[Federal Register Volume 81, Number 181 (Monday, September 19, 2016)]
[Notices]
[Pages 64254-64256]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-22404]


=======================================================================
-----------------------------------------------------------------------

SOCIAL SECURITY ADMINISTRATION

[Docket No. SSA-2016-0036]


Request for Information on Strategies for Improving Work Outcomes 
for Individuals With Musculoskeletal Disabilities

AGENCY: Social Security Administration.

ACTION: Request for information.

-----------------------------------------------------------------------

SUMMARY: The Bipartisan Budget Act of 2015 amended section 234 of the 
Social Security Act, which authorizes us to plan and implement new 
demonstration projects that waive certain Social Security Disability 
Insurance (SSDI) program requirements in order to evaluate strategies 
for improving work outcomes for SSDI beneficiaries and applicants. This 
request for information (RFI) seeks public input on possible 
demonstration projects designed to improve employment and earnings 
outcomes for individuals with musculoskeletal impairments. The input we 
receive will inform our deliberations about the possible design of a 
future demonstration project using the section 234 authority.

DATES: Comments must be received by November 18, 2016.

ADDRESSES: You may submit comments by any one of three methods--
Internet, fax, or mail. Do not submit the same comments multiple times 
or by more than one method. Regardless of which method you choose, 
please state that your comments refer to Docket No. SSA-2016-0036 so 
that we may associate your comments with the correct docket.
    Caution: You should be careful to include in your comments only 
information that you wish to make publicly available. We strongly urge 
you not to include in your comments any personal information, such as 
Social Security numbers or medical information.
    1. Internet: We strongly recommend that you submit your comments 
via the Internet. Please visit the Federal eRulemaking portal at http://www.regulations.gov. Use the ``Search'' function to find docket number 
SSA-2016-0036. The system will issue a tracking number to confirm your 
submission. You will not be able to view your comment immediately 
because we must post each comment manually. It may take up to a week 
for your comment to be viewable.
    2. Fax: Fax comments to (410) 966-2830.
    3. Mail: Mail your comments to the Office of Regulations and 
Reports Clearance, Social Security Administration, 3100 West High Rise 
Building, 6401 Security Boulevard, Baltimore, Maryland 21235-6401.
    Comments are available for public viewing on the Federal 
eRulemaking portal at http://www.regulations.gov or in person, during 
regular business hours, by arranging with the contact person identified 
below.

FOR FURTHER INFORMATION CONTACT: Susan Wilschke, Deputy Associate 
Commissioner for Research, Demonstration, and Employment Support, 
Office of Retirement and Disability Policy, Social Security 
Administration, 6401 Security Boulevard, Baltimore, MD 21235-6401, 
(410) 966-8906, for information about this notice. For information on 
eligibility or filing for benefits, call our national toll-free number, 
1-800-772-1213 or TTY 1-800-325-0778, or visit our Internet site, 
Social Security Online, at http://www.socialsecurity.gov.

SUPPLEMENTARY INFORMATION:

Purpose

    The SSDI program provides financial support for disabled 
individuals and their dependents. In 2015, the SSDI program provided 
more than $140 billion in benefits to 10.8 million Americans.\1\ Given 
the large number of individuals who rely on SSDI and the interest in 
supporting employment efforts of those with disabilities when possible, 
policymakers need a strong evidentiary base from which to consider 
future program improvements and innovations that can strengthen the 
ability of individuals with disabilities to work.
---------------------------------------------------------------------------

    \1\ https://www.ssa.gov/OACT/STATS/table4a6.html; https://www.ssa.gov/OACT/STATS/OASDIbenies.html.
---------------------------------------------------------------------------

    This request for information offers interested parties, including 
States, community-based and other non-profit organizations, 
philanthropic organizations, researchers, and members of the public, 
the opportunity to provide information and recommendations on effective 
approaches for improving employment and earnings outcomes for 
individuals with musculoskeletal impairments. For the purposes of this 
notice, ``musculoskeletal impairments'' means any impairment included 
in section 1.00 of our Listing of Impairments, 20 CFR part 404, app. 1, 
affecting the musculoskeletal system and connective tissue. Impairments 
in this section include, but are not limited to, major joint 
dysfunction, spinal disorders, amputation, and soft tissue injuries.

Background

    Musculoskeletal impairments are the primary diagnosis for 31 
percent of all SSDI disabled workers and for 36 percent of disabled 
workers awarded SSDI in 2014.\2\ A small, growing body of research 
involving studies of workers compensation and occupational health 
programs in the United States and in other countries suggests that the

[[Page 64255]]

withdrawal of individuals with musculoskeletal impairments from the 
labor force is preventable with appropriate services, such as health 
care and work supports provided at the onset of a work disruption.
---------------------------------------------------------------------------

    \2\ https://www.ssa.gov/policy/docs/statcomps/di_asr/index.html, 
Tables 21 and 40.
---------------------------------------------------------------------------

    Researchers and policy experts have suggested that it we may find 
it useful to conduct a demonstration project related to musculoskeletal 
impairments. For example, as part of the Committee for a Responsible 
Federal Budget's (CRFB) SSDI Solutions series, several researchers 
proposed a demonstration project involving health care and work 
supports for approximately 12 weeks after an individual's work is 
disrupted, but before he or she applies for SSDI.\3\ This proposal 
notes that musculoskeletal impairments do not necessarily prevent 
individuals from working if those individuals have appropriate health 
care and work supports.
---------------------------------------------------------------------------

