Factors Associated with Workforce Participation among SSDI Beneficiaries

Abstract

The Social Security Disability Insurance (SSDI) program provides cash benefits and health insurance to approximately 6.8 million disabled workers and their families, at a total annual cost of about $66 billion (Social Security Administration, 2004). The program has grown rapidly, a trend attributed to various factors, including general population growth (Yeas, 1995), enrollment of workers at younger ages (Rupp & Stapleton, 1995), greater longevity of workers (Riley, Lubitz, & Zhang, 2003), SSA policy changes (Burkhauser, Butler, & Weathers, 2001), and dislocations and transformations of the u.s. labor market (Catalano & Kennedy, 1998; Khan, Gerdtham, & Jansson, 2004; Yelin & Katz, 1994). Once participants enroll in the SSDI program, they tend to stay in the program until they reach age 65 and receive regular retirement benefits. The U.S. General Accounting Office reports that only one-half of one percent of beneficiaries leave the program rolls and return to work (GAO, 2001). This persistently low rate of disenrollment is inconsistent with a growing political consensus, bolstered by survey data, that people with disabilities want to work and, with sufficient support services and adequate opportunities, can work (Kaye, 1997; National Council on Disability, 1997). In 1999, Congress passed the Ticket-to-Work and Work Incentives Improvement Act (TWWIIA, PL 106-170), which mandates a series of program changes to encourage employment among both SSDI beneficiaries and Supplemental Security Income (SSI) recipients. These changes for SSDI beneficiaries included vouchers for rehabilitation services, maintenance of Medicare coverage for working beneficiaries, and a streamlined re-enrollment process (SSA, 2001). The economic ramifications of such efforts are significant: doubling the small proportion of SSDI beneficiaries who return to work (e.g., from 0.5% to 1%) would return billions to the Social Security trust fund (GAO, 1999). Kennedy, Olney and Schiro-Geist (2004) using data from the 1994 and 1995 National Health Interview Survey (NHIS) disability supplement, found that about 9.2% of SSDI beneficiaries reported being employed, and another 1.3% reported looking for work. This paper uses data from the 2001 and 2002 NHIS to investigate the intensity (hours per week) and duration of employment among SSDI recipients, and identify factors associated with employment. While the SSA has regularly monitored work among SSI beneficiaries (SSA, 2000), little comparable data has been available for working SSDI beneficiaries. This study roughly mirrors the published SSA reports on working SSI beneficiaries. Prior research has identified a core set of person-level factors associated with workforce and program participation (e.g., Bound, Cullen, Nichols & Schimdt, 2001; Favreault, 2002; GAO, 1998; Gruber & Kubik, 2002; Kruse, 1997; Mitchell & Phillips, 2002; NASI, 1996; RTI, 2000; Schechter, 1999; Stern, 1989), including age, gender, race, education, income, marital status, health status, chronic condition, and severity of disability. In this study, working and nonworking beneficiaries are compared on each of these factors, and significant factors are included in a multivariate model predicting employment among SSDI beneficiaries. Methods This study is a secondary analysis of the 2001 and 2002 National Health Interview Surveys (NHIS). The NHIS is an ongoing household survey, conducted by the Centers for Disease Control's National Center for Health Statistics (Adams & Benson, 1991; Massey, Moore, Parsons, & Tadros, 1989). Such national surveys offer a timely and cost-effective approach for studying program participation (Apfel, 2000), and have played a crucial role in informing SSA policy. All population estimates were weighted using U.S. decennial census data. Because of the relatively low rates of workforce participation among SSDI beneficiaries, two panels of the NHIS (2001 and 2002) were merged, and the weights were adjusted accordingly. …

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