ICF model, 54, 56, 58-59, 258, 279 ICIDH model, 54, 57, 58-59, 60, 185, 190, 192-195, 196, 197, 198, 201, 259, 261-263 impairment concept, 186, 192, 196, 197, 201, 203-204, 212, 213, 243, 259, 261 intraindividual factors, 188, 189, 203 IOM models, 54, 56, 60, 188, 190, 194, 200 labor market structural changes and, 4, 30-31, 56, 62, 94, 318 major schools of thought, 56-63, 185-195 and measurement of work disability, 61, 62, 183-184, 212, 200-205, 283-284 for monitoring work disability, 289 Nagi’s Disablement Model, 56, 57-58, 60, 185-190, 192, 195-196, 197, 198, 201, 259 neutral terminology, 193-194, 261, 263-264, 286 in ongoing federal surveys, 49 n.6, 283-284 participation restriction, 193-195, 196, 197, 201-202, 212, 261, 264, 286 pathology/health condition, 186, 192, 196, 197, 201, 203 purposes of, 55, 183, 184-185 quality-of-life and, 58, 60, 190, 199-200, 201 recommendations, 12-13, 63-64 risk factors, 188, 189 as screening device, 55-56, 61, 183-184 secondary conditions, 60, 190, 198-199 social roles concept, 54, 57, 58, 59-60, 61, 187-190, 193, 195-198, 199, 201 statutory, 4, 17-18, 30, 54, 55, 57, 60, 74, 94, 128, 184, 185, 190, 200, 213, 242-243, 251, 262, 279, 281, 283, 289 in surveys, 7-8, 49 n.6, 56, 74, 83-84, 87, 94, 183, 184-185, 211, 212, 213, 263-264, 281-284 Demographic trends growth of disability programs, 1-2, 18-19, 35, 42, 43-46, 89 Department of Health and Human Services, 18-19 Department of Housing and Urban Development, 300-301 Department of Labor, 9, 61, 122, 123, 132-134, 136, 145, 310, 317, 328-329 Dependents of beneficiaries, 35 Diagnostic and Statistical Manual of Mental Disorders, 245, 246 Dictionary of Occupational Titles, 9, 61, 122, 132, 134, 136, 145, 328-329 Differential response error, 220-221 Disability Analyst, 244, 249 Disability claims process, 3, 19, 21 Disability decision process. See also Administration and processing of claims; Eligibility criteria adversary models of benefits adjudication, 138 alternatives to, 10-11, 137-139 American Psychiatric Association evaluation of, 241, 250-257, 268, 269, 272-273, 274, 279 appeals, 19-20, 21 baseline evaluative criteria for redesign, 9, 38, 40, 118, 126-129, 130-131, 139 conceptual issues, 4, 113, 183-184, 242-243, 251; see also Definition of work disability Consultative Examiner, 250 continuing disability reviews (CDRs), 39, 40 date-of-onset/period-of-review documentation, 255, 256, 270 difficult claim types, 253, 255-256, 257, 270, 271, 272, 273, 274, 277 environmental factors in, 4, 61, 138 functional assessment instruments, 25, 26, 90, 113, 114, 116-117, 119, 120-122, 124-125, 129, 172, 271, 272, 273-274 and growth of awards and allowances, 19, 37, 38, 39, 40, 114, 136-137, 212 ICF assessment instrument and, 242, 257-266, 268, 273, 275, 277, 278, 279 Index of Severely Disabling Impairments, 25, 116-117, 124, 127, 270 for initial claims, 19, 22-26, 34, 37, 114-117, 241-279 Listings of Impairments, 8-9, 22-23, 24 n.4, 48, 55, 63, 115, 123, 124, 125, 126, 127, 129-132, 203-204, 244-250, 253-254, 256, 265, 268, 275, 276

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The Dynamics of Disability: Measuring and Monitoring Disability for Social Security Programs medical evidence, 19, 22-23, 40, 48, 63, 114, 115, 129, 243, 244, 250, 254-255, 256-257, 268, 270, 271, 272-273, 277-278 for mental impairments, 68, 129, 243-244, 248-249, 253, 265, 275-276, 277-278 Mental Residual Functional Capacity Assessment, 248, 249, 250, 251, 254, 256, 264, 270, 273, 278 NSHA and, 118, 119 objectives, 137-138 occupational classification system, 9, 61, 114, 117, 119, 122-123, 132-134, 136, 172, 312-314, 322-323 organizational fragmentation, 145-146 physician opinions in, 40 post-redesign period, 123-137 Psychiatric Review Technique Form, 244, 248-249, 250, 251, 253-254, 256, 265, 269, 270, 275 quality assurance reviews, 38, 40 recommendations, 9, 10-11, 14, 63-64, 123, 127, 130-131, 138, 172-173, 256-257, 275-279 redesign proposal, 3, 8, 21, 