    \3\ Jennifer Christian, Thomas Wickizer, and A. Kim Burton, 
Proposal to the CRFB SSDI Solutions Initiative for a Community-
Focused Health and Work Service (HWS) (2015) (available at: http://www.webility.md/SSDI-HWS/Health%20and%20Work%20Service-submitted%20by%20Webility%202015-07-15.pdf).
---------------------------------------------------------------------------

    We expect that public input provided in response to this request 
will provide us with information that will allow us to determine if a 
musculoskeletal demonstration project will be useful and, if so, what 
interventions may be most valuable to consider in the demonstration 
project design. For example, a demonstration project could test whether 
coordinating and providing services can have a positive impact on a 
worker's ability to remain in the workforce. Those services may include 
case management, care coordination, and communication assistance 
between the employer, worker, medical providers, and others. 
Importantly, a potential demonstration project related to 
musculoskeletal impairments would improve the evidentiary base for 
future potential SSDI program reforms.
    If we decide to pursue a musculoskeletal demonstration project, we 
would likely issue a contract for demonstration project implementation 
and evaluation.

Request for Information

    Through this notice, we are soliciting feedback from interested 
parties on the potential value of a demonstration project related to 
providing health and work supports to individuals with musculoskeletal 
impairments, and on design aspects of a demonstration project aimed at 
improving employment and earnings outcomes for these individuals. 
Responses to this request will inform our decisions about whether to 
pursue a new demonstration project, and how such a project may be 
designed. This notice is for our internal planning purposes only and 
should not be construed as a solicitation or as an obligation on our 
part or on the part of any participating Federal agencies. We ask 
respondents to address the following questions, where possible, in the 
context of the discussion in this document. You do not need to address 
every question and should focus on those that relate to your expertise 
or perspectives. To the extent possible, please clearly indicate which 
question(s) you address in your response.

General Questions

    1. What specific programs or practices have shown promise at the 
State or local level to assist workers with musculoskeletal impairments 
to remain in or re-enter the workforce?
    2. What programs and practices might be especially applicable to 
individuals who might be enrolled in SSDI in the absence of 
interventions, and how might those programs and practices be 
incorporated into a potential demonstration project?

Detailed Questions

I. Target Population and Sites

    1. Should we target specific types of musculoskeletal impairments 
in a demonstration project? If so, which ones, and why those?
    2. What is an appropriate age range of individuals with 
musculoskeletal impairments for us to consider targeting for a 
demonstration project? Why?
    3. Which populations should we consider targeting? How can we 
identify these populations? How many individuals enter these 
populations per year?
    4. What types of sites (for example, State vocational 
rehabilitation agencies, medical practices, etc.) would be the most 
beneficial for us to consider including in a demonstration project?
    5. Are there sites we could look to as exemplars based on current 
practices for serving individuals with musculoskeletal impairments? 
What evidence exists to suggest these sites are effectively providing 
early intervention services for workers with musculoskeletal 
impairments?
    6. How might we consider structuring a demonstration project to 
investigate the potential for screening workers for their likelihood of 
responding to employment supports?

II. Health Services

    7. What types of health services should we consider for workers 
with musculoskeletal impairments?
    8. When should these services be provided?
    9. To what extent should we prioritize certain services, whether 
case management, care coordination, or other on-site work support 
services?
    10. Are there rehabilitative and pain management healthcare 
delivery models that we should consider combining with other work 
support services? What specific healthcare practices and models should 
we avoid or discourage?
    11. What are the best ways to involve workers with disabilities in 
planning and implementing a demonstration project in order to ensure 
that demonstration project services will be effective in meeting their 
needs?
    12. What health service program designs and interventions 
demonstrate promise for improving long-term employment outcomes for 
workers with musculoskeletal impairments? What evidence supports these 
interventions?

III. Employment and Job-Related Services

    13. What specific employment related interventions related to skill 
development, job training, job placement, or pre- and post-placement 
services should we consider for individuals with musculoskeletal 
impairments?
    14. What employment program designs and interventions demonstrate 
promise for improving long-term employment outcomes for workers with 
musculoskeletal impairments? What evidence supports these 
interventions?

Guidance for Submitting Documents

    We ask that each respondent include the name and address of his or 
her institution or affiliation, if any, and the name, title, mailing 
and email addresses, and telephone number of a contact person for his 
or her institution or affiliation, if any.

Rights to Materials Submitted

    By submitting material in response to this notice, you agree to 
grant us a worldwide, royalty-free, perpetual, irrevocable, 
nonexclusive license to use the material, and to post it publicly. 
Further, you agree that you own, have a valid license, or are otherwise 
authorized to provide the material to us. You should not provide any 
material you consider confidential or proprietary in response to this 
notice. We will not

[[Page 64256]]

provide any compensation for material submitted in response to this 
notice.

Carolyn W. Colvin,
Acting Commissioner of Social Security.
[FR Doc. 2016-22404 Filed 9-16-16; 8:45 am]
 BILLING CODE 4191-02-P