SSA Program Rules

A Comparison of Biomarker Profiles Among SSDI Beneficiaries, SSDI Applicants, and the General Population of Older Adults

Analysis of Simplified and Unified Work Incentives

Consequences of Overpayment to Beneficiaries

Literature Review of Vocational Factors

Incidence and Size of Work-Related Overpayments and Subsequent Beneficiary Behavior

The Labor Market Experience of Older Workers Who Are Denied SSDI on the Basis of Vocational Factors

How Do Overpayments Affect Beneficiary Earnings?

A Comparison of Biomarker Profiles Among SSDI Beneficiaries, SSDI Applicants, and the General Population of Older Adults
Investigators: Laura Blue and David Stapleton (Mathematica Policy Research)

Abstract

The goal of this project is to determine whether there are systematic differences in objective, readily measured health markers among those who apply for Social Security Disability Insurance (SSDI) benefits and those who do not, and how these “biomarkers” vary among disability applicants who were allowed or denied benefits. Commonly collected data on biomarkers include indicators of disease status (such as white blood cell count or the presence of an antigen), senescence (such as telomere length), or environmental exposure (such as blood lead levels). Research on the relationship between biomarkers and disability could be valuable for two reasons. First, it could suggest a role for biomarkers in predicting who will go onto SSDI. Second, biomarkers could ultimately be incorporated in the SSDI eligibility criteria and disability determination process if they can provide adjudicators with better information about the applicant’s current or future ability to engage in substantial gainful activity.

We will analyze multiple biomarkers in the Health and Retirement Study that can be linked to Social Security Administration data on program participation outcomes. We will compare biomarker levels among adults ages 51 and over who receive SSDI benefits, those who applied for SSDI but were not awarded benefits, and those that did not apply for SSDI, after adjusting for differences in age. The statistical analysis will include a comparison of mean biomarker values in the three populations of interest as well as a calculation of the sensitivity and specificity of different biomarkers in predicting SSDI receipt.

"Predicting Receipt of Social Security Administration Disability Benefits Using Biomarkers and Other Physiological Measures: Evidence from the Health and Retirement Study," Journal of Aging and Health, Laura Blue, Lakhpreet Gill, Jessica Faul, Kevin Bradway, and David Stapleton, October 2017.

Analysis of Simplified and Unified Work Incentives
Investigators: Gina Livermore and David Wittenburg (Mathematica Policy Research)

Abstract

The Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) provisions that govern the treatment of post-entitlement earnings are complex and often confusing to beneficiaries. Although the intent is to encourage work, beneficiaries’ limited knowledge of the provisions combined with processing delays by the Social Security Administration (SSA) of earnings information can lead to abrupt and unanticipated termination of benefits. Such shocks are believed to create work disincentives for those who experience them as well as an inflated perception among beneficiaries in general of the risks associated with attempting to work. Administering these complex work incentives is a significant and challenging workload for SSA staff, and benefit adjustments due to earnings are often made retroactively.

There is considerable interest among SSA, policymakers, and advocates in reducing the complexity of the SSDI and SSI work incentive provisions in ways that promote employment among beneficiaries and make incentives easier for SSA to administer. Both outcomes could ultimately result in savings to the federal government. This study will—using the best information available—model and analyze the distributional and budgetary effects of several options designed to simplify the SSI and SSDI provisions governing post-entitlement earnings. We will focus on the effects of innovations that have been considered by SSA and others interested in reducing disability program complexity and encouraging work.

Consequences of Overpayment to Beneficiaries
Investigator: John Kregel (Virginia Commonwealth University)

Abstract

The receipt of overpayments by Supplemental Security Income (SSI) and Title II beneficiaries is a major concern for beneficiaries, Social Security Administration (SSA), and Congress. In this research project, the investigator attempts to improve understanding of the effect of overpayments on the employment retention of working Social Security beneficiaries. Some researchers have argued that moving into overpayment status may have a negative impact on beneficiaries’ efforts to maintain employment (Kregel 2011), although little is formally known about the employment behaviors of beneficiaries who experience overpayments.

This project addresses the overall question of whether receipt of a work-related overpayment notice significantly reduces subsequent work activity among affected SSI and Social Security Disability Insurance (SSDI) beneficiaries. The qualitative study will use a set of structured interviews with 50 beneficiaries who have received overpayment notices to address three specific research questions:

1. To what extent does receipt of an overpayment reduce a beneficiary’s subsequent work activity?
2. Do factors such as the size of the overpayment, age of the individual, and causes of the overpayment affect a beneficiary’s decision to increase, maintain, or reduce employment?
3. From a behavioral economics perspective, what decision-making processes do the beneficiaries who modify their work activity use?

Literature Review of Vocational Factors
Investigators: David Mann and David Stapleton (Mathematica Policy Research)

Abstract

The Social Security Administration (SSA) uses a five-step process to make disability award determinations for the Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) programs. At the fifth step, SSA must determine whether the applicant, given his or her vocational factors of age, education, and previous work history, can adapt to any vocation that he or she has not previously attempted. If the applicant cannot adapt to new work, the disability claim is allowed; otherwise, the claim is rejected. At this step in the disability award determination, SSA must consider how the vocational factors affect new work ability independent of (1) the person’s health or impairment(s); (2) other personal factors, such as motivation to work; and (3) how likely the person would be to obtain that employment.

The rules and guidelines that SSA currently uses at step five were developed during the late 1970s and rely on limited, outdated empirical information. Therefore, the step five determination rules and guidelines could potentially benefit from changes informed by more recent data. This project will identify and evaluate the most recent literature, reports, studies, and other materials that could facilitate evidence-based conclusions about how vocational factors affect a person’s ability to adapt to new work. SSA can use this information to inform possible future changes to how it incorporates consideration of the vocational factors into the process of disability award determination. This evaluation of the literature will not include policy recommendations.