24-26, 90, 116-123, 127, 128-129, 130-132, 133, 139, 145, 172, 211-212, 241, 242 regulations and guidelines, 114, 115 research plan, 10-11, 63-64, 119-123, 125, 126, 130, 131, 132, 133, 139, 172-173, 241, 256-257, 268-279 Residual Physical Functional Capacity Assessment, 24, 273-274 responsibility for, 19, 21, 34, 37, 107, 136-137, 243, 244 return-to-work model, 8, 10-11, 138 Reviewing Medical Consultant, 244, 248-249, 251, 253-254, 271 scope of committee review of, 3, 8 screening instruments, 247, 267-268, 269, 271, 275, 278 simulation and modeling of, 67, 70, 72, 173, 289, 290 vocational capacity assessment, 9-10, 24, 25, 63, 113, 115, 117, 119, 132-137, 172, 203, 204-205, 242-243, 245, 263, 275, 303 WHO DAS II and, 267-268, 275, 278 Disability Determination Services (DDs), 10, 19, 21, 37, 107, 136-137, 243 Disability Employment Strategy, 67, 70 Disability Evaluation Study (DES), 20, 63-64, 212, 170-171. See also National Study of Health and Activity Disability insurance tax rate and trust fund, 34-35 Disability Research Institute, 109, 131, 143 Disabled people desire to work, 207 discrimination against, 207 employer tolerance, 108 labor force participation rates, 319-321 labor market for, 49-51, 317, 318-328 number of, 212 quality-of-life issues, 58, 60, 190, 199-200, 201 self-classification of disability, 218-219, 225-227 socioeconomic status, 90 stereotypes, 62, 202-203 support for SSA’s Disability Employment Strategy, 67 Disablement process, 84, 188-190, 200 Drug abuse and alcoholism, 48 Duration or chronicity of disability, 19, 44, 62-63, 202-203 Dynamic nature of disability, conceptual issues, 4, 60, 62-63, 84, 198-200, 202-203, 213 enabling-disabling process, 74, 190, 191, 213, 224, 226 and work disability monitoring system, 91 E Economic censuses, quinquennial, 92 Economic conditions and growth of disability programs, 2, 18, 37, 38, 40, 41, 42, 47, 48, 49, 88, 89, 287, 288 Education and ability to work, 10, 135-136, 242 and labor force participation rates, 308-309, 321-322 Effectiveness, defined, 128 Efficiency, defined, 128 831 Disability file, 107 Eligibility criteria. See also Disability decision process and definitions of disability, 55 medical and functional, 48

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The Dynamics of Disability: Measuring and Monitoring Disability for Social Security Programs for mental impairments, 40, 41, 68 noncitizens, 43-44, 48 original, 34 and program size, 2, 33, 39, 40, 41 substantial gainful activity and, 2, 19, 34, 40, 53, 55, 63, 66 n.1, 94, 114, 115, 123, 184 and survey instrument design, 212 threshold severity requirement, 116 Enabling-disabling process, 7, 74, 190, 191, 224, 226, 281 Environment. See Work environment Equal Employment Opportunity Commission, 329 Extraindividual factors, 188, 189, 196, 198. See also Work environment F Federal ongoing surveys definition of disability in, 49 n.6, 283-284 measurement of disability in, 99-104, 212, 213, 282, 285-286 partnerships for monitoring work disability, 5, 93-94, 95, 99-104, 105-106, 109, 110, 294-301 Functional limitations, 40 assessment instruments, 25, 26, 90, 113, 114, 116-117, 119, 120-122, 124-125, 129, 172, 271, 272, 273-274 definition of, 4, 30, 54, 58, 59, 186-187, 193, 196, 197, 202, 204, 208, 212, 283 and disability decision process, 25, 26, 90, 113, 114, 116-117, 119, 120-122, 124-125, 129, 172, 271, 272, 273-274 interviewing techniques, 224-225 of survey respondents, 75, 77-79, 80-81, 223-227, 284 vocational capacity assessment, 132-133, 329 G Gender and growth of disability programs, 43, 44-45, 46, 49, 50 labor force participation rates by, 43, 44, 49, 50, 89, 305-306, 319, 320-321, 325, 326 General Accounting Office, 129 Gore, Al, 20-21 Growth of disability programs administrative initiatives and, 2, 10, 19-20, 37, 38, 39, 40 allowances and awards, 1, 10, 18, 33-42, 46, 47, 136-137 applications, 33, 35, 41 cost shifting by states and, 19, 47, 90 court decisions and, 2, 10, 40, 45, 48, 90, 