The National Academies Press

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From page 1... ... Treasury general funds to adults aged 65 or older, individuals who are blind, and disabled adults and children. As of December 2014, approximately 48 million individuals received OASI benefits, about 11 million received SSDI benefits, and about 8 million received assistance through the SSI program. Read the entire page →
From page 2... ... . In carrying out this task, the committee was asked to address topics including capability determination processes used in at least three similar benefit programs, requisite abilities for managing or directing the management of benefits, methods and measures for assessing capability, the use of capacity assessment tools, appropriate roles for SSA and state Disability Determination Services employees, and effects on the beneficiary of appointing a representative payee. Read the entire page →
From page 3... ... Familiarize itself with SSA's current policy and procedures for capability determinations for adult beneficiaries; 2. Provide an overview of the capability determination processes in at least three similar benefit programs (at least one government program and one private-sector program) Read the entire page →
From page 4... ... These include SSA's and OPM's requirement for lay evidence to find a beneficiary incapable, which provides the opportunity to obtain information about beneficiaries' real-world financial performance; the VA's supervised direct payment option for individuals who are determined incompetent but able to manage their benefits with supervision, which reflects a model of supported decision making; and OPM's instructions to individuals providing evidence to inform capability determinations. EFFECTS OF APPOINTMENT OF REPRESENTATIVE PAYEES ON BENEFICIARIES Representative payee programs have been found to have significant and positive effects on a beneficiary's ability to live independently, which 4 AHIP is the national trade association representing the health insurance industry. Read the entire page →
From page 5... ... SSA representative payees are most commonly friends or family members of the beneficiaries. Such an arrangement can have significant negative effects on beneficiaries' relationships with those serving in this role; for example, beneficiaries can be negatively affected by strain in their familial relationships resulting from conflict over the money management responsibilities of family members acting as representative payees. Read the entire page →
From page 6... ... financial performance relative to what would be expected based on the financial competence they exhibit in controlled settings, it is important to consider more than financial competence when thinking about financial capability. Successful financial performance reflects sufficient financial competence (knowledge and judgment) Read the entire page →
From page 7... ... MENTAL AND PHYSICAL DISORDERS THAT MAY AFFECT FINANCIAL CAPABILITY The presence of certain cognitive disorders, such as a well-documented history of severe intellectual disability or advanced Alzheimer's disease, may be sufficient for a determination of incapability, but such examples are few in number. Disorders with Cognitive Effects Evaluation of financial capability is important for individuals with disorders severe enough to lead to work-related disability that negatively affect the cognitive domains relevant to financial competence (e.g., general cognitive/intellectual ability, attention and vigilance, learning and memory, Read the entire page →
From page 8... ... Finally, as noted above, environmental factors may support continued successful financial performance in individuals experiencing a level of cognitive impairment sufficient to qualify for SSA disability benefits. Disorders with No or Minimal Cognitive Effects Individuals with certain physical impairments may require assistance to accomplish the physical tasks entailed in managing their benefits, but in the absence of cognitive impairment, they retain the ability to direct others to manage their benefits. Read the entire page →
From page 9... ... A relative might under stimate or underreport an individual's financial abilities in the hope e of gaining access to the person's funds or overestimate an individual's abilities so as not to alienate the person. RECOMMENDATIONS Evidence for Determining Financial Capability SSA's requirement for "lay" evidence of beneficiaries' financial performance in making capability determinations is consistent with the committee's conclusion that evidence of real-world financial performance is the most reliable basis for making such determinations. Read the entire page →
From page 10... ... There are times when no or very limited information is available about a beneficiary's financial performance -- for example, when the person has had no funds to manage or when no third-party informant with knowledge of the person's performance can be identified. In such cases, evidence of financial competence may need to be used to inform capability determinations. Read the entire page →
From page 11... ... In addition, SSA beneficiaries also may receive benefits from another federal agency, such as the VA or OPM. While acknowledging the potential technological, legal, and procedural challenges to data sharing, the committee concludes that sharing information about incapability determinations within SSA and among relevant federal agencies could increase the likelihood of each agency's identifying potentially incapable beneficiaries. Read the entire page →
From page 12... ... SSA's lack of a formal process for m periodically reviewing a beneficiary's capability is a significant weakness. Some mechanism for periodic reassessment is needed to ensure that beneficiaries with fluctuating, deteriorating, or improving financial capability are classified accurately. Read the entire page →
From page 13... ... As noted, however, a beneficiary's capa bility may change as a result of progressive or temporary diminution or improvement in his or her financial competence and performance over time. When information available about a beneficiary's financial performance is insufficient to determine the need to appoint a representative payee, the use of a supervised direct payment option may be helpful. Read the entire page →
From page 14... ... Program Evaluation Data are limited on the effectiveness of current SSA processes for identifying beneficiaries who should be evaluated for capability and on the accu racy of capability determinations among those identified for evaluation. Reports issued by OIG-SSA in 2004, 2010, and 2012 suggest that SSA's current capability determination process fails to identify all the beneficiaries who would benefit from the appointment of a representative payee. Read the entire page →
From page 15... ... SUMMARY 15 assessments of the interrater reliability of the capability determination process, in-depth assessments of selected beneficiaries to determine the accuracy of earlier determinations, and evaluations of the impact of the recommendations in this report (e.g., guidance on the evidence to be provided for capability determinations) Read the entire page →

From page 1...

... Treasury general funds to adults aged 65 or older, individuals who are blind, and disabled adults and children. As of December 2014, approximately 48 million individuals received OASI benefits, about 11 million received SSDI benefits, and about 8 million received assistance through the SSI program.

Summary Pages 1-16

Summary
Pages 1-16