[Federal Register Volume 61, Number 175 (Monday, September 9, 1996)]
[Notices]
[Pages 47542-47544]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-22925]


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SOCIAL SECURITY ADMINISTRATION


Research Plan For the Development of a Redesigned Method of 
Evaluating Disability in Social Security Claims

AGENCY: Social Security Administration (SSA).

ACTION: Notice and solicitation of comments.

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SUMMARY: SSA has formulated a research plan for developing a new method 
of determining whether an individual is ``disabled,'' as defined in the 
Social Security Act (the Act), for purposes of entitlement or 
eligibility to disability benefits under titles II and XVI of the Act. 
The goal of this research will be to devise a more efficient and more 
accurate method for making timely determinations of disability for 
Social Security claimants. This notice describes SSA's research plan 
for developing the new methodology.

DATES: To be considered, all comments must be received in writing on or 
before October 24, 1996.

ADDRESSES: Please submit comments on the research plan in one of the 
following manners:
     By E-mail, to David.B[email protected]
     By telefax, to 410-966-0148
     By mail, to Disability Process Redesign Staff, Office of 
Disability, Social Security Administration, 6401 Security Boulevard, 
Room 560 Altmeyer, Baltimore MD 21235.

FOR FURTHER INFORMATION, CONTACT: David Barnes, 410-965-9121.

SUPPLEMENTARY INFORMATION:

Background

    In late 1993, the Social Security Administration (SSA) began an 
initiative to improve its disability process through business 
reengineering, which involves redesigning the business process to 
improve efficiency and service to the customers. In September 1994, the 
Commissioner of Social Security issued a report on SSA's disability 
process redesign entitled Plan for a New Disability Claim Process. That 
report discussed the need for a structured approach to disability 
decisionmaking that takes into consideration the large number of claims 
(2.7 million initial disability decisions in fiscal year 1994) and 
still provides a basis for consistent, equitable decisionmaking by 
adjudicators at each level of review.
    The Commissioner described a proposal for a new method for 
determining whether individuals are ``disabled'' under the Social 
Security Act (the Act) with a goal of focusing decisionmaking on the 
functional consequences of an individual's medically determined 
impairments. However, she also acknowledged that certain aspects of the 
proposed new disability methodology would require much study and 
deliberation.
    A November 1994 follow-up report, Disability Process Redesign: Next 
Steps in Implementation, discussed effectuation of the new disability 
claim process. The report noted that long-term research, consultation, 
development, and refinement will be needed in order to decide on and 
implement a new disability decision methodology.

Integration of Disability Evaluation Study and Disability Redesign 
Research

    In response to concerns about growth in the disability rolls, SSA 
began research in early 1993 to identify factors contributing to this 
growth. One major research question remains unanswered:

    How many adults in the U.S. are ``disabled,'' based on SSA 
criteria? (Existing estimates of the number of disabled vary widely 
because they are based on small sub-groups within the population, 
varying definitions of ``disability,'' and less reliable self-
reports.)

    To provide reliable estimates of the number of disabled adults, SSA 
has developed plans for a national survey, the Disability Evaluation 
Study (DES), which would include not only survey questions, but also 
physical and/or mental examination(s) and current medical records.
    The DES will be in the field as SSA develops a new disability 
decision methodology. By integrating the DES with these plans to 
develop a new disability decision methodology, SSA will be able to use 
DES data to estimate the number of adults with disabilities in the 
United States, and also to collect the data needed to test the new 
proposed disability decision methodology.
    More comprehensively, the DES will attempt to answer four 
fundamental questions:
    (1) Would the types of people found disabled be affected by any 
change in disability decision methodology?
    (2) Why can some persons with disabling impairments work, while 
others cannot?
    (3) How many adults who meet SSA's definition of disability 
(irrespective of work status) are in the population?
    (4) How can SSA cost-effectively monitor, for program planning 
purposes, future changes in the U.S. population of people who meet 
SSA's definition of disability?
    The DES will attempt to answer these questions by screening a 
nationally representative sample of adults aged 18 to 69 in order to 
identify those with either self-identified diagnoses or other positive 
indicators of physical or mental impairment(s). For those screened in, 
the DES will collect sufficient data for accurate predictions of 
whether they would be found disabled under both current SSA criteria 
and the proposed new disability decision methodology.
    The disability methodology research and DES will feed into each 
other in a variety of ways. In general terms, the DES design will 
reflect input from the disability methodology research and, to the 
extent that it can be specified, the new disability methodology itself. 
During a planned Stage 1, the DES will gather a wide range of 
information on functioning of individuals with physical and mental 
impairments and will include functional assessment measures that appear 
to have potential for eventual use in a functionally-based decision 
process. In Stage 2, the DES can field-test proposed functional 
assessment measures and decision processes on a nationally 
representative sample, perhaps concurrently with planned methodology 
laboratory testing.
    In effect, the results and findings from DES Stage 1 and several 
other research projects will assist in the development of a proposed 
decision methodology that can be tested in Stage 2 of the DES. Further, 
the initial work to develop and implement Stage 1, conducted by SSA in 
conjunction with the expert staff of the eventual DES contractor, will 
provide additional relevant information to complement the output of the 
methodology research. It is also likely that, even before the full DES 
sample has been evaluated, certain findings that emerge from the field 
work will provide useful input for decisions on the new methodology.

