As you know, ERISA plan administrators must consider Social Security Administration (SSA) disability determinations when making the disability benefit decision.
ERISA plan administrators are not bound by the SSA’s determination. But the benefit denial letter should provide an explanation why the SSA determination was not followed. Failure to provide that explanation raises questions whether the adverse benefits determination was ‘the product of a principled and deliberative reasoning process.’
So, it is always worthwhile to see the latest trends in disability findings from the Social Security Administration.
Here’s the “Annual Statistical Report on the Social Security Disability Program” (SSA Pub. No. 1311826, December 2014):
A few highlights:
- 35% of people getting Social Security disability benefits have been diagnosed with a mental disorder.
- Massachusetts and New Hampshire have the highest percentage of individuals with a mental disorder: 49.9%.
- Washington D.C. ranks in the top ten of jurisdictions where disabled beneficiaries have a mental disorder diagnosis.
- Alabama, Georgia, South Carolina, Arkansas and Louisiana have the lowest percentage of disabled with mental health diagnoses (28-30%).
- The total number of SSA disabled beneficiaries has increased 49.7% since 2003.
- The total number of SSA disabled beneficiaries has increased 14.3% since 2009.
- 27.7% of disabled individuals have been diagnosed with musculoskeletal issues.