Social Security

Each week, the Social Security Administration (SSA) pays more than $1 billion in cash benefits to disabled beneficiaries under the disability insurance and the supplemental security income programs. Design and implementation weaknesses, however, have hindered the ability of the programs to return beneficiaries to work. The application process stresses work incapacity and presumes that many medical impairments preclude employment. Also, SSA does little to provide the support and assistance that many disabled persons need to work. Not surprisingly, these program weaknesses have yielded poor return-to-work outcomes and the two programs have not kept pace with changing societal attitudes toward economic self-sufficiency among the disabled. Lessons learned from return-to-work strategies in the private sector and other countries could help federal disability programs return the disabled to productive activity and at the same time reduce the flow of cash benefits.

GAO noted that: (1) design and implementation weaknesses in the DI and SSI programs hinder maximizing beneficiary work potential; (2) the application process places a heavy emphasis on work incapacity and presumes that many medical impairments preclude employment; (3) SSA does little to provide the support and assistance that many people with disabilities need to work; (4) these and other program weaknesses yield poor return-to-work outcomes and mean that DI and SSI have not kept pace with societal trends toward the economic self-sufficiency of people with disabilities; (5) lessons learned from return-to-work strategies and practices now used in the U.S. private sector and in other countries may hold potential for improving federal disability programs by helping people with disabilities return to productive activity and at the same time reduce cash benefits; (6) SSA serves a population with a wide range of disabilities that often may be more severe than the disabilities of the average person served by U.S. private sector programs; (7) SSA may face greater difficulty in returning some of its clients to the workplace; (8) the experiences of the social insurance programs of Germany and Sweden show that return-to-work strategies are applicable to government-scale programs serving a broad and diverse population with a wide range of work histories, job skills, and impairment types; (9) GAO's analysis of practices advocated and implemented by the U.S. private sector and by social insurance programs in Germany and Sweden revealed three common strategies in the design of their return-to-work programs: (a) intervene as soon as possible after an actual or potentially disabling event to promote and facilitate return to work; (b) identify and provide necessary return-to-work assistance and manage cases to achieve return-to-work goals; and (c) structure cash and health benefits to encourage people with disabilities to return to work; (10) disability managers emphasize that these return-to-work strategies are interrelated and work most effectively when integrated into a comprehensive return-to-work program; (11) although SSA faces constraints in applying these strategies, opportunities for better identifying and providing assistance to enable more of SSA's clients to engage in work could be created; (12) if an additional 1 percent of the 6.6 million working-age SSI and DI beneficiaries were to leave SSA's disability rolls by returning to work, lifetime cash benefits would be reduced by an estimated $3 billion; and (13) these reductions would be offset by rehabilitation and other costs that may be necessary to return a person with disabilities to work.