Meeting Compares Approaches to Disability Benefits in Nine Nations

On July 21-22, 2004, researchers, policy makers and members of the disability community gathered in Washington, D.C. to attend a meeting on the "Learning from Others" project, which surveyed the temporary and partial disability benefits program in eight countries and the United States. The meeting covered the results of the survey and allowed for discussion of its implications on the future of social disability insurance.

Preliminary results of study presented

The project represents a collaborative effort between the Program for Disability Research (PDR) at Rutgers, The State University of New Jersey, and Rehabilitation International, a non-profit organization comprised of more than 200 national rehabilitation and disability organizations in over 80 different countries. With their help, one or more representatives was chosen from each of nine participating countries to assist in gathering data about the disability programs offered in their countries. The data collection process asked such questions as: who is covered by these programs? What terms are used to define temporary, short-term and disability itself? How are such programs administered? How is disability verified or certified? How is the program financed? Does the program involve a research component?

U.S. system contrasted with others that pay temporary and/or partial benefits

The objective in collecting this information is to learn more about international systems of temporary, short-term and partial disability benefits and how such systems might be adapted to work in the United States' domestic disability program. Presently, the US is one of the few countries in the world with a social insurance disability program that pays benefits only to persons who are totally and permanently disabled. In order to qualify, applicants must demonstrate that their conditions will last for an indefinite period of time or will result in death. Benefits, once granted, continue until the person reaches age 65 and transfers to old-age benefits, medically recovers or returns to work.

In sharp contrast, programs in other countries often pay benefits for so-called short-term disabilities or pay benefits on a partial basis. According to these programs, a person need not be totally disabled to claim benefits, but may receive a partial benefit as a percentage of what they would receive should they be judged to have a total disability.

Initial report presented to RI World Congress in Oslo

The initial reports on the project were presented at the Rehabilitation World Congress 2004 held in Oslo Norway on June 21-23. Todd Honeycutt, research analyst with the Program for Disability Research, presented a summary of the project results, and representatives of three of the participating countries spoke on the disability benefits in their countries: Akira Terashima of Japan, Heini Möller of Sweden and Tone Mørk of Norway. This took place at a parallel academic session, which was very well attended. The audience expressed a great deal of interest in the work of the researchers.

After the reception in Norway, the PDR hoped for an equally enthusiastic response to a planned meeting in Washington, D.C. The event, held July 21-22, 2004 at the Grand Hyatt Washington Hotel, drew approximately 50 invited attendees from throughout the disability community. Representatives from eight of the nine surveyed countries attended, along with those from the United States Social Security Administration, US policy makers, and other members of the disability community. This made for an interesting mix of experience and opinion and facilitated discussion among those interested in the project.

The meeting began with a welcoming reception on Wednesday afternoon. Staff of the PDR and RI gathered to meet with our international guests and other attendees in a relaxed atmosphere. Guests took advantage of the opportunity to network and compare ideas before the work of the meeting began in earnest.

Martin Gerry, Deputy Commissioner of SSA, opens meeting

Thursday's meeting sessions began at 9 A.M. with opening remarks from Martin Gerry, Deputy Commissioner of the Office of Disability and Income Security Programs of SSA; Tomas Lagerwall, Secretary General of Rehabilitation International; Tanya Gallagher of the Disability Research Institute based in Illinois; and Monroe Berkowitz of the PDR. The speakers all expressed their excitement over the opportunity to learn from the data collected in this project, and to share opinions and ideas with such a valuable community of peers.

Four panel discussions

The bulk of the day was divided into four panel discussions on various aspects of the international disability picture. Panel Discussion #1 focused on Permanent Partial Disability Benefits. Moderated by David Dean of the University of Richmond, the panel featured Rienk Prins of the AS/tri research firm in the Netherlands, Chikako Kohyama of Japan's National Organization for Employment of Elderly and Disabled Persons, and Stig Larsson representing the HAREC disability research center in Sweden. Dr. Dean began with a summary of the findings on the systems and effects of partial disability systems. These included the ways in which disability and eligibility for benefits are determined in each country, as well as the effect of partial benefits programs on work force participation. The national representatives then followed up by presenting an overall picture of the disability benefits programs in their respective countries, and time was given for questions and answers.

Sickness and short-term disability benefits

The meeting took a short break before proceeding to Panel Discussion #2 on Sickness and Short-Term Disability Benefits. Todd Honeycutt of the PDR moderated this session, introducing the audience to the definition of short term and sickness benefits used in this project. He discussed the prevalence of such programs and the rates at which they are utilized and covered the various sources of funding used to pay for them, be they social programs or privately financed. He also presented information on the movements toward change in these systems. The moderator's presentation was followed by national summaries of systems change from Prof. Leslie Swartz of the University of Stellenbosch, South Africa and Tone Mørk of the National Insurance Administration of Norway. Ms. Mork's presentation also touched on the fascinating issues involving reintegration of benefits recipients with the work force. As a final note in the second session, Ilene Zeitzer of Disability Policy Solutions in the US presented a comparison of international systems of sickness benefits as well as summarizing the challenges and benefits of such programs.

Time-limited benefits

After lunch, the meeting moved on to Panel Discussion #3 on Time-Limited Disability Benefits. Moderator Sophie Mitra of the PDR introduced the concept of time-limited benefits in both youth assistance programs and national disability benefits programs and shared the findings on this topic from those participating countries that offer these benefits. Following this introduction, Heini Möller of Sweden's National Social Insurance Board presented an overview of the Swedish disability system focused on its activity and sickness programs. Hartmut Haines of the German Federal Ministry of Health and Social Security then offered insight into the German system, and the session concluded with more questions and discussions from the audience.

Future of disability benefits

In the day's final session, Panel Discussion #4 turned the attention to the Future of Disability Benefits. Monroe Berkowitz opened the session with his view of the subject, remarking on the evolution of the United States' disability benefits system to its present state and pointing out the challenges it currently faces. He touched on some of the efforts to address these issues, such as the Early Intervention project that SSA and the PDR are developing as a way to divert disability benefits applicants away from the rolls and back to the work force, but he also acknowledged the possibility of many possible strategies for correcting the problems in the existing system. His presentation focused on the need for policy makers and society itself to break the link between the term "disability" and the concept of an inability to work. Patricia Thornton, disability employment researcher based in the United Kingdom, followed with a British perspective on the issue and researcher Akira Terashima of Urawa University in Japan made the final presentation on the future of disability benefits in Japan. He illustrated the move from a measure-oriented system to a user-oriented system and discussed specifically the issue of whether to connect the award of benefits to rehabilitation or employment.

At the end of the program, attendees expressed appreciation for the opportunity to share this vital information and to open discussion on the lessons each participant nation has to learn from the experiences of the others. The Learning from Others project served as a catalyst to earnest investigation and discussion of the issues involved in social disability insurance programs and has raised additional questions worthy of further study.

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