SSA Disability:

Return-to-Work Strategies From Other Systems May Improve Federal Programs

HEHS-96-133: Published: Jul 11, 1996. Publicly Released: Jul 11, 1996.

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Robert E. Robertson
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Pursuant to a congressional request, GAO identified: (1) key private-sector practices to return disabled workers to the workplace; and (2) other countries' return-to-work strategies for workers with disabilities.

GAO found that: (1) U.S. private-sector and foreign return-to-work programs emphasize early intervention to increase workers' motivation to work, setting work goals soon after the disabling event, providing timely rehabilitation services, and having the employer communicate early and often with disabled employees to encourage them to return to work; (2) for individuals who might return to work, disability managers identify and provide specific return-to-work assistance, use case management techniques where appropriate, and ensure that medical personnel are aware of the disabled worker's job functions and the employer's work accommodations; (3) limiting cash benefits and linking retention of medical benefits to employment provides an incentive for disabled persons to return to work; (4) disability managers believe that these return-to-work strategies work most effectively when integrated into a comprehensive program; (5) in contrast, the Social Security Administration (SSA) emphasizes establishing applicants' eligibility for benefits rather than their potential for returning to work and structures cash and medical benefits as disincentives to returning to work; (6) the return-to-work strategies reviewed can be applied to a broad and diverse population with widely varying work histories, job skills, and disabilities; and (7) return-to-work successes could generate significant program savings.

Recommendation for Executive Action

  1. Status: Closed - Implemented

    Comments: Since report issuance, SSA has taken a number of steps to enhance its return-to-work efforts. However, it wasn't until recently that the Commissioner developed a comprehensive return-to-work strategy to foster return to work at all stages of the disability determination process. In September 2003, the Commissioner announced an overarching strategic plan to conduct several projects aimed at helping people with disabilities return to work and providing work incentives and opportunities earlier in the process. This plan included earlier intervention demonstration projects to provide necessary medical and cash benefits for applicants, as well as earlier identification and provision of return-to-work assistance for applicants. Additionally, the plan included numerous demonstration projects to test changes in the structure of cash and medical benefits, such as: 1) temporary allowances to provide immediate cash and medical benefits for a specified period to certain applicants; 2) interim medical benefits to provide health insurance coverage to certain applicants throughout the disability determination process; 3) ongoing employment supports to assist beneficiaries to obtain and sustain employment, including a benefit offset demonstration to allow certain beneficiaries to work without total loss of benefits; and 4) ongoing medical benefits to provide ongoing health insurance coverage to certain beneficiaries. These projects are in various stages of implementation.

    Recommendation: In line with placing greater emphasis on return to work, the Commissioner of Social Security should develop a comprehensive return-to-work strategy that integrates, as appropriate, earlier intervention, earlier identification and provision of necessary return-to-work assistance for applicants and beneficiaries, and changes in the structure of cash and medical benefits. The Commissioner should also identify legislative changes needed to implement such a program.

    Agency Affected: Social Security Administration


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