Youth Transition Pilot Shows Promise

     From the Arkansas Democrat Gazette:

A program aimed at moving Arkansas youths from the disability rolls to employment is showing early signs of success, according to Brent Thomas Williams, an associate professor of counselor education at the University of Arkansas. ...

Williams is principal investigator for Arkansas Promise, a five-year, $36 million program focused on finding jobs and opportunities for Arkansas teenagers who receive Supplemental Security Income. ...

Richard Luecking of the Center for Transition and Career Innovation at the University of Maryland said early reports from all six projects are highly encouraging. ...

After 18 months, participants in all six pilot projects were more successful at finding work than members of a control group. In four cases, they also saw their earnings increase by a statistically significant amount, according to Mathematica Policy Research, a Princeton, N.J.-based organization that analyzed the data.

The Arkansas experiment, which wraps up this year, surpassed the others, however, in terms of youth employment and youth earnings. 

Roughly 2,000 Arkansas youths participated in the research project. Half received Arkansas Promise services; the others did not.

Participants received training, "intensive case management" and assistance finding jobs. An earned income exclusion allowed them to make money without jeopardizing their SSI payments.

Fifty-six percent of the participants in Arkansas Promise said they had held paying jobs, compared with 20 percent in the control group, officials said. Arkansas Promise participants reported earnings in the previous year of $1,960. The control group had earnings of $747. ...

     In general, I'm very pessimistic about programs to encourage disability benefits recipients returning to work. There's a long history of failure. However, I don't feel that way about youth transition programs. Young people have a far greater capacity to make adaptations that allow them to overcome obstacles than do older people. I've seen too many cases where young people with developmental disabilities leave high school without receiving any help in making the transition to employment. Predictably, they fail to hold down jobs. Give them a counselor to help point them in the right direction and help them find employment and then give them a job coach and many can make it.

SSA To Pay $12.4 Million For Early Intervention

     From a contracting notice recently posted by the Social Security Administration:

Contract Award Dollar Amount:

$12,378,342.00...

Contractor Awardee:

MATHEMATICA POLICY RESEARCH, INC.
1100 1ST STREET NE
12TH FLOOR
WASHINGTON

DC
200024221
USA 

Synopsis: ... 

Single Award Cost Plus Fixed Fee 5-year Contract for Retaining Employment & Talent After Injury/Illness Network (RETAIN) Evaluation - This is a joint project between SSA, the Department of Labor (DOL), and several states. The purpose of the contract is to evaluate the impact of the various interventions implemented under cooperative agreements between the states and the DOL.

     I hope this study shows that early intervention works but let me list just a few of the reasons I don't think it will work very well:

• Most people who become disabled are disabled by degenerative conditions, like diabetes or osteoarthritis. These conditions just get worse with time. Rehabilitating people with this sort of problem isn't realistic. As soon as you get them able to do a new job, their condition has worsened to the point they can't do it.
• Pain is a huge factor in producing disability.  No intervention can take away the pain. If pain prevents one type of work, it's almost certain to prevent other types of work.
• Mental illness is a major cause of disability. It’s not so amenable to intervention that  helps to preserve the ability to work.
• People with below average cognitive abilities are dramatically over-represented among the population of people who apply for Social Security disabilities. That's because their limited intellectual abilities limit them to simpler, more physically demanding work to begin with and make it almost impossible for them to switch to other less demanding work. 
• This whole concept is based upon a misunderstanding of who applies for Social Security disability benefits and why they apply. Those who support this think that most disability is due to trauma and that if you can just help people figure out what they can do despite their injuries and give them a mobility scooter or whatever that they can go back to work. The thing is that the 12 month duration of disability requirement in the definition of disability that is written into the Social Security Act means that folks who are disabled by trauma either go back to their old jobs or figure out something else they can do on their own or with the help of programs that already exist well before 12 months have passed. I don't know that there's anything new that can be offered to help people in this situation. If you wanted to do something useful, you could better fund state vocational rehabilitation agencies. Besides, it's such a small component of disability that it doesn't matter that much anyway.
• In any case, as far as I'm concerned, Mathematica is nothing more than a Beltway Bandit. They get lots and lots of government contracting money but nothing they do ever helps anyone.

There's Social Security Disability As It Really Exists And Social Security Disability As Members Of Congress Imagine It To Be

     Here's some excerpts from an opinion piece written by Senators Manchin (D-WV) and Cotton (R-AR) for Fox News with comments from me in brackets and bolded:

According to the 2015 annual report from the Social Security system’s trustees, the SSDI [Social Security Disability Insurance] trust fund will run out in late 2016. ...

SSDI was established as an insurance program for the “totally and permanently disabled.” [You're putting it in quotes but the phrase "totally and permanently disabled" has never been part of SSDI. Not now. Not ever. Depending upon how you interpret the term "total disability", it can be synonymous with chronic vegetative state. Is that the sort of definition of disability that you'd prefer? Permanence has never been required. However, the one year duration requirement that we have isn't that different from a requirement of permanence, as a practical matter.] ...

Today, nearly 300,000 Arkansans and West Virginians rely on SSDI. In some of our counties, nearly 20% of working-age people receive SSDI benefits. [This might be important enough to your constituents for you to actually learn something about it.]

