impact of changes in the demand for labor, nature of work, and other risk factors on the propensity of individuals with impairments to apply for benefits; and

  • be able to foresee change in demand for benefits by identifying the precursors to change, such as the nature of employment, personal and public attitudes about coping with disability, and alternatives to SSA disability benefits, so that it is better able to anticipate the need for its disability benefits.

Underlying these objectives, the committee believes that SSA must be aware at all times of the potential need for, and effectiveness of, its disability benefits. It must know how many Americans may need their benefits, who has been applying for them and why, how satisfied those receiving them are with the administrative apparatus that has been installed to deliver benefits, and why those eligible but not receiving benefits have not applied.

A disability monitoring system would begin with a comprehensive measurement such as the NSHA, from which a reduced set of indicators of the size and characteristics of the “pool” of applicants for disability benefits would be identified. Every n years a similarly large and in-depth survey would be mounted. In the intervening years the reduced set of indicators (or estimations based on existing data) would be the source of national estimates of the size and distribution of the potentially eligible persons and of other issues. With each passing year the relevance of the comprehensive survey’s data and analysis declines. The magnitude of policy and social changes in the intervening years affects the periodicity of the comprehensive survey. If policy or social changes are large, SSA may need to mount another comprehensive survey of the richness provided by NSHA within a three- to four-year period. If changes are small, the periodicity of the comprehensive study might be extended to, for example, every 7 to 10 years. This periodicity also allows sufficient time for thorough evaluation, planning, and testing innovations. The next iteration of the NSHA-type survey with rich measurements conceivably might use a new set of measures, developed as a result of scientific progress or changes in program direction since the last large disability survey.

Recommendation 5-2: The committee recommends that the disability monitoring system consist of

  • a periodic, comprehensive, and in-depth survey to measure work disability; and

  • a small set of core measures in the intervening years derived from other surveys, reinterviews, and/or administrative data.

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