CONTINUATION OF SECTION 1. SOCIAL SECURITY: THE OLD-AGE, SURVIVORS, AND DISABILITY INSURANCE (OASDI) PROGRAMS
BENEFIT AMOUNTS The monthly benefit amount payable to a disabled worker under age 65, or to a retired worker who first receives benefits at the full retirement age, is the PIA rounded to the next lower dollar, if not already a multiple of $1. Auxiliary benefit amounts are also based on the worker's PIA. Table 1-16 lists major types of benefits and the percent of the insured worker's PIA that is applicable to benefits paid at the full rate, unreduced for early election of retirement. TABLE 1-16.--PERCENTAGE OF PRIMARY INSURANCE AMOUNT (PIA) PAID FOR DEPENDENTS' AND SURVIVORS' BENEFITS ------------------------------------------------------------------------ Percent Type of monthly benefit of PIA ------------------------------------------------------------------------ Dependents: \1\ Wives, husbands--age 65..................................... \3\ 50.0 Mothers, fathers, children, grandchildren................... 50.0 Survivors: \1\ Widows, widowers--age 65 \2\................................ \3\ 100. 0 Dependent parent--age 62.................................... 82.5 Widows, widowers--age 60; disabled--ages 50-59.............. 71.5 Mothers, fathers, children.................................. 75.0 ------------------------------------------------------------------------ \1\ Subject to maximum family benefit limitation. \2\ Subject to general limitation that the survivor cannot get a higher benefit than the deceased worker would be getting if alive. \3\ These percentages decrease as the full retirement age increases for workers born after 1937. Source: Congressional Research Service. REPLACEMENT RATES Frequently, Social Security benefits are discussed in terms of how much of a person's preretirement earnings the benefits represent. Benefits expressed as a percent of a person's earnings in the year before retirement are called replacement rates. Table 1-17 shows replacement rates based on the benefits of hypothetical workers who retired at the full retirement age after full-time careers with steady earnings equal to: (1) 45 percent of average earnings in the economy as recorded through the Social Security average wage index (low earner); (2) average earnings in the economy (average earner); and (3) the Social Security maximum taxable earnings base (maximum earner). TABLE 1-17.--SOCIAL SECURITY REPLACEMENT RATES, SELECTED YEARS 1940-2040 [In percent] ---------------------------------------------------------------------------------------------------------------- Year of Replacement rates \1\ attaining ----------------------------------- Year of birth age 65 Low earner Average Maximum \2\ \3\ earner \4\ earner \5\ ---------------------------------------------------------------------------------------------------------------- 1875............................................................. 1940 39.4 26.2 16.5 1885............................................................. 1950 33.2 19.7 21.2 1895............................................................. 1960 49.1 33.3 29.8 1900............................................................. 1965 45.6 31.4 32.9 1905............................................................. 1970 48.5 34.3 29.2 1910............................................................. 1975 \7\ 59.9 42.3 30.1 1911............................................................. 1976 60.1 43.7 32.1 1912............................................................. 1977 61.0 44.8 33.5 1913............................................................. 1978 63.4 46.7 34.7 1914............................................................. 1979 64.4 48.1 36.1 1915............................................................. 1980 68.1 51.1 32.5 1916............................................................. 1981 72.5 54.4 33.4 1917............................................................. 1982 \6\ 65.8 \6\ 48.7 \6\ 28.6 1918............................................................. 1983 \7\ 63.5 45.8 26.3 1919............................................................. 1984 \7\ 62.6 42.8 23.7 1920............................................................. 1985 \7\ 61.1 40.9 22.8 1921............................................................. 1986 \7\ 60.3 41.1 23.1 1922............................................................. 1987 \7\ 59.5 41.2 22.6 1923............................................................. 1988 \7\ 58.4 40.9 23.0 1924............................................................. 1989 \7\ 57.9 41.6 24.1 1925............................................................. 1990 58.2 43.2 24.5 1935............................................................. 2000 57.8 43.0 25.4 1945............................................................. 2010 53.1 39.5 25.4 1955............................................................. 2020 52.5 39.0 25.8 1965............................................................. 2030 49.4 36.7 24.2 1975............................................................. 2040 49.4 36.7 24.2 ---------------------------------------------------------------------------------------------------------------- \1\ Total monthly benefits payable for year of entitlement at age 65 expressed as percent of earnings in previous year for workers with steady career earnings. Projections for 1997 and later are based on the intermediate II assumptions of the 1997 OASDI Trustees' Report. \2\ The age for full (unreduced) retirement benefits will rise from 65 starting with workers born in 1938 and will ultimately reach 67 for workers born in 1960 and later. The lower rates projected for 1945 and later in the table reflect the increased actuarial reduction applied to the benefits of workers retiring at age 65. \3\ Earnings equal to 45 percent of the Social Security average-wage index. \4\ Earnings equal to the Social Security average-wage index. \5\ Earnings equal to the maximum wage taxable for Social Security purposes. \6\ ``Transition guarantee'' under 1977 amendments. \7\ Special minimum benefit. Source: Office of the Actuary, Social Security Administration. BENEFIT REDUCTION AND INCREASE Social Security benefits may be reduced, withheld, or increased for various reasons. Dual Entitlement An individual may be entitled to benefits both as a worker, based on his or her own earnings, and also as a dependent (spouse or widow(er)) of another worker. In the latter case, the individual does not collect both benefits. The amount of the benefit as a spouse or widow(er) is offset dollar for dollar by the amount of any benefit the individual is entitled to as a worker. In other words, workers first receive the benefit based on their work record. The dependent benefit is then payable only to the extent that it is greater than the worker benefit. In effect, the total amount ``dually entitled'' recipients receive is equal to the larger of the two benefits. Actuarial Reduction Actuarial reduction is the reduction imposed on early retirement benefits. If the recipient lives a normal lifespan, the actuarial reduction leads to approximately the same total lifetime benefits as would be paid if the person chose to begin collecting benefits at the full retirement age. It applies to: workers; spouses (including divorced spouses) of a retired or disabled worker (if entitlement is not based on having a child beneficiary in their care); and widows, widowers, and surviving divorced spouses. At the time of initial entitlement, reductions in benefit amounts are made for these benefit categories, as described below. Retired workers The reduction rate is five-ninths of 1 percent for each month of entitlement before age 65 (maximum reduction of 20 percent). Workers retiring today at age 62 therefore receive 80 percent of the PIA. Although the minimum age of eligibility for reduced benefits remains age 62 (age 60 for widows and widowers), the increase in the full retirement age will be accompanied by increases in the amount of reduction for retirement at age 62 for individuals born after 1937. For them, the PIA will be reduced by five-twelfths of 1 percent for each month in excess of 36. For example, for persons born from 1943 through 1954, for whom the normal retirement age will be 66, the benefit payable at age 62 will be 75 percent of the PIA. For persons born in 1960 and later, for whom the normal retirement age will be 67, the benefit payable at age 62 will be 70 percent of the PIA (see table 1-11). Spouses The reduction rate is twenty-five thirty-sixths of 1 percent for each month of entitlement before full retirement age. The maximum reduction is 25 percent. For spouses born after 1937, the benefit will be reduced by five-twelfths of 1 percent for each month of early retirement in excess of 36 months. Widow(er)s The rate of reduction is nineteen-fortieths of 1 percent for each month of entitlement between age 60 and age 65 (maximum reduction of 28.5 percent). There is no scheduled increase in the maximum reduction for widow(er)s. Disabled widow(er)s ages 50 to 59 receive 71.5 percent of the PIA. Generally, benefits continue to be paid at these reduced rates for as long as the recipients remain on the rolls. However, at attainment of the full retirement age for all recipients, and also at age 62 for a widow, widower, and a surviving divorced spouse, the number of months of reduction is adjusted by dropping months for which full benefits were not paid. Data on benefits paid to new retired workers in 1996 indicate that 72 percent of all such benefits were actuarially reduced (69 percent of those payable to men, and 75 percent to women). Table 1-13 presents information on the number of workers retiring in a given year who file for actuarially reduced benefits. Delayed Retirement Credit A worker is eligible for a delayed retirement credit (DRC) for each month the worker: (1) was fully insured; (2) had attained full retirement age but was not yet age 70; and (3) did not receive benefits because the worker had not filed an application or was working. Each DRC increases the worker's monthly benefit by one-twelfth of 1 percent for workers who attained age 62 before 1979 and by one-fourth of 1 percent for workers attaining age 62 from 1979 through 1986 (unless the benefit is based on a special minimum PIA). The increase is applicable to the worker's monthly benefit amount but not to the PIA. Therefore, dependents' benefits are generally not affected. The exception is that an individual receiving benefits as a widow(er) or surviving divorced spouse is entitled, for months after May 1978, to the same increase that was applied to the benefit of the worker, or for which the worker was eligible at the time of death. As a result of the Social Security Amendments of 1983, beginning with workers who attain age 65 in 1990 (i.e., age 62 in 1987) the increment for delaying retirement past the normal retirement age (DRC) will increase by one-half of 1 percent every second year until reaching 8 percent per year of delayed retirement for workers attaining age 65 after 2007 (see table 1-11). Maximum Family Benefit Old-age and survivors insurance (OASI) The maximum monthly amount that can be paid on a worker's earnings record varies with the PIA. For benefits payable on the earnings records of retired and deceased workers, the maximum varies from 150 to 188 percent of the PIA. The family maximum cannot be exceeded regardless of the number of recipients entitled on that earnings record. The family maximum is computed by adding fixed percentages of dollar amounts that are part of the PIA. For the family of a worker who turns 62 or dies in 1997, the total amount of benefits payable is limited to: 150 percent of the first $581 of PIA, plus; 272 percent of PIA from $581 through $839, plus; 134 percent of PIA from $839 through $1,094, plus; 175 percent of PIA over $1,094. The dollar amounts in this benefit formula (i.e., the ``bend points'') are adjusted annually by the same index used to update the bend points in the primary benefit formula. Whenever the total of the individual monthly benefits payable to all the recipients entitled on one earnings record exceeds the maximum, each dependent's or survivor's benefit is reduced in equal proportion to bring the total within the maximum. In computing the maximum family benefit for entitlements based on a single earnings record, any benefit payable to a divorced spouse or to a surviving divorced spouse is not included. Disability insurance (DI) The maximum family benefit is the smaller of 85 percent of the worker's average indexed monthly earnings (AIME), or 150 percent of the worker's primary insurance amount (PIA). However, in no case can the benefit be less than 100 percent of the worker's PIA. Earnings Limit The earnings limit is a provision in the law that reduces benefits for nondisabled recipients who earn income from work above a certain amount. Variations of the earnings limit have been part of the Social Security Program since its beginning. In 1998, recipients under age 65 may earn up to $9,120 a year in wages or self-employment income without having their benefits affected. Those aged 65-69 can earn up to $14,500 a year. For earnings above these amounts, recipients under age 65 lose $1 of benefits for each $2 of earnings, and those age 65-69 lose $1 in benefits for every $3 of earnings. The earnings limit does not apply to recipients aged 70 or older, or to those who are disabled. The earnings limits rise each year indexed to the rise in average wages in the economy. Beginning in 1996, the exempt amounts for those who have attained the full retirement age rises on an ad hoc basis, according to the following schedule: ------------------------------------------------------------------------ Year Exempt amount ------------------------------------------------------------------------ 1996.................................................... $12,500 1997.................................................... 13,500 1998.................................................... 14,500 1999.................................................... 15,500 2000.................................................... 17,000 2001.................................................... 25,000 2002.................................................... 30,000 ------------------------------------------------------------------------ These changes were included in Public Law 104-121 enacted on March 29, 1996. After 2002, the exempt amounts for those who have attained the full retirement age again will be adjusted to rise at the same rate as average wages in the economy. Before enactment of Public Law 104-121, about 1.4 million recipients lost some or all of their benefits because of the earnings limit each year. They represented about 3 percent of all recipients. Of recipients age 65-69, about 9 percent (860,000) were affected, and an additional 110,000 persons were estimated to be deterred from filing for benefits because of the earnings limit. Retired workers whose benefits are not paid due to the earnings limit for one or more months are compensated through future increases in their benefit amount known as delayed retirement credits, or DRCs (discussed earlier). For workers under age 65, their actuarial reduction factor is reduced. Beneficiaries age 65-69 get a DRC for each month benefits were not paid. Examples of effects of the earnings limit: 1. John--Age 63 with $4,000 in annual benefits before the earnings limit is applied: Earnings in 1998................................... $10,120 Exempt amount for under age 65..................... 9,120 ------------ Excess over exempt amount.......................... 1,000 Benefit reduction = 50 percent of excess........... 500 Benefits John will receive in 1998................. 3,500 2. Ida--Age 67 with $4,000 in annual benefits before the earnings limit is applied: Earnings in 1998................................... 15,100 Exempt amount for 65 and older..................... 14,500 ------------ Excess over exempt amount.......................... 600 Benefit reduction = 33\1/3\ percent of excess...... 200 Benefits Ida will receive in 1998.................. 3,800 The earnings limit does not apply to pensions, rents, dividends, interest, and other types of ``unearned'' income. These forms of income have always been exempted in order to encourage savings for retirement to supplement Social Security. History of the earnings limit The earnings limit was part of the original plan that led to Social Security. The 1935 report of the Committee on Economic Security appointed by President Franklin D. Roosevelt recommended that no benefits be paid before a person had ``retired from gainful employment.'' Initially, the Social Security Act provided that benefits would not be paid for any month in which the individual had received ``wages with respect to regular employment.'' Before any benefits were payable under the program, Congress modified this provision in the Social Security Amendments of 1939. No benefits would be paid for any month in which wages from covered employment were $15 or more. This arrangement prevailed until 1950. The 1950 amendments extended Social Security coverage to the bulk of nonfarm self-employed workers. Because it was believed that many self-employed people never retired and therefore would never receive benefits, the 1950 act exempted persons age 75 and over from the earnings limit. In addition, in the first of many legislative actions to increase the amount of earnings permitted, allowable monthly income from wages was increased from $14.99 to $50. Over the years, the earnings limits, the affected ages, and the formulas for reducing benefits have been changed many times. Starting with the 1954 amendments, benefits were no longer totally withheld if the retiree had earnings above the monthly exempt amount. Instead, a reduced benefit was payable. In addition, the 1954 act exempted persons age 72 and over from the earnings limit. The 1972 amendments reduced benefits by $1 for every $2 of earnings above the exempt amount. The 1972 amendments also provided that, beginning in 1975, the exempt amounts would be ``indexed'' to rise at the same rate as wage growth. To compensate workers who did not receive benefits for months between ages 65 and 72, the amendments established the delayed retirement credit. During congressional consideration of major Social Security legislation in 1977, there was pressure to eliminate the earnings limit for persons over age 65. As a compromise, the earnings limit was raised for persons age 65 and older, and since then two different exempt amounts have applied, one for those under full retirement age (currently age 65) and one for those between full retirement age and age 70. (The 1977 amendments also lowered from 72 to 70 the age at which the earnings limit would no longer apply, to be effective in 1982, later postponed until 1983.) In response to criticism that the monthly earnings limit discriminated in favor of workers who had substantial but irregular employment (e.g., teachers), Congress also eliminated the monthly limit except for the first year of retirement. In 1980, Congress extended the monthly limit to the year a dependent beneficiary became ineligible for benefits. As part of major legislation restoring financial integrity to the Social Security system in 1983, Congress made two liberalizations affecting persons who continue to work after attaining retirement age. The first provided that, beginning in 1990, beneficiaries who have attained the full retirement age will lose only $1 in benefits for each $3 in earnings above the exempt amount. The second increased the delayed retirement credit (DRC). Prior to the increase, the DRC was equal to one- fourth of 1 percent for each month (3 percent a year) beyond the full retirement age that a person did not receive benefits. Under the 1983 provision, the DRC increases gradually to two- thirds of 1 percent per month between 1990 and 2009 (8 percent a year). Before 1997, recipients under age 70 who earned more than the limits were required to file a report of their earnings to SSA by April 15 of each year. Because W-2s and self-employment income are now being recorded more rapidly, under new rules most recipients need not file annual reports of earnings. On March 29, 1996, President Clinton signed H.R. 3136, the Contract with America Advancement Act of 1996 (Public Law 104- 121), which increases the Social Security earnings limit exempt amounts--the amount of earnings Social Security recipients may earn before their benefits are reduced--for recipients between the full retirement age (currently age 65) and age 70. Their exempt amounts will increase gradually by higher amounts than under prior law over the period 1996-2000, and then more rapidly over the next 2 years, reaching $30,000 in 2002. Table 1-18 shows amounts exempt from the earnings limit since 1975. TABLE 1-18.--RETIREMENT TEST EXEMPT AMOUNTS, 1975-2002 ------------------------------------------------------------------------ Age 65 Year Under age and over 65 \1\ ------------------------------------------------------------------------ 1975.............................................. $2,520 $2,520 1976.............................................. 2,760 2,760 1977.............................................. 3,000 3,000 1978.............................................. 3,240 4,000 1979.............................................. 3,480 4,500 1980.............................................. 3,720 5,000 1981.............................................. 4,080 5,500 1982.............................................. 4,440 6,000 1983.............................................. 4,920 6,600 1984.............................................. 5,160 6,960 1985.............................................. 5,400 7,320 1986.............................................. 5,760 7,800 1987.............................................. 6,000 8,160 1988.............................................. 6,120 8,400 1989.............................................. 6,480 8,880 1990.............................................. 6,840 9,360 1991.............................................. 7,080 9,720 1992.............................................. 7,440 10,200 1993.............................................. 7,680 10,560 1994.............................................. 8,040 11,160 1995.............................................. 8,160 11,280 1996.............................................. 8,280 12,500 1997.............................................. 8,640 13,500 1998.............................................. 