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80–315 2013

FIFTH IN A HEARING SERIES ON SECURING 

THE FUTURE OF THE SOCIAL SECURITY 

DISABILITY INSURANCE PROGRAM 

HEARING 

BEFORE THE

SUBCOMMITTEE ON SOCIAL SECURITY 

OF THE

COMMITTEE ON WAYS AND MEANS 

U.S. HOUSE OF REPRESENTATIVES 

ONE HUNDRED TWELFTH CONGRESS 

SECOND SESSION 

SEPTEMBER 14, 2012 

Serial No. 112–SS21 

Printed for the use of the Committee on Ways and Means 

( 


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COMMITTEE ON WAYS AND MEANS 

DAVE CAMP, Michigan, Chairman 

WALLY HERGER, California 

SAM JOHNSON, Texas 

KEVIN BRADY, Texas 

PAUL RYAN, Wisconsin 

DEVIN NUNES, California 

PATRICK J. TIBERI, Ohio 

DAVID G. REICHERT, Washington 

CHARLES W. BOUSTANY, JR., Louisiana 

PETER J. ROSKAM, Illinois 

JIM GERLACH, Pennsylvania 

TOM PRICE, Georgia 

VERN BUCHANAN, Florida 

ADRIAN SMITH, Nebraska 

AARON SCHOCK, Illinois 

LYNN JENKINS, Kansas 

ERIK PAULSEN, Minnesota 

KENNY MARCHANT, Texas 

RICK BERG, North Dakota 

DIANE BLACK, Tennessee 

TOM REED, New York 

SANDER M. LEVIN, Michigan 

CHARLES B. RANGEL, New York 

FORTNEY PETE STARK, California 

JIM MCDERMOTT, Washington 

JOHN LEWIS, Georgia 

RICHARD E. NEAL, Massachusetts 

XAVIER BECERRA, California 

LLOYD DOGGETT, Texas 

MIKE THOMPSON, California 

JOHN B. LARSON, Connecticut 

EARL BLUMENAUER, Oregon 

RON KIND, Wisconsin 

BILL PASCRELL, JR., New Jersey 

SHELLEY BERKLEY, Nevada 

JOSEPH CROWLEY, New York 

JENNIFER M. SAFAVIAN, Staff Director and General Counsel 

JANICE MAYS, Minority Chief Counsel 

SUBCOMMITTEE ON SOCIAL SECURITY

SAM JOHNSON, Texas, Chairman 

KEVIN BRADY, Texas 

PATRICK J. TIBERI, Ohio 

AARON SCHOCK, Illinois 

RICK BERG, North Dakota 

ADRIAN SMITH, Nebraska 

KENNY MARCHANT, Texas 

XAVIER BECERRA, California 

LLOYD DOGGETT, Texas 

SHELLEY BERKLEY, Nevada 

FORTNEY PETE STARK, California 


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C O N T E N T S 

Page 

Advisory of September 14, 2012 announcing the hearing .................................... 2 

WITNESSES 

Richard Burkhauser, Ph.D., Professor, Cornell University, Ithaca, New York, 

and Adjunct Scholar, American Enterprise Institute ....................................... 7 

David C. Stapleton, Ph.D., Director, Center for Studying Disability Policy, 

Mathematica Policy Research ............................................................................. 20 

Marty Ford, Director of Public Policy, The Arc of the United States, on 

behalf of the Consortium for Citizens with Disabilities Social Security Task 

Force ...................................................................................................................... 33 

Daniel Bertoni, Director, Education, Workforce, and Income Security, Government Accountability Office .................................................................................. 44 

Jill Houghton, Executive Director, U.S. Business Leadership Network ............. 55 

Nadine Vogel, Founder and President, Springboard Consulting, Mendham, 

New Jersey, on behalf of the Society for Human Resource Management ....... 66 

SUBMISSIONS FOR THE RECORD 

CFE, statement ........................................................................................................ 150 

SSSC, statement ...................................................................................................... 155 

QUESTIONS FOR THE RECORD 

Daniel Bertoni .......................................................................................................... 122 

David C. Stapleton ................................................................................................... 129 

Jill Houghton ........................................................................................................... 140 

Nadine Vogel ............................................................................................................ 143 

Richard Burkhauser ................................................................................................ 145 


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FIFTH IN A HEARING SERIES ON SECURING 

THE FUTURE OF THE SOCIAL SECURITY 

DISABILITY INSURANCE PROGRAM 

FRIDAY, SEPTEMBER 14, 2012 

U.S. HOUSE OF REPRESENTATIVES, COMMITTEE ON WAYS AND MEANS, SUBCOMMITTEE ON SOCIAL SECURITY, Washington, DC. 

