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The Dynamics of Disability: Measuring and Monitoring Disability for Social Security Programs
FIGURE 2-4 Percentage distribution of SSDI awards for adults aged 18–64, by diagnostic groups, 1981 and 2000.
SOURCE: SSA, 2001d.
As mentioned in the previous section, mandated outreach activities to enroll persons in the SSI program contributed to growth in the programs in the early and mid-1970s, when a nationwide effort was launched to enroll eligible persons in the new SSI program that was enacted in 1972 and implemented in 1974. During the late 1980s, Congress again mandated a number of SSI outreach activities to facilitate applications by needy individuals with severe disabilities (U.S. House of Representatives, 2000). Beginning with earmarked appropriations in 1989, SSI outreach activities became a priority for SSA. In addition to its own effort, SSA promoted outreach through a series of grants to the private sector (Muller and Wheeler, 1995). Some who applied for SSI were found to have enough covered work experience to qualify for disability insurance benefits concurrently with SSI.
Cost Shifting by States
In times of poor economy, cuts made in state and locally funded general assistance and other welfare programs result in shifting the burden from state and local programs to federal programs. Welfare agencies routinely refer persons to SSA’s disability programs. During 1989–1992, such cost shifting may have contributed to the acceleration of applications and awards particularly in the SSI programs (Rupp and Stapleton, 1995). Deinstitutionalization of persons with mental disorders and mental retardation and other disabilities who were previously cared for in and financed by state hospital systems also led to an increase in the SSI claims.