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Suggested Citation:"Appendix C Committee Recommendations." Institute of Medicine and National Research Council. 2002. The Dynamics of Disability: Measuring and Monitoring Disability for Social Security Programs. Washington, DC: The National Academies Press. doi: 10.17226/10411.
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Suggested Citation:"Appendix C Committee Recommendations." Institute of Medicine and National Research Council. 2002. The Dynamics of Disability: Measuring and Monitoring Disability for Social Security Programs. Washington, DC: The National Academies Press. doi: 10.17226/10411.
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Page 171
Suggested Citation:"Appendix C Committee Recommendations." Institute of Medicine and National Research Council. 2002. The Dynamics of Disability: Measuring and Monitoring Disability for Social Security Programs. Washington, DC: The National Academies Press. doi: 10.17226/10411.
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Page 172
Suggested Citation:"Appendix C Committee Recommendations." Institute of Medicine and National Research Council. 2002. The Dynamics of Disability: Measuring and Monitoring Disability for Social Security Programs. Washington, DC: The National Academies Press. doi: 10.17226/10411.
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Page 173

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Appendix C Committee Recommendations The following is a compilation of all recommendations made by the committee in the interim reports. DISABILITY EVALUATION STUDY DESIGN First Interim Report RECOMMENDATION 3-1. The committee strongly endorses the conduct by the Social Security Administration of a well-designed, carefully pretested, and statistically sound Disability Evaluation Study. RECOMMENDATION 3-2. The committee recommends that the current stage 1 and pilot study be merged, expanded, and extended into a research, development, and testing phase of the survey with application to samples of the type that are more traditionally used in methods testing. Only when the development and refinement of the functional assessment instruments, survey operations, and other is- sues are tested and resolved should a national sample survey be launched using a single protocol. RECOMMENDATION 3-3. The committee recommends that the national survey should be conducted with one sample large enough 170

COMMITTEE RECOMMENDATIONS 171 to estimate the sizes of the populations at risk with acceptable levels of statistical precision. RECOMMENDATION 3-4. The committee recommends that the Social Security Administration use relevant data from the National Health Interview Survey Disability Supplement, National Health and Nutrition Examination Survey, Survey of Income and Program Participation, and other relevant surveys to assist in developing the sample design, survey operation, and questionnaire content for the Disability Evaluation Study. RECOMMENDATION 4-5. The committee recommends that the Dis- ability Evaluation Study be based on a design offering full coverage of the U.S. household population of adults. If resources are lacking to mount an area probability sample using face-to-face interviews, the Social Security Administration should use a multiple frame design of a statistically optimum mix of the general population followed by face-to-face interviews of the eligible population. RECOMMENDATION 4-6. The committee recommends that once the options for using different combinations of team composition and origin, examination setting, and other dimensions are sufficiently set for assessments, a formal field experiment should be performed dur- ing the research, development, and testing phase of the survey to determine the validity and reproducibility of these options as well as the most cost-effective approach to meeting the objectives of the survey. RECOMMENDATION 4-7. The committee recommends that the Social Security Administration require in the scope of work a rigor- ously designed experiment in the field testing and development phase of the survey to identify mechanisms for enhancing participation in the Disability Evaluation Study, to guide decisions on the use of home examination for those unable to travel to an examination site, to estab- lish the validity of the measures obtained, and to assess the quality of the medical evidence of record. RECOMMENDATION 4-8. The committee recommends that the Social Security Administration enhance the safeguards of matched data according to accepted practices by employing procedures used in recent federal surveys and that it take into consideration the effect of such procedures on response rates.

172 THE DYNAMICS OF DISABILITY THE SOCIAL SECURITY ADMINISTRATION’S DISABILITY DECISION PROCESS: A FRAMEWORK FOR RESEARCH Second Interim Report RECOMMENDATION 4–1. The committee recommends that early in the redesign effort, the Social Security Administration should specify how it will define, measure, and assess the criteria it will use to evaluate the current disability determination process, as well as any alternative processes being developed. RECOMMENDATION 4–2. The committee recommends that the Social Security Administration develop an alternative plan for use of functional assessment measures in the disability decision process in the event that the proposed global, standardized, functional assess- ment measure is not developed and tested in time for implementa- tion. RECOMMENDATION 4–3. The committee recommends that the Social Security Administration develop an interim plan for an occu- pational classification system in the event that the Occupational Infor- mation Network (O*NET) database is either not completed or insuffi- cient to meet the needs of a new disability decision process. RECOMMENDATION 4–4. The committee recommends that the Social Security Administration conduct baseline studies on the role of the evaluation of vocational factors in the current decision-making process and the effects of these factors on the populations of claim- ants and beneficiaries. RECOMMENDATION 4–5. The committee recommends that the Social Security Administration reconsider the timeframe for comple- tion of the redesign research so that the necessary questions can be answered in an appropriately sequenced and coordinated manner. RECOMMENDATION 4–6. The committee recommends that the Social Security Administration establish a cognitive laboratory for the Disability Evaluation Study, disability decision process research, and for other purposes of the agency. RECOMMENDATION 4–7. The committee recommends that the Social Security Administration actively engage process engineering experts (such as industrial engineers, operations researchers) to

COMMITTEE RECOMMENDATIONS 173 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 effi- ciency. RECOMMENDATION 4–8. The committee recommends that the Social Security Administration develop plans for simulation and modeling of alternative disability decision processes and other policy options, and devote adequate resources for this activity. RECOMMENDATION 5–1. The committee recommends that the Social Security Administration’s research and evaluation staff and its extramural research program be expanded substantially. REVIEW OF THE DISABILITY EVALUATION STUDY DESIGN Third Interim Report RECOMMENDATION: The committee strongly recommends that SSA revise the project schedule to allow significantly more time to plan and analyze the pilot study and test alternative solutions for problem areas before starting the national study.

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The Society Security disability program faces urgent challenges: more people receiving benefits than ever before, the prospect of even more claimants as baby boomers age, changing attitudes culminating in the Americans With Disabilities Act. Disability is now understood as a dynamic process, and Social Security must comprehend that process to plan adequately for the times ahead. The Dynamics of Disability provides expert analysis and recommendations in key areas:

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