"Vocational Factors in the Social Security Disability Determination Process: A Literature Review," David R. Mann, David C. Stapleton, and Jeanette de Richemond, July 2014. (PDF)

Incidence and Size of Work-Related Overpayments and Subsequent Beneficiary Behavior
Investigators: Denise Hoffman and David Wittenburg (Mathematica Policy Research) and John Jones and Renee Ferguson (Social Security Administration)

Abstract

Work-related Social Security Disability Insurance (SSDI) overpayments create administrative and fiscal challenges for SSA and might negatively affect beneficiaries’ attitudes towards employment. One source estimates that work-related annual overpayments were in excess of $840 million in 2010. Because overpayments often accrue over many months, the total for individual beneficiaries can be quite high relative to their benefit checks. Beneficiaries are required to repay this money, which may take several years, and in some cases, SSA may never fully recover the debt. Anecdotal evidence suggests that overpayments can be a traumatic experience for beneficiaries and may negatively affect employment. Additionally, overpayments represent an important program integrity issues for the agency, particularly as the trust fund nears exhaustion. Despite the magnitude of the issue, few details are known about the beneficiaries affected by overpayments or how overpayments affect their behavior.

In this study, we will estimate the incidence of overpayments, average size of overpayments, characteristics of beneficiaries who received overpayments, and the association between overpayments and subsequent employment and program outcomes. We will focus on SSDI beneficiaries (SSDI-only and concurrent SSDI and Supplemental Security Income recipients) who are not participating in SSA demonstrations. We will identify overpayments in calendar year 2010 and track subsequent outcomes, including benefit receipt and employment. This information will improve understanding of the impact of overpayments on beneficiaries and explore ways to identify these beneficiaries before they receive overpayments. Such understanding could help SSA avoid these issues.

"Work-Related Overpayments of Social Security Disability Insurance Beneficiaries: Prevalence and Descriptive Statistics," (DRC Working Paper Number: 2018-04), Denise Hoffman, Benjamin Fischer, John Jones, Andrew McGuirk, and Miriam Loewenberg, July 2018.

"Quantifying the Work-Related Overpayments of Social Security Disability Insurance Beneficiaries," (DRC Brief Number: 2018-03), Denise Hoffman, Benjamin Fischer, and John Jones, July 2018.

The Labor Market Experience of Older Workers Who Are Denied SSDI on the Basis of Vocational Factors
Investigators: April Yanyuan Wu and Jody Schimmel Hyde (Mathematica Policy Research)

Abstract

This study will assess the employment experiences of older workers who are denied Social Security Disability Insurance (SSDI) benefits because they were found to be able to engage in substantial gainful activity (SGA). These applicants had enough work history to be eligible for benefits—and presumably had a significant medical condition—but they were denied benefits on the basis of a residual ability to work in their pre-onset occupation or in other occupations. For those who had impairments that prevented them from continuing to work in their pre-onset occupation, disability examiners use a “vocational grid” that accounts for age, education, and work experience to determine whether an applicant can continue to work in other occupations. Determinations based on vocational factors are particularly salient for applicants age 50 and older.

We will use data from the Health and Retirement Study linked to Social Security administrative records to compare characteristics and outcomes for workers who were denied SSDI on the basis of vocational factors to those who were allowed benefits on that basis. We will compare the two groups in terms of their education, work experience, and job attributes before they applied for SSDI. For those who were rejected on the basis of vocational factors, we will also assess changes in their employment and occupational attributes before and after their SSDI application. We will use data from the Occupational Information Network to derive occupational attributes. Results from this study will shed light on the well-being of older workers with disabilities who were found to be able to engage in SGA. The results may also have implications for the use of vocational factors in the SSDI eligibility determination process.

"Do Older SSDI Applicants Denied Benefits on the Basis of their Work Capacity Return to Work After Denial?" (DRC Brief Number: 2018-01), Jody Schimmel Hyde and April Yanyuan Wu, July 2018.

"The Benefit Receipt Patterns and Labor Market Experiences of Older Workers Who Were Denied SSDI on the Basis of Work Capacity," (DRC Working Paper 2018-01), Jody Schimmel Hyde, April Yanyuan Wu, and Lakhpreet Gill, March 2018.

How Do Overpayments Affect Beneficiary Earnings?
Investigators: Denise Hoffman, Heinrich Hock, and Priyanka Anand (Mathematica Policy Research), John Jones (Social Security Administration)

Abstract

The majority of Social Security Disability Insurance (SSDI) beneficiaries who engage in substantial work for enough time receive work-related overpayments. These overpayments often accrue over many months or even years, and beneficiaries are required to repay this debt after being notified of it. The amount owed by an individual beneficiary can be quite high relative to the monthly benefit amount. Qualitative research suggests that this can be a traumatic experience, negatively affecting beneficiaries’ attitudes toward employment. However, there is no quantitative evidence on how overpayments affect the subsequent work-related decisions made by these beneficiaries.

In this study, we will estimate the impacts of work-related overpayments on the employment outcomes of beneficiaries. Because beneficiaries who do and do not have overpayments are likely to differ systematically from one another, our analysis will be based on within-beneficiary changes after they are notified of an overpayment by the Social Security Administration (SSA). We will identify the main analysis sample of SSDI beneficiaries by using SSA’s Recovery of Overpayment, Accounting, and Reporting system. For this sample, we will assess the proportions of beneficiaries who are engaged in substantial gainful activity each month during the periods shortly before and after they are notified of an overpayment. We will also estimate the effects of an overpayment notification on the likelihood of engaging in substantial gainful activity each month after the notification is received. This research will help SSA to have a better understanding of the consequences of overpayments for the labor market outcomes of beneficiaries.