Report

By the end of 2010, the Social Security Administration (SSA) expects that more than 3.3 million individuals will have applied for disability benefits on the basis that they have a physical or mental impairment that prevents them from engaging in any substantial gainful activity. SSA uses a screening tool called the Listing of Impairments—known as the Listings—to identify claimants who are so severely impaired that they clearly cannot work at all and thus immediately qualify for benefits. The Listings screen provides many claimants with a quicker decision and saves SSA substantial administrative costs. As such, it is important that the Listings conform to advances in medical treatment and diagnostic methods. SSA asked the IOM to provide guidance on updating the cardiovascular system Listings, which were last revised in 2006.

In this report, the IOM makes several recommendations for improving the cardiovascular system Listings and for improving SSA’s capacity to determine disability benefits more quickly and efficiently. The IOM recommends that SSA revise most Listings to require evidence of serious functional limitations in addition to appropriate measures of cardiovascular impairment. In addition, the IOM identifies several cardiovascular conditions for which new Listings would be beneficial. Finally, SSA should support a full and balanced program of in-house and external research to fill knowledge gaps and to inform future revisions. With these changes, SSA will be able to screen applicants more efficiently and continue to provide assistance to those in need.