We estimate a multistage sequential logit model reflecting the structure of the disability determination process of the Social Security Administration (SSA), as implemented by state Disability Determination Services (DDS) agencies. The model is estimated using household survey information exactly matched to SSA records on disability adjudications from 1989 to 1993. Information on health, activity limitations, demographic traits, and work is taken from the 1990 Survey of Income and Program Participation. We also use information on occupational characteristics from the Directory of Occupational Titles, DDS workload pressure, and local area economic conditions from unpublished SSA sources. Under the program provisions, different criteria dictate the outcomes at different steps of the determination process. We find that without the multistage structural approach, the effects of many of the important health, disability, and vocational factors are not readily discernible. As a result, the split-sample predictions of overall allowance rates from the sequential model performed considerably better than the conventional approach based on a simple allowed/denied logit regression.

The GAO convened a 1-day forum on March 16, 2010 to identify public and private sector options for, and the federal government’s role in, assisting adults with disabilities in their efforts to remain employed or return to the workforce. To ensure that they focused on the most important issues, prior to the forum we iteratively surveyed 60 individuals with subject matter or professional expertise to solicit input and help determine the forum’s agenda. Of the 60 survey recipients, 17 were invited to participate in our 1-day forum. Forum participants included federal officials, researchers, disability advocates, and medical and vocational service providers, among others, and as a whole reflected a wide array of sectors, professions, and perspectives.5 Informed by the survey results, and with the help of consensus and facilitation techniques, forum participants fleshed out issues related to providing incentives, services, and cash and health benefits to individuals, and proposed actions related to improving education, tools, and incentives to employers.6 They also discussed the federal government’s role in implementing their proposals and other policies to support individuals with disabilities. This report summarizes key options and issues identified through the forum discussion and surveys we conducted.

Shier, Michael, John Graham, and Marion Jones. "Barriers to Employment as Experienced by Disabled People: A Qualitative Analysis in Calgary and Regina, Canada." Disability and Society; Volume 24, Number 1, January 2009 , pp. 63-75(13).

Despite governmental efforts and organizational initiatives, the number of disabled professionals in full-time employment is small, and the number of those occupying leadership positions remains even smaller. Past research into disability and employment has outlined a range of barriers that disabled people face in seeking and maintaining employment. Yet, not enough is known about the challenges they encounter in top ranking appointments. This article extends Ryan's and Haslam's notion of the glass cliff to help explain the precariousness experienced by a group of disabled employees in leadership positions - focusing on the nature of the positions they hold and the difficulties they encounter as they attempt to advance their careers.

On September 7, 2004, SSA notified Congress of its intent to conduct the national demonstration project. The contract for the national study program design was awarded to Abt Associates on September 30, 2004. In September 2008, SSA concluded the design contract with Abt Associates. The contract for the implementation and evaluation of the project will be awarded in 2009.

This paper develops an approach for tracking medical eligibility for the Social Security Administration's (SSA's) disability programs on the basis of self-reports from an ongoing survey. Using a structural model of the disability determination process estimated on a sample of applicants, we make out-of-sample predictions of eligibility for nonbeneficiaries in the general population. This work is based on the 1990 panel of the Survey of Income and Program Participation. We use alternative methods of estimating the number of people who would be found eligible if they applied, considering the effects of sample selection adjustments, sample restrictions, and several methods of estimating eligibility/ineligibility from a set of continuous probabilities. The estimates cover a wide range, suggesting the importance of addressing methodological issues. In terms of classification rates for applicants, our preferred measure outperforms the conventional single variable model based on the "prevented" measure.

Under our preferred estimate, 4.4 million people—2.9 percent of the nonbeneficiary population aged 18–64—would meet SSA's medical criteria for disability. Of that group, about one-third have average earnings above the substantial gainful activity limit. Those we classify as medically eligible are similar to allowed applicants in terms of standard measures of activity limitations.

This paper presents the social and demographic characteristics of those disability claimants whose cases go to hearing. Particular attention is given to how these characteristics may be related to (1) the individual decision to contest a denial or accept it; (2) the general increase in disability claims and contested applications in recent years; and (3) the high proportion of reversals in hearings.

Employer views of people with disabilities and vocational rehabilitation programs have evolved along with societal views of disability and legislative initiatives to prevent employment discrimination. This article discusses relevant literature on these employer perspectives, relates these perspectives to an evolving paradigm of dual customer and demand-side job development, and discusses the implications of these perspectives for job development practice, especially as they relate to facilitating job development with job seekers who have requirements for unusual or extensive accommodation and support.

