Older workers' progression from private disability benefits to Social Security disability benefits

People with medical conditions that limit their ability to work tend to receive short-term disability benefits initially and may then move to long-term and eventually to permanent disability benefits. The progression of older workers (those aged 55 to 64) along that continuum of benefits is documented here with data from a large disability insurance company. The data show that older workers who receive short-term medical disability benefits are three times as likely as younger workers to progress to receipt of Social Security Disability Insurance (SSDI) benefits, although a slight reversal of that trend occurs as workers pass age 62. Musculoskeletal conditions are the most frequent basis of short-term disability claims among older workers, with circulatory conditions running a close second. Furthermore, although all medical conditions are more likely to lead to SSDI benefits among older workers, circulatory conditions do so most frequently. This article discusses industry standards for the management of disability claims at each level of severity. It also addresses common and emerging disability management practices that may reduce the likelihood of impaired workers developing long-term or permanent financial dependence on disability benefits programs.     

The erosion of retiree health benefits and retirement behavior: implications for the disability insurance program

The effects of retiree health insurance on the decision to retire have not been examined until recently. It is an area of increasing significance because of rising health care costs for retirees, the uncertain future of Medicare, and increased life expectancy. In general, studies suggest that individual retirement decisions are strongly responsive to the availability of retiree health insurance. Early retiree benefits and retirement behavior are also important because they may affect the Social Security Disability Insurance (DI) program. It is not apparent that if a person loses retiree health benefits, or if fewer people are eligible for retiree health benefits in general, claims for DI will increase. The potential 2-year loss of health benefits may be a deterrent to leaving the labor force and claiming DI, although persons who are unable to work would leave the labor force even without health benefits. In order to understand how the decline in retiree health benefits may affect enrollment in DI, analysts must at least incorporate the role of coverage under the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA). That act provides many people with access to health insurance during the 2-year gap between eligibility for DI and Medicare. In fact, persons with sufficient means to retire early could use the income from Disability Insurance to buy COBRA coverage during the first 2 years of DI coverage. Determining the effect of the erosion of retiree health benefits on DI must account properly for the role of other factors that affect DI eligibility and participation. The financial incentives of Social Security, pension plans, retirement savings programs, health status, the availability of health insurance, and other factors influencing retirement decisions must be taken fully into account in order to isolate the precise effect of retiree health benefits.     

Applying for entitlements: Employers and the targeted jobs tax credit

The Targeted Jobs Tax Credit (TJTC) is probably the most outstanding example of a generous entitlement program with a very low participation rate. Only about 10 percent of eligible youth hired are claimed as a tax credit by their employers. The causes of the low participation rates are analyzed by estimating a Poisson model of the number of TJTC-eligibles hired and certified during 1980, 1981, and 1982. Information costs, both fixed and variable, are found to be key barriers to TJTC participation. The cost-effectiveness of TJTC is low because of the stigma attached and the very high recruitment costs of hiring additional TJTC-eligibles. Because employers find it relatively cheap to certify after the fact eligible new employees who would have been hired anyway, this passive mode of participating in TJTC predominates.     

利益政治的失效:利益非和谐的成因分析

利益政治的应然效能就是实现利益的和谐发展,但在实然层面,利益和谐往往被认为可欲而不可求,原因在于利益政治会出现失效,本文着力于此,希望清楚解读这一问题,以便为深入实践研究提供理论支撑。     

Terminating Taiwan's Fourth Nuclear Power Plant under the Chen Shui-bian Administration

This article integrates the termination literature with the Punctuated‐Equilibrium (P‐E) model of policy change into a broader framework of policy termination to examine the Chen Shui‐bian administration's abrupt decision to terminate Taiwan's fourth nuclear power plant (FNPP) as well as to explore the evolution of agenda‐setting for the FNPP's termination over a decade. The termination of the FNPP may be viewed as a result of interactions among the nuclear policy image, the institutional venue, and the political or policy strategy over time, as indicated in the integrated framework. Nevertheless, changing nuclear policy image is not sufficient to automatically change the institutional venue in the process of Taiwan's transition from an authoritarian regime to a pluralist political system. Before venue shopping for policy termination, antinuclear activists had to ally with the Democratic Progressive Party to struggle for opening up Taiwan's political institutions along with Taiwan's democratization. On the other hand, as a consequence of Taiwan's recent democratization, antinuclear activists were unsuccessful in terminating the FNPP in the absence of sufficient political resources, notwithstanding a major venue change from the Kuomintang (KMT) government to the Democratic Progressive Party (DPP) government under President Chen's leadership. Furthermore, besides domestic venues, international institutions also appear to be important to the creation and maintenance of the nuclear policy system, as well as to the dramatic reversal of the Chen administration's termination decision in this case.     

