the era in which it relied extensively on the testimony of “vocational experts” or their written evaluations.

Moreover, SSA has not updated the research base on the effect of age, education, and work experience on work disability. The research base was used in developing the medical–vocational guidelines of 1978. Since then much has changed with regard to the relative importance of each of these factors. As part of the initiative to redesign the decision process, SSA included in its redesign research plan an evaluation of the effect of vocational factors—age, education, and work experience—on the ability to work or adapt to work in the presence of functional impairment. A review of existing knowledge concerning vocational factors and their impact on the ability to perform jobs in the national economy raised challenging questions about the continuing validity of the approach taken by SSA’s existing regulations. The review suggested a critical need for research designed to validate the use of vocational factors in SSA’s disability decision process.

Disability Allowances

Over the past two decades, the number of disability beneficiaries in the working age population has risen steadily. Although the number of applicants for benefits has increased only moderately, the number of new beneficiaries has nearly doubled. Disability allowance rates (awards as a percentage of applications) have varied over time from 31.4 percent in 1980 to nearly 47 percent in 2000.

Variations in allowance rates occur for several reasons. For example, SSA’s standards for judging claims differ over time. Dramatic reductions in allowance rates occurred when standards were abruptly tightened in 1980 and then subsequently relaxed. Significant differences are observed in allowance rates across states, between Disability Determination Service (DDS) decision makers, and between DDSs and administrative law judges. The allowance rate is also influenced by legislative changes as well as court decisions, and the adequacy of resources to process and review cases. Increased research is needed to explain these variations and whether they are predictable.

The objectives of the current disability decision process are to attempt to make decisions that are consistent with the statutory definition of disability as consistently, expeditiously, and cost-effectively as possible. Recent legislation—the Ticket to Work and Work Incentives Improvement Act of 1999 (P.L. 106-170)—suggests that Congress is increasingly interested in the return to work model and is prepared to have SSA experiment with some alternative strategies that might facilitate the pursuit of work rather than benefits. The committee concludes that SSA should ini-

The National Academies of Sciences, Engineering, and Medicine
500 Fifth St. N.W. | Washington, D.C. 20001

Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement