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Suggested Citation:"Index." 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:"Index." 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:"Index." 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:"Index." 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:"Index." 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:"Index." 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:"Index." 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:"Index." 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:"Index." 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:"Index." 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:"Index." 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:"Index." 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:"Index." 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:"Index." 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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Index A American Community Survey, 99-101, 109, 295, 297, 298 Activities of daily living, 58, 61, 187, 192- American Housing Survey, 100-101, 295, 193, 195-196, 227-232, 247, 253, 265, 300-301 292, 296 American Institutes for Research (AIR), Activity limitation concept, 193, 196, 197, 122, 133 201, 202, 204-205, 208, 261, 264, 286 American Medical Association (AMA), Administration and processing of claims. Guides to Evaluation of Permanent See also Disability decision process Impairment, 55-56, 203-204 definitional issues, 4, 55 American Psychiatric Association, 241, 242, file linkages for monitoring work 245, 250-257, 268, 269, 272-273, 274, disability, 5, 93, 94, 95, 96, 97, 106- 279 108, 290-291, 293 American Psychological Association, 245- growth issues, 2, 10, 19-20, 37, 38, 39, 40 246 research recommendations, 172-173 Americans with Disabilities Act of 1990 Age (ADA), 4, 31, 51, 54, 60, 194, 213, and ability to work, 10, 135, 242 262, 310, 328, 329 and growth of disability programs, 1-2, Assistive devices and accommodations, 62, 35, 18-19, 42, 43, 44-45, 46 84, 116, 187, 202, 207, 208, 283-284, labor force participation, 306-308, 320- 310 321, 325, 326 Awards and allowances Agency for Healthcare Research and growth of, 1, 18, 33-42, 46, 47 Quality, 110, 143, 294, 297 replacement rate caps, 39 Aid to the Blind, 37 review requirements, 39 Aid to the Permanently and Totally minimum benefits, 39 Disabled, 37 variations in, 136-137 AIDS/HIV infection, 41 Aliens, qualified, 43-44 Allowances. See Awards and allowances 335

336 INDEX B Continuous Work History Sample, 107 Cost containment, 34 Baby boom generation, 2, 11, 43, 46, 51, 89, Cost-of-living adjustments, 35 141, 145, 307, 308 Court decisions and class action suits Behavioral Risk Factor Surveillance and definitions of disability, 213 System, 95, 100-101, 290, 295, 299- and growth of disability programs, 2, 300 10, 40, 45, 48, 90, 127 Bias, defined, 214 Coverage error, 75-78, 85, 95, 104, 171, 215, Black Lung Program, 35, 37 220, 223, 227, 284, 285, 290, 292 Boston College, 143 Cross-sectional design Bureau of Justice Statistics, 282, 298-299 for monitoring work disability, 95, 96, Bureau of Labor Statistics, 133, 282, 299, 105-106, 291, 293-294 310, 314, 315, 316, 317, 324, 326 for survey measurement of disability, Bureau of the Census, 94, 297-298, 300 96, 219, 291, 293-294 Current Population Survey, 51, 95, 100-101, 104, 106, 206, 234, 290, 295, 298, 299, C 318, 324 California Work and Health Survey, 324- 326 Canadian Health and Activity Limitation D Survey, 77, 207, 298 Data collection modes Cardiovascular disease, 46 for monitoring work disability, 95, 97, Centers for Disease Control and 102, 106, 110, 291-292, 294, 295 Prevention, 192, 299-300 for survey measurement of disability, Centers for Medicare and Medicaid 69, 70, 72, 74, 78-79, 82, 83-84, 86, 87, Service, 143 95, 106, 212, 216, 218, 219-220, 223, Classification of disabilities. See also 228-229, 284, 285, 291-292, 301 International Classification of Decennial Census, 206, 228-229, 230, 234- Functioning, Disability and Health 235, 236-237, 298 by disabled persons, 218-219, 225-227 Definition of work disability. See also fuzzy logic in, 225 Disability decision process mental, 245-250, 253-254 activity limitation concept, 193, 196, SSA Listings of Impairments, 48, 55, 63, 197, 201, 202, 204-205, 208, 261, 264, 124, 129-132, 203-204, 245-250 286 in work disability monitoring system, 6, biopsychosocial model, 260, 285-286 296, 298 conceptual issues, 4, 53-56, 59, 184-195 Clinical Disability Severity Rating, 252 cultural perspective, 54, 193 Cognitive considerations duration or chronicity considerations, interviewing, 224-225 62-63, 202-203 in survey measurements of disability, dynamic nature of disability and, 4, 60, 223-225, 236-237, 238, 298 62-63, 84, 198-200, 202-203, 213 Cognitive theory, 223-225 enabling-disabling process, 7-8, 74, 190, Composite International Diagnostic 191, 213, 281 Interview, 267 environmental factors, 4, 7, 54, 57-58, Conceptual issues. See Definition of work 59-60, 61, 62-64, 83-84, 185-186, 188- disability 190, 191, 194, 196, 198, 204-205, 208, Consultative Examiner, 250 211, 213, 261-262, 283, 285-286 Content Reinterview Survey (CRS), 228- functional limitation, 4, 30, 54, 58, 59, 231, 234-235 186-187, 193, 196, 197, 202, 204, 208, Continuing disability reviews (CDRs), 39, 212, 283 40

