Many claimants of Social Security Disability Insurance (SSDI) retain legal representation to help with the approval process. The Social Security Administration imposes strict rules on representative ...compensation. Representatives are only paid if claimants are awarded disability, and they are paid the lesser of 25 percent of the claimant’s past due benefits or a pre-specified maximum fee ($7,200 since 2022). Because past due benefits are a function of the number of months claimants wait to be awarded, representatives face incentives to delay case resolution until past due benefits push the representative fees past the fee ceiling. We use difference-in-differences to evaluate how these incentives impact SSDI claimant wait times. After the fee ceiling increased in 2002, average wait times increased by 0.85 months among claimants for whom the fee threshold is more binding, implying a 2.6–5.6 month increase for claimants with representatives. This indicates that the structure of representative compensation does matter for case outcomes, and highlights the importance of interactions with auxiliary agents so common in modern social programs.
•Fees for SSDI representatives are a function of claimant wait time.•In theory, this incentivizes representatives to delay case resolution.•Representative fees are subject to a cap and the SSA raised that cap in 2002.•Using difference-in-differences we estimate the effect of that change on wait time.•We find average wait times increased by 0.85 months among more affected claimants.•This implies a 2.6–5.6 month increase for claimants with representatives.•The structure of representative compensation matters for case outcomes.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
In 2008, a group of uninsured low-income adults in Oregon was selected by lottery for the chance to apply for Medicaid. Using this randomized design and 2009 administrative data, we find no ...significant effect of Medicaid on employment or earnings. Our 95 percent confidence intervals allow us to reject that Medicaid causes a decline in employment of more than 4.4 percentage points, or an increase of more than 1.2 percentage points. Medicaid increases food stamps receipt, but has little, if any, impact on receipt of other measured government benefits, including SSDI.
Full text
Available for:
BFBNIB, CEKLJ, INZLJ, IZUM, KILJ, NMLJ, NUK, ODKLJ, PILJ, PNG, SAZU, UL, UM, UPUK, ZRSKP
Background/Objectives
Older adults are at risk for adverse outcomes after trauma, but little is known about post-acute survival as state and national trauma registries collect only inpatient or ...30-day outcomes. This study investigates long-term, out-of-hospital mortality in geriatric trauma patients.
Methods
Level I Trauma Center registry data were matched to the US Social Security Death Index (SSDI) to determine long-term and out-of-hospital outcomes of older patients. Blunt trauma patients aged ≥65 were identified from 2009 to 2015 in an American College of Surgeons Level 1 Trauma Center registry, n = 6289 patients with an age range 65-105 years, mean age 78.5 ± 8.4 years. Dates of death were queried using social security numbers and unique patient identifiers. Demographics, injury, treatments, and outcomes were compared using descriptive and univariate statistics.
Results
Of 6289 geriatric trauma patients, 505 (8.0%) died as an inpatient following trauma. Fall was the most common mechanism of injury (n = 4757, 76%) with mortality rate of 46.5% at long-term follow-up; motor vehicle crash (MVC) (n = 1212, 19%) had long-term mortality of 27.6%. Overall, 24.1% of patients died within 1 year of trauma. Only 8 of 488 patients who died between 1 and 6 months post-trauma were inpatient. Mortality rate varied by discharge location: 25.1% home, 36.4% acute rehabilitation, and 51.5% skilled nursing facility, P < .0001.
Conclusion
Inpatient and 30-day mortality rates in national outcome registries fail to fully capture the burden of trauma on older patients. Though 92% of geriatric trauma patients survived to discharge, almost one-quarter had died by 1 year following their injuries.
Full text
Available for:
NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
This book examines some of the mechanisms which are currently conceived as affording individual security. The idea of security includes emotional and financial components. These interconnect so that ...such common concepts as 'trust' in someone and 'care taking' include both ideas of emotional and financial support. State policies on security rest on perceptions of two other institutions, the family and insurance, both of which are subject to change. At one time the extended family was seen as a major security-providing institution, but the contemporary nuclear family is more fragile. The concept of insurance originally entailed ideas of community and mutual aid; however, the institution has developed, in its modern private form, as a profit-driven entity. This book addresses various uses of state power in providing security for individuals, and outlines different ways in which this can be done.
Full text
Available for:
CEKLJ, NUK, ODKLJ, UL, UM, UPUK
Specialist groups have often advised health ministers and other decision makers in developing countries on the use of social health insurance (SHI) as a way of mobilizing revenue for health, ...reforming health sector performance, and providing universal coverage. This book reviews the specific design and implementation challenges facing SHI in low- and middle-income countries and presents case studies on Ghana, Kenya, Philippines, Colombia, and Thailand.
The positive impacts of social protection on reducing poverty and inequality and contributing to development are well evidenced. Establishing an integrated system facilitates the provision of a ...social protection floor, whereby individuals are appropriately protected throughout the life cycle.
PDF
