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Audit Report - A-13-97-21008


Office of Audit

Disability Applicants’ Responses to Vocational Rehabilitation Issues: A Mail Survey - A-13-97-21008 - 9/24/97

TABLE OF CONTENTS

INTRODUCTION

FINDINGS

Respondents Were Uninformed about Vocational Rehabilitation

Health Care Initiatives Were Rated as Important by Most Respondents

Most Respondents Were Uninformed about Work Incentives

Most Respondents Were Not Motivated by Others to Participate in Vocational Rehabilitation

Health Factors Limited Participation in Vocational Rehabilitation

CONCLUSION AND RECOMMENDATIONS

APPENDICES

Appendix A - Survey Response Data

Appendix B - Sample Selection and Nonrespondent Analysis

Appendix D - SSA Activities to Disseminate Information Concerning Vocational Rehabilitation Services

Appendix F - List of Contributors

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INTRODUCTION

OBJECTIVE

Our objective was to survey applicants for Social Security and Supplemental Security Income (SSI) disability benefits to determine their knowledge of and participation in the Department of Education's Vocational Rehabilitation program. We also asked about the importance of work incentives as a motivator for the applicants' return to work.

BACKGROUND

The Social Security Administration (SSA) administers two disability programs, Social Security Disability Insurance and SSI, which pay benefits to qualified disabled individuals. To help those with the most severe physical and mental disabilities return to the work force, the Department of Education's Vocational Rehabilitation program provides comprehensive vocational rehabilitation services.

The Social Security Act (Act) permits payment of SSA funds for vocational rehabilitation services to make services more readily available to Social Security beneficiaries and to achieve savings for the SSA trust funds. Also, the Act authorizes the Commissioner of Social Security to enter into agreements or contracts with alternative service providers in cases where a State agency declines to participate in providing vocational rehabilitation services.

On May 13, 1994, the Joint Vocational Rehabilitation Referral Task Force issued its final report which identified obstacles to achieving greater numbers of referral acceptances by the Vocational Rehabilitation Agencies under the existing process. The report found that, "...there is a need for improving the information available to the public to assist them in better understanding and using the rehabilitation and employment features in the disability program." The task force further stated that, "Existing SSA public information does not clearly link work incentives and other disability benefit protections to their potential use for participating in available rehabilitation programs and the attainment of substantial gainful work."

SSA, as part of its disability process reengineering program, is undertaking several initiatives to strengthen the entire disability determination process. To assist in this effort, SSA requested that the Office of the Inspector General conduct this survey to obtain applicants' opinions about the vocational rehabilitation referral process.

SCOPE AND METHODOLOGY

We selected the population for this study from the Disability Determination File (SSA-831), including all adult, nonblind disability and SSI applicants whose initial claims were adjudicated in 1992. From a universe consisting of those individuals identified as potential candidates for vocational rehabilitation services, we selected a random sample of 600 applicants. We excluded 25 applicants from this sample due to death, imprisonment, disabled children incorrectly identified as adults, and incorrect Social Security numbers.

We conducted a mail survey in which we released 575 initial questionnaires, with second and third mailings to nonrespondents. We received 327 usable questionnaires for an overall response rate of 56.9 percent. We surveyed applicants concerning a number of vocational rehabilitation issues. For complete response data, see Appendix A. Percentages listed in the report are based on the number of respondents answering each question. Appendix B contains the confidence interval ranges to be used for each question cited in this report.

We conducted this inspection in accordance with the Quality Standards for Inspections issued by the President's Council on Integrity and Efficiency.

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FINDINGS

Respondents Were Uninformed about Vocational Rehabilitation

SSA informs applicants about vocational rehabilitation through interviews, letters, and brochures. Regardless of the methods used, we found that:

  • Seventy percent stated they were either not told or do not recall being told they might be contacted about vocational rehabilitation services.
  • Seventy-six percent of those whose claims were approved said they were not told or do not recall being told that their payments might stop if they refused to participate in a vocational rehabilitation program.
  • Seventy-five percent did not receive or do not recall receiving the leaflet "Working While Disabled--How Social Security Can Help?"
  • Seventy-four percent indicated that the information they received was either not helpful in understanding vocational rehabilitation or they did not recall receiving the information.