9,120 14,500 1999.............................................. \2\ 9,360 15,500 2000.............................................. \2\ 9,720 17,000 2001.............................................. \2\ 10,08 0 25,000 2002.............................................. \2\ 10,44 0 30,000 ------------------------------------------------------------------------ \1\ In 1955-82, retirement earnings test did not apply at ages 72 and over; beginning in 1983, it does not apply at ages 70 and over. Amounts for 1978-82 specified by Public Law 95-216; for 1996-2002, Public Law 104-121. \2\ Based on economic assumptions in the 1997 Annual Report of the Board of Trustees of the Federal Old-Age and Survivors Insurance and Disability Insurance Trust Funds. Source: Office of the Chief Actuary, Social Security Administration. Earnings of retired workers Of 9.5 million recipients entitled to retired worker benefits who were under the age of 70 in 1994, about 3.5 million had earnings from work. Table 1-19 shows the distribution of the earnings of these workers. Offsets Offset for other public disability benefits When a worker receiving Social Security disability benefits also qualifies for other disability benefits that are provided by Federal, State or local governments or worker's compensation, any Social Security benefits payable to the worker and his or her family are reduced by the amount, if any, that the total monthly benefits payable under the two or more programs exceed 80 percent of average current earnings before the worker became disabled. Needs-tested benefits, Veterans Administration disability benefits, and benefits based on public employment covered by Social Security are not subject to the reduction. A worker's average current earnings for this purpose are the larger of: (1) the average monthly earnings used for computing Social Security benefits; or (2) the average monthly earnings in employment or self-employment covered by Social Security during the 5 consecutive years of highest covered earnings after 1950; or (3) the average monthly earnings during the calendar year of highest covered earnings during a period consisting of the year in which disability began and the preceding 5 years without regard to the limitations which specify a maximum amount of earnings creditable for Social Security benefits. The combined payments after the reduction are never less than the total amount of the DI benefits payable before the reduction. In addition, the Social Security benefit after the reduction is increased by the full amount of the cost-of-living increase as applied to the unreduced benefit. Every 3 years the original amount of benefits subject to reduction is redetermined to reflect changes in average wage levels. If increases in average national wages would result in a higher benefit than that payable based on the original computation, the benefit is increased effective in January of the redetermination year. TABLE 1-19.--RETIRED WORKERS WITH EARNINGS IN 1994 ------------------------------------------------------------------------ Total earnings Ages 62-64 Ages 65-69 ------------------------------------------------------------------------ $1-4,999.................................... 501,200 977,300 5,000-9,999................................. 346,800 537,300 10,000-14,999............................... 111,600 305,300 15,000-19,999............................... 52,800 123,000 20,000-24,999............................... 32,300 87,600 25,000-29,999............................... 20,500 71,000 30,000-34,999............................... 16,300 54,500 35,000-39,999............................... 9,100 40,100 40,000-44,999............................... 9,400 31,700 45,000-49,999............................... 5,600 25,200 50,000-54,999............................... 3,600 20,100 55,000-59,999............................... 3,300 15,100 60,000-64,999............................... 3,500 35,800 65,000-69,999............................... 1,000 7,500 70,000-74,999............................... 2,100 6,300 75,000-79,999............................... 1,100 5,700 80,000-84,999............................... 1,000 4,500 85,000-89,999............................... 400 3,700 90,000-94,999............................... 800 3,100 95,000-99,999............................... 200 3,200 100,000 +................................... 2,900 29,300 --------------------------- Total................................. 1,125,500 2,387,300 ------------------------------------------------------------------------ Source: Social Security Administration; 1994 Continuous Work History Sample (CWHS). The offset begins in the month during which concurrent entitlement begins under a Federal or State law. However, the offset will not be made if the State workers' compensation law provides for an offset against Social Security disability benefits. Offsets for receipt of pension from noncovered employment Government pension offset.--Social Security benefits payable to spouses of retired, disabled, or deceased workers are generally reduced to take account of any public pension the spouse receives as a result of work in a government job (Federal, State, or local) not covered by Social Security. The amount of the reduction is equal to two-thirds of the government pension. This provision is intended to place spouses who worked in jobs not covered by Social Security in the same position as other workers by imposing on them the equivalent of the Social Security ``dual entitlement'' rule, which imposes a dollar-for-dollar offset of spouses' benefits (discussed earlier). Two-thirds of the government pension represents a surrogate of the Social Security worker's benefit that would be subtracted from any Social Security spousal benefit. The offset does not apply to workers whose government job is covered by Social Security on the last day of the person's employment. Generally, Federal workers hired before 1984 are part of the Civil Service Retirement System (CSRS) and are not covered by Social Security. Federal workers hired after 1983 are covered by the Federal Employee's Retirement System Act of 1986 (FERS), which includes coverage by Social Security. Employees covered by the CSRS were given the opportunity in 1987 to join FERS and thereby obtain Social Security coverage. Windfall elimination provision.--Under the windfall elimination provision of the Social Security Amendments of 1983, a different benefit formula reduces the Social Security benefits of most workers who also have pensions from work that was not covered by Social Security (e.g., work under the Federal Civil Service Retirement System). The regular benefit formula (see earlier discussion) is weighted, in order to help workers who spend their work careers in low-paying jobs, by providing them with a benefit that replaces a higher proportion of their earnings than the benefit that is provided for workers with high earnings. However, the formula cannot differentiate between those who worked in low-paid jobs throughout their careers and other workers who appeared to have been low paid because they worked many years in jobs not covered by Social Security (these noncovered earnings are shown as zeros for Social Security benefit purposes). Thus, before the law was changed, workers who were employed for only a portion of their careers in jobs covered by Social Security also received the advantage of the ``weighted'' formula, because their few years of covered earnings were averaged over their entire working career to determine the average covered earnings on which their Social Security benefits were based. This was the case even if their noncovered earnings were high. The windfall benefit formula is intended to remove this advantage for these workers. It does so by substituting 40 percent for the 90 percent factor in the first bracket of the benefit formula (see discussion in earlier section on ``Benefit Formula''). The resulting reduction in the worker's Social Security benefit is limited to one-half the amount of the noncovered pension. The new law was phased in over a 5-year period and affects those first eligible for both Social Security benefits and noncovered pensions after 1985. Workers who have 30 years or more of substantial Social Security coverage are fully exempt from this provision. For workers who have 21-29 years of coverage, the percentage in the first bracket in the formula increases by 5 percentage points for each year over 20, as shown in table 1-20. TABLE 1-20.--WINDFALL BENEFIT FORMULA FACTORS ------------------------------------------------------------------------ First factor in Years of Social Security coverage formula (percent) ------------------------------------------------------------------------ 20 or fewer.................................................. 40 21........................................................... 45 22........................................................... 50 23........................................................... 55 24........................................................... 60 25........................................................... 65 26........................................................... 70 27........................................................... 75 28........................................................... 80 29........................................................... 85 30 or more................................................... 90 ------------------------------------------------------------------------ Source: Social Security Administration. Suspension of Benefits to Prisoners In 1980, legislation was enacted barring payment of disability benefits to prisoners who committed felonies (Public Law 96-473). In 1983, the prohibition was broadened to include retirement and survivor benefits (Public Law 98-21); and in 1994, payment of benefits was barred to those in public institutions who committed serious crimes, but who were found incompetent to stand trial, or not guilty by reason of insanity (Public Law 103-387). Only benefits to the prisoner are barred; benefits to a prisoner's eligible spouse and children are payable. COST-OF-LIVING ADJUSTMENTS Monthly cash benefits were increased on an ad hoc basis 10 times before the first automatic cost-of-living adjustment (COLA) was implemented as a result of the Social Security Amendments of 1972. Beginning in 1975, benefits have been automatically adjusted to keep pace with inflation. Since 1975, there have been increases annually except during calendar year 1983, when the adjustment was delayed 6 months (see table 1-1). Social Security beneficiaries receive a COLA in January of each year if there is a measurable annual increase in prices (0.1 percent). The Consumer Price Index for Wage Earners and Clerical Workers (CPI-W), updated monthly by the Bureau of Labor Statistics (BLS), is the measure used to compute the increase. The average CPI-W for the third calendar quarter of one year is compared to the average CPI-W for the third calendar quarter of the next year, and the resulting percentage increase represents the COLA that will become effective for the following December. The increase actually becomes effective for Social Security checks payable beginning in January, since Social Security checks always reflect the benefits due for the preceding month. A COLA of 2.1 percent beginning with checks payable in January 1998 was triggered by the rise in the CPI-W from the third quarter of 1996 to the third quarter of 1997. As in all years since 1975, this COLA, in turn, triggered identical percentage increases in Supplemental Security Income (SSI), veterans' pensions, and railroad retirement benefits, and caused other changes in the Social Security Program. Although COLAs under the Federal Civil Service Retirement System and the Federal Military Retirement Program are not triggered by the Social Security COLA, these programs use the same measuring period and formula for computing their COLAs. Determination of the COLA The 2.1 percent COLA for January 1998 became known on October 16, 1997, when the BLS announced the CPI-W figure for September 1997. With release of the September index, the two July-September sets of CPI-W figures needed to compute the 1998 COLA--one for 1996 and another for 1997--became available. Table 1-21 shows how the January 1998 COLA was computed under procedures set forth in the law. \5\ Table 1-22 shows the comparison between average wage increases and changes in the CPI from 1965 to 1997. --------------------------------------------------------------------------- \5\ Under section 215(i) of the Social Security Act. TABLE 1-21.