Social Security Disability Insurance:

Multiple Factors Affect Beneficiaries' Ability to Return to Work

HEHS-98-39: Published: Jan 12, 1998. Publicly Released: Jan 12, 1998.

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Jane L. Ross
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Pursuant to a congressional request, GAO reviewed the Social Security Disability Insurance (DI) program, focusing on: (1) the self-reported health and functional status of DI beneficiaries who work while still on the rolls; (2) the occupations, earnings, and benefits of working beneficiaries; (3) factors that working beneficiaries believe were helpful in becoming employed; and (4) working beneficiaries' long-term employment plans, including factors perceived as positively and negatively affecting work plans.

GAO noted that: (1) in general, beneficiaries that GAO interviewed achieved a range of work outcomes--some had substantial attachment to the labor force, and others reported more modest gains; (2) respondents achieved these outcomes despite indicating significant limitations or difficulties associated with their impairments; (3) many respondents rated their disability as severe or somewhat severe, reported experiencing difficulty getting through the work day, and reported having difficulty performing daily tasks and activities; (4) nevertheless, beneficiaries were gainfully employed and, on average, had moderate pay and benefits; most were satisfied in their positions; (5) most beneficiaries GAO interviewed reported that financial need and the desire to enhance self-esteem were the main reasons for attempting work; (6) they indicated that a range of factors enabled them to return to work; (7) those most prominently cited were improved functioning through health care intervention and encouragement from family, friends, health care providers, and coworkers; (8) to a somewhat lesser extent, respondents told GAO that: (a) a flexible work schedule that allowed them to receive health care services; (b) job-related training and vocational rehabilitation services; and (c) high self-motivation also helped facilitate employment; (9) DI work incentives and assistance from Social Security Administration staff appeared to play a limited role in helping beneficiaries become employed, although a number of respondents said the program provision allowing them to work for a period of time without losing cash and medical benefits, as well as the provision to retain health care coverage for a limited time period after cash assistance ends, was helpful; (10) about four of every ten respondents told GAO that they planned to leave the rolls in the future; (11) availability of worksite-based health insurance appears to differentiate respondents who plan to leave the rolls in the future from respondents who plan to stay; (12) many respondents--those planning to leave the rolls as well as those planning to stay--regard their future health status as an important factor affecting their plans; (13) many respondents told GAO they had experienced impediments to employment such as limited skills and training, or employers' not recognizing their ability; and (14) such factors could affect respondents' future attachment to the labor force.

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