The Subcommittee met, pursuant to call, at 9:30 a.m., in Room 

B–318, Rayburn House Office Building, the Honorable Sam Johnson [chairman of the subcommittee] presiding. 

[The advisory of the hearing follows:] 


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HEARING ADVISORY 

FROM THE COMMITTEE ON WAYS AND MEANS 

Chairman Johnson Announces the Fifth in a 

Hearing Series on Securing the Future of the 

Social Security Disability Insurance Program 

Friday, September 7, 2012 

U.S. Congressman Sam Johnson (R–TX), Chairman of the House Committee on 

Ways and Means Subcommittee on Social Security, today announced the fifth hearing in the series entitled ‘‘Securing the Future of the Disability Insurance (DI) Program.’’ This hearing will focus on key challenges facing the DI program and options 

to address those challenges. The hearing will take place on Friday, September 

14, 2012, in room B–318 Rayburn House Office Building, beginning at 9:30 

a.m. 

In view of the limited time available to hear witnesses, oral testimony at this 

hearing will be from invited witnesses only. However, any individual or organization 

not scheduled for an oral appearance may submit a written statement for consideration by the Subcommittee and for inclusion in the printed record of the hearing. 

BACKGROUND: 

The Subcommittee’s hearing series has explored the challenges facing the Social 

Security Disability Insurance (DI) program, including the findings of the 2012 Annual Report of the Board of Trustees that DI revenues will cover only 79 percent 

of benefits beginning in 2016 due to the aging of the baby boomer workforce into 

their most-disability prone-years, the increased number of women in the workforce 

now eligible for benefits should they become severely disabled, decisions made by 

Congress regarding the financing of the DI Trust Fund and the eligibility criteria 

for benefits, and the recent economic downturn. The Congressional Budget Office 

projects that as a result of the recent recession and slow recovery, the number of 

disabled workers will continue to rise over the next few years. 

The Social Security Subcommittee began its five-part series examining the DI program in 2011. The series’ first hearing provided an overview of the program, its history, the importance of its benefits, the growth of the program and the drivers of 

that growth along with the program’s current and future financing challenges. The 

second hearing focused on the Social Security Administration’s program integrity efforts to minimize improper payments and protect taxpayer dollars from waste, 

fraud, and abuse. The third hearing examined how disability eligibility decisions are 

made, including the definition of disability and the Federal-State relationship. The 

fourth hearing considered the Social Security appeals process including its history, 

legal requirements, and whether the current process provides fair, accurate, and 

consistent outcomes while balancing the needs of claimants and taxpayers. 

In the hearing series, many questions have been raised about the current DI program. These include: is the concept of disability that prevailed at the start of the 

program in 1956 still appropriate today given advances in medicine, rehabilitation, 

and the workplace? Are there ways to better support individuals with disabilities 

to stay in the workplace? Can the decision-making process be strengthened so that, 

when appropriate, awards are made as early as possible and decisions on applications and appeals are made with greater accuracy and consistency? 

Increasingly, experts are researching these questions and developing proposed solutions. Employers are also finding new ways to retain in the workforce those individuals with disabilities who want to work. The imminent fiscal challenge facing the 

DI program has made discussion of these issues both relevant and timely for the 

final hearing of this series. 


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In announcing the hearing, Social Security Subcommittee Chairman Sam Johnson 

(R–TX) said, ‘‘We must and we will secure the future of this essential program for the millions of Americans who count on benefits. As we look at 

options to keep that promise, we must balance the needs of those with disabilities with the needs of workers who support the program. Striking that 

important balance will result in a program that makes the right decision 

as soon as possible, supports work, prevents fraud, and treats all workers 

fairly.’’ 

FOCUS OF THE HEARING: 

The hearing will focus on options to address the key structural and fiscal challenges facing the disability program. 

DETAILS FOR SUBMISSION OF WRITTEN COMMENTS: 

Please Note: Any person(s) and/or organization(s) wishing to submit for the hearing record must follow the appropriate link on the hearing page of the Committee 

website and complete the informational forms. From the Committee homepage, 

http://waysandmeans.house.gov, select ‘‘Hearings.’’ Select the hearing for which you 

would like to submit, and click on the link entitled, ‘‘Click here to provide a submission for the record.’’ Once you have followed the online instructions, submit all requested information. ATTACH your submission as a Word or WordPerfect document, in compliance with the formatting requirements listed below, by the close 

of business on Friday, September 28, 2012. Finally, please note that due to the 

change in House mail policy, the U.S. Capitol Police will refuse sealed-package deliveries to all House Office Buildings. For questions, or if you encounter technical 

problems, please call (202) 225–1721 or (202) 225–3625. 

