In this report, we focus on Disability Insurance (DI) and Supplemental Security Income (SSI)—the two largest federal programs providing assistance to people with disabilities. DI and SSI are administered by the Social Security Administration (SSA) with the assistance of state agencies. Caseloads Have Grown Rapidly and Changed Since the Mid-1980s

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. These factors include eligibility expansion; program outreach; fewer continuing disability reviews; and occurrences external to the programs, for example, a downturn in the business cycle and demographic changes. 2.1). Beneficiary Population Presents Return-to-Work Challenges

Developing effective return-to-work strategies for people with disabilities presents challenges to policymakers. Some people may require a one-time medical intervention, while others may need ongoing and changing levels of medical support; some individuals may require remedial retraining, and others may need education and job coaching. Advances Increase Return-to-Work Potential

Although efforts to maximize the work potential of people currently on the disability rolls face many challenges, numerous technological and medical advances and economic changes have created more potential for some people with disabilities to engage in work. DI and SSI Work Incentives Provide Different Benefit Protections

The DI and SSI programs offer a number of work incentives to encourage beneficiaries to return to work. Studies have also found that beneficiaries generally do not understand work incentive provisions.
Why GAO Did This Study

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.

What GAO Found

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.