Disability Income Research Articles

It's Just That Much Harder

This article reports on a focus-group study that examined the experiences and perspectives of low-income mothers with disabilities who were receiving disability income transfers. The women faced severe deprivation and multilayered hardships. Their impairments were not their central problem, but they intersected with the challenges associated with the women's poverty and single-parent status. The women coped with or resisted their hardships by serving as advocates for their and their children's needs, accessing resources from safety-net services and their families, and relying on their religious beliefs. The women's aspirations included setting a moral example for their children, securing a better life for their children, and wanting to work. Implications for policy and practice are discussed.

Transitioning To Medicare Before Age Sixty-Five

Disabled workers who start receiving Social Security Disability Income (SSDI) must wait twenty-four months to qualify for Medicare. Legislation introduced in Congress would eliminate this waiting period, to guarantee that people with disabilities severe enough to qualify for SSDI will not be uninsured. We provide a longitudinal view of Medicare enrollment before age sixty-five by following a national sample of people ages 55-64. One person in six was covered by Medicare before turning sixty-five. A quarter of new enrollees were uninsured during the waiting period. There were great disparities in reliance on Medicare and coverage in the waiting period.

Long-Term Effects of Vietnam-Era Conscription: Schooling, Experience and Earning

Instrumental variables (IV) estimates using the draft lottery show that white Vietnam-era draftees suffered substantial post-service earnings losses in the 1970s and 1980s. Angrist (1990) explains these losses as due primarily to lost labor market experience. Non-public use data fromthe 2000 Census allow the first longerterm follow-up for a large sample from the draft-lottery cohorts. We use these data to estimate the effects of military service on earnings, schooling, and a number of other variables. Consistent with the loss-of-experience model, IV estimates of the effects of Vietnam-era service on earnings are close to zero in 2000, when the draft-lottery cohorts were middle-aged and experience profiles relatively flat. On the other hand, draft-lottery estimates show a marked increase in schooling for Vietnam-era veterans. A variety of evidence suggests this increase reflects the impact of the Vietnam-era GI Bill more than draft-avoidance behavior. The economic return to the increased schooling generated by Vietnam-era service,estimated in a wage equation that constrains the impact of Vietnam-era military service to run solely through the experience and schooling channels, appears to be less than the OLS return. Finally, we look at measures of disability. The IV estimates point to an increase in non-work-related disability rates and non-SSA disability income, but the fact that there is no corresponding effect on employment, hours worked, or work-related disability rates suggests health was affected little by Vietnam-era service. Allowing for excess disability among veterans raises the estimated returns to GI-Bill schooling slightly.

Welfare to Work in Australia: Disability Income Support, Housing Affordability and Employment Incentives

Internationally, considerable policy attention is being paid to increasing the employment participation of disabled working-age people. Like other OECD countries, Australia has experienced growth in the number of Disability Support Pension (DSP) recipients due to changes in industry structure and increases in precarious employment. This history is well-rehearsed in policy debates. However, little research attention has been given to the housing circumstances of DSP recipients. This is important, particularly when we note the increasing incidence of working-age DSP recipients in the private rental market and public housing. For public renters the incidence has more than tripled to 27 per cent over the period 1982-2002. This paper addresses two questions: 'What are the housing circumstances of DSP recipients?' and 'What are the likely consequences of programme changes aimed at increasing employment participation of DSP recipients?' Using Australia as an example, this article considers interactions between the new disability payment system being implemented through Welfare to Work, housing costs and employment income.