FORMATTING REQUIREMENTS: 

The Committee relies on electronic submissions for printing the official hearing record. As always, submissions will be included in the record according to the discretion of the Committee. 

The Committee will not alter the content of your submission, but we reserve the right to format 

it according to our guidelines. Any submission provided to the Committee by a witness, any supplementary materials submitted for the printed record, and any written comments in response 

to a request for written comments must conform to the guidelines listed below. Any submission 

or supplementary item not in compliance with these guidelines will not be printed, but will be 

maintained in the Committee files for review and use by the Committee. 

1. All submissions and supplementary materials must be provided in Word or WordPerfect 

format and MUST NOT exceed a total of 10 pages, including attachments. Witnesses and submitters are advised that the Committee relies on electronic submissions for printing the official 

hearing record. 

2. Copies of whole documents submitted as exhibit material will not be accepted for printing. 

Instead, exhibit material should be referenced and quoted or paraphrased. All exhibit material 

not meeting these specifications will be maintained in the Committee files for review and use 

by the Committee. 

3. All submissions must include a list of all clients, persons and/or organizations on whose 

behalf the witness appears. A supplemental sheet must accompany each submission listing the 

name, company, address, telephone, and fax numbers of each witness. 

The Committee seeks to make its facilities accessible to persons with disabilities. 

If you are in need of special accommodations, please call 202–225–1721 or 202–226– 

3411 TTD/TTY in advance of the event (four business days notice is requested). 

Questions with regard to special accommodation needs in general (including availability of Committee materials in alternative formats) may be directed to the Committee as noted above. 

Note: All Committee advisories and news releases are available on the World 

Wide Web at http://www.waysandmeans.house.gov/ 

f 

Chairman JOHNSON. We have a short morning this morning, 

and a lot of good testimony to listen to, so we are going to go ahead 


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and get started. Mr. Becerra is on his way, so the committee will 

come to order. 

Welcome to the fifth and last hearing in our series on Securing 

the Future of the Social Security Disability Insurance Program. 

Over the course of the series we have heard about the program’s 

striking and continuing growth at a time when workers paying into 

the system have increased nearly 70 percent between 1970 and 

today. The number of people collecting disability checks has increased by over 300 percent, like from 2.6 to 10.8 million people. 

By 2021 the number of beneficiaries will exceed 12 million and 

total benefits paid will reach over $200 billion. That is a 52 percent increase over the $132 billion paid in benefits last year. We have heard how some of that growth is caused 

by factors like the size of the overall workforce, more women in the 

workforce, and the aging of the baby boomers. And some of the 

growth has been caused by Congress’ decisions that expanded the 

ways in which people could qualify for benefits. 

We have heard about the people who try to defraud the system 

by falsely claiming they are disabled and we have seen some of 

them. We have heard that Social Security’s efforts to conduct continuing eligibility reviews are a shifting priority, adding unnecessary costs and weakening public trust in the program. And we have 

heard how last century’s view of disability hasn’t kept up with this 

century’s advances in medicine, technology, and the workplace, resulting in a program that pays people not to work. 

In fact, GAO has designated the program high risk because the 

medical criteria and occupational information relied on to make 

benefit decisions are out of date. 

And we have heard that the World Health Organization and 

many distinguished medical experts look at disability today as the 

individual’s ability to function in different environments, especially 

with assistance of technology or workplace accommodations for the 

disabled. 

In the hearing series, we have also heard how important it is to 

make the right decision as early in the process as possible. We 

have walked through the complicated lengthy and open-ended initial determination and appeals process that enables claimant representatives to drag out appeals in hope of getting awards. And we 

have heard how outlier judges, many of whom award disability 

benefits in most of the cases they hear, in other words, rubber 

stamping, can’t be managed or questioned about their decisions 

and leaving the process virtually unmanaged and adding more 

costs. 

And we have also heard how the courts have taken it upon themselves to reinterpret Congress’ will, creating inequities and inconsistencies. We have heard again and again that we must keep this 

program strong for those who truly cannot work. And we have 

heard the Disability Insurance Program is on an unsustainable 

path, and that unless Congress acts, in 2016 the program will be 

able to pay only 79 percent of the benefits, putting individuals with 

disabilities at risk. 