Health Care Initiatives Were Rated as Important

  • Seventy-five percent rated continued Medicare coverage as very important to encouraging work.
  • •Seventy-nine percent rated extended Medicaid eligibility as very important to encouraging work.

Most Respondents Were Uninformed about Work Incentives

  • Fifty-six percent alleged that no one told them about work incentives.
  • Only 32 percent stated they were told about work incentives by a SSA employee.

Most Respondents Were Not Motivated by Others to Participate

  • Only 44 percent of respondents reported someone encouraging them to participate in vocational rehabilitation services.

Health Factors Limited Participation

  • Over two-thirds of respondents listed health problems as the primary reason for not participating in vocational rehabilitation.
  • Seventy percent stated they were either not told or do not recall being told they might be contacted about vocational rehabilitation services.
  • Seventy-six percent of those whose claims were approved said they were not told or do not recall being told that their payments might stop if they refused to participate in a vocational rehabilitation program.
  • Seventy-five percent did not receive or do not recall receiving the leaflet "Working While Disabled--How Social Security Can Help?"
  • Seventy-four percent indicated that the information they received was either not helpful in understanding vocational rehabilitation or they did not recall receiving the information.

Health Care Initiatives Were Rated as Important

  • Seventy-five percent rated continued Medicare coverage as very important to encouraging work.
  • Seventy-nine percent rated extended Medicaid eligibility as very important to encouraging work.

Most Respondents Were Uninformed about Work Incentives

  • Fifty-six percent alleged that no one told them about work incentives.
  • Only 32 percent stated they were told about work incentives by a SSA employee.

Most Respondents Were Not Motivated by Others to Participate

  • Only 44 percent of respondents reported someone encouraging them to participate in vocational rehabilitation services.

Health Factors Limited Participation

  • Over two-thirds of respondents listed health problems as the primary reason for not participating in vocational rehabilitation.

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CONCLUSION AND RECOMMENDATIONS

The survey showed that, despite SSA's efforts, applicants remain uninformed about vocational rehabilitation services and work incentives. The applicants' medical conditions often limited their participation in the program. In addition, applicants' uncertainties concerning loss of medical coverage was frequently mentioned as an important factor in their reluctance to seek these services.

The low percentage of participation in vocational rehabilitation services, as well as applicants' lack of awareness of these services, reemphasizes the need for SSA to take steps to strengthen the dissemination of information regarding the availability of vocational rehabilitation services and to promote recipients' rehabilitation. In support of the May 13, 1994 Joint Vocational Rehabilitation Referral Task Force report, we recommend expanding public access to information, focusing on the positive aspects of rehabilitation, employment, and work incentives. We recommend that SSA consider the following options:

  • pilot test revisions to public information materials through focus group meetings;
  • include periodic "stuffers" or "reminder notices" in mailings such as annual cost-of-living notices, annual earnings notices, continuing disability review notices, etc., emphasizing the availability of vocational rehabilitation services, participation in those services, and work reporting requirements;
  • develop and administer exit surveys of individuals completing applications to ensure that explanations of vocational rehabilitation and work incentives are understandable; and
  • seek front-line employee insights and recommendations concerning vocational rehabilitation referrals.

SSA COMMENTS

SSA agreed with the recommendation and indicated that some of the options had merit. The Agency has already taken action in some of the areas. The full text of SSA comments, except for technical comments, is in Appendix C of this report. SSA also identified a number of activities undertaken since the issuance of our draft report to strengthen the dissemination of information regarding the availability of vocational rehabilitation services to promote recipients' rehabilitation. Those activities are identified in Appendix D of this report.