[[Page 47543]]

    Critical elements of the integrated research process will be:
     The combined product of two research projects on (1) 
functional assessment tools and (2) occupational classification 
systems. This will provide a comprehensive review and analysis of 
existing tools and systems, and also provide a basis for further 
research, which will allow SSA to make informed judgments about an 
appropriate way(s) of assessing functional capacity and how an 
individual's functional capacities relate to capacity for work.
     Two additional comprehensive research programs addressing 
disability methodology issues other than functional capacity 
measurement. Information derived from these programs will be used to 
develop the new proposed disability decision methodology. These 
programs are:
    1. A survey of existing systems and methods of identifying disabled 
individuals (such as foreign and other domestic disability programs 
using functionally based methodologies, existing methods of screening 
in or screening out clear-cut cases, comparable to the proposed steps 
for use in the SSA disability determinations). The survey will provide 
an overview of how other disability programs address similar 
methodology problems; and
    2. An analysis of the relationship between vocational factors (age, 
education, and work experience) and an individual's ability to work, 
which will be considered in making policy decisions on how to 
incorporate the statutorily-required consideration of such vocational 
factors into the new methodology.
     A project management approach [see Organization, below] 
that provides senior executive oversight, multi-level involvement of 
outside consultants, and both internal and external stakeholder 
consultation.
     Methodology laboratories, which will allow testing, in a 
controlled setting, of proposed components of a new methodology (e.g., 
specific functional assessment tools, proposed screening mechanisms). 
The laboratory setting and testing procedures will vary depending on 
the issue under investigation. Data from this testing will help to 
narrow choices among possible policy options by developing empirical 
data on which to base policy decisions.
     DES Stage 1 and Stage 2 data, which can provide a focused 
analysis of a new disability methodology in a nationally representative 
sample.

Organization

    The organizational structure supporting the disability decision 
methodology research will have seven components:

A. Steering Committee

    A three-person Steering Committee consisting of executives from 
SSA's Office of Disability (OD), Office of Research, Evaluation and 
Statistics (ORES), and Disability Process Redesign Team (DPRT) will be 
charged with overall supervision of the project. The Steering Committee 
will be advised by an Expert Panel and will delegate day-to-day 
management and operation of the project to a Research Workgroup.

B. Independent Review and Oversight

    SSA intends to enter a contractual relationship with the National 
Academy of Sciences (NAS). NAS will review the overall research design, 
as well as specific research plans and products, and will advise the 
Steering Committee on all aspects of the project.

C. Research Workgroup

    The Research Workgroup will be composed of OD, ORES, and DPRT 
staff, possibly supplemented by one or more consultants from outside 
SSA (see section D below). The Workgroup will direct day-to-day 
operation of all aspects of the project. Subject to Steering Committee 
oversight and direction, the Research Workgroup will review research 
products, develop laboratory testing scenarios, oversee laboratory 
testing, review test results, and identify and address policy options.
    The Research Workgroup will rely on four sources for advice and 
comment: Consultants, Internal Stakeholders, External Stakeholders, and 
the General Public. Any recommendations of the Research Workgroup are 
subject to review and approval of the Steering Committee.