Psychiatric Sequelae of Traumatic Brain Injury: A Case Report

Psychiatric Sequelae of Traumatic Brain Injury: A Case Report

Successful Tobacco Dependence Treatment in Schizophrenia

Individuals with schizophrenia smoke at rates three times higher than the general population in the United States, with smoking prevalence rates of at least 60% (1, 2). International studies have also typically found increased rates of smoking among persons with schizophrenia (3). A pattern of heavy smoking (more than 20 cigarettes per day) and severe nicotine dependence (4, 5) is characteristic. Smokers with schizophrenia have increased nicotine and cotinine levels that are attributed to increased nicotine intake per cigarette (6–8). Higher blood nicotine levels are associated with greater severity of tobacco dependence and more difficulty quitting. High nicotine levels may be needed for activation of low-affinity alpha-7 nicotinic receptors, which are reduced in both number and function in schizophrenia (9, 10). Evidence for this self-medication hypothesis comes from abnormal electrophysiological measures and saccadic eye movements that are reversed or improved when nicotine is administered by smoking cigarettes or with high-dose nicotine gum or nasal spray (11–13). Despite nicotine being beneficial, tobacco is not a pharmaceutical and is associated with more than 4,000 toxins and more than 60 carcinogens. Nicotine can be delivered more safely in commercially available nicotine products, including gum, nasal spray, inhalers, and patches. Schizophrenia is associated with a 20% reduced life expectancy and increased rates of smoking-related respiratory and cardiovascular diseases compared to members of the general population (14, 15). A 10-year study of elevated risk of coronary heart disease in schizophrenia showed that the risk remained extremely high even after control was added for factors such as weight and body mass index and was attributable mainly to smoking (16). Besides health, tobacco use results in other consequences, with smokers suffering financially and socially. Smokers with schizophrenia spend almost one-third of their monthly disability income on cigarettes (17). Smoking influences community integration because smokers have less income to spend on clothing and housing. As the smoking rate decreases among the general population, there is also the stigma in being a smoker in addition to the stigma of having mental illness. This can reduce success in obtaining employment, housing, or interpersonal relationships. Studies have found that heavy smoking among individuals with schizophrenia is associated with higher levels of positive symptoms and higher antipsychotic medication doses (18, 19). Despite the magnitude of tobacco use problems, quit rates for seriously mentally ill smokers are significantly lower than in the general population (5, 20). Individuals with schizophrenia are able to quit smoking, although the success is about half that of other groups (21–23). Contributing factors likely include lower motivation to quit tobacco use, fewer lifetime quit attempts, and increased severity of nicotine dependence. Another important consideration is that access to treatment for this group is reduced. Few mental health professionals identify and treat tobacco use in their patients (24, 25). Tobacco dependence interventions provided in primary care and public health settings are often brief and may lack the intensity or specialization needed for this population to stop smoking. These services often rely on a highly motivated and organized client who is ready to quit. In 2001, the University of Medicine and Dentistry of New Jersey—Robert Wood Johnson Medical School and Tobacco Dependence Program both collaborated to develop specialized services for smokers with schizophrenia and other mental illnesses. These differed from traditional services in several ways: services were open ended and not limited to a set number of contacts, all patients were encouraged to use a combination approach of pharmacotherapy and counseling, and there was no requirement to set a quit date to be in treatment. An addictions psychiatrist and mental health social worker that was also a certified tobacco treatment specialist provided most services. Both individual and group counseling services were available. More than 300 smokers with schizophrenia and other serious mental illnesses have received these specialty services and achieve long-term abstinence rates as high as those without a history of mental health problems (26). We describe here the treatment of one such patient.

Compensation of Veterans with Psychiatric or Substance Abuse Disorders and Employment and Earnings

Using a national sample of veterans, we examined the relationship between disability income and employment, adjusting for health status and other factors. Veterans Affairs disability income payments had no globally detrimental effect on labor force participation, in that the likelihood of employment was reduced only at payment levels of more than $800 per month. Although unearned income from other sources also did not have a substantial negative effect on labor force participation, veterans who received benefits from the Social Security Administration or welfare payments were less likely to be employed, mostly likely because employment earnings above a certain level in some programs may result in the loss of monetary benefits and health insurance.

The Misuse of Social Security Disability Income on Drug and Alcohol Abuse

The Misuse of Social Security Disability Income on Drug and Alcohol Abuse

Employment and quality of life in liver transplant recipients

The purposes of liver transplantation (LT) include the extension of survival, improvement in quality of life, and the return of the recipient as a contributing member of society. Employment is one measure of the ability to return to society. The aim of this study is to determine the factors affecting employment/subemployment after LT. A total of 308 adult liver transplant recipients who were seen at the University of California, Los Angeles were administered the Medical Outcomes Short Form 36 (SF-36) and a questionnaire regarding work history and insurance coverage. Multivariate analysis were used to identify independent variables associated with posttransplantation employment. Interaction terms were used to examine effect modification. Of 308 transplant recipients, 218 (70.8%) worked prior to transplantation, and 78 (27%) worked posttransplantation. Pretransplant variables that were independently associated with posttransplantation employment included the following: lack of disability income (odds ratio [OR] = 1.86; 95% confidence interval [CI], 1.32-7.18; P = 0.36); health maintenance organization (HMO)/preferred provider organization (PPO) insurance (OR = 3.08; 95% CI, 1.32-7.18; P < 0.01); the number of hours worked (OR = 1.17; 95% CI, 1.08-1.28; P < 0.01); and the lack of diabetes mellitus (OR = 0.23; 95% CI, 0.70-0.73; P < 0.01). An interaction term between disability income and hours worked prior to transplantation (OR = 0.16; 95 % CI, 0.03-0.83; P = 0.03) was independently associated with posttransplantation employment. In a separate regression model of SF-36 responses, posttransplantation physical functioning (OR = 1.17; 95% CI, 1.10-1.26; P < 0.01) and role-physical (OR = 1.1; 95% CI, 1.02-1.16; P < 0.01) were independently associated with employment after transplantation. In conclusion, HMO or PPO insurance, lack of disability income coverage prior to transplant, the absence of diabetes mellitus, the number of hours worked prior to transplantation, and high physical functioning were associated with posttransplantation employment.