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APPENDIX A

SURVEY TABLES

Sex (327 responses)

Responses

OASDI

SSI

In Pay

Total

% of Respondents

Female

59

87

102

146

44.65

Male

82

99

143

181

55.35

TOTAL

141

186

245

327

100.00

% of Respondents

43.12

56.88

74.92

   

Age (at established onset date) when disabled (281 responses)

Responses

F

M

OASDI

SSI

In Pay

Total

% of Respondents

1-10

11

10

10

11

16

21

7.47

11-20

12

8

4

16

14

20

7.12

21-30

22

23

20

25

37

45

16.01

31-40

18

48

26

40

49

66

23.49

41-50

37

40

36

41

56

77

27.40

51-60

22

25

35

12

39

47

16.73

61-64

3

2

2

3

5

5

1.78

TOTAL

125

156

133

148

216

281

100.00

% of Respondents

44.48

55.52

47.33

52.67

76.87

   

No Response

21

25

8

38

29

46

N/A

Number of years of education prior to any education acquired as part of a rehabilitation program: (320 responses)

Responses

F

M

OASDI

SSI

In Pay

Total

% of Respondents

1-6

8

17

9

16

20

25

7.81

7-9

29

52

34

47

60

81

25.31

10-12

36

37

25

48

54

73

22.81

High School Graduate

45

45

43

47

71

90

28.13

Some College

20

20

22

18

27

40

12.50

College Graduate

5

4

5

4

6

9

2.81

Post Graduate College Study

1

1

1

1

2

2

.63

TOTAL

144

176

139

181

240

320

100.00

% of Respondents

45.00

55.00

43.44

56.56

74.38

   

No Response

2

5

2

5

5

7

N/A

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At the present time, how many others do you financially help to support in the household? (322 responses)

Responses

F

M

OASDI

SSI

In Pay

Total

% of Respondents

0

79

76

57

98

123

155

48.14

1

31

43

39

35

57

74

22.98

2

15

19

18

16

21

34

10.56

3

8

21

14

15

23

29

9.01

4

10

11

8

13

11

21

6.52

5

2

2

1

3

3

4

1.24

6

0

3

0

3

2

3

.93

7

0

1

0

1

1

1

.31

8

0

1

1

0

1

1

.31

TOTAL

145

177

138

184

242

322

100.00

% of Respondents

45.03

54.97

42.86

57.14

70.81

   

No Response

1

4

3

2

3

5

N/A

At the present time, how many of those you help to support in the household are children under age 18? (310 responses)

Responses

F

M

OASDI

SSI

In Pay

Total

% of Respondents

0

97

111

88

120

161

208

67.10

1

24

20

18

26

31

44

14.19

2

10

23

19

14

21

33

10.64

3

8

9

3

14

11

17

5.48

4

2

1

1

2

3

3

.97

5

0

2

0

2

2

2

.65

6

0

2

0

2

1

2

.65

7

0

1

1

0

1

1

.32

TOTAL

141

169

130

180

231

310

100.00

% of Respondents

45.48

54.52

41.94

58.06

74.52

   

No Response

5

12

11

6

14

17

N/A

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Were you working at the time you became disabled? (319 responses)

Responses

F

M

OASDI

SSI

In Pay

Total

% of Respondents

Yes

82

115

110

87

147

197

61.76

No

62

60

29

93

93

122

38.24

TOTAL

144

175

139

180

240

319

100.00

% of Respondents

45.14

54.86

43.57

56.43

75.24

   

No Response

2

6

2

6

5

8

N/A

About how many people worked where you last worked? (Check only one box.) (279 responses)

Responses

F

M

OASDI

SSI

In Pay

Total

% of Respondents

10 or less

36

70

42

64

84

106

37.99

11-24

9

19

12

16

24

28

10.04

25-49

15

21

18

18

30

36

12.90

50-74

5

7

6

6

8

12

4.30

75-99

4

6

5

5

9

10

3.59

100 or more

25

24

32

17

39

49

17.56

I don't know

24

14

15

23

27

38

13.62

TOTAL

118

161

130

149

211

279

100.00

% of Respondents

42.29

57.71

46.59

53.41

75.63

   

