Improving access to disability benefits among homeless persons with mental illness: an agency-specific approach to services integration.
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OBJECTIVES: This study evaluated a joint initiative of the Social Security Administration (SSA) and the Department of Veterans Affairs (VA) to improve access to Social Security disability benefits among homeless veterans with mental illness. METHODS: Social Security personnel were colocated with VA clinical staff at 4 of the VA's Health Care for Homeless Veterans (HCHV) programs. Intake assessment data were merged with SSA administrative data to determine the proportion of veterans who filed applications and who received disability awards at the 4 SSA-VA Joint Outreach Initiative sites (n = 6709) and at 34 comparison HCHV sites (n = 27 722) during the 2 years before and after implementation of the program. RESULTS: During the 2 years after the initiative began, higher proportions of veterans applied for disability (18.9% vs 11.1%; P < .001) and were awarded benefits (11.4% vs 7.2%, P < .001) at SSA-VA Joint Initiative sites. CONCLUSION: A colocation approach to service system integration can improve access to disability entitlements among homeless persons with mental illness. Almost twice as many veterans were eligible for this entitlement as received it through a standard outreach program. (+info)
Trends in sickness benefits in Great Britain and the contribution of mental disorders.
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BACKGROUND: Government benefits paid to those unfit for work or the work market as a result of ill health have been rising dramatically in Great Britain, in parallel with increases throughout Europe and North America. Psychological conditions are known to be an important cause of sickness absence. This study set out to examine trends in government sickness and invalidity benefits in Britain between April 1984 and April 1995. The importance of mental disorders as a cause of 'incapacity' (the condition for which benefits are paid) was examined. METHODS: Data from the Department of Social Security were used to chart trends in incapacity according to gender, age group, employment category and cause. An exploratory ecological analysis of associations between regional rates of incapacity and socio-economic and health indices was also undertaken using correlation analysis and multiple regression. RESULTS: Steadily increasing rates of incapacity were observed, primarily reflecting increases in the longer-term 'invalidity' benefit. The non-employed made up a rising proportion of recipients. Regional incapacity rate was most strongly associated with socio-economic factors, particularly social class. Mental disorders were the second most numerous causal category and consisted mainly of milder conditions, namely depressive and neurotic disorders. CONCLUSION: The dramatic increase in incapacity benefits is unlikely to be attributable to changes in population size or structure. It contrasts with improvements in the objective health status of the population. Mental disorders, and particularly milder conditions, account for a substantial and increasing amount of incapacity. The data are consistent with the hypothesis that sickness benefits increasingly represent disguised unemployment. (+info)
Disability management, employee health and fringe benefits, and long-term-disability claims for mental disorders: an empirical exploration.
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Mental disorders account for a large share of claims and benefit costs in both private and public long-term-disability (LTD) insurance programs. This is the first empirical study to explore factors that may explain variations in private-sector LTD claims incidence and cost across groups of employees. Employee fringe-benefit arrangements, including patterns of coverage for mental health treatment, are found to be important predictors of incidence rates. Award rates for public disability insurance coverage (SSDI) are also strongly related to claims incidence, suggesting that private LTD is an important pathway to SSDI benefits. Some employee disability-management strategies, such as front-line manager involvement and provision of alternative jobs for employees returning from disability leave, are predictive of lower claims rates and/or costs. (+info)
Client with epilepsy in a work Brazilian rehabilitation center.
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INTRODUCTION: People with epilepsy (PWE) may have problems in obtaining or maintaining regular employment because of restrictions related to their handicap, social prejudices and also high rates of unemployment of the population. The main aim of this pilot study was to know the vocational rehabilitation problems involving PWE sent to a vocational rehabilitation center (VRC) in Rio de Janeiro. METHOD: Fifteen PWE were selected unbiased from those seen at the VCR. It was reviewed their records in the search of sociodemographic, health care, employment suitability and work rehabilitation data. RESULTS: Only one person was eligible for the training program, four were ineligible, six were temporarily ineligible, and the other four do not necessitate the rehabilitation, but as the majority, the better seizures control. CONCLUSIONS: The studied sample of selected PWE, but representative of the studied population, do not show any important successful in the vocational rehabilitation carried out at the VRC. (+info)
Determining disability and blindness; substantial gainful activity guides. Social Security Administration. Final rules.
