5
Concluding Comments

The committee commends the Social Security Administration (SSA) for initiating the daunting task of improving the disability decision process and for developing research activities to assess the feasibility, validity, and reliability of a proposed redesigned decision process.

This report provides a preliminary review of SSA's research plan and the timeline for its completion. The committee has strong reservations that the present research design, the timeframe for completion of the redesign research, and the sequencing of the individual projects will not be able to adequately answer the necessary questions. The research planned and currently being conducted is a good start, but it lacks critical elements of a well-designed research plan. The committee urges SSA to adopt a rigorous research design process; to develop, early in the research, objective validation criteria and validation plans to be able to make the ultimate judgments on whether or not the proposed changes will yield the desired results. The committee is issuing this brief report at this time in the hope that the recommendations embodied herein will be incorporated in the contract research that is currently underway and in new research not yet initiated.

This report has focused on additional required research in the disability decision process. The committee is aware of the limited resources allocated to all Social Security research activities. Two recent reports of the Social Security Advisory Board (1997 and 1998) noted the very small number of staff positions and budget amounts devoted to research and recommended that SSA should increase its intramural and extramural research activities. A third report (Institute for Health and Aging, 1997) reviewed the mission, resources, and capabilities in SSA's Office of Research, Evaluation and Statistics (ORES) and recommended that at least 50 new full-time positions be added to ORES staff to strengthen the internal research and evaluation capacity, to develop and support external resources for research, and to insure that adequate funding be required to support these programs. Further it stated that “Social Security currently is a $496 billion program. In fiscal year 1997, a total of $400,000 is allocated for extramural research grants; this amounts to one one-millionth of the total program. Compare this minuscule amount with the approximately $10 billion spent by the National Institutes of Health on research grants” (Institute for Health and Aging, 1997, p. 33). While these recommendations encompass all of SSA's research activities and go beyond research in the disability decision process, the



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OCR for page 35
The Social Security Administration's Disability Decision Process: A Framework for Research, Second Interim Report 5 Concluding Comments The committee commends the Social Security Administration (SSA) for initiating the daunting task of improving the disability decision process and for developing research activities to assess the feasibility, validity, and reliability of a proposed redesigned decision process. This report provides a preliminary review of SSA's research plan and the timeline for its completion. The committee has strong reservations that the present research design, the timeframe for completion of the redesign research, and the sequencing of the individual projects will not be able to adequately answer the necessary questions. The research planned and currently being conducted is a good start, but it lacks critical elements of a well-designed research plan. The committee urges SSA to adopt a rigorous research design process; to develop, early in the research, objective validation criteria and validation plans to be able to make the ultimate judgments on whether or not the proposed changes will yield the desired results. The committee is issuing this brief report at this time in the hope that the recommendations embodied herein will be incorporated in the contract research that is currently underway and in new research not yet initiated. This report has focused on additional required research in the disability decision process. The committee is aware of the limited resources allocated to all Social Security research activities. Two recent reports of the Social Security Advisory Board (1997 and 1998) noted the very small number of staff positions and budget amounts devoted to research and recommended that SSA should increase its intramural and extramural research activities. A third report (Institute for Health and Aging, 1997) reviewed the mission, resources, and capabilities in SSA's Office of Research, Evaluation and Statistics (ORES) and recommended that at least 50 new full-time positions be added to ORES staff to strengthen the internal research and evaluation capacity, to develop and support external resources for research, and to insure that adequate funding be required to support these programs. Further it stated that “Social Security currently is a $496 billion program. In fiscal year 1997, a total of $400,000 is allocated for extramural research grants; this amounts to one one-millionth of the total program. Compare this minuscule amount with the approximately $10 billion spent by the National Institutes of Health on research grants” (Institute for Health and Aging, 1997, p. 33). While these recommendations encompass all of SSA's research activities and go beyond research in the disability decision process, the

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The Social Security Administration's Disability Decision Process: A Framework for Research, Second Interim Report committee recognizes the need to revitalize and strengthen ORES's research program and encourage collaboration with other federal agencies in activities relevant to SSA. The committee fully endorses these recommendations for increased resources and in-house capacity for research. Recommendation 5-1: The committee recommends that the Social Security Administration's research and evaluation staff and its extramural research program be expanded substantially. The above recommendation and earlier statements throughout the report on the importance of strengthening the in-house research capacity in SSA in no way suggest that there is no role for extramural research. A balanced program of intramural and extramural research is needed. Extramural research by itself cannot solve the problems. “No amount of external research will replace the need for the agency to invest in the internal research capability, for it is essential in itself and inextricably linked with the capacity to implement and use an effective extramural program” (Institute for Health and Aging, 1997, p. 29). Moreover, extramural research program places its own demands on the agency's research staff. Even when external researchers are competent, the oversight responsibility for careful evaluation of the work to insure the quality, adequacy, and appropriateness of the products, and for designing the approaches to testing and experimentation is that of the agency. The text of the committee's recommendations follows, keyed to the chapter in which they appear in the body of this report.

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The Social Security Administration's Disability Decision Process: A Framework for Research, Second Interim Report RECOMMENDATIONS 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 assessment measure is not developed and tested in time for implementation. Recommendation 4-3. The committee recommends that the Social Security Administration develop an interim plan for an occupational classification system in the event that the Occupational Information Network (O*NET) database is either not completed or insufficient 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 claimants and beneficiaries. Recommendation 4–5. The committee recommends that the Social Security Administration reconsider the timeframe for completion 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 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 efficiency. 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.