The hearing series has been about how the Disability Insurance 

Program works, problems plaguing the program, and the need for 

sensible changes to make it work better. This series has raised imVerDate Mar 15 2010 11:53 May 23, 2013 Jkt 080315 PO 00000 Frm 00008 Fmt 6633 Sfmt 6602 I:\WAYS\OUT\80315.XXX 80315

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portant questions. Is the concept of disability that existed in 1956 

still appropriate today in this 21st century economy? Are there better ways to support individuals with disabilities who can remain in 

the workplace instead of paying them to stop working? And are 

there ways to award benefits sooner and provide a fair, timely appeals process? And finally, what are the risks of doing nothing? 

Today we will hear several views about where the existing system falls short and how it might be fixed as well as some new approaches that are already working. What each of our witnesses has 

in common is they believe we can fundamentally do better, and I 

thank you all for that. 

We will also hear from the business community on the amazing 

success of employers who are hiring those with disabilities and the 

challenges they face keeping those with disabilities in a job. 

I want to thank the members of this subcommittee for engaging 

in this much needed conversation, and I know we are all committed 

to continuing this dialogue. Together, including Mr. Becerra and I, 

we will find answers to securing the future of the Disability Insurance Program for generations to come. 

I now recognize Mr. Becerra for any comments you may have, 

sir. 

Mr. BECERRA. Mr. Chairman, thank you very much and thank 

you to our witnesses for being here. 

Severely disabled American workers have earned the right to receive disability benefits and they rely on them. One hundred sixty 

million Americans contribute to Social Security. They need protection for themselves and their families when they retire, or if they 

should die, they also get the benefits, or if they become disabled, 

severely disabled, they get the benefits. 

It is not easy to qualify for Social Security disability benefits. DI 

is only for people who paid into the system, first; second, it is only 

available to Americans with the most severe impairments, Americans who are dying or who are generally at a point where they 

can’t even earn a poverty level wage at any job in the national 

economy because of a long-term condition. 

Fewer than half of Americans who apply for DI benefits are 

awarded such benefits, even after a lengthy appeals process. DI 

benefits aren’t especially generous. A typical worker receives about 

$13,000 a year which replaces about half the earnings that worker 

had while working. For nearly half of DI recipients, Social Security 

provides 90 percent or more of their total income. 

The Social Security Disability Insurance Trust Fund’s challenge, 

which we are hearing more and more about, is modest and it is stable. Although the Social Security system overall can pay full benefits until 2033, the DI Trust Fund considered on its own is projected to be able to pay only about 80 percent of scheduled benefits 

starting in 2016. Fortunately, the DI shortfall is relatively modest. 

Over the next 75 years, the financing shortfall is equal to about 0.1 

percent of GDP or, to put it in context, that is about one-eighth of 

the cost of extending the Bush tax cuts for people who earn more 

than $250,000 a year. 

The DI shortfall, by the way, is not a surprise. When Congress 

last rebalanced the allocation of payroll taxes going into the two 

Social Security trust funds, it did so knowing that the amount alloVerDate Mar 15 2010 11:53 May 23, 2013 Jkt 080315 PO 00000 Frm 00009 Fmt 6633 Sfmt 6602 I:\WAYS\OUT\80315.XXX 80315

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cated to DI would result in a shortfall in 2016, the same date as 

projected in the most recent trustees report. The recent growth in 

DI is also not a surprise since it is due primarily to demographic 

changes and other predictable factors in combination with, of 

course, the recession. The biggest factor is demographic. The baby 

boom generation has reached its most disability-prone years. More 

women have worked long enough to be protected in the event they 

become severely disabled and can no longer work. Finally, the economic downturn has also made it more difficult for people with disabilities to obtain work. 

I do think it is very important that we operate DI in the most 

fiscally responsible way possible, and we have to here in Congress 

take responsibility for our own actions in how we provide the resources for the Social Security Administration to do its work, both 

as a program for those who are retired and those who are disabled. 

As we work to address the challenges that face us and to strengthen DI for the future, we must first do no harm. 

As we talk about the possible changes to Social Security disability insurance, we should keep in mind that American workers 

have paid for their Social Security benefits. Over its lifetime, Social 

Security has taken in $15.5 trillion and only paid out $12.8 trillion, 

leaving an overall trust fund surplus of $2.7 trillion. Surplus. 