127 definitions of disability and, 35, 37, 40, 41 demographic trends and, 1-2, 18-19, 35, 42, 43-46, 89 disability decision process and, 19, 37, 38, 39, 40, 114, 136-137, 212 econometric research studies, 20, 34 economic conditions and, 2, 18, 37, 38, 40, 41, 42, 47, 48, 49, 88, 89, 286, 288 eligibility criteria and, 2, 33, 39, 40, 41, 136-137 historical developments and, 34-42 impairments and, 2, 18, 34, 40, 45-47, 48 labor market dynamics and, 43, 44, 48, 49-51, 52, 89, 288 labor market structural changes and, 2, 18, 48, 89, 304 legislative and regulatory changes and, 2, 10, 18, 19, 34, 35, 38, 39-41, 42, 44, 45, 48, 51-52, 90, 127 for mental impairments, 2, 45-46, 47, 48 outreach efforts and, 2, 19, 37, 42, 47 projected, 2, 43, 51, 141, 145 research needs, 20, 34, 52, 89-94, 127, 212 SSA surveys of, 286-288 trends, 1-2, 35-42 H Handicap, defined, 193, 194, 195, 259 Health and Retirement Survey (HRS), 288 Homeless populations, 75-76 I ICF Checklist, 266, 267, 275, 277, 278 Impairments. See also Mental impairments AMA evaluation guides, 55-55, 203-204 awards by diagnostic group, 47

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The Dynamics of Disability: Measuring and Monitoring Disability for Social Security Programs circulatory conditions, 2, 46, 47, 62, 203 classification, 54, 57, 58-59, 60, 185, 190, 192-195, 261-263 conceptual issues, 186, 192, 196, 197, 201, 203-204, 212, 213, 243, 259, 261 date of onset and period of review, 255 environmental limitations, 115 fatigue, 62, 203 functional, 54 and growth of disability programs, 2, 18, 34, 40, 45-47, 48 multiple combined, 40, 47, 115, 243 musculoskeletal conditions, 2, 46, 47, 62, 203 pain, 62, 203 pathology/health condition, 186, 192, 196, 197, 201, 203 survey design considerations, 76-77 systemic diseases, 47, 62, 203 threshold severity requirement, 116 Index of Severely Disabling Impairments, 25, 116-117, 124, 127, 270 Institute of Medicine, conceptual models of disability, 54, 56, 60, 188, 190, 194, 200 Institutionalized populations, 75-76 Instrumental activities of daily living, 58, 61, 187, 192-193, 247, 296 Internal consistency, 222 International Classification of Functioning, Disability and Health (ICF) coding and rating, 263-264 conceptual model, 54, 58-59, 83-84, 185, 195, 196, 197, 198, 201-202, 258, 261-263, 277, 279, 285-286 and disability decision process, 242, 257-266, 268, 273, 275, 277, 278, 279 domains, 196, 286 features of, 83-84, 257-258, 285-286 ICF Checklist, 266, 267, 278 ICIDH-1 (1980) compared, 54, 57, 58-59, 60, 185, 190, 192-195, 198, 201, 259, 261-263, 285 ICIDH-2, 185, 196, 197, 265, 282, 285 revision process, 185, 192, 260-261, 265 survey questionnaire mapping to, 285-286 taxonomy, 263 work disability, 265-266 International Classification of Impairments, Disabilities, and Handicaps (ICIDH). See International Classification of Functioning, Disability and Health International Statistical Classification of Diseases and Related Health Problems (ICD), 257-258 International Task Force on Mental Health, and Addictive, Behavioural, Cognitive, and Developmental Aspects of ICIDH, 260, 265 Interviewing methods, 76-77, 81, 85, 95, 171, 215-217, 219, 220, 224-225, 228, 291-292 L Labor force participation accommodations and, 62, 84, 310 age and, 306-308, 320-321, 325, 326 and disability definitions, 56, 62 by disabled persons, 319-321 dynamics of, 89, 304-309 early withdrawal from, 288 educational attainment and, 308-309, 321-322 gender and, 43, 44, 49, 50, 89, 305-306, 319, 320-321, 325, 326 race and, 306, 320-321 Labor market dynamics alternative work arrangements, 316 contingent employment, 315-316 and definition of work disability, 4, 30-31, 94, 318 for disabled people, 49-51, 317, 318-328 displacement rates, 317-318, 326-328 employment characteristics, 309-318, 321-327 and growth of disability programs, 43, 44, 48, 49-51, 52, 89, 288 industries, 310-312, 321-322 internal structure of work, 317 job security, 315 location of work, 316-317 measuring functional demands, 328-330 occupations, 312-314, 322-323 part-time employment, 314-315, 323-324 structural changes, 2, 18, 30-31, 48, 89, 304 terms of employment, 315-318, 324-326