INDEX 337 and growth of awards and allowances, Department of Labor, 9, 61, 122, 123, 132- 35, 37, 40, 41 134, 136, 145, 310, 317, 328-329 handicap concept, 193, 194, 195, 259 Dependents of beneficiaries, 35 ICF model, 54, 56, 58-59, 258, 279 Diagnostic and Statistical Manual of Mental ICIDH model, 54, 57, 58-59, 60, 185, 190, Disorders, 245, 246 192-195, 196, 197, 198, 201, 259, 261- Dictionary of Occupational Titles, 9, 61, 263 122, 132, 134, 136, 145, 328-329 impairment concept, 186, 192, 196, 197, Differential response error, 220-221 201, 203-204, 212, 213, 243, 259, 261 Disability Analyst, 244, 249 intraindividual factors, 188, 189, 203 Disability claims process, 3, 19, 21 IOM models, 54, 56, 60, 188, 190, 194, Disability decision process. See also 200 Administration and processing of labor market structural changes and, 4, claims; Eligibility criteria 30-31, 56, 62, 94, 318 adversary models of benefits major schools of thought, 56-63, 185-195 adjudication, 138 and measurement of work disability, alternatives to, 10-11, 137-139 61, 62, 183-184, 212, 200-205, 283-284 American Psychiatric Association for monitoring work disability, 289 evaluation of, 241, 250-257, 268, 269, Nagi’s Disablement Model, 56, 57-58, 272-273, 274, 279 60, 185-190, 192, 195-196, 197, 198, appeals, 19-20, 21 201, 259 baseline evaluative criteria for redesign, neutral terminology, 193-194, 261, 263- 9, 38, 40, 118, 126-129, 130-131, 139 264, 286 conceptual issues, 4, 113, 183-184, 242- in ongoing federal surveys, 49 n.6, 283- 243, 251; see also Definition of work 284 disability participation restriction, 193-195, 196, Consultative Examiner, 250 197, 201-202, 212, 261, 264, 286 continuing disability reviews (CDRs), pathology/health condition, 186, 192, 39, 40 196, 197, 201, 203 date-of-onset/period-of-review purposes of, 55, 183, 184-185 documentation, 255, 256, 270 quality-of-life and, 58, 60, 190, 199-200, difficult claim types, 253, 255-256, 257, 201 270, 271, 272, 273, 274, 277 recommendations, 12-13, 63-64 environmental factors in, 4, 61, 138 risk factors, 188, 189 functional assessment instruments, 25, as screening device, 55-56, 61, 183-184 26, 90, 113, 114, 116-117, 119, 120- secondary conditions, 60, 190, 198-199 122, 124-125, 129, 172, 271, 272, 273- social roles concept, 54, 57, 58, 59-60, 61, 274 187-190, 193, 195-198, 199, 201 and growth of awards and allowances, statutory, 4, 17-18, 30, 54, 55, 57, 60, 74, 19, 37, 38, 39, 40, 114, 136-137, 212 94, 128, 184, 185, 190, 200, 213, 242- ICF assessment instrument and, 242, 243, 251, 262, 279, 281, 283, 289 257-266, 268, 273, 275, 277, 278, 279 in surveys, 7-8, 49 n.6, 56, 74, 83-84, 87, Index of Severely Disabling 94, 183, 184-185, 211, 212, 213, 263- Impairments, 25, 116-117, 124, 127, 264, 281-284 270 Demographic trends for initial claims, 19, 22-26, 34, 37, 114- growth of disability programs, 1-2, 18- 117, 241-279 19, 35, 42, 43-46, 89 Listings of Impairments, 8-9, 22-23, 24 Department of Health and Human n.4, 48, 55, 63, 115, 123, 124, 125, 126, Services, 18-19 127, 129-132, 203-204, 244-250, 253- Department of Housing and Urban 254, 256, 265, 268, 275, 276 Development, 300-301

