The Social Security Administration (SSA) recently released the results of a major study on disability and work patterns. The latest in a series of well-crafted, random-assignment demonstrations sponsored by the agency, it sheds light on policy debates between Republicans and Democrats about the underlying work capacity of individual job seekers. of disability benefits.
It also points the way to rethinking federal policy on disability and employment.
The new study, called the Supported Employment Demonstration, seeks to determine whether service interventions can improve labor market success for young adults (that is, under the age of 50). who suffer from mental disabilities.
Individuals in the treatment groups received employment support integrated with behavioral health services. These services and supports, known as the Individual Placement and Support (IPS) model, focus on rapid job placement and removing barriers to employment. The control group received no direct services or support.
An important part of the Supported Employment Demonstration is that it focuses on individuals who are denied Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) disability benefits. Thus, the experiences of the control group illuminate the likely consequences of proposals by Republican leaders and conservative economists to reduce the reach of such programs.
The Trump administration has offered one such proposal that would make it more difficult for older people to qualify for disability, leading to more individuals being denied benefits. Supporters argue that such individuals will find success in the labor market and thus be unaffected.
The Supported Employment Demonstration tells a very different story, however.
In the third year of the study, the average monthly income of individuals in the control group was only $395 – not enough to avoid severe hardship. Bearing in mind that the participants were younger than the targets of the Trump administration proposal and that discouraged workers (ie, those with no interest in finding work) were not included, it is reasonable to expect that the results of The labor market will be even worse under the Trump administration. suggestion.
The apparent confusion among conservatives about the likely consequences of their proposed policies stems from either a lack of understanding or recognition of the severity of the health problems faced by applicants for disability programs. Social Security. When Kentucky Sen. Rand Paul’s 2015 presidential campaign, for example, he told an audience in New Hampshire, “More than half of people with disabilities have anxiety or back pain. Join the group. […]Everyone over 40 has back pain. “
The comments of Sen. Paul shows contempt for a vulnerable group, but also highlights how Republicans are poor empiricists on this issue. Only about 6 percent of the total working-age population in the United States report frequent bouts of depression or anxiety. The number for Social Security disability beneficiaries? 46 percent. And while about 3 percent of the general working-age population reports difficulty walking a distance of three blocks, nearly 3 in 5 disabled Social Security beneficiaries have difficulty with such simple physical task.
Conservatives often emphasize the importance of financial disincentives to disability programs. However, the SSA’s gold-standard random-assignment demonstration found no effect on earnings from the financial incentives included in the benefit rules. Why? Because the fundamental problem facing disabled applicants stems from the way in which severe health problems, directly and indirectly, interfere with every aspect of employment.
Here the Supported Employment Demonstration points to a way to rethink federal policy.
The demonstration treatment groups had higher earnings than the control group. The average monthly income of those who received employment support and behavioral health services was 40-50 percent higher than those who did not receive services – further evidence that individuals with severe problems in health needs services and support to have some success in the labor market. An early demonstration run by SSA, the Mental Health Treatment Study, found services and support increased employment and reduced hospitalizations among Social Security beneficiaries with disabilities.
To be sure, the average monthly income of those receiving Supported Employment Demonstration services is still low, ranging from $553 to $590. This information is important, however, because it challenges the idealized view of jobs and unemployment held by Republicans and Democrats.
In an idealistic view, only full-time employment at a high level of income is considered a successful outcome for the disabled. Rethinking disability and work will allow programs, policies and communication to support different work patterns among people with disabilities, including part-time work, episodic work and less formal work, including volunteering.
SSA should clearly and regularly communicate to disabled beneficiaries that, under current law, SSDI beneficiaries can generally work part-time without stopping or reducing their benefits. Social Security. Policy changes could include updating the amount of earnings that disabled SSI recipients can earn before benefits are reduced (the amount has been frozen at $65 per month for the past five decades ) and exclude all volunteer work from disability decisions (in some cases, the SSA will consider volunteer work equivalent to work for pay).
Finally, SSA should consider reforming the Ticket to Work program. This back-to-work program currently has little or no focus on part-time or episodic work and offers no assistance to denied applicants. It is possible that the program could adopt, as part of its structure, the employment support model tested in the Supported Employment Demonstration and apply the model to beneficiaries and denied applicants.
By rethinking disability and work, the federal government can begin to support all the different work patterns of individuals with serious health problems.
David A. Weaver, Ph.D., is an economist and retired federal employee who has written several studies of the Social Security program. His views do not reflect the views of any federal agency.
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