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The Dynamics of Disability: Measuring and Monitoring Disability for Social Security Programs Legislation and regulations and growth of disability programs, 2, 10, 18, 19, 34, 35, 38, 39-41, 42, 44, 45, 48, 51-52, 90, 127 Leisure activities, 188 Listings of Impairments, 8-9, 22-23, 24 n.4, 48, 55, 63, 115, 123, 124, 125, 126, 127, 129-132, 203-204, 244-250, 253-254, 256, 265, 268, 275, 276 Longitudinal design for measurement surveys, 96, 199, 219-220, 228, 291, 293 for monitoring work disability, 5, 95, 96, 97, 105-106, 199, 291, 293 M Master Beneficiary Record (MBR), 107, 108 Master Earnings File (MEF), 107, 108 Measurement error disabled person as source of, 223-227 in essential survey conditions, 212, 219-221 in Index of ADLs, 228, 296 interviewer-related, 219, 221 psychometric perspective, 221-222, 228, 231-232, 238 questionnaire-related, 82-83, 85, 216-217, 221, 286 research needs on, 74-75, 82-83, 284-285 respondent-related, 217-218, 223-227, 292 in surveys, 74-75, 82-83, 85, 95, 212, 216-227, 232-237, 284, 285, 286, 290, 291, 292 Measurement of disability. See also National Study of Health and Activity; Survey measurement of disability activity limitation (at work), 201, 204-205 conceptual issues, 61, 62, 183-184, 200-205, 212, 283-284 direct assessment, 205-208 duration/chronicity considerations, 202-203 empirical evidence on error in, 227-236 environmental barriers and accommodations and, 109, 232-233, 237 functional limitations, 204, 227-236 health condition or pathology, 201, 203 impairment, 201, 203-204 with Index of ADL, 227-232, 292 participation restriction, 201-202 quality-of-life considerations, 90 research recommendations, 109 role of work and, 201, 205 threshold, 62, 202 work disability, 201, 205, 232-236 Medicaid coverage, 2, 35, 37, 138 Medical evidence, 19, 22-23, 40, 48, 63, 114, 115, 129, 243, 244, 250, 254-255, 256-257, 268, 270, 271, 272-273, 277-278 Medical examinations and performance tests for monitoring work disability, 95, 96, 102, 290, 293, 295, 300 for NSHA, 70, 71, 78, 79-80, 81 for surveys, 70, 71, 78, 79, 81, 95, 96, 289, 290, 293, 295, 300 Medical Expenditure Panel Survey, 100-101, 102, 106, 108, 110, 294, 295, 297 Medicare, 2, 138 Mental impairments affective disorders, 253 anxiety disorders, 247, 253, 254 autistic disorder, 247 American Psychiatric Association evaluation of claims process, 241, 250-257, 268, 269, 272-273, 274, 279 Clinical Disability Severity Rating, 252 date-of-onset/period-of-review documentation, 255, 256, 270 difficult claim types, 253, 255-256, 257, 270, 271, 272, 273, 274, 277 disability determination process, 68, 129, 243-244, 248-249, 253, 265, 275-276, 277-278 eligibility criteria, 40, 41, 68 growth in awards and allowances for, 2, 45-46, 47, 48 ICF assessment instrument, 242, 257-266, 268, 273, 275, 277, 278, 279 Listing of, 48, 244-250, 253-254, 256, 265, 268, 275, 276 medical evidence, 243, 244, 250, 254-255, 256-257, 268, 270, 271, 272-273, 277-278 Mental Residual Functional Capacity Assessment, 248, 249, 250, 251, 254, 256, 264, 270, 273, 278

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The Dynamics of Disability: Measuring and Monitoring Disability for Social Security Programs mental retardation, 247, 253 organic mental disorders, 253 personality disorders, 247, 253, 256 Psychiatric Review Technique Form, 244, 248-249, 250, 251, 253-254, 256, 265, 269, 270, 275 recommendations, 256-257, 275-279 research issues, 256-257, 268-279 schizophrenic, paranoid and other psychotic disorders, 246, 253, 254 sequential evaluation, 243-244, 248-249, 253, 276, 277-278 somatoform disorders, 253 statutory definition, 242-243 substance addiction disorder, 247 vocational capacity assessment, 242-243, 245, 