DI and SSI are the two largest federal programs providing cash assistance to people with disabilities. The DI and SSI programs use the same statutory definition of disability. In addition, many technological and medical advances have created more opportunities for some individuals with disabilities to work. Weaknesses in the design and implementation of the DI and SSI programs, summarized in table 1, have impeded identifying and encouraging the productive capacities of those who might benefit from reasonable and appropriate rehabilitation and employment assistance. Social insurance disability programs in Germany and Sweden also invest in return-to-work efforts, and their experiences show that return-to-work strategies can be applied to government-scale programs that serve people with a wide range of work histories, job skills, and disabilities. Our analysis of practices advocated and implemented by the U.S. private sector and other countries reveals three common strategies in the design of their return-to-work programs. Disability managers emphasized that these return-to-work strategies are not independent of each other and are most effective when merged into a comprehensive return-to-work program. Return-to-work strategies and practices may potentially enhance federal disability programs by enabling beneficiaries to work and by helping to reduce program costs. In Germany and Sweden, laws and policies require that an individual’s potential for returning to work be assessed soon after the onset of a disabling condition. Setting return-to-work goals soon after the onset of disability and providing timely rehabilitation services are believed to be critical in encouraging workers with disabilities to return to the workplace as soon as possible. Conclusions

Return-to-work strategies used in the U.S. private sector and other countries reflect the expectation that people with disabilities can and do return to work. If even an additional 1 percent of the 6.6 million working-age beneficiaries were to leave SSA’s disability rolls by returning to work, lifetime cash benefits would be reduced by an estimated $3 billion. These reductions, however, would be offset at least in part by rehabilitation and other costs that may be necessary to return a person with disabilities to work. Although SSA faces constraints and challenges in applying the return-to-work strategies of other programs, opportunities exist for providing the return-to-work assistance that could enable more of SSA’s beneficiaries to reduce or eliminate their dependence on cash benefits. We are sending copies of this report to the Commissioner of the Social Security Administration and other interested parties.
Why GAO Did This Study

GAO updated information in previous reports regarding the Social Security Administration's (SSA) return-to-work program for Disability Insurance (DI) and Supplemental Security Income (SSI) beneficiaries. Although GAO did not independently verify the data used in the analysis of this report, the data cited came from either U.S. government data systems or issue area experts.

What GAO Found

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.