338 INDEX medical evidence, 19, 22-23, 40, 48, 63, Disability Evaluation Study (DES), 20, 63- 114, 115, 129, 243, 244, 250, 254-255, 64, 212, 170-171. See also National 256-257, 268, 270, 271, 272-273, 277- Study of Health and Activity 278 Disability insurance tax rate and trust for mental impairments, 68, 129, 243-244, fund, 34-35 248-249, 253, 265, 275-276, 277-278 Disability Research Institute, 109, 131, 143 Mental Residual Functional Capacity Disabled people Assessment, 248, 249, 250, 251, 254, desire to work, 207 256, 264, 270, 273, 278 discrimination against, 207 NSHA and, 118, 119 employer tolerance, 108 objectives, 137-138 labor force participation rates, 319-321 occupational classification system, 9, 61, labor market for, 49-51, 317, 318-328 114, 117, 119, 122-123, 132-134, 136, number of, 212 172, 312-314, 322-323 quality-of-life issues, 58, 60, 190, 199- organizational fragmentation, 145-146 200, 201 physician opinions in, 40 self-classification of disability, 218-219, post-redesign period, 123-137 225-227 Psychiatric Review Technique Form, socioeconomic status, 90 244, 248-249, 250, 251, 253-254, 256, stereotypes, 62, 202-203 265, 269, 270, 275 support for SSA’s Disability quality assurance reviews, 38, 40 Employment Strategy, 67 recommendations, 9, 10-11, 14, 63-64, Disablement process, 84, 188-190, 200 123, 127, 130-131, 138, 172-173, 256- Drug abuse and alcoholism, 48 257, 275-279 Duration or chronicity of disability, 19, 44, redesign proposal, 3, 8, 21, 24-26, 90, 62-63, 202-203 116-123, 127, 128-129, 130-132, 133, Dynamic nature of disability, conceptual 139, 145, 172, 211-212, 241, 242 issues, 4, 60, 62-63, 84, 198-200, 202- regulations and guidelines, 114, 115 203, 213 research plan, 10-11, 63-64, 119-123, 125, enabling-disabling process, 74, 190, 191, 126, 130, 131, 132, 133, 139, 172-173, 213, 224, 226 241, 256-257, 268-279 and work disability monitoring system, Residual Physical Functional Capacity 91 Assessment, 24, 273-274 responsibility for, 19, 21, 34, 37, 107, 136-137, 243, 244 E return-to-work model, 8, 10-11, 138 Reviewing Medical Consultant, 244, Economic censuses, quinquennial, 92 Economic conditions 248-249, 251, 253-254, 271 scope of committee review of, 3, 8 and growth of disability programs, 2, screening instruments, 247, 267-268, 18, 37, 38, 40, 41, 42, 47, 48, 49, 88, 89, 287, 288 269, 271, 275, 278 simulation and modeling of, 67, 70, 72, Education 173, 289, 290 and ability to work, 10, 135-136, 242 and labor force participation rates, 308- vocational capacity assessment, 9-10, 24, 25, 63, 113, 115, 117, 119, 132-137, 309, 321-322 172, 203, 204-205, 242-243, 245, 263, Effectiveness, defined, 128 Efficiency, defined, 128 275, 303 WHO DAS II and, 267-268, 275, 278 831 Disability file, 107 Disability Determination Services (DDs), Eligibility criteria. See also Disability decision process 10, 19, 21, 37, 107, 136-137, 243 Disability Employment Strategy, 67, 70 and definitions of disability, 55 medical and functional, 48

INDEX 339 for mental impairments, 40, 41, 68 General Accounting Office, 129 noncitizens, 43-44, 48 Gore, Al, 20-21 original, 34 Growth of disability programs and program size, 2, 33, 39, 40, 41 administrative initiatives and, 2, 10, 19- substantial gainful activity and, 2, 19, 20, 37, 38, 39, 40 34, 40, 53, 55, 63, 66 n.1, 94, 114, 115, allowances and awards, 1, 10, 18, 33-42, 123, 184 46, 47, 136-137 and survey instrument design, 212 applications, 33, 35, 41 threshold severity requirement, 116 cost shifting by states and, 19, 47, 90 Enabling-disabling process, 7, 74, 190, 191, court decisions and, 2, 10, 40, 45, 48, 90, 224, 226, 281 127 Environment. See Work environment definitions of disability and, 35, 37, 40, Equal Employment Opportunity 41 Commission, 329 demographic trends and, 1-2, 18-19, 35, Extraindividual factors, 188, 189, 196, 198. 42, 43-46, 89 See also Work environment disability decision process and, 19, 37, 38, 39, 40, 114, 136-137, 212 econometric research studies, 20, 34 F economic conditions and, 2, 18, 37, 38, 40, 41, 42, 47, 48, 49, 88, 89, 286, 288 Federal ongoing surveys eligibility criteria and, 2, 33, 39, 40, 41, definition of disability in, 49 n.6, 283- 136-137 284 historical developments and, 34-42 measurement of disability in, 99-104, impairments and, 2, 18, 34, 40, 45-47, 48 212, 213, 282, 285-286 labor market dynamics and, 43, 44, 48, partnerships for monitoring work 49-51, 52, 89, 288 disability, 5, 93-94, 95, 99-104, 105- labor market structural changes and, 2, 106, 109, 110, 294-301 18, 48, 89, 304 Functional limitations, 40 legislative and regulatory changes and, assessment instruments, 25, 26, 90, 113, 2, 10, 18, 19, 34, 35, 38, 39-41, 42, 44, 114, 116-117, 119, 120-122, 124-125, 45, 48, 51-52, 90, 127 129, 172, 271, 272, 273-274 for mental impairments, 2, 45-46, 47, 48 definition of, 4, 30, 54, 58, 59, 186-187, outreach efforts and, 2, 19, 37, 42, 47 193, 196, 197, 202, 204, 208, 212, 283 projected, 2, 43, 51, 141, 145 and disability decision process, 25, 26, research needs, 20, 34, 52, 89-94, 127, 212 90, 113, 114, 116-117, 119, 120-122, SSA surveys of, 286-288 124-125, 129, 172, 271, 272, 273-274 trends, 1-2, 35-42 interviewing techniques, 224-225 of survey respondents, 75, 77-79, 80-81, 223-227, 284 H vocational capacity assessment, 132-133, 329 Handicap, defined, 193, 194, 195, 259 Health and Retirement Survey (HRS), 288 Homeless populations, 75-76 G Gender I and growth of disability programs, 43, 44-45, 46, 49, 50 ICF Checklist, 266, 267, 275, 277, 278 labor force participation rates by, 43, 44, Impairments. See also Mental impairments 49, 50, 89, 305-306, 319, 320-321, 325, AMA evaluation guides, 55-55, 203-204 326 awards by diagnostic group, 47

