title: Outcome variation in the social security disability insurance program: the role of primary diagnoses.
abstract: Based on the adjudicative process, the author classifies claimant-level data over an 8-year period (1997-2004) into four mutually exclusive categories: (1) initial allowances, (2) initial denials not appealed, (3) final allowances, and (4) final denials. The ability to predict those outcomes is explored within a multilevel modeling framework, with applicants clustered by state and primary diagnosis code. Variance decomposition suggests that medical diagnoses play a substantial role in explaining individual-level variation in initial allowances. Moreover, there is statistically significant high positive correlation between the predictions of an initial allowance and a final allowance across the diagnoses. This finding suggests that the ordinal ranking of impairments between these two adjudicative outcomes is widely preserved. In other words, impairments with a higher expectation of an initial allowance also tend to have a higher expectation of a final allowance.
authors.affiliation: Office of Economic Analysis and Comparative Studies, Office of Research, Evaluation, and Statistics, Office of Retirement and Disability Policy, Social Security Administration, USA.
authors.forename: Javier
authors.initials: J
authors.lastname: Meseguer
mesh_terms: D000293:Adolescent; D001499:Bayes Theorem; D003953:Diagnosis-Related Groups / Q000145:classification / Q000706:statistics & numerical data*; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000145:classification / Q000706:statistics & numerical data; D004608:Eligibility Determination / Q000145:classification / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D018868:Insurance, Disability / Q000592:standards / Q000706:statistics & numerical data*; D038801:International Classification of Diseases / Q000145:classification / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D055361:Multilevel Analysis; D012943:Social Security / Q000592:standards / Q000706:statistics & numerical data*; D014481:United States; D055815:Young Adult