--COMPUTATION OF THE SOCIAL SECURITY COLA, JANUARY 1998 ------------------------------------------------------------------------ CPI-W index points Month ------------------------- 1996 1997 ------------------------------------------------------------------------ July.......................................... 154.3 157.5 August........................................ 154.5 157.8 September..................................... 155.1 158.3 3-month average........................... 154.6 157.9 ------------------------------------------------------------------------ Note.--The reference base period for the CPI-W is 1982-84, i.e., the period when the index equalled 100. Source: Bureau of Labor Statistics. Based on the third quarter index points shown in table 1- 21, there are three steps to calculating the annual Social Security COLA. First, the annual increase in CPI index points from the third quarter of 1996 to the third quarter of 1997 is calculated (157.9 - 154.6 = 3.3). Second, the rate of increase is converted into a percentage by dividing the increase in index points by the base year level (3.3/154.6 = 2.135). Finally, the resulting figure (2.135) is rounded to the nearest tenth of a percent, making the 1998 COLA 2.1 percent. TABLE 1-22.--HISTORICAL COMPARISON OF AVERAGE WAGE INCREASES TO BENEFIT INCREASES AND CHANGES IN CPI, 1965-97 [In percent] ---------------------------------------------------------------------------------------------------------------- Increase in wages Increase in CPI \2\ Increase in \1\ --------------------- benefits \3\ --------------------- -------------------- Calendar year Cumulative Over Cumulative Cumulative Over from each prior from each Over from each prior year to year year to prior year to year 1997 1997 year 1997 ---------------------------------------------------------------------------------------------------------------- 1965............................................. 1.8 476.1 1.6 397.2 7.0 501.5 1966............................................. 6.0 443.5 3.2 382.0 0.0 501.5 1967............................................. 5.6 414.8 2.8 369.0 0.0 501.5 1968............................................. 6.9 381.7 4.2 350.3 13.0 432.3 1969............................................. 5.8 355.4 5.4 327.1 0.0 432.3 1970............................................. 5.0 333.8 5.7 304.1 15.0 362.9 1971............................................. 5.0 313.1 4.4 287.2 10.0 320.8 1972............................................. 9.8 276.2 3.4 274.3 20.0 250.6 1973............................................. 6.3 254.1 6.2 252.6 0.0 250.6 1974............................................. 5.9 234.2 11.0 217.7 11.0 215.9 1975............................................. 7.5 211.0 9.1 101.3 8.0 192.5 1976............................................. 6.9 190.9 5.7 175.5 6.4 174.9 1977............................................. 6.0 174.4 6.5 158.8 5.9 159.6 1978............................................. 7.9 154.3 7.7 140.2 6.5 143.7 1979............................................. 8.7 133.8 11.4 115.6 9.9 121.8 1980............................................. 9.0 114.5 13.4 90.1 14.3 94.0 1981............................................. 10.1 94.9 10.3 72.4 11.2 74.5 1982............................................. 5.5 84.7 6.0 62.6 7.4 62.5 1983............................................. 4.9 76.1 3.0 57.9 \4\ 3.5 57.0 1984............................................. 5.9 66.3 3.5 52.6 3.5 51.7 1985............................................. 4.3 59.5 3.5 47.4 3.1 47.1 1986............................................. 3.0 54.9 1.6 45.1 1.3 45.2 1987............................................. 6.4 45.7 3.6 40.1 4.2 39.4 1988............................................. 4.9 38.8 4.0 34.7 4.0 34.0 1989............................................. 4.0 33.5 4.8 28.5 4.7 28.0 1990............................................. 4.6 27.6 5.2 22.2 5.4 21.4 1991............................................. 3.7 23.0 4.1 17.3 3.7 17.1 1992............................................. 5.2 17.0 2.9 14.0 3.0 13.7 1993............................................. 0.9 16.0 2.8 10.9 2.6 10.8 1994............................................. 2.7 13.0 2.5 8.2 2.8 7.8 1995............................................. 4.0 8.6 2.9 5.2 2.6 5.1 1996............................................. 4.9 3.6 2.9 2.3 2.9 2.1 1997............................................. \5\ 3.6 .......... 2.3 .......... \6\ 2.1 .......... ---------------------------------------------------------------------------------------------------------------- \1\ Average annual wages used to index earnings records. \2\ Increase in annual average CPI-W. \3\ Legislated benefit increases through 1975 and increases based on CPI thereafter. After 1975, the CPI and benefit increases are different because they reflect the change in prices measured over different periods of time. \4\ As a result of the Social Security Amendments of 1983, COLAs are provided on a calendar year basis, with the benefit increase payable in January rather than July. The July 1983 COLA was delayed to January 1984. This delay and a change in the computation period led to 6 months of 1983 (first quarter-third quarter) not being accounted for in any COLA increase--a period in which the CPI increased 2.4 percent. \5\ Preliminary. \6\ Effective December 1997, payable in January 1998. Source: Office of the Chief Actuary, Social Security Administration. TAXATION OF BENEFITS Beneficiaries with income (defined as adjusted gross income plus tax-exempt bond interest plus one-half of Social Security benefits) above certain thresholds are required to include a portion of their Social Security benefits (and railroad retirement tier 1 benefits) in their federally taxable income. The Social Security Amendments of 1983 required beneficiaries with income of more than $25,000 if single, and $32,000 if married, to include up to 50 percent of their benefits in their taxable income, beginning in 1984. Revenues from this provision are credited to the OASDI Trust Funds. The Omnibus Budget Reconciliation Act of 1993 required beneficiaries with incomes of more than $34,000 if single, and $44,000 if married, to include up to 85 percent of their benefits in their taxable income, beginning in 1994. Revenues from this provision are credited to the Medicare HI Trust Fund. The following worksheet shows the steps involved in determining how much of a beneficiary's Social Security benefits are taxable. Worksheet for Determining the Taxable Portion of Social Security Benefits 1. Enter yearly Social Security benefits ________________ 2. Multiply line 1 by 0.50 ________________ 3. Enter adjusted gross income plus tax-free interest ________________ 4. Add line 2 and line 3 ________________ 5. Enter: $25,000 if single or head of household; $32,000 if married filing jointly; $0 if married filing separately ________________ 6. Subtract line 5 from line 4 ________________ (If result on line 6 is zero or a negative number, stop; no benefits are taxable.) 7. Divide line 6 by 2 ________________ 8. Enter smaller of amounts on line 2 or line 7 ________________ 9. Enter amount on line 4 ________________ 10. Enter: $34,000 if single or head of household; $44,000 if married filing jointly; $0 if married filing separately ________________ 11. Subtract line 10 from line 9 ________________ (If result on line 11 is zero or a negative number, stop; amount on line 8 is amount of benefits taxable.) 12. Multiply line 11 by 0.85 ________________ 13. Enter smallest of: amount on line 8; $4,500 if single or head of household; $6,000 if married filing jointly; $0 if married filing separately ________________ 14. Add amounts on line 12 and line 13 ________________ 15. Multiply line 1 by 0.85 ________________ 16. Enter smaller of amounts on line 14 or line 15 ________________ (The amount on line 16 is the total amount of benefits taxable.) Source: Congressional Research Service. Examples of results of applying worksheet (1997): ---------------------------------------------------------------------------------------------------------------- Single Single Married Married Married ---------------------------------------------------------------------------------------------------------------- Total income (including Social Security)................. $31,000 $35,000 $38,000 $50,000 $80,000 Social Security benefits................................. 12,000 7,000 12,000 12,000 18,000 Amount of benefits taxable............................... 0 3,250 0 6,000 15,300 Percent of benefits taxable.............................. 0 46 0 50 85 Income tax liability on all benefits taxable............. 0 488 0 900 4,284 ---------------------------------------------------------------------------------------------------------------- For calendar year 1998 (see table 1-23), CBO projects that 26 percent of Social Security beneficiaries will be affected by the taxation of benefits (see table 1-23). Table 1-24 shows amounts credited to trust funds from taxation of benefits. SOCIAL SECURITY BENEFITS FOR NONCITIZENS Provisions in the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 and the Immigration Responsibility Act of 1996 affect the way Social Security benefits are paid to aliens in the United States. Effective December 1, 1996, persons applying for title II monthly benefits in the United States must provide evidence that they are U.S. citizens, nationals, or aliens who are lawfully present in the United States in order to get Social Security benefits. To be considered a lawfully present alien in the United States, the beneficiary must be an alien: --lawfully admitted for permanent residence; --admitted as a refugee under section 207 of the Immigration and Nationality Act (INA); --granted asylum under section 208 of the INA; --granted conditional entry as a refugee under section 203(a)(7) of the INA prior to April 1, 1980; --who has submitted application for political asylum under section 208 of the INA; or --who belongs to any class of aliens permitted to reside in the United States for humanitarian or other reasons. TABLE 1-23.--PROJECTED EFFECT OF TAXING SOCIAL SECURITY BENEFITS BY INCOME CLASS, CALENDAR YEAR 1998 [Numbers of persons in thousands; dollars in millions] -------------------------------------------------------------------------------------------------------------------------------------------------------- Persons age 65 and over All recipients Aggregate ------------------------------------------------------------------------------------- amount of Aggregate Taxes as a Level of individual or couple Number Percent Number of Social Number Percent Social amount of percent of income \1\ Number affected by affected by Security affected by affected by Security taxes on benefits taxation \2\ taxation \2\ beneficiaries \3\ taxation \3\ taxation \3\ benefits benefits -------------------------------------------------------------------------------------------------------------------------------------------------------- Less than $10,000................ 6,196 0 0 7,852 0 0 $46,246 0 0 $10,000-$15,000.................. 4,132 0 0 5,189 0 0 42,291 0 0 $15,000-$20,000.................. 3,786 0 0 4,472 0 0 38,149 0 0 $20,000-$25,000.................. 3,150 0 0 3,621 0 0 31,525 0 0 $25,000-$30,000.................. 2,862 118 4.1 3,247 147 4.5 27,691 $16 0.1 $30,000-$40,000.................. 4,185 1,017 24.3 4,928 1,315 26.7 42,577 395 0.9 $40,000-$50,000.................. 2,611 1,982 75.9 3,098 2,529 81.6 28,214 1,157 4.1 $50,000-$100,000................. 3,922 3,533 90.1 4,606 4,450 96.6 46,000 6,155 13.4 Over $100,000.................... 