No Response

28

20

11

37

34

48

N/A

Was your disability caused by the work you were doing? (307 responses)

Responses

F

M

OASDI

SSI

In Pay

Total

% of Respondents

Yes

17

44

30

31

46

61

19.87

No

90

84

76

98

127

174

56.68

Don't Know

31

41

29

43

58

72

23.45

TOTAL

138

169

135

172

231

307

100.00

% of Respondents

44.95

55.05

43.97

56.03

75.24

   

No Response

8

12

6

14

14

20

N/A

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Did your employer try to make changes on the job to make it easier for you to work in spite of your disability? (275 responses)

Responses

F

M

OASDI

SSI

In Pay

Total

% of Respondents

Yes

21

15

24

12

29

36

13.09

No

81

115

88

108

142

196

71.27

Don't Remember

17

26

15

28

31

43

15.64

TOTAL

119

156

127

148

202

275

100.00

% of Respondents

43.27

56.73

46.18

53.82

73.45

   

No Response

27

25

14

38

43

52

N/A

When you filed an application with Social Security for disability benefits, were you informed that you might be contacted about vocational rehabilitation services and how these services might help you go to work? (322 responses)

Responses

F

M

OASDI

SSI

In Pay

Total

% of Respondents

Yes

41

57

51

47

80

98

30.43

No

59

61

54

66

76

120

37.27

Don't Remember

44

60

36

68

87

104

32.30

TOTAL

144

178

141

181

243

322

100.00

% of Respondents

44.72

55.28

43.79

56.21

73.29

   

No Response

2

3

0

5

2

5

N/A

If your disability claim was approved by Social Security, were you informed that your disability payments may be stopped if you refused to participate in a vocational rehabilitation program and you did not have a good cause for refusing? (307 responses)

Response

F

M

OASDI

SSI

In Pay

Total

% of Respondents

Yes

28

46

38

36

64

74

24.10

No

67

70

58

79

96

137

44.63

Don't Remember

41

55

37

59

81

96

31.27

TOTAL

136

171

133

174

241

307

100.00

% of Respondents

44.30

55.70

43.32

56.68

78.50

   
               

No Response

10

10

8

12

4

20

N/A

Did any of the following people encourage you to take part in vocational rehabilitation services? (Check all boxes that apply.) (143 responses)

 Responses1

F

M

OASDI

SSI

In Pay

Total

Family

29

38

30

37

54

67

Doctor(s)

15

27

25

17

32

42

Friends

18

18

15

21

30

36

Social Security Employee

15

19

16

18

23

34

Someone Else

17

17

17

17

23

34

Employer

4

5

8

1

9

9

Church Members

6

2

1

7

7

8

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If you have not tried participating in a program of vocational rehabilitation services, please check the following possible concern(s) you have about going to work. (Check all boxes that apply.) I have not participated because: (220 responses)

 Responses1

F

M

OASDI

SSI

In Pay

Total

My health problem severely limits what I think I can do at work.

61

90

74

77

124

151

I have not been contacted about applying for services.

46

63

41

68

82

109

Employers don't think that I am capable of doing a full-time job due to my health problem.

34

44

38

40

63

78

I don't have the skills, education or training needed to get a full-time job.

23

32

16

39

43

55

Other reasons.

29

23

19

33

35

52

I do not want to risk losing my Medicare or Medicaid coverage.

23

20

18

25

41

43

I can't earn enough to replace my disability payment(s).

17

19

16

20

31

36

I can't get affordable or convenient transportation to and from work, or can't find housing near work.

18

16

8

26

26

34

No full-time work is available in my line of work or I can't find work.

13

14

11

16

17

27

I need special equipment or devices to work, to speak with or hear others at work, or to get around at work.

4

6

5

5

9

10

I can't arrange childcare or have other family responsibilities.

7

3

4

6

7

10

I have other income or financial support available.