Disability Income Insurance: The Private Market and the Impact of Genetic Testing

This article discusses the disability insurance industry in order to provide context regarding the potential impact of genetic testing on disability insurance. It describes disability income insurance, exploring both the protection it offers and its main contract provisions. It goes on to describe the private insurance market and the differences between group and individual insurance, and concludes with implications of genetic testing with respect to the private disability insurance market.

Violence and Leveraged Community Treatment for Persons With Mental Disorders

Objective: This article explores the link between violence and the practice of legally mandating treatment in the community or leveraging benefits from the social welfare system, such as subsidized housing and disability income support, to ensure adherence to treatment. Method: Data are presented from a survey of 1,011 persons with psychiatric disorders receiving treatment in public mental health service systems in five U.S. cities. Multinomial logit analysis was used to examine the association between physically assaultive behavior and experience of social welfare leverage, legal leverage, or both types of leverage, with the analyses controlling for demographic and clinical characteristics. Results: Across study sites, 18% to 21% of participants reported having committed violent acts in the past 6 months; 3% to 9% reported having used or made threats with a lethal weapon, committed sexual assault, or caused injury. About three-quarters of subjects who reported such serious violence also reported having experienced some form of leveraged treatment, compared with about one-half of subjects who did not report serious violence. Demographic and clinical factors that were independently associated with the likelihood of experiencing both types of leverage included younger age, male gender, poorer clinical functioning, more years in treatment, more frequent hospitalizations, higher frequency of outpatient visits, and negative attitudes toward medication adherence. Among participants who did not voluntarily take psychotropic medication, even minor assaultiveness was associated with having experienced legal leverage. Conclusions: A combination of concerns about safety and treatment nonadherence may influence decisions by clinicians and judges to apply legal leverage.

Violence and Leveraged Community Treatment for Persons With Mental Disorders

This article explores the link between violence and the practice of legally mandating treatment in the community or leveraging benefits from the social welfare system, such as subsidized housing and disability income support, to ensure adherence to treatment. Data are presented from a survey of 1,011 persons with psychiatric disorders receiving treatment in public mental health service systems in five U.S. cities. Multinomial logit analysis was used to examine the association between physically assaultive behavior and experience of social welfare leverage, legal leverage, or both types of leverage, with the analyses controlling for demographic and clinical characteristics. Across study sites, 18% to 21% of participants reported having committed violent acts in the past 6 months; 3% to 9% reported having used or made threats with a lethal weapon, committed sexual assault, or caused injury. About three-quarters of subjects who reported such serious violence also reported having experienced some form of leveraged treatment, compared with about one-half of subjects who did not report serious violence. Demographic and clinical factors that were independently associated with the likelihood of experiencing both types of leverage included younger age, male gender, poorer clinical functioning, more years in treatment, more frequent hospitalizations, higher frequency of outpatient visits, and negative attitudes toward medication adherence. Among participants who did not voluntarily take psychotropic medication, even minor assaultiveness was associated with having experienced legal leverage. A combination of concerns about safety and treatment nonadherence may influence decisions by clinicians and judges to apply legal leverage.

Estimated Payments to Employment Service Providers for Persons With Mental Illness in the Ticket to Work Program

The Ticket to Work and Work Incentives Improvement Act of 1999 removes work disincentives and promotes access to vocational services for people with disabilities. This study calculated the amount of payments that would have been made to employment service providers if study participants had been enrolled in the Ticket program. Data were from 450 Social Security Disability Insurance beneficiaries with psychiatric disabilities enrolled in a multisite study of supported employment. Earnings over two years were used to calculate provider payments under two reimbursement formulas used in the Ticket program. Only a quarter of service recipients (26 percent) reached earnings levels that would have triggered provider payments under the first reimbursement formula. Only 4 percent would have completed their trial work period and left the rolls, generating payments under the second formula. The current provider payment systems of the Ticket to Work program do not reflect the reality of rehabilitation for individuals with severe mental illness. Reforms should take into account outcomes of return-to-work services for this population.

