Longitudinal Patterns of Disability Program Participation and Mortality Across Childhood SSI Award Cohorts

We follow six cohorts of childhood Supplemental Security Income (SSI) disability awardees for a time horizon up to 30 years, using program records on demographics, type of impairment, SSI and Disability Insurance (DI) recipiency, and mortality. We use descriptive analysis and multinomial logit regression for repeated cross-sections of the six award cohorts, controlling for years since first award. For all award cohorts, many individuals transition from SSI recipiency to DI or nonbeneficiary status. Others die over time. Accounting for DI program participation is necessary to obtain a full picture of disability program participation in adulthood. SSI-only recipiency substantially diminishes in adulthood. However, DI involvement increases. An increasing proportion of individuals receives both benefit types (SSI and DI) as the cohorts age in adulthood. The trajectories of outcomes across successive award cohorts change in important ways. First, we observe a strong trend of increased transitions to nonbeneficiary status among survivors as we move from early award cohorts to later cohorts, with a sharp upward shift around the time of welfare reform in the mid-1990s. Second, the data show a secular decline in mortality across award cohorts. The data suggest that a substantial portion, but not all, of that decline has been affected by the Supreme Court's Zebley decision. Increased incidence of transitions to nonbeneficiary status and reduced mortality across award cohorts have opposing effects on the duration of disability benefit receipt