340 INDEX circulatory conditions, 2, 46, 47, 62, 203 International Classification of Impairments, classification , 54, 57, 58-59, 60, 185, 190, Disabilities, and Handicaps (ICIDH). 192-195, 261-263 See International Classification of conceptual issues, 186, 192, 196, 197, Functioning, Disability and Health 201, 203-204, 212, 213, 243, 259, 261 International Statistical Classification of date of onset and period of review, 255 Diseases and Related Health Problems environmental limitations, 115 (ICD), 257-258 fatigue, 62, 203 International Task Force on Mental Health, functional, 54 and Addictive, Behavioural, and growth of disability programs, 2, Cognitive, and Developmental 18, 34, 40, 45-47, 48 Aspects of ICIDH, 260, 265 multiple combined, 40, 47, 115, 243 Interviewing methods, 76-77, 81, 85, 95, musculoskeletal conditions, 2, 46, 47, 171, 215-217, 219, 220, 224-225, 228, 62, 203 291-292 pain, 62, 203 pathology/health condition, 186, 192, 196, 197, 201, 203 L survey design considerations, 76-77 systemic diseases, 47, 62, 203 Labor force participation accommodations and, 62, 84, 310 threshold severity requirement, 116 Index of Severely Disabling Impairments, age and, 306-308, 320-321, 325, 326 25, 116-117, 124, 127, 270 and disability definitions, 56, 62 by disabled persons, 319-321 Institute of Medicine, conceptual models of disability, 54, 56, 60, 188, 190, 194, dynamics of, 89, 304-309 200 early withdrawal from, 288 educational attainment and, 308-309, Institutionalized populations, 75-76 Instrumental activities of daily living, 58, 321-322 61, 187, 192-193, 247, 296 gender and, 43, 44, 49, 50, 89, 305-306, 319, 320-321, 325, 326 Internal consistency, 222 International Classification of Functioning, race and, 306, 320-321 Disability and Health (ICF) Labor market dynamics alternative work arrangements, 316 coding and rating, 263-264 conceptual model, 54, 58-59, 83-84, 185, contingent employment, 315-316 195, 196, 197, 198, 201-202, 258, 261- and definition of work disability, 4, 30- 31, 94, 318 263, 277, 279, 285-286 and disability decision process, 242, for disabled people, 49-51, 317, 318-328 257-266, 268, 273, 275, 277, 278, 279 displacement rates, 317-318, 326-328 employment characteristics, 309-318, domains, 196, 286 features of, 83-84, 257-258, 285-286 321-327 ICF Checklist, 266, 267, 278 and growth of disability programs, 43, 44, 48, 49-51, 52, 89, 288 ICIDH-1 (1980) compared, 54, 57, 58-59, 60, 185, 190, 192-195, 198, 201, 259, industries, 310-312, 321-322 261-263, 285 internal structure of work, 317 job security, 315 ICIDH-2, 185, 196, 197, 265, 282, 285 revision process, 185, 192, 260-261, 265 location of work, 316-317 survey questionnaire mapping to, 285- measuring functional demands, 328-330 occupations, 312-314, 322-323 286 taxonomy, 263 part-time employment, 314-315, 323-324 work disability, 265-266 structural changes, 2, 18, 30-31, 48, 89, 304 terms of employment, 315-318, 324-326