Many of these individuals are permanently disabled, and we’re committed to protecting this vulnerable population. But we must also dramatically improve the program for the temporarily disabled to help them recover and return to work. [How many temporarily disabled people do you really think receive SSDI? You have to have been or be predicted to be disabled for at least a year to be found disabled. How much ground do you think there is between a year and permanent? In the real world, there's little.]...

We must intervene early. On average, applicants wait more than a year before getting an SSDI eligibility decision. [So, the agency needs more money so it can decide cases quicker? However, Manchin and Cotten are enthuaistic budget hawks who favor endless cuts to the federal budget.] We can use this time to help applicants who are disabled, but have the potential for work activity stay connected to the workforce by providing support services. This can be done through vocational training, supportive employment, health services, incentives for employers, and more. [All of this already exists. What more do you want?]

We also need to shift SSDI from a one-size-fits-all mindset to a smarter approach that differentiates between the permanently disabled and those who, with medical treatment and rehabilitation services, can recover. [We have 50 years of evidence that there is no significant number of people drawing SSDI who have the realistic capacity to return to work on a regular basis, regardless of the assistance they receive.]

While SSA categorizes beneficiaries based on likelihood of medical improvement, there’s no requirement to pursue rehabilitation or medical services to prepare for a return to work. [You're attacking straw men. There's zero evidence that claimants are refusing to pursue vocational rehabilitation. Mostly, they're way too sick to take advantage of it. The idea that a claimant would avoid medical treatment in order to stay on SSDI is bizarre. We have strong evidence that this virtually never happens.] We need to help individuals with temporary disabilities gain access to rehabilitation and recovery services and offer a timeline to re-enter the workforce. [They already have such access. It doesn't work. There's no reason to believe that it will ever work] ...

     I suppose I shouldn't complain. It's better for Manchin and Cotton to concentrate upon worthless ideas than upon dangerous ideas.

Rehab Pushed At Congressional Hearing

     Here are some excerpts from two of the written statements for today's hearing before the House Social Security Subcommittee:

• Richard Burkhauser:

In sum, SSDI growth has primarily been driven by factors other than an aging workforce, health declines, and the increasing SSDI coverage of women. Loosening of program rules in the 1980s has made it more difficult for gatekeepers to judge eligibility and increased the likelihood that applicants facing rising replacement rates or declining economic opportunities will apply for SSDI benefits. A growing number of individuals being allowed onto the rolls could work in some capacity and would do so if they were not judged eligible for benefits.

     Burkhauser's evidence to support the proposition that age is the cause of increasing claims for disabiliity benefits is the fact that increasing age didn't cause an increase in the incidence of disability in the time period 1983-2003. Of course, that was before the baby boom generation started hitting their 50s, making it irrelevant in my opinion.

     Burkhauser's solution is to adopt the emulate Holland which "required all Dutch firms to fund the first two years of disability benefits to their workers and to pay an experience-rated disability tax based on the number of workers they subsequently moved onto the long-term Dutch disability insurance program."

• Daniel Bertoni of the Government Accountability Office (GAO):

Although giving broad consideration of assistive devices and workplace accommodations may be difficult to incorporate into the current disability criteria and process, SSA may be missing opportunities to move further in this direction. Officials we spoke with from an organization of vocational examiners expressed frustration with having seen young individuals who could work with minor accommodations being provided disability benefits likely throughout their working life, rather than receiving support to pursue work.

Does Rehabilitating Disability Benefits Recipients Cost More Money Than It Saves?

Social Security has some very preliminary results from the Benefits Offset Pilot Demonstration (BOPD) (emphasis added):

We designed the four-State BOPD project to provide information about the implementation and the effect of a benefit offset for SSDI beneficiaries.  We used the information collected in BOPD to help design the BOND [Benefits Offset National Demonstration] project....

The pilot includes a targeted group of SSDI [Social Security Disability Insurance] beneficiaries who chose to volunteer for the project.  We gave them the opportunity to receive a $1 reduction in benefits for every $2 earned above the SGA [Substantial Gainful Activity] threshold amount during the extended period of eligibility (EPE), instead of losing their entire benefit, as they would have under our usual rules....

The State [by state] reports show that the benefit offset had a positive effect on the percentage of beneficiaries who have earnings above the SGA amount ($980 per month for the non-blind in 2009).  We conducted our own analysis using Internal Revenue Service earnings data and our benefit payment administrative records.  We found similar effects on earnings.  However, our analysis also showed an increase in benefit payments because we made partial benefit payments under the benefit offset to beneficiaries who would have had their benefits suspended due to SGA under the current program rules....

 No wonder Social Security wants to stretch out BOND over ten years.

Senate Finance Committee Written Statements

The written statements for the Senate Finance Committee's hearing today barriers to work for Social Security disability recipients are now available online.

The only witness whose written statement suggests a strong attachment to the delusion that some change in policy could return vast numbers of disability recipients to work was Dr. David Stapleton of the Cornell University Institute for Policy Research. Stapelton has been receiving a good deal of grant money from Social Security. Could considerations of his own self-interest have something to do with this paragraph at the close of his statement?

I urge this Committee, all government leaders, and advocates for people with disabilities to support the design, testing, and eventual implementation of transformative disability policy changes – changes that will help people with disabilities achieve both greater economic self-sufficiency and more fulfilling lives. Within that framework, the highest priority should go to efforts that will reduce the premature exit of workers with disabilities from the labor force and
into SSDI.

I would like to read even one report or statement from one of these researchers that did not call for more research dollars to be funeled to them.