"Fast-track" strategies in long-term public disability programs around the world.

Long-term public disability programs in the United States and several other countries have incorporated fast-track (FT) procedures that share a common goal of accelerating applicants through various stages of the disability determination process--generally for those with severe disabilities, blindness, or terminal illness. This article identifies a variety of FT procedures either implemented or under consideration in public long-term disability programs operated in the United States and other countries," compares FT procedures in those disability programs with respect to specific program features, differences with respect to the administrative components involved in those procedures, and the level of technology used," examines more generally why countries may consider implementing FT procedures; and describes how FT procedures may be employed to improve overall processing of claims and contribute to disability case management. Introduction This article explores the domestic and international experience with "fast-track" (FT) (1) procedures in the determination process of public disability programs. FT procedures target applicants with severe disabilities who are likely to receive favorable determinations. Disability programs in the United States and several other countries have adopted a variety of FT procedures. Those procedures reduce delays, which negatively affect individuals and their families, and may help governments with disability caseload management. In the United States, the Social Security Administration (SSA) expanded its list of FT procedures in recent years with the introduction of the Quick Disability Determination (QDD) and Compassionate Allowance (CAL) initiatives. Known collectively as "fast-track disability processes" by SSA, those initiatives provide additional tools for the agency to manage the growth of disability applications from the American baby boomer population. (2) Complementing the more traditional "expediting" procedures operated by SSA, QDD and CAL take advantage of sophisticated software, which enables fast-tracking operations within an electronic disability process. Other countries have introduced a variety of FT procedures. Like the United States (US), the four other countries in this sample are in the process of experimenting with or fine tuning recent disability reform efforts in the area of fast tracking disability determinations. While country-specific goals and medical conditions of interest tend to be similar, the variety of disability program designs, associated claims processes, and administrative arrangements give rise to subtle and some not-so-subtle differences. The article is divided into five sections, the first of which introduces the five countries examined in the study and chronicles the methodology used in the selection process for the non-US sample. The next section documents how country-specific FT procedures operate in the context of the application and decision-making processes. This is followed by a comparison of the operational aspects of fast tracking disability claims across the country sample as laid out in the previous section. In the last sections, some tentative conclusions are offered based on a data review and the country descriptions, which are followed by several brief observations. Country Selection and Methodological Approach This research produces a qualitative assessment of FT strategies using the United States as its starting point. In the process, several countries are identified as operating public disability programs with FT features employed at various stages of the determination process. To the author's knowledge, there is no cross-national study on this topic in the disability literature. The subject matter discussion relies on the availability of material provided by staff in national disability agencies who have agreed to participate in this study. As a result, the country presentations that follow constitute the best information on these countries available at this stage. …