1,527 1,304 85.4 1,475 1,447 98.1 17,524 4,104 23.4 ---------------------------------------------------------------------------------------------------------------------- All.......................... 32,372 7,959 24.6 38,488 9,894 25.7 320,216 11,834 3.7 -------------------------------------------------------------------------------------------------------------------------------------------------------- \1\ Cash income (based on income of tax filing unit) plus capital gains realizations. \2\ Some elderly individuals do not receive Social Security benefits and thus are not affected by taxation of benefits. \3\ Includes beneficiaries under and over age 65. Note.--Aggregate benefits and revenues are understated by about 10 percent because of benefits paid abroad, deaths of recipients before March interview, and exclusion of institutionalized beneficiaries. The number of beneficiaries also is understated. Source: Congressional Budget Office simulations based on data from the Current Population Survey. TABLE 1-24.--TAXATION OF OASDI BENEFITS BY TRUST FUNDS CREDITED AND AS A PERCENT OF TOTAL OASDI BENEFIT PAYMENTS, 1984-2002 [Dollars in millions] ---------------------------------------------------------------------------------------------------------------- Taxes credited to trust Taxes credited to Total funds from the taxation trust funds as percent Fiscal year OASDI of OASDI benefits of OASDI benefits benefits -------------------------------------------------- OASDI HI Total OASDI HI Total ---------------------------------------------------------------------------------------------------------------- 1984.............................................. $173,603 $2,275 ....... $2,275 1.3 ...... 1.3 1985.............................................. 183,959 3,368 ....... 3,368 1.8 ...... 1.8 1986.............................................. 193,869 3,558 ....... 3,558 1.8 ...... 1.8 1987.............................................. 202,430 3,307 ....... 3,307 1.6 ...... 1.6 1988.............................................. 213,907 3,390 ....... 3,390 1.6 ...... 1.6 1989.............................................. 227,150 3,772 ....... 3,772 1.7 ...... 1.7 1990.............................................. 243,275 3,081 ....... 3,081 1.3 ...... 1.3 1991.............................................. 263,104 5,921 ....... 5,921 2.3 ...... 2.3 1992.............................................. 281,650 6,237 ....... 6,237 2.2 ...... 2.2 1993.............................................. 298,176 6,161 ....... 6,161 2.1 ...... 2.1 1994.............................................. 313,129 5,656 $1,625 7,281 1.8 0.5 2.3 1995.............................................. 328,841 5,449 3,883 9,332 1.7 1.2 2.8 1996.............................................. 343,235 6,155 4,039 10,194 1.8 1.2 3.0 1997 \1\.......................................... 359,232 7,198 4,001 11,199 2.0 1.1 3.1 1998 \1\.......................................... 376,907 7,632 4,328 11,960 2.0 1.1 3.2 1999 \1\.......................................... 396,628 8,166 4,591 12,757 2.1 1.2 3.2 2000 \1\.......................................... 417,393 8,773 4,975 13,748 2.1 1.2 3.3 2001 \1\.......................................... 440,311 9,437 5,368 14,805 2.1 1.2 3.4 2002 \1\.......................................... 465,390 10,175 5,802 15,977 2.2 1.2 3.4 ---------------------------------------------------------------------------------------------------------------- \1\ Projected; based on intermediate assumptions in the 1997 Annual Report of the Board of Trustees of the Federal Old-Age and Survivors Insurance and Disability Insurance Trust Funds. Note.--Tax amounts are the amounts collected through the Federal income tax system (including adjustments for actual experience in prior years) plus, for OASDI only, taxes withheld from the OASDI benefits of certain nonresident aliens. Source: Office of the Chief Actuary, Social Security Administration. DETERMINATION OF DISABILITY BENEFITS Determination of Disability Disability determinations are generally made by State agencies, which are 100 percent federally funded. These agencies agree to make such determinations and in doing so to substantially comply with the regulations of the Commissioner, which specify performance standards, administrative requirements, and procedures to be followed in performing the disability determination function. The law authorizes the Commissioner to terminate State administration and assume responsibility for making disability determinations when a State disability determination service (DDS) is substantially failing to make determinations consistent with regulations. The law also allows for termination by the State. Application of Law and Regulations Claims are determined on a sequential basis. The first step is to determine whether the individual is engaging in substantial gainful activity (SGA). Under current regulations, in most cases if a person is earning more than $500 a month (net of impairment-related work expenses), he will be considered to be engaging in SGA. In the case of blind individuals, SGA is $1,000 a month in 1997 ($1,050 in 1998). If it is determined that the individual is engaging in SGA, a decision is made that he is not disabled without considering medical factors. If an individual is found not to be engaging in SGA, the severity and duration of the impairment are explored. If the impairment is determined to be ``not severe'' (i.e., it does not significantly limit the individual's capacity to perform work), the individual's disability claim is denied. If the impairment is ``severe,'' a determination is made as to whether the impairment ``meets'' or ``equals'' the medical listings published in regulations by SSA, \6\ and whether it will last for 12 months. If the impairment neither ``meets'' nor ``equals'' the listing (which would result in an allowance), but meets the 12-month duration rule, the individual's residual functional capacity (what an individual still can do despite his limitations) and the physical and mental demands of his past relevant work must be evaluated. If the impairment does not prevent the individual from meeting the demands of his past relevant work, then benefits are denied. If it does, then it must be determined whether the impairment prevents other work. --------------------------------------------------------------------------- \6\ The listing of impairments contains over 100 examples of medical conditions that would ordinarily prevent an individual from engaging in substantial gainful activity. Each listing describes a degree of severity such that an individual who is not working, and has such an impairment, is considered unable to work by reason of the medical impairment. The listing describes specific medically acceptable clinical and laboratory findings and signs which establish the severity of the impairments. An impairment or combination of impairments is said to ``equal the listings'' if the medical findings for the impairment are at least equivalent in severity and duration to the findings of a listed impairment. --------------------------------------------------------------------------- At this stage in the adjudication process, because of a court decision and subsequent administrative and legislative ratification, the burden of proof switches to the government to show that the individual can, considering his impairment, age, education, and work experience, engage in some other kind of substantial gainful activity that exists in the national economy. Such work does not have to exist in the immediate area in which he lives, and a specific job vacancy does not have to be available to him. Work in the national economy is defined in statute as work which exists in significant numbers either in the region where such individual lives or in several regions of the country. SSA has developed a vocational ``grid'' designed to reduce the subjectivity and lack of uniformity in applying the vocational factor. The grid regulations embody in a formula certain worker characteristics such as age, education, and past work experience, in relation to the individual's residual functional capacity to perform work-related physical and mental activities. If the applicant has a particular level of residual work capability--characterized by the terms sedentary, light, medium, heavy and very heavy--an automatic finding of ``disabled'' or ``not disabled'' is required when such capability is applied to various combinations of age, education, and work experience. Federal Review of State Determinations The Commissioner must review 50 percent of the disability allowances and a sufficient number of other determinations to ensure a high degree of accuracy. The Commissioner may also, on his or her own initiative, review any determination by a DDS. Periodic Review of Individuals Receiving Disability Benefits The 1980 disability amendments required that, at least once every 3 years, the Social Security Administration reexamine every individual on the rolls who is determined to be nonpermanently disabled. Where there is a finding of permanent disability, the Commissioner may reexamine at such times as are determined to be appropriate. These reviews are in addition to the administrative eligibility review procedures existing before the 1980 amendments. Medical Improvement Standard The 1984 Disability Benefits Reform Act required that in continuing eligibility review cases, benefits may be terminated only if the Commissioner finds that there has been medical improvement in the person's condition and that the individual is now able to engage in substantial gainful activity. There are several exceptions to this standard, which are described in greater detail in the ``Recent Legislation'' section of this chapter. Medical Evidence An individual is not considered to be under a disability unless she furnishes such medical and other evidence as the Commissioner may require. The Commissioner will generally reimburse physicians or hospitals for supplying medical evidence in support of claims for DI benefits. The Commissioner also pays for medical examinations that are needed to adjudicate the claim. Attorneys' Fees and Representation A claimant may be represented by an attorney or any other qualified person in proceedings before SSA. A person who has been suspended or disqualified by SSA from representing Social Security claimants or who is otherwise prohibited by law from acting as a representative may not represent claimants. The claimant must appoint a representative in writing over his own signature and file the written appointment with SSA. If the representative is not an attorney, he also must submit a written acceptance of appointment to SSA. The appointed representative may obtain the same information about the claimant that would be available to the claimant. The representative may also submit evidence, make statements about facts and law, and make any request or give any notice concerning the proceedings. She may not sign an application on behalf of a claimant for rights or benefits, or testify on the claimant's behalf in any administrative proceeding. The amount of any fee that an attorney or other person may charge and collect from the claimant for services performed as a representative in proceedings before SSA must be authorized by SSA. SSA has two methods of authorizing fees for representation: Fee petition and fee agreement. Under the fee petition process, the representative must file a fee petition with SSA after completing his services on a claim and send a copy of the fee petition to the claimant. All Social Security offices have forms available that list the information required to petition for a fee. The representative should submit the petition for a fee for services rendered as soon as possible after all proceedings are complete. SSA determines the amount of the fee authorized under the fee petition process based on several factors, including, but not limited to, the extent and type of services the representative performed, the complexity of the case, and the amount of time the representative spent on the