Improving the Social Security Disability Decision Process


The Social Security Administration (SSA) uses a time-saving screening tool called the Listing of Impairments to identify individuals who meet the Social Security definition of disability. However, the SSA is concerned by a substantial drop in the percentage of claims granted disability benefits based on the Listings over the past 25 years.

At the request of the SSA, the IOM issued the report Improving the Social Security Disability Decision Process in 2007. The report addressed the medical aspects of disability determination and recommended improvements. The IOM recommended the SSA: 

  • Investigate the reliability and validity of the Listings as a tool for identifying the truly disabled; 
  • Incorporate condition-specific functional assessment tools in the Listings that demonstrate a strong
  • correlation with work disability; 
  • Strengthen the process for revising and updating the Listings; 
  • Expand medical and functional expertise at the staff level; and, 
  • Establish an external advisory committee system.

The IOM concluded that a better mechanism than the Listings does not exist at this time, although it recommends that the SSA monitor and support promising alternative approaches to disability assessment.