INDEX 341 Legislation and regulations health condition or pathology, 201, 203 and growth of disability programs, 2, impairment, 201, 203-204 10, 18, 19, 34, 35, 38, 39-41, 42, 44, 45, with Index of ADL, 227-232, 292 48, 51-52, 90, 127 participation restriction, 201-202 Leisure activities, 188 quality-of-life considerations, 90 Listings of Impairments, 8-9, 22-23, 24 n.4, research recommendations, 109 48, 55, 63, 115, 123, 124, 125, 126, role of work and, 201, 205 127, 129-132, 203-204, 244-250, 253- threshold, 62, 202 254, 256, 265, 268, 275, 276 work disability, 201, 205, 232-236 Longitudinal design Medicaid coverage, 2, 35, 37, 138 for measurement surveys, 96, 199, 219- Medical evidence, 19, 22-23, 40, 48, 63, 114, 220, 228, 291, 293 115, 129, 243, 244, 250, 254-255, 256- for monitoring work disability, 5, 95, 96, 257, 268, 270, 271, 272-273, 277-278 97, 105-106, 199, 291, 293 Medical examinations and performance tests for monitoring work disability, 95, 96, M 102, 290, 293, 295, 300 for NSHA, 70, 71, 78, 79-80, 81 Master Beneficiary Record (MBR), 107, 108 for surveys, 70, 71, 78, 79, 81, 95, 96, Master Earnings File (MEF), 107, 108 289, 290, 293, 295, 300 Measurement error Medical Expenditure Panel Survey, 100- disabled person as source of, 223-227 101, 102, 106, 108, 110, 294, 295, 297 in essential survey conditions, 212, 219- Medicare, 2, 138 221 Mental impairments in Index of ADLs, 228, 296 affective disorders, 253 interviewer-related, 219, 221 anxiety disorders, 247, 253, 254 psychometric perspective, 221-222, 228, autistic disorder, 247 231-232, 238 American Psychiatric Association questionnaire-related, 82-83, 85, 216- evaluation of claims process, 241, 217, 221, 286 250-257, 268, 269, 272-273, 274, 279 research needs on, 74-75, 82-83, 284-285 Clinical Disability Severity Rating, 252 respondent-related, 217-218, 223-227, date-of-onset/period-of-review 292 documentation, 255, 256, 270 in surveys, 74-75, 82-83, 85, 95, 212, 216- difficult claim types, 253, 255-256, 257, 227, 232-237, 284, 285, 286, 290, 291, 270, 271, 272, 273, 274, 277 292 disability determination process, 68, Measurement of disability. See also 129, 243-244, 248-249, 253, 265, 275- National Study of Health and 276, 277-278 Activity; Survey measurement of eligibility criteria, 40, 41, 68 disability growth in awards and allowances for, 2, activity limitation (at work), 201, 204- 45-46, 47, 48 205 ICF assessment instrument, 242, 257- conceptual issues, 61, 62, 183-184, 200- 266, 268, 273, 275, 277, 278, 279 205, 212, 283-284 Listing of, 48, 244-250, 253-254, 256, 265, direct assessment, 205-208 268, 275, 276 duration/chronicity considerations, medical evidence, 243, 244, 250, 254-255, 202-203 256-257, 268, 270, 271, 272-273, 277- empirical evidence on error in, 227-236 278 environmental barriers and Mental Residual Functional Capacity accommodations and, 109, 232-233, Assessment, 248, 249, 250, 251, 254, 237 256, 264, 270, 273, 278 functional limitations, 204, 227-236

342 INDEX mental retardation, 247, 253 National Longitudinal Study (NLS), 288 organic mental disorders, 253 National Medical Care Expenditure personality disorders, 247, 253, 256 Survey, 294 Psychiatric Review Technique Form, National Medical Care Utilization and 244, 248-249, 250, 251, 253-254, 256, Expenditure Survey, 294 265, 269, 270, 275 National Organization on Disability/ recommendations, 256-257, 275-279 Harris Survey of Americans with research issues, 256-257, 268-279 Disabilities, 226 schizophrenic, paranoid and other National Performance Review, 20-21 psychotic disorders, 246, 253, 254 National Science Foundation, 143 sequential evaluation, 243-244, 248-249, National Study of Health and Activity. See 253, 276, 277-278 also Survey measurement of somatoform disorders, 253 disability statutory definition, 242-243 corrective revisions, 8, 71-72, 86, 87 substance addiction disorder, 247 data collection plans, 7, 69, 70, 72, 74, vocational capacity assessment, 242-243, 78-79, 85, 86, 171, 290 245, 263, 275 disability decision process evaluation, WHO DAS II, 267-268, 275, 278 118, 119 Mentally disabled features, 67-70 deinstitutionalization of, 19, 40, 47 field experiments, 6, 73, 74, 171 stigmatization, 84 information goals, 20, 52, 65, 66-67, 88, survey design for, 75-76 91 Monitoring interim reports on, 66, 70, 78, 80, 81, of costs, 34-35 170-173 of work disability, see Work disability long-term usefulness of, 8, 91 monitoring system medical examinations, 70, 71, 78, 79-80, 81 monitoring system for work disability, N 5, 97-99, 104, 109 pilot study, 6-7, 8, 70, 71, 72-74, 78, 81, Nagi, Saad, 57, 185, 259 82, 86 Nagi’s Disablement Model, 56, 57-58, 60, quality issues, 70-74 185-190, 192, 195-196, 197, 198, 201, questionnaire design and testing, 70, 71, 259 72, 73, 81-82, 85, 87, 90, 171, 284 National Academy of Social Insurance recommendations, 12, 70, 85, 87, 147- (NASI), 129, 130, 269, 271 148, 170-171, 173 National Center for Health Statistics, 94, research, 72-73, 85, 172-173 108, 110, 192, 299-300 response rates, 8, 69-70, 73, 81, 171 National Comorbidity Survey, 299 sample design, 7, 67-68, 73, 78, 80, 171 National Crime Victimization Survey, 100- sample sizes, 7-8, 68-69, 70, 80, 170-171 101, 295, 298-299 scope of committee study, 2-3, 26-27, National Health and Nutrition 65-66, 147-148 Examination Survey, 100, 101-103, simulation of disability decision 109, 171, 295, 289, 300 process, 67, 70, 72, 173 National Health Interview Survey, 49 n.6, testing phase, 7, 72, 78, 86, 170 95, 100, 102-103, 109, 110, 206, 290, time allocation for, 6-7, 70-74, 86, 173 295, 296, 299, 300, 318 Nonobservation errors, 214-216, 284-285 Disability Supplement, 171, 226, 234, 235 Nonresponse error, 76, 77, 80-81, 85, 95, National Household Survey of Drug Abuse, 104, 215-216, 220, 227, 284, 285, 290, 100, 102-103, 104, 292, 295, 301 291, 292 National Institute of Mental Health, 278 Numident, 108 National Institutes of Health, 143, 267

