The Social Security Administration's Disability Decision Process A Framework for Research, Second Interim Report (1998) / Chapter Skim
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4 SSA's Research Plan for a Redesigned Disability Decision Process
4 SSA's Research Plan for a Redesigned Disability Decision Process
Pages 15-34
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From page 15... ...
. The new disability decision process, as envisioned by SSA, will assess a person's functional ability once, relying on objective, standardized, functional assessment instruments.
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From page 16... ...
Information gathering (comprehensive review and analysis of existing information) on: functional assessment instruments, occupational classification systems, disability determination processes used in other clisability programs in the United States and other countries, and the effects of age, education, and work experience (vocational factors)
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From page 17... ...
SSA's research plan comprises projects that are oriented to developing and testing the functional assessment instruments in the disability decision process, exploring the effect of vocational factors on decisions, and developing a prototype for a revised disability decision process. Ultimately, however, the questions that need to be answered include: Will the projects together answer the questions that need to be answered?
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From page 18... ...
Assembling and analyzing existing information using administrative and statistical data, internal agency data and other documents, and results from special small studies and internal and external surveys to examine the relative roles of the factors associated with the problems and their concentrations, helps to understand the problems associated with the current disability decision process. It should also help define the goals to be achieved.
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From page 19... ...
evaluate the options to correct the problems detected by these evaluations, as it develops any new list of medical impairments. Throughout the documents reviewed by the committee relating to the redesign research, including the scope of work for the research contracts and in presentations before the committee, SSA has recognized the need to test the new disability decision process by applying standards of validity, reliability, sensitivity, specificity, credibility, and flexibility.
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From page 20... ...
Validity represents a set of criteria by which the credibility of research may be judged. For example, it measures the degree of agreement between the disability decision and actual fact of disability.
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From page 21... ...
Only with such openness will the validity assessments be accepted when they become available. The brief discussion of measurement terms and issues clearly demonstrates the need for SSA to specify early in the redesign effort what it means by the terns validity, reliability, sensitivity, specificity, credibility, flexibility, and all the other related terms that it uses; and how it plans to measure them, that is, what measurable criteria will be used to assess these standards vis a vis the disability decision process research.
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From page 22... ...
The committee is convening a workshop in June 1998 to discuss measures of functional capacity and work requirements as they relate to SSA's disability decision process research. The committee urges SSA to take into consideration the results of the workshop as it proceeds in the area offunctional assessment.
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From page 23... ...
NET and a functional assessment taxonomy is especially useful, given the unique needs of SSA's disability decision process. Such a matrix would allow SSA to observe, and possibly supplement, any potential gaps that exist within the O*
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From page 24... ...
activity. Other Disability Decision Programs In September 1997, SSA awarded a contract to Westat to review other disability programs, public and private in the United States and In other countries, to determine if such programs have criteria, instruments, or any other features that may be appropriate for use in developing SSA's new disability decision process (SSA, 1997a)
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From page 25... ...
In some programs, benefit awards are made simply on the basis of the extent of the physical or mental impairment. In other jurisdictions, the decisionmaker is required to inquire into the extent of work incapacity, taking into account the applicant's education, age, and work experience, and possibly even the condition of the labor market.
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From page 26... ...
, is to assist SSA in deciding an appropriate way to incorporate into the redesigned disability decision process the specific statutory requirement to consider an individual's age, education, and work experience in determining ability to work. The committee has concerns about several parts of the scope of work described in the request for proposals.
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From page 27... ...
This process will include a detailed assessment of each factor's contribution to the evaluation process; documentation of the separate effects of each vocational factor, as well as their interaction with one another and with an individual's functional abilities; assessment of the ability of an individual to adjust to work other than that which has been previously performed; and recommendations for any change in the role of vocational factors in a new disability decision process. As a result of this review and analysis, SSA states that it hopes to detains if the present process; the proposed decision process; or some other, as yet unspecified, process provides the optimal mechanisms for considering vocational factors.
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From page 28... ...
To illustrate the point, task two of this task order contract requires the contractor: (~) to review critically and analyze the findings of the four literature review projects (Functional Assessment Instruments conducted by VCU, Occupational Classification Systems conducted by AIR, Other Disability Programs awarded to Westat, and the Effects of Vocational Factors awarded to the Library of Congress as an Interagency Agreement)
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From page 29... ...
The assessment will address potential development costs and timeframes, potential administrative and programmatic effects of such a new process, and make recommendations for development of alternative decision methods. Some of the other tasks to be conducted in this task order include: investigating issues related to the definition of a single baseline of work demands applicable to all circumstances in terms of common and fundamental functional requirements and use of ONSET to develop such a baseline, identifying the dimensions of functioning to be measured in the functional assessment instruments, developing standardized functional assessment protocols, and analyzing and assessing the feasibility of using these protocols.
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From page 30... ...
In response to the committee's questions, SSA explained that a "laboratory" for purposes of its research plan could be anything from a small number of disability decisionmakers reviewing case files to determine whether they contain sufficient occupational information to a formal evaluation of the validity and reliability of a specific functional assessment protocol. To date, SSA has not developed any specific requirements regarding key questions and subject pools to be included.
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From page 31... ...
Whereas, many of the committee's recommendations have addressed the need to assess the utility of the disability decision process (i.e., the first ingredient) , none of its recommendations have specifically addressed the need for research into the process engineering of SSA's disability claims process (i.e., the second ingredient)
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From page 32... ...
to evaluate and improve the Social Security Administration's disability benefits administrative process to assure that task assignments and participant roles achieve a maximum level of effectiveness and efficiency. This recommendation implies that SSA form a group of suitably oriented faculty from some of the leading academic process engineering programs (e.g., industrial engineenng, operations research, and operations management in business)
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From page 33... ...
The committee hopes that data generatedirom this effort wiR be analyzedfor modeling alternative disability decision processes, using the evaluative criteria established early in the redesign research. Moreover, the effect of redesigning the decision process on the number and characteristics of future beneficiaries also needs further study and development, and this will require specific and detailed information on health, impairment, as well as functional assessments.
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From page 34... ...
SSA will need tools to evaluate the performance of the new candidate measures relative to those used in DES. The committee believes that SSA should identify ways to test new ideas in future studies, including randomized controlled experiments of alternative procedures, which would facilitate ongoing improvements in SSA 's disability decision process.
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