According to a report by the Washington State Department of Social and Health Services Research and Data Analysis Division, participants in Healthcare for Workers with Disabilities, Washington’s Medicaid Buy-In program, demonstrated improved outcomes in the year following enrollment compared to similar non-participants. Highlights include:

• Employment. HWD participants with prior coverage are working 193 hours more per year than their counterparts, and people without prior Medicaid coverage worked 414 hours more than their counterparts.
• Earnings. In the year following enrollment participants with prior coverage earned an annual average of $1,190 more than their counterparts, and participants without prior coverage earned an average of $5,269 more than their counterparts.
• Self-Sufficiency. Participants are paying health insurance premiums, contributing more in taxes, and relying less on food stamps.

The study remains in the field for 3-1/2 years, and a final report is expected in February 2011.

Disability benefit recipiency rates have increased in a majority of OECD countries, particularly among women, young adults and individuals with mental health problems. While health problems appear to be important drivers of the inflow into disability benefits, other individual and work-related factors matter for both retention of workers and entry into disability benefits. Disability recipiency rates are also found to vary across countries, partly because of different economic and labour market conditions but mainly because of wide differences in disability policy. Indeed, new OECD indicators of disability policy reveal a diversity in both the generosity aspect and the employment integration component of disability policy. At the same time, most countries have tightened access to benefits in the last decade while improving employment integration. This is a promising development because there is evidence that more generous disability policy is associated with higher numbers of beneficiaries while more comprehensive employment and rehabilitation programmes are associated with lower recipiency rates.

This study examines the effects of socio-economic, attitudinal, and support-related variables on the employment status of young adults with disabilities who participate in community-based and facility-based work settings. It was based on a nationally representative sample of 1,899 young adults with disabilities, ages 18 to 26, from White, Black/African-American, and Latino backgrounds living in the U.S. Secondary analyses of the data showed that race/ethnicity, gender, education, socioeconomic level, perception of disability by respondents and family members, and the availability of formal (e.g., vocational rehabilitation service) and informal supports (e.g., family/friends) are significantly related to community-based employment. The results suggest that non-White young adults with disabilities are less likely to be employed in a community-based setting, compared with their White peers, even after controlling for other variables. The need for more effective policies and programs to support successful transition into community-based employment for members of ethnic and racial population groups is discussed.

This document identifies collaborative strategies states have implemented to address the needs of students with disabilities whose IEP transition services specify postsecondary career and technical education, vocational rehabilitation and/or immediate employment upon departure from secondary school.

The article presents the reports of the START-UP/USA project, funded by U.S. Department of Labor, The Office of Disability Employment Policy. The objective of the project was to study the effectiveness of the Federal/State Vocational Rehabilitation Program in supporting self-employment vocational alternatives for individuals with disabilities in the country. The report provides an analysis of self-employment participation and outcomes by individuals with disabilities within the Federal/State Vocational Rehabilitation (VR) System and it also focuses on outcomes in selfemployment. The outcomes are gathered through a longitudinal analysis of closure data contained in the Rehabilitation Services Administration (RSA) 911 Closure Reports for the period covering Fiscal Years 2003-2007.

This paper presents the statistical methods used to estimate Medicare costs in the waiting period that were presented in text tables 2–3 of Bye and Riley (1989). The first part describes the development of Medicare utilization equations for each Social Security Disability Insurance (DI) program status group. The second part describes how these equations were used to predict expected costs per month and how the monthly estimates were aggregated to yield estimates of costs in the full 2-year waiting period and in the second year only. Finally, there is a brief discussion of the accuracy of the predictions.

This article reviews and compares disability benefit systems in nine countries—Australia, Germany, Great Britain, Japan, the Netherlands, Norway, South Africa, Sweden, and the United States. It focuses on temporary and partial disability benefit programs and on how such programs may help return persons with disabilities to work. An analysis of the general advantages and disadvantages of temporary and partial disability programs is presented. Specific concerns if such programs were to be implemented in the United States are addressed. Time-limited programs seem to have the potential to improve return to work among persons with disabilities and reduce program costs. Caution is needed in adopting such a program, as implementation would be complex and the employment outcomes of recently adopted time-limited programs overseas are yet to be evaluated. In contrast, the study found that partial disability benefit programs are complex to administer and appear to offer little potential to encourage return to work.

