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Introduction

The Social Security Administration (SSA) is reengineering its disability claims process for providing cash benefits and medical assistance to blind and disabled persons under the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) Program (Title II and Title XVI of the Social Security Act). As one element of this effort, SSA has proposed a redesigned disability determination process. The agency has undertaken a multi-year research effort to develop and test the feasibility, validity, reliability, and practicality of the redesigned disability determination process before making any decision about implementing it nationally. SSA requested the National Academy of Sciences to review and provide advice on its research relating to the development of a revised disability decision process, including the approach, survey design, and content of the Disability Evaluation Study (DES). One of the committee's tasks is to examine SSA's research into existing and other developing functional assessment instruments for the redesign efforts and to provide advice for adopting or developing instruments for the redesigned decision process and the DES. (See Appendix A for the study mandate.)

In 1995, SSA contracted with Virginia Commonwealth University (VCU) to review systems, methods, and instruments that measure a person's functional capacity to work and to evaluate their potential application in the disability decision process. VCU's main conclusion in its report was that no government or private organization is currently using functional assessment instruments specifically for determining work disability benefits and a global measure of functional assessment does not exist that would be a valid indicator of disability for populations currently served by SSA. Such an instrument will likely have to be developed.

As a step toward exploring these issues, the National Academy of Sciences' Committee to Review the Social Security Administration's Disability Decision



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Measuring Functional Capacity and Work Requirements: Summary of a Workshop 1 Introduction The Social Security Administration (SSA) is reengineering its disability claims process for providing cash benefits and medical assistance to blind and disabled persons under the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) Program (Title II and Title XVI of the Social Security Act). As one element of this effort, SSA has proposed a redesigned disability determination process. The agency has undertaken a multi-year research effort to develop and test the feasibility, validity, reliability, and practicality of the redesigned disability determination process before making any decision about implementing it nationally. SSA requested the National Academy of Sciences to review and provide advice on its research relating to the development of a revised disability decision process, including the approach, survey design, and content of the Disability Evaluation Study (DES). One of the committee's tasks is to examine SSA's research into existing and other developing functional assessment instruments for the redesign efforts and to provide advice for adopting or developing instruments for the redesigned decision process and the DES. (See Appendix A for the study mandate.) In 1995, SSA contracted with Virginia Commonwealth University (VCU) to review systems, methods, and instruments that measure a person's functional capacity to work and to evaluate their potential application in the disability decision process. VCU's main conclusion in its report was that no government or private organization is currently using functional assessment instruments specifically for determining work disability benefits and a global measure of functional assessment does not exist that would be a valid indicator of disability for populations currently served by SSA. Such an instrument will likely have to be developed. As a step toward exploring these issues, the National Academy of Sciences' Committee to Review the Social Security Administration's Disability Decision

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Measuring Functional Capacity and Work Requirements: Summary of a Workshop Process Research convened a workshop on functional capacity as it relates to work requirements for the working age population. The workshop, held on June 4–5, 1998, was an opportunity to augment the knowledge and expertise of the committee through focused discussion of research into existing functional assessment and other instruments and protocols being developed; a wide range of researchers and other interested members of the public took part. Participants included members of the committee; experts on functional assessment, work performance, and physical and cognitive impairments; and other invited experts.1 OBJECTIVES AND FOCUS OF THE WORKSHOP The objectives of this workshop were to better understand how functional capacity for work can be defined, to explore how measures can be designed and used to assess a person's ability to work, and to aid the committee in advising SSA on measuring functional capacity in relation to work requirements for SSA's disability decision process. The workshop opened with a presentation of a paper on measuring functional capacity of persons with disabilities in light of emerging demands in the workplace. Participants then identified and discussed issues pertaining to: linking components of functional capacity domains with work requirements; desired characteristics of instruments to measure functional capacity to work; the use of functional capacity measures in public and private programs in the United States and in other countries in determining eligibility for disability benefits; and measurements of functional capacity to work that require resolution before implementation in SSA's redesigned disability decision process. The workshop attempted to link these issues with some of the operational issues involved in applying and using academic research in a program setting specific to SSA's disability decision process. This report is a summary of the workshop presentations2 and group discussions flowing from these presentations outlined in the agenda (Appendix B). This report is limited to the views and opinions of those participating in the 1   The committee organized the workshop through a small planning group composed of Edward Yelin, Dorothy Rice, Harold Pincus, and Donald Patrick. The full committee reviewed the plans, and modifications were made in response to the comments received. Thus, the workshop reflects the collective thinking of the committee regarding the issues discussed. 2   The exception is the first paper, which is included in its entirety in chapter 2.

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Measuring Functional Capacity and Work Requirements: Summary of a Workshop workshop and reflects the concerns and areas of expertise of the participants (A list of participants is shown in Appendix C). As such, the report does not provide a comprehensive review of the research and current status of functional assessment measures for work requirements. The issues and themes of the workshop provided a unifying focus for the various presentations and discussions that flowed over the course of the day-and-a-half workshop. The organization of the report approximates the order of presentations at the workshop.