However, the experiences of Germany and Sweden show that return-to-work strategies are applicable to a population with a wide range of work histories, job skills, and disabilities. These efforts include intervening as soon as possible after a disabling event occurs, helping the worker set return-to-work goals, providing the services the worker needs to return to work, and offering incentives that encourage return to work. To develop this information, we (1) identified key practices used by U.S. private sector companies to return disabled workers to the workplace and (2) obtained examples of how other countries’ social insurance programs approach returning people with disabilities to work (discussed in chs. We selected disability programs in Germany and Sweden for review because (1) both countries have political structures and standards of living, including the use of technology, similar to those in the United States, and (2) their disability programs have policies and practices that have been identified by the U.S. private sector and other experts as being key to disability management: early intervention and an emphasis on return to work through the provision and management of services, incentives, and rehabilitation. Most individuals who apply to SSA for disability benefits are not working, but SSA’s focus is not on returning them to work. As mentioned, the respondents indicated they believe it is highly important to structure cash benefits to provide an incentive to return to work; however, we noted that their mean rating for this practice was slightly lower than the mean ratings they gave to other return-to-work practices they considered important, such as maintaining communication, setting return-to-work expectations as early as possible, ensuring that medical service providers understand essential job functions, and providing transitional work opportunities. In line with placing greater emphasis on return to work, we recommend that the Commissioner develop a comprehensive return-to-work strategy that integrates, as appropriate, earlier intervention, earlier identification and provision of necessary return-to-work assistance for applicants and beneficiaries, and changes in the structure of cash and medical benefits.
Why GAO Did This Study

Pursuant to a congressional request, GAO identified: (1) key private-sector practices to return disabled workers to the workplace; and (2) other countries' return-to-work strategies for workers with disabilities.

What GAO Found

GAO found that: (1) U.S. private-sector and foreign return-to-work programs emphasize early intervention to increase workers' motivation to work, setting work goals soon after the disabling event, providing timely rehabilitation services, and having the employer communicate early and often with disabled employees to encourage them to return to work; (2) for individuals who might return to work, disability managers identify and provide specific return-to-work assistance, use case management techniques where appropriate, and ensure that medical personnel are aware of the disabled worker's job functions and the employer's work accommodations; (3) limiting cash benefits and linking retention of medical benefits to employment provides an incentive for disabled persons to return to work; (4) disability managers believe that these return-to-work strategies work most effectively when integrated into a comprehensive program; (5) in contrast, the Social Security Administration (SSA) emphasizes establishing applicants' eligibility for benefits rather than their potential for returning to work and structures cash and medical benefits as disincentives to returning to work; (6) the return-to-work strategies reviewed can be applied to a broad and diverse population with widely varying work histories, job skills, and disabilities; and (7) return-to-work successes could generate significant program savings.