SSA Disability:

Program Redesign Necessary to Encourage Return to Work

HEHS-96-62: Published: Apr 24, 1996. Publicly Released: May 23, 1996.

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Pursuant to a congressional request, GAO provided information on the Social Security Disability Insurance (DI) and Supplemental Security Income (SSI) programs, focusing on program weaknesses that impede the Social Security Administration (SSA) from identifying and expanding beneficiaries' return-to-work capabilities.

GAO found that: (1) between 1985 and 1994, the combined DI and SSI beneficiary population increased 70 percent and the inflation-adjusted cost of cash benefits grew 66 percent; (2) increases were due to eligibility expansion, program outreach, fewer continuing disability reviews, economic factors, and demographic changes; (3) the beneficiary population is also growing younger and more beneficiaries have longer-term impairments; (4) the development of effective return-to-work strategies for people with severe disabilities is challenging because individuals may require various and changing levels of medical intervention or support, remedial retraining, education, or job coaching; (5) technological and medical advances and economic and social changes have created more potential for some individuals with disabilities to engage in work; (6) the SSI and DI benefit structure, their focus on inabilities rather than abilities, and poor access to rehabilitation services further complicate the difficult process of making disability and work capability determinations; and (7) although the programs offer such work incentives as trial work periods, extended eligibility, earned income exclusion, work expense subsidies, continued health insurance coverage, and reentitlement, they are not appropriately designed or implemented to motivate beneficiaries to return to work.

Recommendation for Executive Action

  1. Status: Closed - Implemented

    Comments: SSA has increased access to private vocational rehabilitation (VR) providers and awarded cooperative agreements to 12 states to develop integrated services to assist beneficiaries in returning to work. SSA is also planning to conduct research that will identify potentially eligible disabled populations and interventions that enable continued work effort among these populations. These efforts, however, would have greater impact if the determination process and cash and medical benefits were structured to give beneficiaries greater impetus to use VR services and to attempt work, and if return-to-work assistance were provided earlier in the decisionmaking process. Because SSA has placed greater emphasis on returning disabled beneficiaries to work, GAO is closing this recommendation.

    Recommendation: The Commissioner of Social Security should take immediate action to place greater priority on return to work, including designing more effective means to more accurately identify and expand beneficiaries' work capacities and better implementing existing return-to-work mechanisms. As part of this effort, the Commissioner should develop a legislative package for those areas in which SSA does not currently have legislative authority to enact change in order to position the agency to expeditiously redirect its emphasis on return to work.

    Agency Affected: Social Security Administration


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