Summary
We examined descriptive patterns within the frequency of medical persevering with incapacity critiques (CDRs) for youngster Supplemental Safety Earnings (SSI) recipients. These CDRs are designed to find out whether or not youngsters proceed to fulfill the incapacity standards required to qualify for SSI. Advantages stop for youngsters who not meet the incapacity standards. The frequency with which youngsters face CDRs is meant to replicate the probability of medical enchancment. Nonetheless, in follow, this frequency has diverse primarily based on funding availability, which impacts workers and caseloads. Our analysis aimed to summarize longitudinal patterns of which youngster SSI recipients had advantages ceased over time and their subsequent outcomes, in addition to quantify the extent to which CDR cessation patterns contributed to caseload dynamics over time.
The paper discovered that:
- CDR cessations influenced youngster SSI participation patterns substantively. Due to price range shortfalls, comparatively few youngsters’s advantages ceased from 2003 to 2013; many extra had advantages ceased from 2014 to 2017 because the Social Safety Administration (SSA) processed a backlog of CDRs. Our analyses point out that CDR cessations can usually clarify three-fifths to two-thirds of the general modifications within the variety of youngsters receiving SSI, each in periods of program progress (2002 to 2013) and subsequent caseload declines (2013 to 2021).
- Regardless of variation within the frequency with which youngsters confronted cessation from CDRs, the kids’s traits have been largely secure. For instance, youngsters whom SSA anticipated to expertise medical enchancment have been at all times disproportionately extra prone to have advantages ceased, as have been youngsters dwelling in areas with excessive socioeconomic deprivation.
- Comparatively few youngsters returned to SSI within the 5 years after cessation. For kids ceased in 2011 and later, fewer than 6 % returned inside 5 years. These youngsters usually confronted vital challenges, as evidenced by pretty restricted early-adult earnings outcomes. (We will measure earnings solely amongst youngsters 16 and older.)
The coverage implications of the findings are:
- The latest funding for CDRs by way of a particular “program integrity” price range has stabilized childhood CDR workloads. Minimizing these fluctuations may assist youngsters and households plan for the potential lack of advantages following a CDR. Different analysis suggests few households anticipate that advantages is likely to be ceased when youngsters attain age 18; presumably, anticipation of those less-frequent childhood CDRs could be even decrease. (Throughout our research interval, CDRs not often occurred on schedule, as SSA labored by way of a backlog.) Nonetheless, analysis from different assessments of intensive companies and counseling has not led to improved early grownup outcomes. Various approaches to getting ready youth and households for the attainable lack of advantages, together with elevated connections with different applications, is likely to be mandatory.
- Fairness issues can play an vital position in figuring out the focusing on of CDRs. Although youth from areas with excessive socioeconomic deprivation make up a big share of kid SSI recipients, they’re disproportionately extra prone to have advantages ceased following a CDR. Importantly, this occurs not due to variations within the charges of appeals, which we had hypothesized could be extra frequent for youth from higher-resourced areas. Additional understanding what drives this discovering is vital to making sure equitable participation in SSI.