263, 275 WHO DAS II, 267-268, 275, 278 Mentally disabled deinstitutionalization of, 19, 40, 47 stigmatization, 84 survey design for, 75-76 Monitoring of costs, 34-35 of work disability, see Work disability monitoring system N Nagi, Saad, 57, 185, 259 Nagi’s Disablement Model, 56, 57-58, 60, 185-190, 192, 195-196, 197, 198, 201, 259 National Academy of Social Insurance (NASI), 129, 130, 269, 271 National Center for Health Statistics, 94, 108, 110, 192, 299-300 National Comorbidity Survey, 299 National Crime Victimization Survey, 100-101, 295, 298-299 National Health and Nutrition Examination Survey, 100, 101-103, 109, 171, 295, 289, 300 National Health Interview Survey, 49 n.6, 95, 100, 102-103, 109, 110, 206, 290, 295, 296, 299, 300, 318 Disability Supplement, 171, 226, 234, 235 National Household Survey of Drug Abuse, 100, 102-103, 104, 292, 295, 301 National Institute of Mental Health, 278 National Institutes of Health, 143, 267 National Longitudinal Study (NLS), 288 National Medical Care Expenditure Survey, 294 National Medical Care Utilization and Expenditure Survey, 294 National Organization on Disability/Harris Survey of Americans with Disabilities, 226 National Performance Review, 20-21 National Science Foundation, 143 National Study of Health and Activity. See also Survey measurement of disability corrective revisions, 8, 71-72, 86, 87 data collection plans, 7, 69, 70, 72, 74, 78-79, 85, 86, 171, 290 disability decision process evaluation, 118, 119 features, 67-70 field experiments, 6, 73, 74, 171 information goals, 20, 52, 65, 66-67, 88, 91 interim reports on, 66, 70, 78, 80, 81, 170-173 long-term usefulness of, 8, 91 medical examinations, 70, 71, 78, 79-80, 81 monitoring system for work disability, 5, 97-99, 104, 109 pilot study, 6-7, 8, 70, 71, 72-74, 78, 81, 82, 86 quality issues, 70-74 questionnaire design and testing, 70, 71, 72, 73, 81-82, 85, 87, 90, 171, 284 recommendations, 12, 70, 85, 87, 147-148, 170-171, 173 research, 72-73, 85, 172-173 response rates, 8, 69-70, 73, 81, 171 sample design, 7, 67-68, 73, 78, 80, 171 sample sizes, 7-8, 68-69, 70, 80, 170-171 scope of committee study, 2-3, 26-27, 65-66, 147-148 simulation of disability decision process, 67, 70, 72, 173 testing phase, 7, 72, 78, 86, 170 time allocation for, 6-7, 70-74, 86, 173 Nonobservation errors, 214-216, 284-285 Nonresponse error, 76, 77, 80-81, 85, 95, 104, 215-216, 220, 227, 284, 285, 290, 291, 292 Numident, 108

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The Dynamics of Disability: Measuring and Monitoring Disability for Social Security Programs O Observational errors, 216-221, 227, 284-285 Occupational classification systems, 9, 61, 114, 117, 119, 122-123, 132-134, 136, 172, 312-314, 322-323, 328-329 Occupational Information Network (ONET) database, 9-10, 61, 122-123, 132-134, 145, 172, 328-329 Office of the Inspector General, 129 Old Age Assistance, 37 Old Age, Survivors, and Disability Insurance (OASDI) program, 107-108 Outreach efforts, and growth of disability programs, 2, 19, 37, 42, 47 Owens, Patricia, 250 P Paid and unpaid role activities, 187 Pain, and disability, 40, 62, 114, 203 Parkinson’s disease, 187 Parsons, Talcott, 54, 58, 59, 195 Participation, conceptual issues, 193-195, 196, 197, 201-202, 212, 261, 264, 286 Provider-based survey data, 102, 290, 295, 296 Proxy respondents, 78-79, 83, 95-96, 106, 212, 216, 218, 223, 225, 226, 228, 230-231, 284, 292 Q Quality issues, in NSHA, 70-74 Quality of Employment surveys, 317 Quality of life and disability definitions, 58, 60, 190, 199-200, 201 health-related, 199-200 Questionnaire design for monitoring work disability, 293 for NSHA, 70, 71, 72, 73, 81-82, 85, 87, 90, 171, 284 for survey measurement, 70, 76-77, 82-83, 85, 87, 205-207, 212, 216-217, 223-224, 226-227, 228, 230-231, 232, 233, 236-238, 281-282, 284, 285-286, 293-294 R Race, and labor force participation rates, 306, 320-321 Recall bias, 217-218 Recommendations concepts of work disability, 12-13, 