Informing Social Security's Process for Financial Capability Determination

by National Academies of Sciences, Engineering, and Medicine, Institute of Medicine, Board on the Health of Select Populations, Committee to Evaluate the Social Security Administration's Capability Determination Process for Adu, Frank R. Valliere (Editor)

Overview

The U.S. Social Security Administration (SSA) provides benefits to disabled adults and children, offering vital financial support to more than 19 million disabled Americans. Of that group, approximately 5.5 million have been deemed — by virtue of youth or mental or physical impairment - incapable of managing or directing the management of their benefits. Hence, a representative payee has been appointed to receive and disburse SSA payments for these beneficiaries to ensure that their basic needs for shelter, food, and clothing are met. Periodically, however, concerns have been expressed about the accuracy of the process by which SSA determines whether beneficiaries are capable of managing their benefits, with some evidence suggesting that underdetection of incapable recipients may be a particular problem.

The importance of creating as accurate a process as possible for incapability determinations is underscored by the consequences of incorrectly identifying recipients either as incapable when they can manage their benefits or as capable when they cannot. Failure to identify beneficiaries who are incapable of managing their funds means abandoning a vulnerable population to potential homelessness, hunger, and disease.

Informing Social Security's Process for Financial Capability Determination considers capability determination processes used by other similar benefit programs, abilities required to manage, and direct the management of, benefits, and effective methods and measures for assessing capability. This report evaluates SSA's capability determination process for adult beneficiaries and provides recommendations for improving the accuracy and efficiency of the agency's policy and procedures for making these determinations.

Product Details

ISBN-13:	9780309392570
Publisher:	National Academies Press
Publication date:	06/20/2016
Pages:	244
Product dimensions:	8.90(w) x 5.90(h) x 0.50(d)

Table of Contents

Acronyms and Abbreviations xvii

Summary 1

1 Introduction 17

Context 20

Clarification of Study Scope 22

Terminology and Conceptual Model 23

Study Approach 28

Report Organization 28

References 29

2 Review of the Social Security Administration and Other Selected Capability Determination Processes 31

Overview of SSA and Other Selected Programs 32

Defining the Beneficiary's Ability to Manage Funds 35

Triggers for Capability Assessment 36

Types and Sources of Evidence 39

Instructions to Informants 44

Developing Evidence and Determining Capability 46

Appeals Processes 54

Review 56

Summary 57

References 59

3 Effects of Appointment of Representative Payees on Beneficiaries 67

Benefits Associated with the Appointment of a Representative Payee 67

Risks Associated with the Appointment of a Representative Payee 69

Use of Benefits as Leverage 70

The Beneficiary's Perspective 71

Minimizing the Impact on Autonomy of Having a Representative Payee 73

Supported Decision Making 74

Summary 76

References 77

4 Abilities Required to Manage and Direct the Management of Benefits 81

Financial Competence 82

Financial Performance 93

Preference for Performance in Determining Capability 99

Mental and Physical Disorders That May Affect Financial Capability 101

Summary 115

References 116

5 Methods and Measures for Assessing Financial Competence and Performance 125

Overview of Assessment of Financial Capability 125

Instruments Designed to Assess Financial Capability 126

Uses and Limitations of Available Assessment Instruments 135

Considerations and Challenges in Assessment of Financial Competence and Performance 137

Summary 142

References 142

6 Conclusions and Recommendations 153

Evidence for Determining Financial Capability 153

Systematic Identification of Adult SSA Beneficiaries at Risk for Financial Incapability 157

Responding to Changes in Capability Over Time 159

Innovation and Evaluation 160

Appendixes

A Public Session Agendas 163

B Glossary 169

C Selected Forms 173

D Biographical Sketches of Committee Members 217