	Background

DI and SSI—the two largest federal programs providing cash and medical assistance to people with disabilities—grew rapidly between 1985 and 1994, with the enrollment of working-age people increasing 59 percent, from 4 million to 6.3 million, and the inflation-adjusted cost of cash benefits growing by 66 percent. Technological Advances and Social Change Foster Return to Work

While DI and SSI return-to-work outcomes have been poor, many technological and medical advances have created more opportunities for some individuals with disabilities to engage in work. Current Program Structure Impedes Return to Work

The cumulative impact of weaknesses in the design and implementation of the disability programs is to understate beneficiaries’ work capacity and impede efforts to improve return-to-work outcomes. Work incentives are not well understood by beneficiaries and program staff alike. About 70 percent of new awardees are eligible for disability because their impairments meet or equal the listings. Studies have shown that a meaningful portion of DI and SSI beneficiaries possess such characteristics. As mentioned, our review of the disability determination process shows that the work capacity of an individual found eligible for DI and SSI benefits may be understated. Supplemental Security Income: Growth and Changes in Recipient Population Call for Reexamining Program (GAO/HEHS-95-137, July 7, 1995). 2, 1995).
Why GAO Did This Study

GAO discussed Social Security Disability Insurance (DI) and Supplemental Security Income (SSI) program weaknesses that impede the Social Security Administration (SSA) from requiring beneficiaries to work.

What GAO Found

GAO noted that: (1) between 1985 and 1994, the combined DI and SSI beneficiary population increased 70 percent and the cost of cash benefits grew 66 percent; (2) these increases were due to eligibility expansion, program outreach, fewer continuing disability reviews, economic factors, and demographic changes; (3) the beneficiary population is growing younger, and more beneficiaries have long-term impairments; (4) the development of effective return-to-work strategies for people with severe disabilities is challenging because individuals require various levels of support, remedial training, and education; (5) technological and medical advances and economic and social changes have created more potential for some individuals with disabilities to return to work; (6) the SSI and DI benefit structure further complicates disability and work capability determinations; and (7) although SSI and DI 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.