I am concerned that experiments that some would like to perform on the DI program could be harmful to those with severe illnesses or disabilities. They could increase employment discrimination against the disabled, or they might deny or delay earned benefits for those who need them, increasing hardship for already struggling American families. There is little evidence to suggest that 

people who qualify for DI are, in fact, able to work at any kind of 

self-supporting level. 

Mr. Chairman, I hope we can work together on a bipartisan basis 

to strengthen DI, always applying the test that we should first do 

no harm. And with that, Mr. Chairman, I think we have an opportunity to hear from some very important witnesses and I hope that 

we are able to then move forward with that information in a way 

that lets us do right by this important program for so many millions of Americans. 

With that I yield back the balance of my time. 

Chairman JOHNSON. Thank you. 

As is customary, any member is welcome to submit a statement 

for the hearing. Before we move on to our testimony today I want 

to remind our witnesses to please limit your oral statements to 5 

minutes. However, without objection, all of the written testimony 

will be made part of the hearing record. 

We have one witness panel today, and seated at the table are 

Richard Burkhauser, Ph.D., Professor, Cornell University, Ithaca, 

New York and Adjunct Scholar, American Enterprise Institute. 

Thank you for being here. David Stapleton, Ph.D., Director, Center 

for Studying Disability Policy, Mathematica Policy Research; Marty 

Ford, Director of Public Policy, The Arc of the United States on behalf of the Consortium for Citizens with Disabilities Social Security 

Task Force; Daniel Bertoni, Director, Education Workforce and Income Security, Government Accountability Office; Jill Houghton, 

Executive Director, U.S. Business Leadership Network; Nadine 


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Vogel, Founder and President, Springboard Consulting, Mendham, 

New Jersey, on behalf of the Society for Human Resource Management. Welcome to all of you and thanks for being here. 

Dr. Burkhauser, you are recognized. Please go ahead. 

STATEMENT OF RICHARD BURKHAUSER, PH.D., PROFESSOR, 

CORNELL UNIVERSITY, ITHACA, NEW YORK, AND ADJUNCT 

SCHOLAR, AMERICAN ENTERPRISE INSTITUTE 

Mr. BURKHAUSER. Thank you for the opportunity to outline 

the main Social Security Disability Insurance policy reforms contained in my book with Mary Daly. 

The DI program is growing at an unsustainable pace. Unless policy reforms are enacted, the Social Security trustees predict DI will 

be insolvent by 2016. Based on our reading of the evidence the dramatic growth in beneficiaries captured in Figure 1 is not primarily 

the result of factors outside the control of policymakers. Rather, it 

is the consequence of changing eligibility standards and their interpretation by DI gatekeepers, changes that have increasingly turned 

DI into a long-term unemployment program, rather than a last resort income safety net for those unable to work that its founders 

envisioned. 

As can be seen in Figure 1, between 1990 and 2009 Americans 

on the disability rolls more than doubled from 40 to 82 per thousand workers. This troubling statistic is now well-known. What is 

less known is how over this period the Netherlands, once called the 

sick country of Europe for its runaway disability system, initiated 

fundamental reforms that reduced their disability rolls from 110 to 

80 per thousand workers, a ratio that is now below the United 

States’ rate. The Dutch reforms focused on reducing the inflow of 

beneficiaries by making employers more directly bear program 

costs. All Dutch firms must now fund the first 2 years of their 

worker’s disability benefits and pay an experience rated disability 

tax based on the number of their workers who move on to the longterm program. These reforms provide incentives for employers who 

are in the best position to offer accommodation and rehabilitation 

to do so. Most importantly, these reforms led to the development 

of a market for private long-term disability insurance, and more effective case management of impaired workers by private sector 

case managers. It is this early intervention that is credited with 

the significant decline in beneficiaries shown in Figure 1. Importantly, the reduction of new beneficiaries was the result of those 

with disabilities working rather than moving on to other welfare 

programs. 

Currently about one-third of U.S. workers are covered by private 

long-term disability insurance. The question is, how do we get the 

private sector more involved in case management? Rather than 

mandate that all firms provide such coverage we proposed an alternative to better align the public and private costs of long-term disability. 

The United States should stop funding the DI system with a uniform payroll tax and replace it with a tax based on a firm’s experience rating. Doing so would raise the payroll tax of firms whose 

workers enrolled at below-average rates and lower it for firms 

whose workers enroll at low-average rates. Employers who bore the 


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cost of both options would be more incentivized to make investments that clear a work path for their employees following the 

onset of a disability than to push them onto the DI rolls. 