5

3

4

4

3

8

I have previously dealt with a State vocational rehabilitation agency and I was not pleased with the service(s) I received.

4

2

3

3

6

6

I have previously dealt with a State vocational rehabilitation agency and I was not able to obtain a job after receiving services.

2

2

1

3

1

4

I have previously dealt with a private vocational rehabilitation organization and I was not able to obtain a job after receiving services.

0

2

1

1

1

2

I have previously dealt with a private vocational rehabilitation organization and I was not pleased with the service(s) I received.

0

0

0

0

0

0

If you did participate in a program of vocational rehabilitation services, but did not finish, please check the possible concern(s) you had that caused you not to complete the program. (Check all boxes that apply.) I did not complete vocational rehabilitation services because: (31 responses)

 Responses1

F

M

OASDI

SSI

In Pay

Total

My disability got worse.

6

8

6

8

12

14

My health problem severely limited what I thought I could do at work.

5

7

7

5

11

12

I was physically or mentally unable to participate in the services the Vocation Rehabilitation counselor offered to me.

9

3

4

8

10

12

I felt I did not need to work because I have other income or financial support available to me that covers my living expenses.

7

4

4

7

6

11

I needed medical treatment or therapy for my health problem which conflicted with obtaining vocational rehabilitation services.

4

6

4

6

8

10

I did not think the services the Vocational Rehabilitation counselor was providing would get me a job I would like.

4

1

0

5

2

5

The Vocational Rehabilitation counselor was not helpful in the initial interview.

2

2

1

3

3

4

I could not earn enough to replace my disability payment(s).

1

1

1

1

2

2

I did not want to risk losing my Medicare or Medicaid coverage.

1

1

1

1

2

2

I could not arrange childcare or have other family responsibilities.

1

1

1

1

2

2

I could not get affordable, convenient or accessible transportation to and from work or housing near work.

0

1

1

0

1

1

I did not think the services the Vocational Rehabilitation counselor was providing would get me a job I would like.

0

0

0

0

0

0

If you participated in and completed a program of vocational rehabilitation services, please check the possible reason(s) you had for participating. (Check all boxes that apply.) I participated in vocational rehabilitation services because: (19 responses)

 Responses1

F

M

OASDI

SSI

In Pay

Total

Working is an important part of my lifestyle.

7

8

8

7

12

15

I was determined to overcome my disability.

8

7

7

8

12

15

I was interested in improving my education or training.

7

6

7

6

9

13

I am young and feel I have some future in the workforce.

5

8

8

5

9

13

I believed that vocational rehabilitation could help me to learn new skills and find employment.

6

6

6

6

10

12

The Vocational Rehabilitation counselor was so helpful.

7

4

6

5

10

11

I believed I could earn more money by working than by receiving disability payments from Social Security.

6

4

5

5

9

10

My family encouraged me to work.

3

5

4

4

6

8

I felt that others expected me to work.

3

4

5

2

7

7

My disability improved.

2

2

2

2

3

4

I was afraid I would lose my disability payments if I did not participate.

2

2

3

1

4

4

Other reasons you participated.

2

1

3

0

2

3

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In your opinion, how important are each of the following in encouraging you to work? (Check one box in each row.) (203 responses)

Continued Medicare coverage

 Responses1

F

M

OASDI

SSI

In Pay

Total

Very Important

66

87

69

84

128

153

Somewhat Important

5

10

6

9

13

15

Not Important

9

7

11

5

14

16

Continuation of payments for those in an approved vocational rehabilitation program

 Responses1

F

M

OASDI

SSI

In Pay

Total

Very Important

56

77

61

72

109

133

Somewhat Important

10

16

14

12

24

26

Not Important

8

8

9

7

15

16

Trial work period

 Responses1

F

M

OASDI

SSI

In Pay

Total

Very Important

55

70

60

65

101

125

Somewhat Important

13

12

9

16

22

25

Not Important

9

14

12

11

20

23

Reentitlement to cash payments and Medicare (new period of entitlement)

 Responses1

F

M

OASDI

SSI

In Pay

Total

Very Important

52

70

58

64

102

122

Somewhat Important

15

17

12

20

26

32

Not Important

5

9

9

5

13

14

Reinstatement during an extended period of eligibility (continuation of entitlement).

