This paper presents an "audit" of the multistage application and appeal process that the U.S. Social Security Administration (SSA) uses to determine eligibility for disability benefits from the Disability Insurance (DI) and Supplemental Security Income (SSI) programs. We study a subset of individuals from the Health and Retirement Study (HRS) who applied for DI or SSI benefits between 1992 and 1996. We compare the SSA's ultimate award decision (i.e. after allowing for appeals) to the applicant's self-reported disability status. We use these data to estimate classification error rates under the hypothesis that applicants' self-reported disability status and the SSA's ultimate award decision are noisy but unbiased indicators of, a latent "true disability status" indicator. We find that approximately 20\% of SSI/DI applicants who are ultimately awarded benefits are not disabled, and that 60\% of applicants who were denied benefits are disabled. Our analysis also yields insights into the patterns of self-selection induced by varying delays and award probabilities at various levels of the application and appeal process. We construct an optimal statistical screening rule using a subset of objective health indicators that the SSA uses in making award decisions that results in significantly lower classification error rates than does SSA's current award process.
SUMMARYA pervasive concern with the use of self-reported health measures in behavioural models is that individuals tend to exaggerate the severity of health problems in order to rationalize their decisions regarding labour force participation, application for disability benefits, etc. We re-examine this issue using a self-reported indicator of disability status from the Health and Retirement Study. We study a subsample of individuals who applied for disability benefits from the Social Security Administration (SSA), for whom we can also observe the SSA's decision. Using a battery of tests, we are unable to reject the hypothesis that self-reported disability is an unbiased indicator of the SSA's decision.
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