63-64 disability decision process, 9, 10-11, 14, 63-64, 123, 127, 130-131, 138, 172-173, 256-257, 275-279 for monitoring work disability, 5, 13, 92-93, 147 for NSHA, 70, 85, 87, 170-171, 173 research infrastructure and capacity building, 14, 142 survey measurement of disability, 13, 85, 86-87, 170-171 Regulations. See Legislation and regulations Rehabilitation, 60, 134, 188, 190, 191, 198, 203, 259 Reliability defined, 221, 127 of disability decision process, 127 of Index of ADL, 227 interrater, 134, 222, 254 measures of, 222 of Mental Residual Functional Capacity Assessment, 254 of occupational classifications, 134 of survey measures of disability, 221, 222, 227, 231-232, 236 of WHO DAS II, 267 Research issues cooperative agreements, 144 disability decision process, 10-11, 63-64, 119-123, 125, 126, 130, 131, 132, 133, 138, 139, 172-173, 241, 256-257, 268-279 extramural programs, 11, 143 grant programs, 142-143, 144 growth of disability programs, 20, 34, 52, 212 infrastructure and capacity building, 11-12, 142, 140-147 intramural programs, 11, 144 measurement of disabilities, 141-147, 208, 284-285 mental impairments, 268-274 monitoring work disability, 301 NSHA, 72-73, 85, 172-173

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The Dynamics of Disability: Measuring and Monitoring Disability for Social Security Programs resource requirements, 14, 141-144 survey methods, 74-87, 208, 284-286, 301 Residual Physical Functional Capacity Assessment, 24, 273-274 Respiratory disorders, 203 Respondent burden, 70, 76-77, 81-82, 106, 216, 217-218 Response rates, 8, 69-70, 73, 76, 81, 171, 215 Retirement History Survey, 288 Retirement Research Consortium (RRC), 143 Reviewing Medical Consultant, 244, 248-249, 251, 253-254, 271 S Sample design, 7, 67-68, 73, 78, 80, 171, 214, 219 Sample sizes, 7-8, 68-69, 70, 80, 98, 104, 106, 170-171, 218, 295, 296 Sampling error, 79-80, 214, 290, 292 Schedules for Clinical Assessment in Neuropsychiatry, 267 Screening instruments, 247, 267-268, 269, 271, 275, 278 methods, 70, 75-78, 81, 85, 227-232, 298 Secondary conditions, 60, 190, 198-199 Selection bias, 228 Self reports, 83, 95-96, 106, 212, 218-219, 220, 223, 226, 230-231, 284, 291-292 Sensitivity and specificity, 129, 130 Social activities, 188 Social classification, 226-227 Social cognition, 225-226 Social roles, and definition of work disability, 54, 57, 58, 59-60, 61, 84, 187-190, 193, 195-198, 199, 201 Social Security Act, 34 amendments, 35, 44 definition of disability, 4, 17-18, 61, 94, 184, 185, 190, 242-243, 262, 279, 281, 283, 289 Social Security Administration administrative databases, 106-108 disability surveys, 88 234, 286-288 information needs for policy decisions, 89-91 Office of Research, Evaluation and Statistics (ORES), 141 Program Operations Manual System, 273 regulations, 273 Social Security Advisory Board, 129, 141 Social Security Benefits Reform Act of 1984, 40 Social Security Disability Insurance (SSDI) program administrative database, 107 applications and awards, 18, 35-36, 38, 41, 46, 47, 243 beneficiaries enrolled, 18, 35, 36, 39, 42 composition of beneficiary population, 43, 44-45, 46 cost containment measures, 34-35 coverage and support levels, 34, 35 defined, 1 n.1, 17 definition of disability, 242 DHHS analysis of, 18-19, 20 eligibility criteria, 243 growth trends, 1, 18, 35-37, 41, 43, 44, 45, 46, 48, 49 inception, 33, 34-35 income replacement rates, 39 initial determination of disability, 34, 243; see also Disability decision process SSI benefits concurrently with, 47 terminations, 35, 36, 38-39, 41-42 waiting period to receive benefits, 35, 37 workers insured, 42, 43 Social Security retirement program, 37, 49, 51-52, 107, 288 Social Security Survey of Disabled Adults, 287 States. See also Disability Determination Services (DDs) cost shifting by, 19, 47, 90 initial disability determinations, 34, 37 welfare recipients, 37 Stigmatization, 84, 193, 226 Substance Abuse and Mental Health Services Administration, 301 Substantial gainful activity (SGA), 2, 19, 34, 40, 53, 55, 63, 66 n.1, 94, 114, 123, 133, 184, 242-243 Supplemental Security Income (SSI) program, 33 administrative database, 107 applications and awards, 18, 37-38, 42

