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Introduction

The Social Security Administration (SSA) has been engaged in a major effort to redesign the process for determining disability for cash benefits and medical assistance under its Social Security Disability Insurance (SSDI), Title II of the Social Security Act and the Supplemental Security Income (SSI), Title XVI of the Social Security Act. Because of the complexity and far-reaching impact of its efforts, SSA concluded that the redesign effort requires extensive research, testing, and validation, as well as further development of some of its components before national implementation. The effect of the new determination process on the number and characteristics of future beneficiaries also needs further study. The agency asked the National Academies to provide ongoing independent and unbiased review of, and recommendations on, its current and proposed research as it relates to the development of a revised disability decision process including the approach, survey design, and content of the complex multiyear Disability Evaluation Study (DES).

The present report is the third in a series of short interim reports of the National Academies' Committee to Review the SSA's Disability Decision Process (hereafter referred to as "the committee"). The first interim report reviewed and commented on the general features of the proposed survey design, data collection plan, coverage and sampling for the DES. It provided a preliminary examination of these components as described in the scope of work in the draft request for proposal (RFP) developed by SSA for a contract to conduct a DES. In that report the committee made no attempt to comment on the content of the questionnaires, specific measures of functional capability, or the content of the medical examinations and medical and diagnostic tests proposed for the DES.

The second interim report contained a preliminary assessment of the adequacy of SSA's research plan for developing a new disability decision process and the timeline for its completion. In that context, the report outlined a framework for a research design and reviewed the general features and directions specified by SSA in the scope of work in the relevant RFPs for the conduct of the research. The report identified critical elements of a research design that were missing from SSA's plans and offered suggestions for changes in priorities and improvements in the research projects underway and others yet to be developed.



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OCR for page 1
Review of Disability Evaluation Study Design: Third Interim Report 1 Introduction The Social Security Administration (SSA) has been engaged in a major effort to redesign the process for determining disability for cash benefits and medical assistance under its Social Security Disability Insurance (SSDI), Title II of the Social Security Act and the Supplemental Security Income (SSI), Title XVI of the Social Security Act. Because of the complexity and far-reaching impact of its efforts, SSA concluded that the redesign effort requires extensive research, testing, and validation, as well as further development of some of its components before national implementation. The effect of the new determination process on the number and characteristics of future beneficiaries also needs further study. The agency asked the National Academies to provide ongoing independent and unbiased review of, and recommendations on, its current and proposed research as it relates to the development of a revised disability decision process including the approach, survey design, and content of the complex multiyear Disability Evaluation Study (DES). The present report is the third in a series of short interim reports of the National Academies' Committee to Review the SSA's Disability Decision Process (hereafter referred to as "the committee"). The first interim report reviewed and commented on the general features of the proposed survey design, data collection plan, coverage and sampling for the DES. It provided a preliminary examination of these components as described in the scope of work in the draft request for proposal (RFP) developed by SSA for a contract to conduct a DES. In that report the committee made no attempt to comment on the content of the questionnaires, specific measures of functional capability, or the content of the medical examinations and medical and diagnostic tests proposed for the DES. The second interim report contained a preliminary assessment of the adequacy of SSA's research plan for developing a new disability decision process and the timeline for its completion. In that context, the report outlined a framework for a research design and reviewed the general features and directions specified by SSA in the scope of work in the relevant RFPs for the conduct of the research. The report identified critical elements of a research design that were missing from SSA's plans and offered suggestions for changes in priorities and improvements in the research projects underway and others yet to be developed.

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Review of Disability Evaluation Study Design: Third Interim Report This third interim report relates directly to one of the contract tasks-review of the design, approach, and content of the DES, as proposed by SSA's contractor for the survey, Westat, Inc*. This report is limited to a brief review of the sample design (including that of the pilot study), instruments and procedures, and response rates goals developed by Westat and provided by SSA in June 1999 to the committee for its review and recommendations (Westat, Inc., 1999 a-c). It also comments on the proposed timeline for initiation of each phase of the survey. *    The committee conducted much of the work on this report through a subcommittee composed of William Kalsbeek Chair, Ronald Brookmeyer, Gerben DeJong, Robert Groves, and Catharine Maslow. The full committee reviewed the draft report, and subsequent revisions were made in response to comments from committee members. Thus, the report reflects the collective thinking of the committee on the issues addressed.