Academic journal article Social Security Bulletin

Length of Stay on the Supplemental Security Income Disability Program

Academic journal article Social Security Bulletin

Length of Stay on the Supplemental Security Income Disability Program

Article excerpt

This article analyzes duration on the Supplemental Security Income (SSI) disability rolls prior to age 65 among children and working-age adults, based on a 10-year followup of 1974-82 cohorts of new awardees by utilizing monthly data from administrative records for 1974-92, and on statistical projections beyond the followup period. Although SSI means testing is responsible for a high proportion of early suspensions, when multiple spells are accounted for, long stays dominate. The estimated mean length of all first SSI spells is 5.5 years. It is 11.3 years for disabled children, 1.3 years for disabled adults eligible for both the Social Security Administration's Disability Insurance (DI) and SSI, and 6.4 years for adults eligible for SSI only. When multiple spells are accounted for, the projected mean total pre-retirement-age SSI disability stay almost doubles to 10.5 years for all awardees an increases to 26.7 years for children.

This article examines the contribution of long program stays to the cost of the SSI disability program, as well as the patterns of length of stay in other means-tested government programs. The article focuses on the following questions:

* How long do people stay on SSI during the first 10 postward years?

* What are the main reasons for leaving SSI?

* What is the length of first benefit recipiency spell?

* What is the expected lifetime number of benefit years for new awardees before age 65?

* How do length-of-stay patterns vary by age and by diagnosis? * How do SSI length-of-stay patterns compare with those of other means-tested welfare programs and to the Social Security Disability Insurance program (DI)?

Answers to these and similar questions are of great potential policy importance, primarily because program costs are directly related to the length of program stay. Because of the strict disability test applied in SSI, few awardees are expected to have a full medical recovery. Many of those who do not leave the program due to death will face long-term disabilities. Long stayers (persons with a first spell of disability that lasted at least 10 years), even if they form a small fraction of new awardees, contribute disproportionally to the caseload and, therefore, to SSI program cost. Expected future program outlays are largely a product function of the number of new awardees entering the rolls and their lengths of stay. The recent sharp rise in the number of persons awarded SSI benefits has been accompanied by an increasing proportion of children and young adults. To the extent that young people stay in benefit status longer than older awardees, there is concern that the recent explosion in the number of awards to younger persons will eventually have a magnified effect on program costs, because of the coincident rise both in the number of new awards and expected lengths of stay. Therefore, projection of future program outlays critically depends on assumptions about length of stay. Policymakers might also be interested in how length of stay varies by subgroup characteristics (such as age and diagnosis).

There are two distinct questions concerning length of stay: What is the distribution of new enrollees by expected length of stay? And what is the contribution of long stayers to the beneficiary rolls? In our analysis we will analyze length of stay from both of these perspectives, and will also provide information on the length of initial stays, return to the rolls, and total time spent in benefit receipt status. The proportion and characteristics of long stayers are important in addressing policy options for containing caseload growth. For example, policies that prevent the entry of potential long stayers or induce earlier exits might have substantial effects on caseloads. To the extent that there are no feasible policies to induce earlier exits among potential long stayers, a high proportion of potential long stayers among new awardees is expected to result in difficulties in containing future caseload growth. …

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