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The Dynamics of Disability: Measuring and Monitoring Disability for Social Security Programs
ment of disability programs administered by SSA. The SSI is a nationwide federal assistance program administered by SSA that guarantees a minimum level of income for needy aged, blind, and disabled persons (SSA, 2001b). SSI benefits are provided on the basis of need to eligible individuals to the extent that their needs are not met by other sources; insured worker status is not required. SSI replaced the means-tested assistance programs administered by the states—Old-Age Assistance, Aid to the Blind, and Aid to the Permanently and Totally Disabled—with a program of uniform benefits and eligibility criteria across states. The definition of disability and blindness for adults was the same as that used for SSDI, and as with SSDI, state Disability Determination Services (DDSs) have the responsibility to process initial disability claims. The five-month waiting period before the start of benefits under SSDI does not apply to SSI recipients. Whereas SSDI beneficiaries are transferred to the Social Security retirement program, SSI recipients may remain on the rolls even after they are 65 years of age. SSI recipients also are eligible for Medicaid. Benefit payments under the SSI program started in January 1974. About 1.3 million disabled persons who were receiving welfare payments under the state programs were transferred to the SSI rolls in 1974 (DHHS, 1992).
During 1972–1974, processing disability redeterminations for continuing eligibility of former state welfare recipients for SSI disability payments and for new disability claims under the new SSI program resulted in additional workloads for processing disability claims. The SSI program requires applicants under the age of 65 to apply first for benefits from all other programs, including SSDI, that may partially or fully offset SSI benefits. This provision, combined with the increased publicity and active outreach efforts that accompanied implementation of this new program, as well as pressures on limited staff resources of administering the new programs, may have contributed to the sharp increase in applications and new awards under both SSI and SSDI from 1972 to 1976. The recession of 1974–1975 placed additional burden on the two programs. Applications for benefits continued to increase and terminations declined. Disability benefit allowances were increased during this period, first in 1970 and again in 1971 and 1972, making it more financially attractive for people to apply for disability benefits and for beneficiaries to remain on the rolls rather than return to work. Figure 2-2 shows the absolute number of SSI applications, awards, recipients, and terminations for persons 18–64 years of age from 1974 to 2000 comparable to the trends in the SSDI program shown in Figure 2-1. In 1974 when the SSI payments started, 1,503,000 persons aged 18–64 received federally administered SSI payments; by the end of 2000 there were 3,744,000 SSI recipients 18–64 years of age (SSA, 2001d).