 Responses1

F

M

OASDI

SSI

In Pay

Total

Very Important

47

69

58

58

95

116

Somewhat Important

14

15

11

18

26

29

Not Important

6

10

8

8

15

16

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Deduction for impairment related items

 Responses1

F

M

OASDI

SSI

In Pay

Total

Very Important

32

46

40

38

63

78

Somewhat Important

21

26

18

29

42

47

Not Important

15

18

17

16

30

33

If you receive SUPPLEMENTAL SECURITY INCOME DISABILITY PAYMENTS, complete this section.

Check any of the following incentives you were told about. (Check all boxes that apply.)

Responses1

F

M

OASDI

SSI

In Pay

Total

None of the incentives.

51

49

39

61

83

100

Partial reduction in Supplemental Security Income disability payments to recipients when earnings go above the monthly allowable limit.

23

29

17

35

48

52

Extended Medicaid eligibility.

11

17

11

17

26

28

Plan for achieving self-support (PASS).

9

13

9

13

19

22

Continuation of payments for those who medically recover while they are participating in an approved vocational rehabilitation program.

10

12

8

14

19

22

A deduction for costs of certain impairment-related items and services.

9

9

9

9

17

18

In your opinion, how important are each of the following in encouraging you to work? (Check one box in each row.) (127 responses)

Extended Medicaid eligibility

 Responses1

F

M

OASDI

SSI

In Pay

Total

Very Important

52

48

32

68

81

100

Somewhat Important

4

4

1

7

6

8

Not Important

3

3

4

2

5

6

Plan for achieving self-support

 Responses1

F

M

OASDI

SSI

In Pay

Total

Very Important

45

40

29

56

65

85

Somewhat Important

7

12

6

13

15

19

Not Important

3

3

4

2

6

6

Continuation of payments for those in an approved vocational rehabilitation program

 Responses1

F

M

OASDI

SSI

In Pay

Total

Very Important

43

42

28

57

67

85

Somewhat Important

6

11

7

10

10

17

Not Important

6

4

4

6

10

10

Partial reduction in Supplemental Security Income payments

 Responses1

F

M

OASDI

SSI

In Pay

Total

Very Important

40

37

22

55

63

77

Somewhat Important

9

10

7

12

14

19

Not Important

8

7

6

9

14

15

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Deduction for impairment related items

 Responses1

F

M

OASDI

SSI

In Pay

Total

Very Important

26

26

20

32

39

52

Somewhat Important

17

16

8

25

26

33

Not Important

8

11

8

11

18

19

Who told you about these incentives? (Check all boxes that apply.) (189 responses)

 Responses1

F

M

OASDI

SSI

In Pay

Total

No one

53

52

40

65

80

105

The Social Security office

26

35

22

39

51

61

Someone else

13

4

8

9

13

17

A doctor

6

9

5

10

12

15

A lawyer

5

7

5

7

8

12

A Vocational Rehabilitation counselor

4

8

6

6

9

12

An employer

2

3

2

3

4

5

An insurance company

3

2

2

3

3

5

 

Did Social Security give you a leaflet called "Working While Disabled--How Social Security Can Help?" (This leaflet explains the rules by which you can work while you get disability payments.) (259 responses)

Responses

F

M

OASDI

SSI

In Pay

Total

% of Respondents

Yes

28

38

35

31

57

66

25.48

No

45

49

35

59

60

94

36.29

Don't Remember

43

56

36

63

85

99

38.23

TOTAL

116

143

106

153

202

259

100.00

% of Respondents

44.79

55.21

40.93

59.07

77.99

   
               

No Response

30

38

35

33

43

68

N/A

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Was the notice and any attached information that you received from Social Security helpful to you in understanding what vocational rehabilitation is? (262 responses)