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We are revising our rules to reflect amendments to the Social Security Act (the Act) concerning the trial work period and the disability insurance reentitlement period. We are also clarifying certain standards we use to determine whether work is substantial gainful activity and whether an individual is entitled to a trial work period, thereby further explaining how we determine disability under titles II and XVI of the Act. (+info)
Trapped in the neutral zone: another symptom of whiplash-associated disorder?
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Instability of the cervical spine following whiplash trauma has been demonstrated in a number of studies. We hypothesized that, in patients with whiplash-associated disorder, rotation of the head would be accompanied by an earlier onset of neck muscle activity to compensate for intrinsic instability. The aim of the study was to examine the range of motion (RoM) of the cervical spine and the onset and activity of the sternocleidomastoid (SCM) muscles during axial rotation, in healthy control subjects and in patients with chronic whiplash-associated disorder. Forty-eight control subjects (42% male) and 46 patients (33% male) with chronic whiplash-associated disorder (symptoms lasting longer than 3 months) were examined. Cervical axial RoM differed significantly (P = 0.0001) between the groups, with the whiplash patients showing lower values (83 degrees +/- 30 degrees) than the healthy controls (137 degrees +/- 19 degrees). The whiplash patient group showed no evidence of the predicted earlier activation of SCM muscles. Many patients never reached the point in the RoM where SCM muscle activity rises steeply, as it does in the healthy controls (the 'elastic zone'), and their movements remained mostly within the region of low muscle activity (the 'neutral zone'). The whiplash patients appeared either unable or unwilling to drive the cervical spine into this region of high muscle activity, possibly because they were restricted by existing pain or fear of pain. (+info)
Extension of expiration date for the respiratory body system listings. Social Security Administration (SSA). Final rule.
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We adjudicate claims at the third step of our sequential evaluation process for evaluating disability using the Listing of Impairments (the Listings) under the Social Security and Supplemental Security Income (SSI) programs. This final rule extends until July 2, 2002, the date on which the respiratory body system listings will no longer be effective. We have made no revisions to the medical criteria in these listings; they remain the same as they now appear in the Code of Federal Regulations. This extension will ensure that we continue to have medical evaluation criteria in the listings to adjudicate claims for disability based on impairments in the respiratory body system at step three of our sequential evaluation process. (+info)
Old-age, survivors, and disability insurance and Supplemental Security Income for the aged, blind, and disabled; substantial gainful activity amounts; "services" for trial work period purposes--monthly amounts; student child earned income exclusion. Social Security Administration. Final rules.
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We are revising the rules to automatically adjust each year, based on any increases in the national average wage index, the average monthly earnings guideline we use to determine whether work done by persons with impairments other than blindness is substantial gainful activity; provide that we will ordinarily find that an employee whose average monthly earnings are not greater than the "primary substantial gainful activity amount," has not engaged in substantial gainful activity without considering other information beyond the employee's earnings; increase the minimum amount of monthly earnings and the minimum number of self-employed work hours in month that we consider shows that a person receiving title II Social Security benefits based on disability is performing or has performed "services" during a trial work period, and automatically adjust the earnings amount each year thereafter; increase the maximum monthly and yearly Student Earned Income Exclusion amounts we use in determining Supplemental Security Income (SSI) Program eligibility and payment amounts for student children, and automatically adjust the monthly and yearly exclusion amounts each year thereafter. We are revising these rules as part of our efforts to encourage individuals with disabilities to test their ability to work and keep working. We expect that these changes will provide greater incentives for many beneficiaries to attempt to work or, if already working, to continue to work or increase their work effort. (+info)