Social Security Disability Determination Project

The Social Security Disability Determination Project seeks to improve the process of how people with disabilities can receive Social Security. The three-year project, funded by the Rehabilitation Medicine Department at the National Institutes of Health Clinical Center, will examine Computer Adaptive Testing (CAT) instruments, which can provide more precise outcomes than more traditional forms of functional assessment, to help improve the SSA disability determination process.

The demonstrated advantages of the CAT instruments (CATs) compared to more traditional testing methods are: reduced respondent burden, increased score precision, elimination of ceiling and floor effects, client-specific confidence intervals, monitoring of data quality in real time, and lower data collection costs. Because functional outcomes have a clear hierarchical structure, gains in precision and efficiency of score estimation are superior to traditional fixed forms of functional assessment, thus transforming the ways in which outcomes can be monitored.

The project team will determine the key domain useful to the SSA disability determination and claims decision-making processes and develop and test CAT methods for assessment. These efforts will include: thorough evaluation of the feasibility of implementing CAT tools in the SSA environment, further development of existing CAT instruments, and development of new CAT instruments to assess critical aspects important to the disability evaluation process such as job related functional requirements and the workplace environment. In addition, cut-points will need to be established along each disability domain scale, as measured by CAT, to facilitate interpretation of levels of disability.

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