The Social Security Administration (SSA) is funding Youth Transition Demonstration (YTD) projects in multiple sites across the country. These projects seek to improve transitions to adulthood for youth whose disabilities are so severe that they either are currently receiving Supplemental Security Income (SSI) or Social Security disability benefits, or are at high risk of receiving them in the future. Youth participating in the projects are eligible for more generous earnings disregards and other incentives under SSA waivers of certain disability program rules. In addition, the projects provide them with individualized employment and benefits planning services. The waivers and services are designed to increase the likelihood that the YTD participants will become employed, earn enough to reduce their disability benefits, and eventually leave the disability rolls. Under contract with SSA, Mathematica Policy Research, Inc. is conducting a rigorous random assignment evaluation of six of the demonstration projects. Approximately 880 youth at each site who agree to participate in the evaluation are being randomly assigned to treatment or control groups. The treatment group members are eligible for the SSA waivers and YTD services; the control group members are eligible for neither, but they can receive standard disability program work incentives and whatever alternative services may be available in their communities. Mathematica is gathering data on the treatment and control group members for up to four years following random assignment through surveys and SSA administrative records. By comparing mean values of outcomes such as earnings and disability benefit amounts for the treatment and control groups, the evaluation will assess whether the YTD projects are successful at improving transitions to adulthood. Findings from the evaluation will be presented in site-specific interim reports in 2010–2012 and in a comprehensive final report in 2014.

US and UK Routes to Employment: Strategies to Improve Integrated Service Delivery to People with Disabilities aims to identify strategies that employment services in both countries have used in the delivery of services to meet the more complex employment support needs of people with disabilities within systems designed for the "universal" job seeker, and to investigate the extent to which these strategies are effective in reaching their goal. The strategies discussed are:

• Proactively reach out and market to people with disabilities to increase access to employment programs and services.
• Create universally accessible and customer-friendly environments for direct employment service delivery.
• Provide specialist support to people with disabilities as needed.
• Train staff on disability and related issues to build organizational capacity to better serve people with disabilities.
• Calculate whether people with disabilities would be better off working and give advice on work incentives to help them overcome financial worries about returning to work.
• Provide supports to help people with disabilities do their jobs and stay in work.
• Measure the effectiveness of job finding for people with disabilities to continuously improve employment service delivery.
• Engage disability organizations in direct employment service delivery.
• Partner with other service providers and share resources to provide more comprehensive employment service delivery but also prevent duplication.
• Understand employers' needs as an essential part of the process of finding jobs for people with disabilities.
• Intervene early to help prevent people going onto long-term disability benefits from becoming disconnected from the labor market.
• Help people to understand and manage their disability or health condition so that they are in a better position to obtain and keep employment.

The sixth policy brief in a Mathematica series on working with disability looks at the Demonstration to Maintain Independence and Employment (DMIE), which allows states to provide Medicaid-equivalent or “wrap-around” coverage to supplement existing health insurance for workers with potentially disabling conditions. The brief reviews the rationale for the DMIE and describes programs and participants in four states—Hawaii, Kansas, Minnesota, and Texas.

This report presents recommendations that call for partnerships among federal departments and agencies, their State counterparts, and the private sector, including organizations involved with education/training, health care, and employment services. NCD calls for policymakers at all levels of government to proactively address these shortages and examine how labor market changes are driving both current and future supply.

Some of those recommendations include:

– Establish a mechanism to track ongoing economic, social, labor market, and professional developments so that new information can be used to redirect planning and actions in support of the disability services infrastructure.

– Establish systematic efforts to acquire information on the supply of infrastructure workers.

– Ensure that partnership opportunities are encouraged between the public and private sectors.

– Promote opportunities to encourage new entrants into critical infrastructure occupations, such as home health aide, personal care assistant, mental health worker, and rehabilitation counselor.

To further the President’s New Freedom Initiative goal of increasing employment of individuals with disabilities, SSA created the Youth Transition Demonstration (YTD). YTD began in 2003 with seven projects in six States. During 2007, SSA piloted new projects in five States, and ultimately choose three new sites for full participation. These sites, which include Florida, Maryland and West Virginia, resumed full operations in Spring of 2008.

The States developed service delivery systems to assist youth with disabilities to successfully transition from school, which may include post-secondary education, to employment and economic self-sufficiency. The States established partnerships to improve employment outcomes for youth ages 14-25 who receive SSI or SSDI payments on the basis of their own disability. The projects provide a broad array of transition-related services and supports to SSI and SSDI applicants and children.