INDEX 343 O R Observational errors, 216-221, 227, 284-285 Race, and labor force participation rates, Occupational classification systems, 9, 61, 306, 320-321 114, 117, 119, 122-123, 132-134, 136, Recall bias, 217-218 172, 312-314, 322-323, 328-329 Recommendations Occupational Information Network concepts of work disability, 12-13, 63-64 (ONET) database, 9-10, 61, 122-123, disability decision process, 9, 10-11, 14, 132-134, 145, 172, 328-329 63-64, 123, 127, 130-131, 138, 172-173, Office of the Inspector General, 129 256-257, 275-279 Old Age Assistance, 37 for monitoring work disability, 5, 13, Old Age, Survivors, and Disability 92-93, 147 Insurance (OASDI) program, 107- for NSHA, 70, 85, 87, 170-171, 173 108 research infrastructure and capacity Outreach efforts, and growth of disability building, 14, 142 programs, 2, 19, 37, 42, 47 survey measurement of disability, 13, Owens, Patricia, 250 85, 86-87, 170-171 Regulations. See Legislation and regulations P Rehabilitation, 60, 134, 188, 190, 191, 198, 203, 259 Paid and unpaid role activities, 187 Reliability Pain, and disability, 40, 62, 114, 203 defined, 221, 127 Parkinson’s disease, 187 of disability decision process, 127 Parsons, Talcott, 54, 58, 59, 195 of Index of ADL, 227 Participation, conceptual issues, 193-195, interrater, 134, 222, 254 196, 197, 201-202, 212, 261, 264, 286 measures of, 222 Provider-based survey data, 102, 290, 295, of Mental Residual Functional Capacity 296 Assessment, 254 Proxy respondents, 78-79, 83, 95-96, 106, of occupational classifications, 134 212, 216, 218, 223, 225, 226, 228, 230- of survey measures of disability, 221, 231, 284, 292 222, 227, 231-232, 236 of WHO DAS II, 267 Research issues Q cooperative agreements, 144 Quality issues, in NSHA, 70-74 disability decision process, 10-11, 63-64, Quality of Employment surveys, 317 119-123, 125, 126, 130, 131, 132, 133, Quality of life 138, 139, 172-173, 241, 256-257, 268- and disability definitions, 58, 60, 190, 279 199-200, 201 extramural programs, 11, 143 health-related, 199-200 grant programs, 142-143, 144 Questionnaire design growth of disability programs, 20, 34, for monitoring work disability, 293 52, 212 for NSHA, 70, 71, 72, 73, 81-82, 85, 87, infrastructure and capacity building, 90, 171, 284 11-12, 142, 140-147 for survey measurement, 70, 76-77, 82- intramural programs, 11, 144 83, 85, 87, 205-207, 212, 216-217, 223- measurement of disabilities, 141-147, 224, 226-227, 228, 230-231, 232, 233, 208, 284-285 236-238, 281-282, 284, 285-286, 293- mental impairments, 268-274 294 monitoring work disability, 301 NSHA, 72-73, 85, 172-173

344 INDEX resource requirements, 14, 141-144 Program Operations Manual System, survey methods, 74-87, 208, 284-286, 273 301 regulations, 273 Residual Physical Functional Capacity Social Security Advisory Board, 129, 141 Assessment, 24, 273-274 Social Security Benefits Reform Act of 1984, Respiratory disorders, 203 40 Respondent burden, 70, 76-77, 81-82, 106, Social Security Disability Insurance (SSDI) 216, 217-218 program Response rates, 8, 69-70, 73, 76, 81, 171, 215 administrative database, 107 Retirement History Survey, 288 applications and awards, 18, 35-36, 38, Retirement Research Consortium (RRC), 41, 46, 47, 243 143 beneficiaries enrolled, 18, 35, 36, 39, 42 Reviewing Medical Consultant, 244, 248- composition of beneficiary population, 249, 251, 253-254, 271 43, 44-45, 46 cost containment measures, 34-35 coverage and support levels, 34, 35 S defined, 1 n.1, 17 definition of disability, 242 Sample design, 7, 67-68, 73, 78, 80, 171, 214, DHHS analysis of, 18-19, 20 219 eligibility criteria, 243 Sample sizes, 7-8, 68-69, 70, 80, 98, 104, 106, growth trends, 1, 18, 35-37, 41, 43, 44, 170-171, 218, 295, 296 45, 46, 48, 49 Sampling error, 79-80, 214, 290, 292 inception, 33, 34-35 Schedules for Clinical Assessment in income replacement rates, 39 Neuropsychiatry, 267 initial determination of disability, 34, Screening 243; see also Disability decision instruments, 247, 267-268, 269, 271, 275, process 278 SSI benefits concurrently with, 47 methods, 70, 75-78, 81, 85, 227-232, 298 terminations, 35, 36, 38-39, 41-42 Secondary conditions, 60, 190, 198-199 waiting period to receive benefits, 35, Selection bias, 228 37 Self reports, 83, 95-96, 106, 212, 218-219, workers insured, 42, 43 220, 223, 226, 230-231, 284, 291-292 Social Security retirement program, 37, 49, Sensitivity and specificity, 129, 130 51-52, 107, 288 Social activities, 188 Social Security Survey of Disabled Adults, Social classification, 226-227 287 Social cognition, 225-226 States. See also Disability Determination Social roles, and definition of work Services (DDs) disability, 54, 57, 58, 59-60, 61, 84, cost shifting by, 19, 47, 90 187-190, 193, 195-198, 199, 201 initial disability determinations, 34, 37 Social Security Act, 34 welfare recipients, 37 amendments, 35, 44 Stigmatization, 84, 193, 226 definition of disability, 4, 17-18, 61, 94, Substance Abuse and Mental Health 184, 185, 190, 242-243, 262, 279, 281, Services Administration, 301 283, 289 Substantial gainful activity (SGA), 2, 19, 34, Social Security Administration 40, 53, 55, 63, 66 n.1, 94, 114, 123, administrative databases, 106-108 133, 184, 242-243 disability surveys, 88 234, 286-288 Supplemental Security Income (SSI) information needs for policy decisions, program, 33 89-91 administrative database, 107 Office of Research, Evaluation and applications and awards, 18, 37-38, 42 Statistics (ORES), 141