D. Consultants

    We will contract with experts in relevant fields including 
medicine, disability, rehabilitation, health research, and research 
methodology, to review and evaluate research plans and products, 
recommend additional research activities, consult on the design of 
testing laboratories, etc. They will be selected for their expertise in 
one of the preceding subject areas, and they will provide advice to the 
research workgroup on an individual basis.

E. Internal Stakeholders

    Internal Stakeholders will be individual representatives from other 
interested or affected SSA components (e.g., State Disability 
Determination Services, Field Offices, Office of Program and Integrity 
Reviews, Office of Systems, Office of Hearings and Appeals). They will 
review and comment on specific aspects of the project. Internal 
Stakeholders will be identified by their respective components.

F. External Stakeholders

    External Stakeholders will be individuals and organizations, many 
of whom already interact with SSA, with a special interest in SSA 
disability programs. They will not meet or operate as a single entity, 
but will individually review and comment on major activities and 
products mailed to them. Individuals or organizations interested in 
being considered External Stakeholders should submit their request to 
the contact point listed above.

G. General Public

    The Research Workgroup will seek, receive, and consider comments 
from the general public through a series of notices published in the 
Federal Register. The notices will describe the Agency's research goals 
and plans, discuss major developments in the research process (e.g., 
results of research activities, Research Workgroup and Steering 
Committee decisions, laboratory test procedures and results), and 
invite public comment. If necessary, the Research Workgroup will 
consider organizing public hearings or asking contractors to convene 
groups or to hold public forums.

Process

    SSA is committed to conducting this research in an inclusive 
environment. To that end, SSA is simultaneously publishing this notice 
in the Federal Register and sending the same notice to a comprehensive 
list of Internal and External Stakeholders.
    At major milestones in the research and development process when 
consultant and/or stakeholder input is appropriate (e.g., receipt of a 
research product or laboratory test result, change in research plans, 
preliminary policy decision), SSA will publish a Federal Register 
notice, including a request for comments, and transmit the same notice 
to External Stakeholders.
    SSA also will present the same issue(s) to the Consultants for 
advice and, as needed, to some or all of the Internal Stakeholders for 
comment.
    Upon completion of all research actions, a report will be made to 
the Commissioner making final recommendations for the new disability 
methodology.

[[Page 47544]]

Time Line

------------------------------------------------------------------------
                     Action                                Date         
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Development of Research Plan...................  Completed.             
Publication of Research Plan in Federal          8/96.                  
 Register; Request for Internal and External                            
 Stakeholder Comments.                                                  
Completion of Initial Research on Functional     11/96.                 
 Assessment Instruments.                                                
Federal Register Notice Describing Initial       1/97.                  
 Research Products; Request for Internal and                            
 External Stakeholder Comments.                                         
Award of DES Contract..........................  7/97.                  
Further Research (Other Disability Programs,     7/97-9/97.             
 Vocational Factors); Laboratory Testing; DES                           
 Stage 1 Field Work Begins.                                             
Federal Register Notice Describing Further       9/97.                  
 Research and Testing; Request for Internal and                         
 External Stakeholder Comments.                                         
Supplemental Research (as needed) and Testing;   1/98-9/98.             
 DES Stage 1 Field Work.                                                
Federal Register Notice Describing Supplemental  9/98.                  
 Research and Testing Based on Results to Date;                         
 Request for Internal and External Stakeholder                          
 Comments.                                                              
Review of All Research, Comments, and Testing    10/98-10/99            
 in Conjunction with DES Stage 1 Data; DES                              
 Stage 2 Field Work.                                                    
Federal Register Notice Describing DES Research  11/99                  
 Including Interim Results; Request for                                 
 Internal and External Stakeholder Comments.                            
Final Review of All Research, Testing,           11/99-12/99            
 Comments, and DES Data; Recommendation of                              
 Final Disability Decision Methodology.                                 
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    Dated: August 30, 1996.
John Dyer,
Acting, Principal Deputy Commissioner of Social Security.
[FR Doc. 96-22925 Filed 9-6-96; 8:45 am]
BILLING CODE 4190-29-P