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The Dynamics of Disability: Measuring and Monitoring Disability for Social Security Programs composition of beneficiary population, 43 defined, 1 n.1, 37, 17 eligibility, 37, 243 growth of, 1, 18, 35, 37-38, 42, 43-44, 49 number of recipients, 37—38 outreach efforts, 2, 19, 37, 42, 47 processing of claims, 37, 243; see also Disability decision process qualified aliens, 43-44, 48 SSDI benefits concurrently with, 47, 243 terminations, 37-38 Supplemental Security Record, 107 Survey measurement of disability. See also Work disability monitoring system cognitive considerations, 223-225, 236-237, 238, 298 conceptual issues, 7, 49 n.6, 56, 74, 83-84, 87, 94, 184-185, 211, 212, 213, 263-264, 281-284 coverage error, 75-78, 85, 95, 104, 171, 215, 220, 223, 227, 284, 285, 290, 292 cross-sectional design, 96, 219, 291, 293-294 data collection models, 69, 70, 72, 74, 78-79, 82, 83-84, 86, 87, 95, 106, 212, 216, 218, 219-220, 223, 228-229, 284, 285, 291-292, 301 data sources, 290-291 design options, 83, 215-216, 290-301 development of, 289-290 differential response error, 220-221 environmental measurements, 83-86, 183-184, 211, 232-233, 237, 282, 285-286 errors of nonobservation, 214-216, 284-285 errors of observation, 216-221, 227, 284-285 essential survey conditions, 83, 212, 219-220, 223, 230, 233, 238 functional limitations of disabled persons to respond to, 75, 77-79, 80-81, 223-227, 284 household-based, 75-76, 94, 95-96, 106, 171, 215-216, 220, 282, 284, 289, 290, 292, 293 ICF mapping to questionnaires, 285-286 institutionalized/homeless populations, 75-76 interviewing methods, 76-77, 81, 85, 95, 171, 215-217, 219, 220, 224-225, 228, 291-292 longitudinal design, 96, 199, 219-220, 228, 291, 293 measurement error, 74-75, 82-83, 85, 95, 212, 216-227, 232-237, 284, 285, 286, 290, 291, 292 medical examinations and performance tests, 70, 71, 78, 79, 81, 95, 96, 289, 290, 293, 295, 300 methodological issues, 75-87, 214-238, 284-286 for monitoring work disability, 5, 93, 95, 97-98, 99-104, 109, 284-286, 289-301 nonresponse error, 76, 77, 80-81, 85, 95, 104, 215-216, 220, 227, 284, 285, 290, 291, 292 ongoing federal surveys, 99-104, 212, 213, 282, 285-286 periodicity, 91, 95, 106, 291 prevalence of benefit eligibility as goal, 99 prevalence of disability across surveys, 233-234 provider-based, 102, 290, 295, 296 proxy respondents, 78-79, 83, 95-96, 106, 212, 216, 218, 223, 225, 226, 228, 230-231, 284, 292 questionnaire design, 70, 76-77, 82-83, 85, 87, 205-207, 212, 216-217, 223-224, 226-227, 228, 230-231, 232, 233, 236-238, 281-282, 284, 285-286, 293-294 recall bias, 217-218 recommendations, 13, 85, 86-87, 170-171 research framework, 74-86, 208, 284-286, 301 respondent burden, 70, 76-77, 81-82, 106, 216, 217-218 response rates, 70, 76, 81, 171, 215 sample design, 67-68, 73, 78, 80, 171, 214, 219 sample sizes, 7-8, 68-69, 70, 80, 106, 170-171, 218, 295, 296 sampling error, 79-80, 214, 290, 292 screening methods, 70, 75-78, 81, 85, 227-232 self-classification of disability, 218-219, 225-227 self reports, 83, 95-96, 106, 212, 218-219, 220, 223, 226, 230-231, 284, 291-292

