Disability Trends in the United States: A National and Regio (1994)

The Old-Age, Survivors, and Disability Insurance (OASDI) program, the largest income-maintenance program in the United States, and the Supplemental Security Income (SSI) program, a major cash assistance program, have experienced substantial growth in recent years. Administrative, legislative, and judicial decisions over the past decade, combined with the economic downturn of 1990-91, are all suggested as contributors to a rising number of applications for disability benefits, followed by expanding beneficiary rolls and increasing benefit expenditures. This article examines the level of OASDI and SSI disability program participation among disabled persons since 1975 and relates that participation to the total population. Insured status is also used to examine the program participation of disabled-worker beneficiaries since 1957, the year benefits first became payable under the OASDI disability program. Brief reviews are included of legislative changes and the extent to which they have affected recent trends. This background information will provide a better understanding of the relationship of recent trends to those established during the early years of the program. Recent attention has focused on changes in disability program participation rates during the past 5 years. This period will be examined using State-by-State data to identify areas experiencing the greatest changes between 1987 and 1992. These State data will provide comparisons of OASDI and SSI disability program participation. The OASDI program provides monthly benefits on the basis of disability to disabled workers, widow(ers), and children. Disabled-worker benefits are paid, after a 5-month waiting period to those persons unable to engage in any substantial gainful activity [SGA] by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months. Since the program provides work-based benefits, the individual must meet certain work requirements to be eligible for participation. Benefits are paid to a disabled widow(ers) or surviving divorced spouse at age 50-59, and to disabled children at age 18 or older who are sons or daughters of retired, disabled, or deceased workers. In contrast, the SSI program is a means-tested program that provides a monthly benefit to aged, blind, and disabled persons having limited assets and income. There is no waiting period before such benefits are payable. The qualifying standards for disability payments to persons aged 18 or older are the same under both the OASDI and the SSI programs. For a child under age 18, eligibility is based on disability with severity comparable to that of an adult. Old-Age, Survivors, and Disability Insurance Program Approximately 2.72 percent of the resident population in the United States aged 18-64 received disability benefits in 1993 under the OASDI program, compared with 2.28 percent in 1975 (table 1).(table 1 omitted) This percentage had risen from a low of 2.09 percent in 1983 and 1984. The percentage of persons receiving disability benefits rose slowly through the remainder of the 1980's with 2.22 percent of the U.S. resident population aged 18-64 on the disability rolls by 1989. In 1990, the pace began to accelerate as an increase in the number of benefit applications was accompanied by an increase in the initial allowance rate (34 percent in 1988, 39 percent in 1992).(1) The initial allowance rate is expressed as the ratio of disability awards to total disability decisions at the initial determination level. Disabled workers account for about five out of six disability beneficiaries, and the remainder received benefits as disabled children, widows, or widowers. Adults disabled before age 18 (or age 22, if attending school) who were children of retired, disabled, or deceased workers, became eligible for benefits under the Social Security Amendments of 1956. …