The participatory principle in development projects: the costs and benefits of cooperation

Many development theorists and practitioners, including those in key agencies like the World Bank and UNDP, now see participation as critical to successful project implementation, and strongly support cooperative organizational systems. This article cautions against undue optimism about such forms of organization, and attempts to explain their limited success when they compete with private firms by applying rational choice theory to behaviour in cooperative systems. It examines the relevance of assumptions of self interest, opportunism and bounded rationality in such solidaristic organizations, then uses them to calculate the costs and benefits of using participatory systems. It shows that these costs are likely to outweigh the benefits in large organizations unless participatory processes are effectively associated with managerial autonomy, appropriate incentives, sanctions and hierarchies. © 1996 by John Wiley & Sons, Ltd.     

Collecting information on disability in the 2000 Census: an example of interagency cooperation

The United States Constitution requires that an enumeration (or census) of the population be conducted every 10 years to apportion seats in the House of Representatives. Census information is also used to allocate funds and to plan and manage programs. Census 2000 occurs on April 1, 2000, when one-sixth of all American households will be mailed the "long form," containing disability, demographic, economic, and housing questions. Although no short set of commonly accepted questions on disability existed, one was developed for Census 2000 by a collaborative, federal interagency work group on disability, convened by the Office of Management and Budget. The work group consisted of staff from the Social Security Administration (SSA), the Department of Health and Human Services, the U.S. Census Bureau, and other agencies. They reviewed questions initially proposed by the Census Bureau, developed an alternative proposal, tested both versions in the Census Bureau's cognitive questionnaire lab, and on the basis of testing, derived a consensus version for Census 2000. In many ways, the six questions now contained on Census 2000 are an improvement over previous efforts. Disability is ascertained for children as well as for adults, and information will be collected separately for several domains of disability (for example, sensory, mental, physical). The need for a brief set of disability measures goes beyond Census 2000. If such data were collected regularly on national surveys, critical policy and program concerns across agencies could be addressed because better information could be gathered on changes in disability prevalence and on the characteristics of persons with disabilities. Other similar efforts include the former Disability Evaluation Study, now known as the National Study of Health and Activity--a national sample survey on working-age disability to be conducted by SSA--and the President's Task Force on the Employment of Adults with Disabilities (Executive Order 13078).     

Employment of individuals in the Social Security disability programs

The articles in this special issue present findings from research on the employment and work-related activities of individuals receiving benefits through the Social Security Disability Insurance and Supplemental Security Income programs, and on the factors that hinder their efforts to work at levels that lead to exiting the disability rolls. This article introduces the other articles, highlights their important findings, and discusses the implications for ongoing efforts to increase the earnings and self-sufficiency of these beneficiaries, such as the Ticket to Work program and the Benefit Offset National Demonstration.     

Nudging with care: the risks and benefits of social information

Nudges are popular types of interventions. Recent years have seen the rise of ‘norm-nudges’—nudges whose mechanism of action relies on social norms, eliciting or changing social expectations. Norm-nudges can be powerful interventions, but they can easily fail to be effective and can even backfire unless they are designed with care. We highlight important considerations when designing norm-nudges and discuss a general model of social behavior based on social expectations and conditional preferences. We present the results of several experiments wherein norm-nudging can backfire, and ways to avoid those negative outcomes.

     

Long-term disability programs in selected countries

In 1985, the Social Security Administration commissioned an 18-month research project to study disability in eight industrialized countries: Austria, Canada, Finland, the Federal Republic of Germany, Israel, the Netherlands, Sweden, and the United Kingdom. The study focused on three key areas: (1) the initial determination of disability, (2) the methods of monitoring disability, and (3) the incentives to return to work. Although the study revealed great variations among the countries in the definition of long-term disability, the approach followed in providing benefits, and the organization and features of the programs, some basic similarities were also found. Among the similarities are: (1) most countries have several income-maintenance programs to protect workers in the event that they are disabled, and (2) the disability test to determine whether a person is eligible for a disability benefit is ambiguous in that the various programs each have different eligibility criteria, different definitions of disability, different considerations given to labor-market conditions, and so forth. This article examines the diversity among the countries and attempts to highlight unique approaches to adjudicating disability, providing linkages to rehabilitation, and creating incentives for returning to work.     