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The Dynamics of Disability: Measuring and Monitoring Disability for Social Security Programs social cognition, self-concept, and social desirability aspects of, 225-227 SSA initiatives, 286-288; see also National Study of Health and Activity testing, 85-86, 171 time allocation issues, 74, 86 types of, 205 Survey of Disability and Work (1978), 287-288 Survey of Disabled and Nondisabled Adults (1972), 287 Survey of Economic Opportunity, 234 Survey of Income and Education, 234 Survey of Income and Program Participation, 95, 100, 102-103, 171, 206, 231, 232, 234, 285, 290, 295, 297, 298 T Termination of benefits CDRs and, 41 proof of medical improvements and, 40 reasons for, 38-39 trends, 35, 36, 37-39, 41-42, 51 Test-retest, 222 Testing, survey design, 85-86, 171 Ticket to Work and Self-Sufficiency Program, 67, 138 Ticket to Work and Work Incentives Improvement Act of 1999, 10, 138 U University of Michigan, 143 U.S. Census for Year 2000, 206 V Validity concurrent, 127, 222 construct, 127, 222 criterion, 127, 221-222 defined, 127, 221-122 of disability decision process, 123, 127-128 of Index of ADLs, 227-228 of Listing of Medical Impairments, 130, 131-132 measures of, 222 predictive, 127, 222, 227-228 of survey measurement of disability, 221-222, 227-228, 236, 238 of WHO DAS II, 267 Variable errors, defined, 214, 221 Variance, defined, 221 Virginia Commonwealth University, 27, 120-122 Vocational capacity assessment, 9-10, 24, 25, 63, 113, 115, 117, 119, 132-137, 172, 203, 204-205, 242-243, 245, 263, 275 W Waiting period to receive benefits, 35 Welfare recipients, 19, 37 Welfare reform, 48 Westat, 26, 67-70, 71, 72, 78-79 Work disability. See also Definition of work disability; Measurement of disability dynamic nature of, 60 inconsistencies in reporting of, 235-236 Work disability monitoring system. See also Survey measurement of disability ad hoc special studies, 5-6, 108 administrative data linkages, 5, 93, 94, 95, 96, 97, 106-108, 290-291, 293 assessment of utility of, 289 characteristics, 94-108, 285-286 classification of disability in, 6, 296, 298 committee of experts, 6, 111-112 for continuous monitoring, 5, 87, 91-92, 93, 95, 96-108, 109, 212, 284-286, 291, 293, 294 cost considerations, 96, 98, 104, 290, 294, 301 cross-sectional data collection, 95, 96, 105-106, 291, 293-294 data sources, 94, 95, 290-291 defined, 94 design considerations, 5-6, 94-108, 110-111, 285-286, 289, 290-301 development and planning for, 92-93, 108-112, 289-290 disability decision process modeling component, 290

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The Dynamics of Disability: Measuring and Monitoring Disability for Social Security Programs disability definition for, 289 error considerations, 95, 98, 104, 106, 290, 291, 296 evaluation and testing, 93, 98, 110-112 implementation objectives, 6, 92-93, 111 longitudinal data collection, 5, 95, 96, 97, 105-106, 199, 291, 293 mode of data collection, 95, 97, 102, 106, 110, 291-292, 294, 295 NSHA and, 5, 97-99, 104, 109 partnerships with other federal agencies, 5, 93-94, 95, 99-104, 105-106, 109, 110, 294-301 physical examination data, 95, 96, 102, 290, 293, 295, 300 policy and planning issues to be addressed by, 5, 89-94, 287 purpose of, 88-89, 94-95 questionnaire-related issues, 293 recommendations, 5, 13, 92-93, 147 reduced sets of measures in intervening years, 6, 97-99 research needs, 301 sample sizes, 98, 104, 106, 295, 296 screening instrument, 298 survey measurement component, 5, 93, 95, 97-98, 99-104, 109, 284-286, 289-301 Work environment accommodations, adaptations, and barriers, 62, 84, 187, 202, 207, 208, 211, 283-284 and definition of disability, 4, 7, 54, 57-58, 59-60, 61, 62-64, 83-84, 185-186, 188-190, 191, 194, 196, 198, 204-205, 208, 211, 213, 261-262, 283-284, 285-286 and disability decision process, 4, 61, 138 measures of, 83-86 social, 84, 193 survey measurements of, 83-86, 183-184, 211, 232-233, 237, 282, 285-286 Work experience, and ability to work, 10, 136, 242 Work incentives, 39, 67 Workers’ compensation, 55-56, 134, 204, 303 Workshop on Measuring Functional Capacity and Work Requirements, 90, 132 Workshop on the Measurement of Persons with Work Disability, 293, 301 World Health Assembly, 258 World Health Organization DAS II, 267-268, 275, 277-278 health definition, 199-200 ICIDH model, 54, 57, 58-59, 60, 185, 190-195, 242, 259, 261-263 International Statistical Classification of Diseases and Related Health Problems, 257-258

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