Responses

F

M

OASDI

SSI

In Pay

Total

% of Respondents

Yes

29

38

32

35

55

67

25.57

No

42

46

37

51

57

88

33.59

Don't Remember

51

56

43

64

92

107

40.84

TOTAL

122

140

112

150

204

262

100.00

% of Respondents

46.56

53.44

42.75

57.25

77.86

   

No Response

24

41

29

36

41

65

N/A

Was the notice and any attached information material that you received from Social Security helpful to you in understanding how you could go about obtaining vocational rehabilitation? (259 responses)

Responses

F

M

OASDI

SSI

In Pay

Total

% of Respondents

Yes

29

33

29

33

52

62

23.94

No

42

51

39

54

68

93

35.91

Don't Remember

49

55

41

63

91

104

40.15

TOTAL

120

139

109

150

211

259

100.00

% of Respondents

46.33

53.67

42.08

57.92

81.47

   

No Response

26

42

32

34

41

68

N/A

ENDNOTES

1 Respondents were asked to check all responses that applied. Totals will, therefore, not equal the number of respondents to the question.

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APPENDIX B

Sample Selection and Nonrespondent Analysis

Design Specifications and Sample Selection

The sample size for this inspection was 600 candidates identified for potential referral for vocational rehabilitation services. This sample size assumed a 66 percent response rate and a 95 percent confidence interval that would be within 5 percent of the applicants who were informed that they might be contacted about vocational rehabilitation services with a rate of informed applicants of 50 percent. The actual response rate was 56.9 percent with a rate of informed applicants of 30 percent. The precision of our results are very close to the parameters of the design (5.2 percent as opposed to 5 percent) for questions where at least 300 people responded. However, the response rates for the questions in this questionnaire varied. Therefore, the table below shows a conservative estimate of precision for varying number of respondents. It is assumed that the percent responding break 50:50. If a response breaks other than 50:50 (25:75 or 10:90 for example) the precision of the estimate will be slightly better.

Amount of Precision for Varying Response Rates to Questions

 Number of responses to question

Amount of Precision

50-99

19.6%

100-199

13.9%

200-299

6.9%

300 and up

5.7%

Analysis of Respondents vs Nonrespondents

As of the date of this report, 327 questionnaires had been returned to our office. This represents a response rate of 56.9 percent.

An important consideration in surveys of this type is the bias that may be introduced into the results if the nonrespondents are different than those responding to the survey instrument. To test for the presence of any bias, we obtained information from the Social Security Administration files on all of the individuals to whom questionnaires were sent. The variables we analyzed were selected because they might determine whether an individual would respond to the survey, as well as affect the individuals' actual response. For the 600 individuals, we determined their current pay status (allowed vs. denied), race, sex, and age. Pay status, race, and sex were categorical variables which were tested using a Chi-square with appropriate degrees of freedom. Age is a continuous variable which was tested using the t-statistic for a difference between means.

The results are presented in the following tables. The Chi-square values given in the tables provide a test of the difference in the distribution of the respondents versus the nonrespondents for the variable of interest. Also provided in the tables are the response rates by the different values of the variables.

SEX

 Sex

Responders

Nonresponders

Total

% Respond

Male

181

55%

170

62%

351

58%

Female

146

45%

103

38%

249

42%

Overall

327

100%

273

100%

600

55%

CHI-SQ=2.81
DF=1

RACE

 Race

Responders

Nonresponders

Total

% Respond

White

230

70%

176

64%

406

68%

Non-White

97

30%

97

36%

194

32%

Overall

327

100%

273

100%

600

55%

CHI-SQ=2.34
DF=1

The table for payment status (allowed vs. denied) shows a statistically significant difference between respondents and nonrespondents and the t-test performed on the age variable also showed a statistically significant difference between respondents and nonrespondents.