INDEX 345 composition of beneficiary population, interviewing methods, 76-77, 81, 85, 95, 43 171, 215-217, 219, 220, 224-225, 228, defined, 1 n.1, 37, 17 291-292 eligibility, 37, 243 longitudinal design, 96, 199, 219-220, growth of, 1, 18, 35, 37-38, 42, 43-44, 49 228, 291, 293 number of recipients, 37—38 measurement error, 74-75, 82-83, 85, 95, outreach efforts, 2, 19, 37, 42, 47 212, 216-227, 232-237, 284, 285, 286, processing of claims, 37, 243; see also 290, 291, 292 Disability decision process medical examinations and performance qualified aliens, 43-44, 48 tests, 70, 71, 78, 79, 81, 95, 96, 289, SSDI benefits concurrently with, 47, 243 290, 293, 295, 300 terminations, 37-38 methodological issues, 75-87, 214-238, Supplemental Security Record, 107 284-286 Survey measurement of disability. See also for monitoring work disability, 5, 93, 95, Work disability monitoring system 97-98, 99-104, 109, 284-286, 289-301 cognitive considerations, 223-225, 236- nonresponse error, 76, 77, 80-81, 85, 95, 237, 238, 298 104, 215-216, 220, 227, 284, 285, 290, conceptual issues, 7, 49 n.6, 56, 74, 83- 291, 292 84, 87, 94, 184-185, 211, 212, 213, 263- ongoing federal surveys, 99-104, 212, 264, 281-284 213, 282, 285-286 coverage error, 75-78, 85, 95, 104, 171, periodicity, 91, 95, 106, 291 215, 220, 223, 227, 284, 285, 290, 292 prevalence of benefit eligibility as goal, cross-sectional design, 96, 219, 291, 293- 99 294 prevalence of disability across surveys, data collection models, 69, 70, 72, 74, 233-234 78-79, 82, 83-84, 86, 87, 95, 106, 212, provider-based, 102, 290, 295, 296 216, 218, 219-220, 223, 228-229, 284, proxy respondents, 78-79, 83, 95-96, 106, 285, 291-292, 301 212, 216, 218, 223, 225, 226, 228, 230- data sources, 290-291 231, 284, 292 design options, 83, 215-216, 290-301 questionnaire design, 70, 76-77, 82-83, development of, 289-290 85, 87, 205-207, 212, 216-217, 223-224, differential response error, 220-221 226-227, 228, 230-231, 232, 233, 236- environmental measurements, 83-86, 238, 281-282, 284, 285-286, 293-294 183-184, 211, 232-233, 237, 282, 285- recall bias, 217-218 286 recommendations, 13, 85, 86-87, 170-171 errors of nonobservation, 214-216, 284- research framework, 74-86, 208, 284-286, 285 301 errors of observation, 216-221, 227, 284- respondent burden, 70, 76-77, 81-82, 285 106, 216, 217-218 essential survey conditions, 83, 212, response rates, 70, 76, 81, 171, 215 219-220, 223, 230, 233, 238 sample design, 67-68, 73, 78, 80, 171, functional limitations of disabled 214, 219 persons to respond to, 75, 77-79, 80- sample sizes, 7-8, 68-69, 70, 80, 106, 170- 81, 223-227, 284 171, 218, 295, 296 household-based, 75-76, 94, 95-96, 106, sampling error, 79-80, 214, 290, 292 171, 215-216, 220, 282, 284, 289, 290, screening methods, 70, 75-78, 81, 85, 292, 293 227-232 ICF mapping to questionnaires, 285-286 self-classification of disability, 218-219, institutionalized/homeless populations, 225-227 75-76 self reports, 83, 95-96, 106, 212, 218-219, 220, 223, 226, 230-231, 284, 291-292