case. SSA notifies both the claimant and representative of the fee authorized and gives a complete explanation of how the amount of the fee was determined. The claimant or representative, or both, may request a review of the fee determined under a fee petition within 30 days after receipt of the notice. Under the fee agreement process, the claimant and representative must file a written agreement with SSA before the date SSA makes a favorable determination or decision on the claim. SSA usually will approve the fee agreement if (1) it is signed by both the claimant and representative; (2) the fee specified in the agreement does not exceed the lesser of 25 percent of the past-due benefits or $4,000; (3) SSA's determination or decision in the claim is fully or partially favorable; and (4) the claim results in past-due benefits. The claimant, the claimant's representative, or the SSA agent determining the fee, may request a review of the fee within 15 days after receipt of the notice. If the claimant is represented by an attorney and the claim is for Social Security benefits, SSA withholds 25 percent of past-due benefits owed the claimant and any auxiliary beneficiary or beneficiaries, and certifies for direct payment to the attorney the lesser of the amount of the authorized fee or 25 percent of past-due benefits. SSA assumes no responsibility for payment of any authorized fee if the representative is not an attorney or if the claim is for payments under title XVI of the act (Supplemental Security Income). A Federal court that renders a judgment favorable to a Social Security claimant may allow as part of its judgment a reasonable fee to an attorney who represented the claimant in court. The fee allowed by the court cannot exceed 25 percent of the past-due benefits resulting from the favorable judgment. SSA may certify the amount of the fee allowed by the court for payment directly to the attorney out of the title II past-due benefits. VOCATIONAL REHABILITATION The Social Security Act requires that persons applying for a determination of disability be promptly referred to State vocational rehabilitation (VR) agencies for necessary rehabilitation services. The act provides for withholding of benefits for refusal, without good cause, to accept rehabilitation services available under a State plan approved under the Vocational Rehabilitation Act. Public Law 97-35 eliminated reimbursement from the DI Trust Funds to the State vocational rehabilitation agencies for rehabilitation services except in cases in which the services result in the beneficiary's performance of substantial gainful activity (SGA) for a continuous period of at least 9 months. Such a 9-month period could begin while the individual is under a vocational rehabilitation program and may also coincide with the trial work period or the individual's waiting period for benefits. The services must be performed under a State plan for vocational rehabilitation services under title I of the rehabilitation act. In the case of any State that is unwilling to participate or does not have a plan that meets the requirements of the Vocational Rehabilitation Act, the Commissioner of Social Security may provide such services by agreement or contract with other public or private agencies, organizations, institutions or individuals. The determination that the vocational rehabilitation services contributed to the successful return of the individual to SGA, and the determination of the amount of costs to be reimbursed, are made by the Commissioner. Payments under this provision can be made in advance or by reimbursement, with necessary adjustments for overpayments or underpayments. Using the administrative rulemaking process available under current law, SSA issued new regulations in the Federal Register on March 15, 1994 on the use of alternative rehabilitation providers. The regulations expanded the use of private vocational rehabilitation providers and public non-State VR providers by allowing SSA to refer beneficiaries to such providers if SSA does not receive notification within a specified period of time that the State VR agency has accepted a beneficiary for services or extended evaluation. DISABILITY CLAIMS AND APPEALS STRUCTURE The Social Security appeals and case review process is a complex multilayered structure that is inextricably linked with the disability determination process. Application for disability benefits is made at the Social Security district office where the applicant is interviewed and the sources of medical evidence are recorded. After determining whether the applicant meets the insured status requirements, the SSA district office then sends the case to the State disability determination service (DDS), which makes the initial determination of disability. If an applicant or beneficiary is dissatisfied with an initial denial or termination of disability benefits by the DDS, she can request a reconsideration within 60 days of receipt of the notice of denial. The reconsideration on the disability claim is also carried out by the DDS, but by personnel other than those who made the initial determination. If upon reconsideration the applicant is again denied benefits, the applicant will be given a hearing before an administrative law judge (ALJ) in SSA's Office of Hearings and Appeals (OHA), provided he or she files a request for hearing within 60 days of receipt of the notice of denial. If the claim is denied by the ALJ, the applicant has 60 days to request review by the appeals council. The appeals council is a 24- member body located in the OHA. The appeals council may also, on its own motion, review a decision within 60 days of the ALJ's decision. The 1980 disability amendments required the appeals council to review a percentage of ALJ hearing decisions. The appeals council may review, affirm, modify, or reverse the decision of the ALJ, or may remand it to the ALJ for further development. The applicant is notified in writing of the final action of the appeals council, and is informed of his right to obtain further review by commencing a civil action within 60 days in a U.S. District Court. Under current law, as amended by the 1984 Disability Benefits Reform Act, DI beneficiaries whose benefits have been terminated because of recovery or improvement in the medical condition that was the basis for the disability will have the opportunity to receive a hearing at the reconsideration stage and can elect to continue to receive disability and Medicare benefits through the ALJ hearing stage of the appeals process, subject to recovery. Chart 1-1 shows the number of cases allowed and appealed at various levels of appeal for application decisions and continuing disability reviews (CDRs) processed by State agencies. Table 1-25 presents information for fiscal years 1979-96 on the number of cases that were reviewed and reversed at the ALJ level. Table 1-26 presents information on the number of continuing disability reviews that were conducted in fiscal years 1977-96 on DI cases. Due to an unprecedented increase in initial claims, the number of CDRs processed declined sharply in the early 1990s. National implementation of a new CDR process in 1993 has since enabled the Social Security Administration to increase the number of CDRs significantly. Public Law 104-121 authorized significant additional administrative funding exempt from the discretionary spending cap, and above the annual $200 million previously authorized, to enable SSA to clear its CDR backlog of roughly 3.4 million cases more quickly. Total fiscal year authorizations for CDRs are: 1996, $260 million; 1997, $360 million; 1998, $570 million; and 1999-2002, $720 million each year. CHANGES IN ENROLLMENT AND APPLICANT BACKLOGS Disability Insurance (DI) Awards and Recipients Over the past 18 years, the DI Program experienced a period of declining enrollment followed by a rebound in growth. The number of DI beneficiaries (disabled workers and their dependents) receiving benefits first peaked at 4.9 million in May 1978. The beneficiary population then declined sharply to 3.8 million by July 1984. Thereafter, the number of beneficiaries rose steadily, reaching 6.1 million in December 1996 (table 1-28). Similarly, the number of new DI benefit awards declined from 592,000 in 1975 to approximately 299,000 in 1982. As shown in table 1-27, awards then rose almost steadily, reaching 646,000 in 1995 before declining by 1997 to 587,000. (The large 1992 increase is partially attributable to SSA's short-term measures for dealing with increased DI applications. Increasing the volume of applications processed resulted in increases in both awards and denials.) CHART 1-1. DISABILITY DETERMINATIONS AND APPEALS, FISCAL YEAR 1996 TITLE II, TITLE XVI AND CONCURRENT TITLE II AND XVI DECISIONS FOR DISABILITY CLAIMS BY WORKERS, WIDOWS, AND DISABLED ADULT CHILDREN \1\ GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT \1\ The data relate to workloads processed (but not necessarily received) in fiscal year 1996, i.e., the case processed at each adjudicatory level may include cases received at one or more of the lower adjudicatory levels prior to fiscal year 1996. The data include determinations on initial applications as well as continuing disability reviews (both periodic reviews and medical diary cases). \2\ Includes non-State CDR mailer continuations. Also includes 16,189 CDRs where there was ``no decision.'' The continuance and termination rates are computed without the ``no decision'' cases. \3\ Many ALJ dispositions and appeals council (AC) decisions are based on DDS determinations from a previous year. Therefore, a percent appealed is not provided. \4\ Preliminary data. \5\ Includes ALJ decisions not appealed further by the claimant but reviewed by the appeals council on ``own motion'' authority. \6\ Includes affirmations, denials and dismissals of requests for review, and own motion reopening cases. Source: Social Security Administration. TABLE 1-25.--ADMINISTRATIVE LAW JUDGE DISABILITY INSURANCE \1\ DECISION RATES, INITIAL DENIALS AND TERMINATIONS, \2\ FISCAL YEARS 1979-96 ---------------------------------------------------------------------------------------------------------------- Percent Fiscal year Dismissed Unfavorable Favorable Total favorable ---------------------------------------------------------------------------------------------------------------- Initial denials: 1979............................................... 6,332 31,485 48,934 86,751 56.4 1980............................................... 7,093 31,703 56,733 95,529 59.4 1981............................................... 15,141 59,930 98,129 173,200 56.7 1982............................................... 15,403 67,481 91,865 174,749 52.6 1983............................................... 14,334 65,626 79,427 159,387 49.8 1984............................................... 15,075 63,381 88,301 166,757 53.0 1985............................................... 14,806 61,161 92,118 168,085 54.8 1986............................................... 28,792 44,223 78,737 151,752 51.9 1987............................................... 15,271 58,412 98,180 171,863 57.1 1988............................................... 18,213 58,788 111,748 188,749 59.2 1989............................................... 19,695 54,284 122,070 196,049 62.3 1990............................................... 19,297 45,264 127,707 192,268 66.4 1991............................................... 19,880 44,594 144,945 209,419 69.2 1992............................................... 19,665 48,407 166,661 234,733 71.0 1993............................................... 20,190 47,579 171,508 239,277 71.7 1994............................................... 23,576 49,110 189,373 262,059 72.3 1995............................................... 