Social Security disability beneficiaries with work-related goals and expectations.

This study examines working-age Social Security Disability Insurance and Supplemental Security Income beneficiaries who report having work goals or expectations, referring to these individuals as "work-oriented." The study uses data from the 2004 National Beneficiary Survey matched to administrative data spanning 2004-2007 to identify work-oriented beneficiaries and to analyze their sociodemographic, health, and employment characteristics, as well as their earnings-related benefit suspensions and terminations. Relative to other disability beneficiaries, the 40 percent classified as work-oriented were younger and more educated, had been on the disability rolls a shorter time, had lower income from public assistance, and were healthier. Just over half had recently engaged in work or in work preparation activities at interview, about half had earnings at some point during 2004-2007, and 10 percent left the disability rolls because of earnings for at least 1 month during that period. The findings show that a large share of beneficiaries have work goals, most are attempting to work, and many experience some success.

Longitudinal outcomes of an early cohort of Ticket to Work participants.

Using 2004-2006 National Beneficiary Survey data matched to Social Security administrative data, we follow a cohort of disability beneficiaries participating in the Ticket to Work (TTW) program for several years to assess changes in their service use, health status, employment, and income. About 20 percent of TTW participants achieved employment at levels that would significantly reduce their disability benefits. Another 40 percent achieved some employment success, but the remaining 40 percent reported no earnings during 2003-2005. Use of TTW support services during 2003-2005 was modest. Many participants experienced significant changes in their health status across survey rounds, which might have affected their ability to actively participate in TTW and to become employed. Many also experienced significant employment and income instability. The findings suggest that employment among TTW participants was associated with reduced poverty.

Employment of individuals in the Social Security disability programs.

The articles in this special issue present findings from research on the employment and work-related activities of individuals receiving benefits through the Social Security Disability Insurance and Supplemental Security Income programs, and on the factors that hinder their efforts to work at levels that lead to exiting the disability rolls. This article introduces the other articles, highlights their important findings, and discusses the implications for ongoing efforts to increase the earnings and self-sufficiency of these beneficiaries, such as the Ticket to Work program and the Benefit Offset National Demonstration.

Health care when workers need it most: before and after entry into the Social Security Disability Insurance Program.

This study analyzed survey data on Social Security Disability Insurance (SSDI) beneficiaries during the six-year window surrounding SSDI entitlement to illustrate changes in characteristics, insurance status, and health care access. We found that SSDI beneficiaries were less likely to be insured than the general working-age population, even three years before SSDI entitlement, and their uninsurance rates remained high until the third year after SSDI entitlement. Health care access problems were reported frequently during all periods surrounding SSDI entitlement, and poverty rates increased markedly post-entitlement. The findings suggest that there are significant gaps in the safety net for disabled workers before, during, and after the transition to SSDI.

Premium increases in state health insurance programs: lessons from a case study of the Massachusetts Medicaid buy-in program.

In March 2003, Massachusetts increased the premiums it charges to most enrollees in its CommonHealth-Working (CH-W) program. This study evaluates the impact of the premium change on disenrollment using a comparison group methodology. The findings indicate that the premium change had only a small, but statistically significant impact on program exits. The CH-W experience differs from other state programs that saw substantial enrollment declines in response to new or increased premiums. This is likely due to factors that make CH-W different from other programs, key of which are administrative procedures intended to minimize disenrollment due to premium nonpayment.

Characteristics of adults with psychiatric disabilities participating in the federal disability programs.

OBJECTIVE: We use nationally representative data on working-age recipients of Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) to profile beneficiaries with psychiatric disabilities and compare them with beneficiaries eligible for SSDI and SSI on the basis of other health conditions. METHOD: Using data from 4 National Beneficiary Survey rounds, we conducted descriptive analyses of the personal and health characteristics and employment experiences of beneficiaries with and without psychiatric disabilities. Our sample includes 16,190 SSDI and SSI beneficiaries, of whom 6,447 have psychiatric disabilities. We conducted statistical tests of significance (χ2 and t statistics) to assess the difference between beneficiaries with and without psychiatric disabilities. RESULTS: Beneficiaries with psychiatric disabilities differ in many ways from other beneficiaries. They are significantly more likely to be younger than 55 years of age, female, have children, be unmarried, live alone, and be in poverty. Although a greater share report a desire to work, they are also more likely than their counterparts with other disabilities to report various employment barriers, including being discouraged by previous work attempts, the perception that others do not think they can work, a lack of transportation, and not wanting to lose cash or health insurance benefits. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: The findings suggest that beneficiaries with psychiatric disabilities face numerous significant employment obstacles that would need to be addressed for supported employment or similar approaches to be successful. (PsycINFO Database Record

Dismantling the poverty trap: disability policy for the twenty-first century.

Working-age people with disabilities are much more likely than people without disabilities to live in poverty and not be employed or have shared in the economic prosperity of the late 1990s. Today's disability policies, which remain rooted in paternalism, create a "poverty trap" that recent reforms have not resolved. This discouraging situation will continue unless broad, systemic reforms promoting economic self-sufficiency are implemented, in line with more modern thinking about disability. Indeed, the implementation of such reforms may be the only way to protect people with disabilities from the probable loss of benefits if the federal government cuts funding for entitlement programs. This article suggests some principles to guide reforms and encourage debate and asks whether such comprehensive reforms can be successfully designed and implemented.