The Social Security Administration (SSA) uses a screening tool called the Listing of Impairments to identify claimants who are so severely impaired that they cannot work at all and thus immediately qualify for benefits. In this report, the IOM makes several recommendations for improving SSA's capacity to determine disability benefits more quickly and efficiently using the Listings.

Painâ€"it is the most common complaint presented to physicians. Yet pain is subjectiveâ€"it cannot be measured directly and is difficult to validate. Evaluating claims based on pain poses major problems for the Social Security Administration (SSA) and other disability insurers. This volume covers the epidemiology and physiology of pain; psychosocial contributions to pain and illness behavior; promising ways of assessing and measuring chronic pain and dysfunction; clinical aspects of prevention, diagnosis, treatment, and rehabilitation; and how the SSA's benefit structure and administrative procedures may affect pain complaints.

The United States Social Security Administration (SSA) administers two disability programs: Social Security Disability Insurance (SSDI), for disabled individuals, and their dependent family members, who have worked and contributed to the Social Security trust funds, and Supplemental Security Income (SSSI), which is a means-tested program based on income and financial assets for adults aged 65 years or older and disabled adults and children. Both programs require that claimants have a disability and meet specific medical criteria in order to qualify for benefits. SSA establishes the presence of a medically-determined impairment in individuals with mental disorders other than intellectual disability through the use of standard diagnostic criteria, which include symptoms and signs. These impairments are established largely on reports of signs and symptoms of impairment and functional limitation. Psychological Testing in the Service of Disability Determination considers the use of psychological tests in evaluating disability claims submitted to the SSA. This report critically reviews selected psychological tests, including symptom validity tests, that could contribute to SSA disability determinations. The report discusses the possible uses of such tests and their contribution to disability determinations. Psychological Testing in the Service of Disability Determination discusses testing norms, qualifications for administration of tests, administration of tests, and reporting results. The recommendations of this report will help SSA improve the consistency and accuracy of disability determination in certain cases.

More than 7 million recipients of Social Security benefits have a representative payee-a person or an organization-to receive or manage their benefits. These payees manage Old Age, Survivors and Disability Insurance funds for retirees, surviving spouses, children, and the disabled, and they manage Supplemental Security Income payments to disabled, blind, or elderly people with limited income and resources. More than half of the beneficiaries with a representative payee are minor children; the rest are adults, often elderly, whose mental or physical incapacity prevents them from acting on their own behalf, and people who have been deemed incapable under state guardianship laws. The funds are managed through the Representative Payee Program of the Social Security Administration (SSA). The funds total almost $4 billion a month, and there are more than 5.3 million representative payees. In 2004 Congress required the commissioner of the SSA to conduct a one-time survey to determine how payments to individual and organizational representative payees are being managed and used on behalf of the beneficiaries.1 To carry out this work, the SSA requested a study by the National Academies, which appointed the Committee on Social Security Representative Payees. This report is the result of that study. Improving the Social Security Representative Payee Program: Serving Beneficiaries and Minimizing Misuse (1) assesses the extent to which representative payees are not performing their duties in accordance with SSA standards for representative payee conduct, (2) explains whether the representative payment policies are practical and appropriate, (3) identifies the types of representative payees that have the highest risk of misuse of benefits, and (4) finds ways to reduce the risk of misuse of benefits and ways to better protect beneficiaries.