44,234 65,415 220,558 330,207 66.8 1996............................................... 33,367 89,817 237,131 360,315 65.8 Terminations: 1979............................................... 1,401 4,078 8,052 13,531 59.5 1980............................................... 1,431 4,197 9,909 15,537 63.8 1981............................................... 2,623 6,945 16,685 26,253 63.6 1982............................................... 4,670 17,502 37,306 59,478 62.7 1983............................................... 9,247 37,284 73,821 120,352 61.3 1984............................................... 25,681 22,590 56,327 104,598 53.9 1985............................................... 4,176 2,415 3,126 9,717 32.2 1986............................................... 1,095 2,129 2,014 5,238 38.4 1987............................................... 812 1,954 2,014 4,780 42.1 1988............................................... 1,031 2,807 3,426 7,264 47.2 1989............................................... 1,220 3,482 4,882 9,584 50.9 1990............................................... 1,166 2,940 4,695 8,801 53.3 1991............................................... 1,007 2,140 3,935 7,082 55.6 1992............................................... 812 1,642 2,812 5,266 53.4 1993............................................... 720 1,281 2,079 4,080 51.0 1994............................................... 656 1,082 1,540 3,278 47.0 1995............................................... 821 1,173 1,807 3,801 47.5 1996............................................... 1,172 2,275 2,488 5,935 41.9 ---------------------------------------------------------------------------------------------------------------- \1\ Includes title II and concurrent title II/title XVI disability cases and concurrent title II/title XVI aged cases. \2\ Includes all termination cases regardless of the basis of termination. Source: Office of Hearings and Appeals, Social Security Administration. TABLE 1-26.--CONTINUING DISABILITY REVIEW (CDR) CESSATIONS AND CONTINUATIONS, FISCAL YEARS 1977-96 -------------------------------------------------------------------------------------------------------------------------------------------------------- Cessations Continuations Total cases --------------------------------------------------------------------------------------- Fiscal year Cessations Total Number Percent \1\ Number Percent \2\ and disabled Percent continuations persons \3\ reviewed \4\ -------------------------------------------------------------------------------------------------------------------------------------------------------- 1977............................................................ 41,475 38.7 65,745 61.3 107,220 3,322,230 3.2 1978............................................................ 38,847 46.4 44,804 53.6 83,651 3,447,767 2.4 1979............................................................ 45,216 48.1 48,868 51.9 94,084 3,457,837 2.7 1980............................................................ 44,273 46.8 50,227 53.2 94,550 3,454,010 2.7 1981............................................................ 80,956 47.9 87,966 52.1 168,922 3,413,602 4.9 1982............................................................ 179,857 44.8 221,325 55.2 401,182 3,263,354 12.3 1983............................................................ 182,074 41.7 254,424 58.3 436,498 3,226,888 13.5 1984 \5\........................................................ 31,927 24.6 97,752 75.4 129,679 3,249,367 4.0 1985 \5\........................................................ 475 14.6 2,785 85.4 3,260 3,332,870 0.1 1986............................................................ 2,554 5.6 42,805 94.4 45,359 3,261,768 1.4 1987............................................................ 20,343 12.4 143,712 87.6 164,055 3,433,524 4.8 1988............................................................ 33,565 11.5 257,377 88.5 290,942 3,492,762 8.3 1989............................................................ 24,102 9.2 237,722 90.8 261,824 3,559,840 7.4 1990 \6\........................................................ 15,154 10.5 129,026 89.5 144,180 3,678,509 3.9 1991 \7\........................................................ 5,697 12.5 39,749 87.5 45,446 3,866,645 1.2 1992............................................................ 6,923 15.0 39,291 85.0 46,214 4,165,133 1.1 1993 \8\........................................................ 4,886 9.9 44,316 90.1 49,202 4,457,500 1.1 1994 \8\........................................................ 13,940 14.1 85,189 85.9 99,129 4,729,948 2.1 1995 \8\........................................................ 31,694 16.1 164,281 83.9 196,575 4,980,462 4.0 1996............................................................ 35,452 10.0 311,041 90.0 346,493 5,216,126 6.6 -------------------------------------------------------------------------------------------------------------------------------------------------------- \1\ Percent of cessations = number of cessations divided by (number of cessations + number of continuances) X 100. \2\ Percent of continuances = number of continuances divided by (number of cessations + number of continuances) X 100. \3\ In current pay at end of fiscal year. \4\ Percent of total disabled persons reviewed = (number of cessations + number of continuances) / total disabled persons X 100. \5\ The decline in the number of reviews in 1984 and 1985 was due to the national moratorium on reviews pending enactment and implementation of new legislation that revised criteria for CDRs (legislation enacted in fiscal year 1984; regulations promulgated late fiscal year 1985). \6\ The decline in CDR processing in 1990 was due to the unanticipated demands of processing approximately 40,000 class action court cases. \7\ The continued decline in CDR processing was due to the increase in the initial claims workloads. \8\ Includes non-State CDR mailer continuations. Source: Office of Disability, Social Security Administration. The incidence of disability (number of awards per 1,000 insured workers) fell from an all-time high of 7.1 in 1975 to an all-time low of 2.9 in 1982. In 1996, the rate was 4.9 percent (see table 1-27). Table 1-28 shows the number of DI beneficiaries for selected fiscal years. TABLE 1-27.--DISABLED WORKERS' APPLICATIONS, AWARDS, AWARDS AS A PERCENT OF APPLICATIONS, AND AWARDS PER 1,000 INSURED WORKERS FOR SELECTED YEARS, 1960-97 [Number of applications and total awards in thousands] ---------------------------------------------------------------------------------------------------------------- Awards as a Awards per Number of Total awards percent of 1,000 insured applications applications workers ---------------------------------------------------------------------------------------------------------------- 1960............................................ 418.6 207.8 49.6 4.5 1965............................................ 532.9 253.5 47.9 4.7 1970............................................ 868.2 350.4 40.3 4.8 1971............................................ 924.4 415.9 45.0 5.6 1972............................................ 947.8 455.4 48.1 6.0 1973............................................ 1,066.9 491.6 46.1 6.3 1974............................................ 1,330.2 536.0 40.3 6.7 1975............................................ 1,285.3 592.0 46.1 7.1 1976............................................ 1,232.2 551.5 44.8 6.5 1977............................................ 1,235.2 568.9 46.1 6.5 1978............................................ 1,184.7 464.4 39.2 5.2 1979............................................ 1,187.8 416.7 35.1 4.4 1980............................................ 1,262.3 396.6 31.4 4.0 1981............................................ 1,161.3 345.3 30.3 3.4 1982............................................ 1,020.0 298.5 29.1 2.9 1983............................................ 1,017.7 311.5 30.6 3.0 1984............................................ 1,035.7 357.1 34.9 3.4 1985............................................ 1,066.2 377.4 35.4 3.5 1986............................................ 1,118.4 416.9 37.3 3.8 1987............................................ 1,108.9 415.8 37.5 3.7 1988............................................ 1,017.9 409.5 40.2 3.6 1989............................................ 984.9 425.6 43.2 3.7 1990............................................ 1,067.7 468.0 43.8 4.0 1994............................................ 1,208.7 536.4 44.4 4.5 1992............................................ 1,335.1 636.6 47.8 5.2 1993............................................ 1,425.8 635.2 44.6 5.2 1994............................................ 1,443.8 631.9 43.8 5.1 1995............................................ 1,338.1 645.8 48.3 5.1 1996............................................ 1,279.2 624.3 48.8 4.9 1997............................................ 1,180.2 587.4 49.8 4.5 ---------------------------------------------------------------------------------------------------------------- Source: Office of the Chief Actuary, Social Security Administration. Pending Claims in the Disability Determination Services Until fiscal year 1991, State disability determination services workloads remained relatively constant at about 2.5 million cases per year. In fiscal year 1991, claims began to increase significantly each year to a level of over 3.7 million in fiscal year 1996. During the period of fiscal years 1988-94, pending cases also increased as the ability to hire and train staff did not keep pace with the increases in claims. However, in fiscal year 1995 pending cases were significantly reduced to 590,000 due largely to increased productivity in the States and the additional budgetary resources directed to disability case processing which enabled an aggressive hiring effort in the States. In fiscal year 1996, pending cases again increased significantly. The major cause of this increase was that Congress increased SSA's workload by requiring additional drug addiction and alcoholism reviews. This workload has now been completed but pending cases have risen again due to workloads mandated by welfare reform legislation. Table 1-29 shows disability cases pending and the weeks of work on hand in the States at the end of each fiscal year from 1988 through 1996. TABLE 1-28.--NUMBER OF DISABILITY INSURANCE BENEFICIARIES FOR SELECTED YEARS, 1960-96 [Current payment status as of December] ---------------------------------------------------------------------------------------------------------------- Disabled Year workers Spouses Children Total ---------------------------------------------------------------------------------------------------------------- 1960..................................................... 455,371 76,599 155,481 687,451 1965..................................................... 988,074 193,362 557,615 1,739,051 1970..................................................... 1,492,948 283,447 888,600 2,664,995 1975..................................................... 2,488,774 452,922 1,410,504 4,352,200 1980..................................................... 2,861,253 462,204 1,358,715 4,682,172 1981..................................................... 2,776,519 428,212 1,251,543 4,456,274 1982..................................................... 2,603,713 365,883 1,003,869 3,973,465 1983..................................................... 2,568,966 308,060 935,904 3,812,930 1984..................................................... 2,596,535 303,984 921,285 3,821,804 1985..................................................... 2,656,500 305,528 945,141 3,907,169 1986..................................................... 2,727,386 300,592 965,301 3,993,279 1987..................................................... 