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PAYMENT STATUS

 Decision

Responders

Nonresponders

Total

% Respond

Allowed

153

47%

94

34%

247

41%

Denied

174

53%

179

66%

353

59%

Overall

327

100%

273

100%

600

55%

CHI-SQ=9.1666*
DF=1

For allowed vs. denied, survey results showed that approximately 33 percent of those applicants who were allowed benefits were informed of vocational rehabilitation compared to 28 percent of the denied applicants. To determine the effect of these differences, both in response rates and informed rates, we undertook an analysis of the nonresponders. Assuming that the nonresponders would have responded the same as the responders in the same pay-status category, we calculated a hypothetical global response to the question of being informed of vocational rehabilitation. This calculation gave an estimate of those who were informed of 32.5 percent, which differs by less than one percentage point from the 32.7 percent overall rate found among those responding to the survey.

Age was converted to a categorical variable using the median as the dividing point between the two groups. When a similar calculation was performed for the question of being informed of vocational rehabilitation, the percentages changed very slightly from 27.1 percent for those responding to 27 percent for the entire sample in the age group less than 39 years old. Similarly for those 39 years old and over, the percent changed from 32.97 percent to 33.0 percent.

T-TEST FOR AGE

 Applicants

Sample Number

Mean

Respondents

327

39.87

Nonrespondents

273

36.90

t=3.04*
DF=598

Since these differences are very slight, and are well within the bounds of our confidence interval, plus or minus 5.2 percent, we can state that nonresponders are not significantly different than responders with respect to being informed of vocational rehabilitation services.

*Statistically significant at the 95% confidence level

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APPENDIX D

SSA ACTIVITIES TO DISSEMINATE INFORMATION CONCERNING VOCATIONAL REHABILITATION SERVICES

SSA indicated that it has undertaken the following activities to disseminate vocational rehabilitation (VR) information since our draft report was issued in May 1995.

  • Wrote and published a new public information pamphlet entitled "How Social Security Can Help With Vocational Rehabilitation." This pamphlet is also available on the Internet.
  • Announced a request for proposals (RFP) to attract public and private practitioners of VR services. These alternate participants are receiving Social Security Administration (SSA) referrals of our beneficiaries whom the State VR agencies do not serve. Over 500 proposals were received in response to the RFP. SSA is presently awarding contracts to an ever-increasing number of those who responded.
  • Announced a RFP to solicit proposals for a management contractor to assist SSA with the administration of the functions associated with using alternate participant VR service providers. Among other duties, the selected contractor will operate a toll-free number to distribute information about available VR service provider sources and about work incentives.
  • Contributed to developing a legislative proposal whose central theme is to offer beneficiaries a consumer choice in selecting their VR service provider. Input was sought from various sources such as advocacy groups, parents, employers, etc., and was considered in developing the proposal.
  • Through an Inter-Agency Agreement with the Rehabilitation Services Administration (RSA), a grant was awarded to Cornell University to conduct a training project on the Social Security disability and work incentive programs. Training was offered in multiple sites nationwide. Audiences included State VR agency counselors and private sector VR organization members.
  • Agreed to a workplan with RSA and the council of State Administrators of Vocational Rehabilitation to undertake joint actions intended to improve employment opportunities for our beneficiaries with disabilities.
  • Added a question to its Disability Report form to encourage discussion about interest in VR services at the time of the disability interview.


  • Developed a handbook for use by both State VR agency staff and alternate participants. The handbook consolidates information about the SSA VR payments program, including policy guidance and operational instructions.
  • Established an Internet home page to inform the public about the performance of the SSA VR payments program, VR service provider sources, and new initiatives in this program.

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APPENDIX F

This report was prepared by the Office of Audit under the direction of Scott Patterson, Director, Evaluations and Technical Services. Project staff included Alan Stubbs, Senior Evaluator. The following individuals from the Department of Health and Human Services/Office of Inspector General were responsible for production of the draft report of this project.

Kansas City Region Headquarters

James H. Wolf, Regional Inspector General Linda Moscoe
Linda Paddock, Project Leader
Tim Dold
Perry Seaton
Dennis Tharp

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