Surviving the Tornado of Mental Illness: Psychiatric Survivors' Experiences of Getting, Losing, and Keeping Housing

Surviving the Tornado of Mental Illness: Psychiatric Survivors' Experiences of Getting, Losing, and Keeping Housing

Open Forum: Surviving the Tornado of Mental Illness: Psychiatric Survivors' Experiences of Getting, Losing, and Keeping Housing

This qualitative study explored experiences of psychiatric consumer-survivors related to housing. Nine focus groups involving 90 people were conducted in urban and rural areas in South-Western Ontario. A set of open-ended questions was used. Many participants described a devastating experience of losing much of what was important to them and going through a long arduous process to rebuild their lives. Group discussions were audiotaped and transcribed. Individual and team analyses of the transcripts revealed that psychiatric survivors experienced three levels of upheaval, loss, and destruction, similar to the effects of a tornado: losing ground, struggling to survive, and gaining stability. Within each of these levels, five major themes were identified: living in fear, losing control of basic human rights, attempting to hold onto and create relationships, identifying supports and seeking services, and obtaining personal space and place. A caring community response, including adequate housing, income support, and community care, can help people rebuild their lives.

Cincinnati Financial Corp.

AbstractInsurance (MIC: 8.2 SIC: 6331 NAIC: 524126)Cincinnati Financial offers property and casualty insurance, its main business, through The Cincinnati Insurance Company, The Cincinnati Indemnity Company and The Cincinnati Casualty Company. The Cincinnati Life Insurance Company markets life and disability income insurance and annuities. CFC Investment Company supports the insurance subsidiaries and their independent agent representatives through commercial leasing and financing activities. CinFin Capital Management Company provides asset management services to institutions, corporations and high net worth individuals.

Cincinnati Financial Corp.

Mergent's Dividend AchieversVolume 3, Issue 3 p. 58-58 U.S. Company Reports Cincinnati Financial Corp.† First published: 30 June 2006 https://doi.org/10.1002/div.4284 † Contact: : John J. Schiff Jr. — Chmn., Pres., C.E.O. Address: : 6200 S. Gilmore Road, Fairfield, OH 45014-5141 Web Site: : www.cinfin.com AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Abstract Insurance (MIC: 8.2 SIC: 6331 NAIC: 524126) Cincinnati Financial offers property and casualty insurance, its main business, through The Cincinnati Insurance Company, The Cincinnati Indemnity Company and The Cincinnati Casualty Company. The Cincinnati Life Insurance Company markets life and disability income insurance and annuities. CFC Investment Company supports the insurance subsidiaries and their independent agent representatives through commercial leasing and financing activities. CinFin Capital Management Company provides asset management services to institutions, corporations and high net worth individuals. Volume3, Issue3Summer 2006Pages 58-58 RelatedInformation

Effect of Social Security Payments on Substance Abuse in a Homeless Mentally Ill Cohort

To determine whether receipt of social supplemental security income (SSI) or Social Security disability income (SSDI) disability payments is associated with increased drug and alcohol use. Secondary analysis of data from 6,199 participants in the Access to Community Care and Effective Social Supports and Services demonstration for the homeless mentally ill. Observational, 12-month, cohort study completed over 4 years. Substance abuse and other outcomes were compared between the participants who did not receive SSI or SSDI during the 12-month study, those newly awarded benefits, and those without benefits throughout the 12 months. Social Security administrative records were used to corroborate Social Security benefit status. Drug and alcohol use were measured by self-report and clinician ratings. Participants who did not receive benefits significantly reduced their substance use over time. In generalized estimating equations models that adjusted for potentially confounding covariates, participants who newly received Social Security benefits showed no greater drug use than those without benefits but had significantly more days housed and fewer days employed. Participants whose benefits antedated the demonstration and continued during the 12 months had more clinician-rated drug use over time than those without benefits. In this vulnerable population, participants with newly awarded benefits did not have any different drug use changes than those without benefits, and had relatively more days housed. The hypothesis that Social Security benefits facilitate drug use was not supported by longitudinal data in this high-risk population.

Nursing/Psychosocial/Health Services

Nursing/Psychosocial/Health Services

New Paradigms of Disability in Social Security Law and Policy in Australia: Implications for Exclusion or Participation

This paper explores transformations in the form, purpose and administration of income support law and policies for people with disabilities in the Australian social security system. It identifies a paradigm change which has reinforced a medicalized model of the concept and measurement of disability within social security law, effectively removing from policy discourse and practice recognition of the social and economic factors that influence the capacity for labor force participation. We examine the ways in which the current welfare reform agenda of the Federal Government has developed a disability discourse which constructs the individual as the 'problem' within the welfare system. Changes to eligibility criteria and assessment procedures for disability income support are increasingly based on conceptions of an impaired body, while, paradoxically, welfare reform is increasingly focused on the necessity to meet 'mutual obligation' through market participation (the key-words of the 'new welfare'). We explore the extent to which these policy transformations in Australia are likely to facilitate or impede market participation for people of working age with a disability. Wherever appropriate, comparisons are made with disability income support and employment programs in the USA.