2,785,885 290,895 967,944 4,044,724 1988..................................................... 2,830,284 280,821 963,195 4,074,300 1989..................................................... 2,895,364 271,488 961,975 4,128,827 1990..................................................... 3,011,294 265,890 988,797 4,265,981 1991..................................................... 3,194,938 266,219 1,051,883 4,513,040 1992..................................................... 3,467,783 270,674 1,151,239 4,889,696 1993..................................................... 3,725,966 272,759 1,254,841 5,253,566 1994..................................................... 3,962,954 271,054 1,349,511 5,583,519 1995..................................................... 4,185,263 263,539 1,408,854 5,857,656 1996..................................................... 4,385,623 223,854 1,462,557 6,072,034 ---------------------------------------------------------------------------------------------------------------- Source: Office of Research and Statistics, Social Security Administration. CHARACTERISTICS OF RECIPIENTS Old-Age, Survivors, and Disability Insurance Table 1-30 provides detailed information on the number of OASDI beneficiaries in various categories, and the average amount of monthly benefits by type of beneficiary for both new awards and all beneficiaries currently receiving payments. Disability Insurance Tables 1-31 and 1-32 present data on the demographic, social, and medical characteristics of the disabled population over time. For instance, table 1-31 shows the increase in the receipt of benefits by women, which reflects larger societal trends in female work force participation. Table 1-31 also indicates the higher levels of educational attainment that characterize the present disabled population in comparison to that of 1970. TABLE 1-29.--DISABILITY CASES PENDING AND WAITING TIMES, 1988-96 [Cases pending and weeks of work on hand at State disability determination services] ------------------------------------------------------------------------ Total cases Fiscal year pending at end of Weeks of work year on hand ------------------------------------------------------------------------ 1988................................ 407,000 8.4 1989................................ 479,000 9.8 1990................................ 538,000 11.1 1991................................ 693,000 13.3 1992................................ 725,000 12.0 1993................................ 717,000 10.7 1994................................ 721,000 10.4 1995................................ 590,000 8.4 1996................................ 702,000 9.8 ------------------------------------------------------------------------ Source: National Council of Disability Determination Directors. TABLE 1-30.--NUMBER AND PERCENTAGE OF OASDI RECIPIENTS AND AVERAGE BENEFITS BY AGE, SEX, AND MARITAL STATUS, DECEMBER 1996 [Based on a 10-percent sample] ---------------------------------------------------------------------------------------------------------------- Percent of Average Percent Beneficiaries Number total monthly of total (thousands) beneficiaries benefit benefits ---------------------------------------------------------------------------------------------------------------- Retired workers................................................. 26,898 61.5 $745 68.1 Retired men................................................. 14,011 32.0 838 39.9 Retired women............................................... 12,887 29.5 644 28.2 Disabled workers................................................ 4,386 10.0 704 10.5 Disabled men................................................ 2,644 6.0 788 7.1 Disabled women.............................................. 1,741 4.0 577 3.4 Spouses of retired workers...................................... 2,970 6.8 384 3.9 Wives of retired workers.................................... 2,941 6.7 385 3.8 Wives with entitled children................................ 68 0.2 277 0.1 Wives age 62 and over without entitled children............. 2,872 6.6 388 3.8 Husbands of retired workers................................. 30 0.1 226 (\1\) Spouses of disabled workers..................................... 224 0.5 171 0.1 Wives of disabled workers................................... 218 0.5 173 0.1 Wives with entitled children................................ 167 0.4 147 0.1 Wives age 62 and over without entitled children............. 52 0.1 256 (\1\) Husbands of disabled workers................................ 5 (\1\) 125 (\1\) Children........................................................ 3,803 8.7 357 4.6 Children of retired workers................................. 443 1.0 337 0.5 Minor children (age 0-17)............................... 242 0.6 303 0.2 Student children (age 18 and 19)........................ 11 (\1\) 375 (\1\) Disabled children (age 18 and over)..................... 190 0.4 378 0.2 Children of deceased workers................................ 1,898 4.3 487 3.1 Minor children (age 0-17)............................... 1,391 3.2 478 2.3 Student children (age 18 and 19)........................ 52 0.1 561 0.1 Disabled children (age 18 and over)..................... 454 1.0 506 0.8 Children of disabled workers................................ 1,463 3.3 194 1.0 Minor children (age 0-17)............................... 1,377 3.1 188 0.9 Student children (age 18 and 19)........................ 33 0.1 295 (\1\) Disabled children (age 18 and over)..................... 53 0.1 282 0.1 Widowed mothers and fathers..................................... 242 0.6 515 0.4 Widowed mothers............................................. 231 0.5 520 0.4 Widowed fathers............................................. 11 (\1\) 416 (\1\) Widows and widowers (nondisabled)............................... 5,028 11.5 707 12.1 Widows (nondisabled)........................................ 4,990 11.4 708 12.0 Widowers (nondisabled)...................................... 38 0.1 521 0.1 Widows and widowers (disabled).................................. 182 0.4 471 0.3 Widows (disabled)........................................... 178 0.4 474 0.3 Widowers (disabled)......................................... 4 (\1\) 318 (\1\) Parents total................................................... 4 (\1\) 614 (\1\) Special age 72 (primary)........................................ 1 (\1\) 197 (\1\) ----------------------------------------------- Total OASI beneficiaries.................................. 37,665 86.1 691 88.4 Total DI beneficiaries.................................... 6,072 13.9 561 11.6 Total OASDI beneficiaries................................. 43,737 100.0 673 100.0 ---------------------------------------------------------------------------------------------------------------- \1\ Less than 0.5 percent. Note.--Columns may not add due to rounding. Source: Office of Research, Evaluation, and Statistics, Social Security Administration. TABLE 1-31.--PERCENT DISTRIBUTION BY AGE, SEX AND EDUCATION OF TITLE II DISABLED WORKER BENEFICIARIES GRANTED BENEFITS IN SELECTED CALENDAR YEARS 1970-96, COMPARED WITH ADULT U.S. POPULATION IN 1990 ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ Year granted benefits Characteristics ---------------------------------------------------------------------------------------------------------------- Adult U.S. 1970 1975 1979 1982 1985 1988 1989 1990 1991 1992 1993 1994 1995 1996 population \1\ ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ Age: Under 35...................................................... 9.0 11.0 13.6 14.4 16.8 15.2 16.2 15.7 15.7 16.8 16.2 14.7 13.3 12.3 45.6 35-44......................................................... 11.0 10.0 11.5 12.3 15.0 16.5 17.9 18.7 19.6 20.4 20.9 20.7 20.4 20.4 24.4 45-54......................................................... 26.0 26.0 27.2 26.5 25.7 23.3 24.7 24.7 25.1 25.6 26.8 27.7 28.3 29.7 16.3 55-59......................................................... 24.0 23.0 27.0 27.2 23.9 20.6 20.4 19.9 19.5 18.5 18.6 19.2 19.9 20.0 6.8 60 and over................................................... 30.0 30.0 20.6 19.6 18.7 24.4 20.9 21.0 20.1 18.7 17.6 17.8 18.0 17.4 6.9 Median age (years)............................................ 56.0 55.6 53.4 53.1 51.7 53.3 52.1 51.9 51.4 50.5 50.3 50.8 51.3 51.3 32.9 Sex: Male.......................................................... 74 68 69 70 67 66 64 64 64 63 62 60 58.4 56.7 49.5 Female........................................................ 26 32 31 30 33 34 36 36 36 37 38 40 41.4 43.2 50.5 Education (years of school completed): No schooling \2\.............................................. 2 1 1 1 2 1 1 1 1 1 1 1 NA 1 1 Elementary school (1-8)....................................... 44 37 29 26 23 18 17 16 16 12 11 12 NA 10 9 Some high school.............................................. 46 52 55 56 59 59 60 62 62 50 45 55 NA 58 45 9-11........................................................ 23 24 23 22 22 20 19 19 19 15 14 16 NA 16 11 12.......................................................... 23 28 32 34 37 39 41 43 43 35 31 39 NA 42 34 Some college.................................................. 9 10 12 14 14 15 17 17 17 14 12 16 NA 3 45 Unknown....................................................... 0 0 3 3 2 7 5 5 5 23 31 16 NA 28 0 ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ \1\ Derived from 1990 census. Figures for age based on population aged 18-64. Figures for education based on persons aged 25 and over. \2\ Also includes special schools for handicapped. NA--Not available. Source: Office of Disability, Social Security Administration. TABLE 1-32.--PERCENT DISTRIBUTION BY DISABLING CONDITION OF TITLE II DISABLED WORKER BENEFICIARIES GRANTED BENEFITS IN SELECTED CALENDAR YEARS, 1970-96 -------------------------------------------------------------------------------------------------------------------------------------------------------- Year granted benefits Disabling condition ------------------------------------------------------------------------------------------------- 1970 1975 1979 1982 1985 1988 1989 1990 1991 1992 1993 1994 1995 1996 -------------------------------------------------------------------------------------------------------------------------------------------------------- Infective and parasitic diseases \1\.................. 3 1 1 1 1 0 1 6 6 7 7 6 6 5 Neoplasms............................................. 10 10 14 17 15 16 18 17 16 13 15 16 16 17 Allergic, endocrine system, metabolic and nutritional diseases............................................. 4 3 3 4 5 3 3 3 4 5 5 5 5 5 Mental, psychoneurotic and personality disorders...... 11 11 11 11 18 22 22 23 24 25 26 24 22 22 Diseases of the nervous system and sense organs....... 6 7 8 9 8 8 9 9 8 8 7 8 8 8 Circulatory system.................................... 31 32 28 25 19 18 17 16 15 14 15 14 14 14 Respiratory system.................................... 7 7 6 7 5 5 5 5 5 4 5 5 5 5 Digestive system...................................... 3 3 2 2 2 2 2 2 2 2 2 2 2 2 Musculoskeletal....................................... 15 17 17 16 13 14 11 12 13 13 12 12 12 12 Accidents, poisonings and violence.................... 8 6 6 6 4 5 4 4 4 4 3 3 3 4 Other/unknown......................................... 2 3 3 2 11 7 9 5 5 5 5 6 6 6 ------------------------------------------------------------------------------------------------- Total percent \2\............................... 100 100 100 100 100 100 100 100 100 100 100 100 100 100 -------------------------------------------------------------------------------------------------------------------------------------------------------- \1\ Beginning in 1990, AIDS/HIV cases are included in this category. \2\ May not add to 100 percent due to rounding. Source: Office of Disability, Social Security Administration.