346 INDEX social cognition, self-concept, and social of Listing of Medical Impairments, 130, desirability aspects of, 225-227 131-132 SSA initiatives, 286-288; see also measures of, 222 National Study of Health and predictive, 127, 222, 227-228 Activity of survey measurement of disability, testing, 85-86, 171 221-222, 227-228, 236, 238 time allocation issues, 74, 86 of WHO DAS II, 267 types of, 205 Variable errors, defined, 214, 221 Survey of Disability and Work (1978), 287- Variance, defined, 221 288 Virginia Commonwealth University, 27, Survey of Disabled and Nondisabled 120-122 Adults (1972), 287 Vocational capacity assessment, 9-10, 24, Survey of Economic Opportunity, 234 25, 63, 113, 115, 117, 119, 132-137, Survey of Income and Education, 234 172, 203, 204-205, 242-243, 245, 263, Survey of Income and Program 275 Participation, 95, 100, 102-103, 171, 206, 231, 232, 234, 285, 290, 295, 297, 298 W Waiting period to receive benefits, 35 T Welfare recipients, 19, 37 Welfare reform, 48 Termination of benefits Westat, 26, 67-70, 71, 72, 78-79 CDRs and, 41 Work disability. See also Definition of work proof of medical improvements and, 40 disability; Measurement of disability reasons for, 38-39 dynamic nature of, 60 trends, 35, 36, 37-39, 41-42, 51 inconsistencies in reporting of, 235-236 Test-retest, 222 Work disability monitoring system. See also Testing, survey design, 85-86, 171 Survey measurement of disability Ticket to Work and Self-Sufficiency ad hoc special studies, 5-6, 108 Program, 67, 138 administrative data linkages, 5, 93, 94, Ticket to Work and Work Incentives 95, 96, 97, 106-108, 290-291, 293 Improvement Act of 1999, 10, 138 assessment of utility of, 289 characteristics, 94-108, 285-286 classification of disability in, 6, 296, 298 U committee of experts, 6, 111-112 for continuous monitoring, 5, 87, 91-92, University of Michigan, 143 93, 95, 96-108, 109, 212, 284-286, 291, U.S. Census for Year 2000, 206 293, 294 cost considerations, 96, 98, 104, 290, 294, 301 V cross-sectional data collection, 95, 96, Validity 105-106, 291, 293-294 concurrent, 127, 222 data sources, 94, 95, 290-291 construct, 127, 222 defined, 94 criterion, 127, 221-222 design considerations, 5-6, 94-108, 110- defined, 127, 221-122 111, 285-286, 289, 290-301 of disability decision process, 123, 127- development and planning for, 92-93, 128 108-112, 289-290 of Index of ADLs, 227-228 disability decision process modeling component, 290

INDEX 347 disability definition for, 289 and definition of disability, 4, 7, 54, 57- error considerations, 95, 98, 104, 106, 58, 59-60, 61, 62-64, 83-84, 185-186, 290, 291, 296 188-190, 191, 194, 196, 198, 204-205, evaluation and testing, 93, 98, 110-112 208, 211, 213, 261-262, 283-284, 285- implementation objectives, 6, 92-93, 111 286 longitudinal data collection, 5, 95, 96, and disability decision process, 4, 61, 97, 105-106, 199, 291, 293 138 mode of data collection, 95, 97, 102, 106, measures of, 83-86 110, 291-292, 294, 295 social, 84, 193 NSHA and, 5, 97-99, 104, 109 survey measurements of, 83-86, 183-184, partnerships with other federal 211, 232-233, 237, 282, 285-286 agencies, 5, 93-94, 95, 99-104, 105- Work experience, and ability to work, 10, 106, 109, 110, 294-301 136, 242 physical examination data, 95, 96, 102, Work incentives, 39, 67 290, 293, 295, 300 Workers’ compensation, 55-56, 134, 204, policy and planning issues to be 303 addressed by, 5, 89-94, 287 Workshop on Measuring Functional purpose of, 88-89, 94-95 Capacity and Work Requirements, questionnaire-related issues, 293 90, 132 recommendations, 5, 13, 92-93, 147 Workshop on the Measurement of Persons reduced sets of measures in intervening with Work Disability, 293, 301 years, 6, 97-99 World Health Assembly, 258 research needs, 301 World Health Organization sample sizes, 98, 104, 106, 295, 296 DAS II, 267-268, 275, 277-278 screening instrument, 298 health definition, 199-200 survey measurement component, 5, 93, ICIDH model, 54, 57, 58-59, 60, 185, 190- 95, 97-98, 99-104, 109, 284-286, 289- 195, 242, 259, 261-263 301 International Statistical Classification of Work environment Diseases and Related Health Problems, accommodations, adaptations, and 257-258 barriers, 62, 84, 187, 202, 207, 208, 211, 283-284

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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:

  • Understanding the current social, economic, and physical environmental factors in determining eligibility for disability benefits.
  • Developing and implementing a monitoring system to measure and track trends in work disability.
  • Improving the process for making decisions on disability claims.
  • Building Social Security's capacity for conducting needed research.

This book provides a wealth of detail on the workings of the Social Security disability program, recent and emerging disability trends, issues and previous experience in researching disability, and more. It will be of primary interest to federal policy makers, the Congress, and researchers—and it will be useful to state disability officials, medical and rehabilitation professionals, and the disability community.

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