There are a number of criteria an individual must meet to be eligible for DI benefits, including a sufficient work history and a lost capacity to work due to a disability. The trial work period allows DI beneficiaries to work for a limited time without their earnings affecting their disability benefits. The extended period of eligibility begins the month following the end of the trial work period. The two most frequently reported factors—health interventions and encouragement—appear to have been the most critical in helping beneficiaries become employed. Respondents told us they received encouragement from family, friends, health professionals, and coworkers. They were helpful to me in assessing the merits and benefits of potential job offers. . . . I can call him at any time. Role of SSA Work Incentives and Staff Involvement

Based on our discussions with beneficiaries, DI program incentives for reducing risks associated with attempting work appear to have played a limited role in beneficiaries’ efforts to become employed. Moreover, 42 respondents were unaware of the option to purchase Medicare upon leaving the rolls. As a result, some of these beneficiaries may decide to limit their employment for fear of losing health care coverage, while others, planning to leave the rolls, may think they are putting themselves at risk of foregoing health care coverage entirely upon program termination. Moreover, some respondents indicated that SSA suddenly informed them that they needed to repay cash benefits mistakenly paid to them in the past. Among the 44 respondents without employer-based health insurance coverage, 29 plan to stay on the DI rolls into the foreseeable future or are unsure of their future plans. However, changes to work incentives may help some individual beneficiaries or groups of beneficiaries more than others. Moreover, improving the work incentives could also keep some in the program who might otherwise have left. The costs of proposed reforms are difficult to estimate with certainty because of the lack of information on entry and exit effects. Related GAO Products

Social Security Disability Insurance: Multiple Factors Affect Beneficiaries’ Ability to Return to Work (GAO/HEHS-98-39, Jan. 12, 1998). Social Security Disability: Improving Return-to-Work Outcomes Important, but Trade-offs and Challenges Exist (GAO/T-HEHS-97-186, July 23, 1997). 2, 1995).
Why GAO Did This Study

GAO discussed the factors affecting the return to work of the beneficiaries in the Social Security Disability Insurance (DI) program, focusing on: (1) factors that working beneficiaries believe are helpful in becoming and staying employed; and (2) tradeoffs and challenges that exist in improving work incentives.

What GAO Found

GAO noted that: (1) the group of DI beneficiaries interviewed identified a range of factors that enabled them to return to work; (2) factors most prominently cited were an improved ability to function in the workplace as a result of successful health care and encouragement from family, friends, health care providers, and coworkers; (3) on the other hand, DI work incentives--such as purchasing Medicare upon exit from the rolls--and assistance from Social Security Administration staff appeared to play a limited role in helping beneficiaries become employed; (4) a number of respondents said, however, that the provisions that allow them to work for a period of time without losing cash and medical benefits and to retain health care coverage for a limited time period after cash assistance ends were helpful; (5) availability of worksite-based health insurance appears to differentiate respondents who plan to leave the rolls in the future from respondents who plan to stay; (6) in addition, GAO's analysis of some of the proposed changes to work incentives--such as gradually reducing the DI cash benefit level as earnings increase--indicates that there will be difficult tradeoffs in any attempt to change the work incentives; and (7) although GAO's work sheds additional light on this issue, the lack of empirical analysis with which to accurately predict outcomes of possible interventions reinforces the value of testing and evaluating alternatives to determine what strategies can best tap the work potential of beneficiaries without jeopardizing the availability of benefits for those who cannot work.