Assessing the role of vocational rehabilitation in disability policy.

Since 1975, vocational rehabilitation has represented a small and declining component of federal disability policy. This trend is perhaps reflective of the relatively crude assessment techniques that have been applied to the program in the past. Using the Virginia Vocational Rehabilitation (VR) program as a prototype, we outline how the data and methods of assessment can be improved for purposes of directing public policy. The key issues include identifying an appropriate comparison group for VR, analysis of longitudinal earnings data, and methods for refining measures of program cost. The analysis provides "fixed-effects" estimates of net earnings impacts for each of three postprogram years stratified by disability classification and gender. These treatment impacts are compared to total and service-specific costs. In general, this analysis suggests that evaluation of VR can be substantially improved and that these improvements can be attained at relatively modest analytic cost.     

Interagency information sharing: Expected benefits,manageable risks

The sharing of program information among government agencies can help achieve important public benefits: increased productivity; improved policy-making; and integrated public services. Information sharing, however, is often limited by technical, organizational, and political barriers. This study of the attitudes and opinions of state government managers shows that more than 8 in 10 judge information sharing to be moderately to highly beneficial. It also reveals specific concerns about the inherent professional, programmatic, and organizational risks. The study proposes a theoretical model for understanding how policy, practice, and attitudes interact and suggests two policy principles, stewardship and usefulness, to promote the benefits and mitigate the risks of sharing.     

The discourse of disability in modern China

With the collapse of the imperial system, Confucianism rapidly lost its credibility and authority. 'Nature' was now conceptualized as a set of relatively impersonal forces that could be objectively investigated. No longer were physical bodies thought of as being linked to the cosmological foundations of the universe: bodies were produced according to biological laws inherent in 'nature'. Identity and ancestry were buried deep inside the body. With the spread of an alternative epistemology based on scientific knowledge, a new medical semiology of the 'monster' appeared, in which the causes of malformation were firmly attributed to purely physical factors. Malformed infants came to be symbolic representations of racial degeneration, while freaks embodied the disfigurement of the nation. Raising the spectre of racial extinction, many writers claimed that the poor physical quality of the population was one of the key causes of the nation's backwardness. The strengthening of the population and the improvement of the race were represented as the essential prerequisites for national survival.     

Voter turnout and the benefits of voting

A model of voting behavior is developed that predicts that individuals vote if the absolute value of voting for or against a referendum exceeds the cost of voting. The results obtained from examining voting on city-county consolidation referenda and in New York state (1) provide support for the relatively untested prediction that turnout rises as the absolute value of the mean gains resulting from an electoral outcome increase and (2) augment the evidence that turnout rises as the probability of altering an electoral outcome increases and falls as the cost of voting rises.     

Demographic characteristics of disability applicants: relationship to allowances.

This article highlights some of the causes underlying differences in disability allowances by sex and race. Among the causes are differences in labor-force patterns, the educational background, and the age distributions of the insured and applicant populations. More than half of the differences between the black and white applicants in the proportion of claims allowed is explained by differences in their age distributions. The lower proportion of claims allowed for black applicants may reflect the greater tendency fo the black insured population to apply for disability insurance benefits.     

Commitment to work and the self-perception of disability

Population surveys of the disabled frequently show large numbers of persons who report work activity despite a simultaneous response indicating that they are severely disabled. Using multinomial logit analysis, this article examines the characteristics of persons who express such a commitment to work. The characteristics examined are sex, race, age, family size, education, marital status, health status, and length of work experience prior to onset of disability. The logit analysis allows us to see which of these variables predict work behavior. Data from the 1972 Survey of Disabled and Nondisabled Adults and the 1974 Followup Survey are used. Data are shown in cross section (1972 and 1974) and longitudinally (patterns of change from 1972 to 1974). In 1972, the less severe the level of health problems, the higher the level of education, being male, and needing to help relatives financially were traits associated with the probability of working despite self-report of severe disability. Those who received funds from public income maintenance were not likely to have worked. Essentially, the same findings were obtained for 1974 cross sectionally and 1972-74 longitudinally. Comparison was also made between those severely disabled persons who worked full time and those who worked part time, for both 1972 and 1974. Basically, age and severity of health condition were associated with the probability of working full time as opposed to part time, suggesting that it is a work/no work decision that is more likely to discriminate among the work commitments of the severely disabled than is the type of work schedule.