This is currently the system used to fund State Worker’s Compensation benefits. The best practice for these programs could also 

be considered for DI changes. Alternatively, employers who provide 

private disability insurance could be granted a reduction in DI tax 

rates, while firms that could not be charged higher tax rates either—could be charged higher tax rates. Either of these reforms 

would bend the projected cost curve by reducing incentives for employers and employees who overuse the system. 

Current DI policy built on the assumption that disability and employment are mutually exclusive is both archaic and fiscally 

unsustainable. Fundamental reform is needed to restore DI solvency and to support continued employment and greater self-sufficiency among workers with disabilities. Experience rating is the 

key to doing so. It would bring private sector know-how in case 

management to the front end for a more fully integrated disability 

system. 

This is not pie in the sky reform. This is reform that the Dutch 

have already implemented. It is reform that is going on in Sweden, 

and it is reform that is going on in Great Britain. If you look at 

Figure 1, you can’t possibly believe that changes in the health of 

the Dutch and the United States are actually responsible for the 

dramatic changes in the number of people on their disability rolls. 

The Dutch in the 1980s proved that you could put as many people 

on the disability rolls as you are willing to accept by very open 

rules that allowed people to come on who had only 15 percent impairments. We are now having a higher rate than they are in our 

disability system, and we can do better. 

Thank you, Mr. Chairman. 

[The prepared statement of Mr. Burkhauser follows:] 


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f 

Chairman JOHNSON. Dr. Stapleton, you are recognized for 5 

minutes. Thank you. 


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STATEMENT OF DAVID C. STAPLETON, PH.D., DIRECTOR, CENTER FOR STUDYING DISABILITY POLICY, MATHEMATICA 

POLICY RESEARCH 

Mr. STAPLETON. Thank you for the opportunity to testify 

today. I will briefly state and explain my views which have been 

formed over 20 years of conducting research on disability and employment issues. More support for my views can be found in my 

written testimony. 

SSDI is just one component of our Nation’s disability support 

system, albeit a key one. Like many others I think the overall system is failing. There is no easy fix, but there are prospects for systemic reforms that would provide better opportunities for people 

with disabilities to live fulfilling lives, and at the same time reduce 

growth in Federal and State expenditures for their support. Congressional action, however, is required to jump start a process that 

over time could lead to successful restructuring. 

Now, I characterized the disability system as failing because it 

is well documented that economically working age people with disabilities are falling further and further behind their peers without 

disabilities even though taxpayers are paying more and more for 

their support. For over two decades relative employment rate and 

household income of working-age people with disabilities has been 

declining and Federal expenditures to support that population are 

very high and are growing much more rapidly than we would expect based on growth and the size of the workforce and the changes 

in its age and sex composition. In short, taxpayers are being asked 

to pay more and more for a support system that is less and less 

adequate. 

I see two fundamental causes of systemic failure: The first is the 

use of long-term inability to work because of a medically determinable condition as an eligibility criterion for SSDI and SSI. This 

criterion might have made sense in 1956, SSDI’s first year, but in 

today’s world many people with severe medically determinable impairments can, in fact, substantially support themselves through 

work. My guess is that you all know people with such significant 

impairments that they would be eligible for SSDI if they did not 

actually work. And I suspect there are some in this room. They 

likely have high levels of education. They have received excellent 

health care, they use technology and accommodations to greatly 

mitigate their functional limitations, and they have developed 

strong personal support networks, factors that SSA does not, of 

course, routinely consider in its disability determinations. 

The inability to work criterion creates work disincentives for all 

those with qualifying medical conditions or conditions that nearly 

qualify, and fosters long-term dependence on public support. 

The second fundamental flaw with the current policy is program 

fragmentation, as has been amply documented by Dan Bertoni and 

his colleagues at the GAO. The patchwork of Federal and State disability support programs creates pervasive inefficiencies. Among 

these, and there are many, are multiple financial incentives for 

States and others to encourage and help people with disabilities 

apply for SSDI rather than to support work. 

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ities and reduce growth in Federal and State expenditures for their 

support. Such win/win policy reforms would be oriented towards 

helping people with disabilities take advantage, take better advantage of their productive potential rather than undermine their efforts to do so. They would also integrate or better coordinate programs, all in a manner that improves outcomes for people with disabilities and reduces total expenditures for their support. 

Now, that is very fine in theory, but what is the evidence? Is this 

all pie in the sky? In my written remarks, I summarize a growing 

body of evidence that such win/win reforms do exist. Given the evidence, it is not hard to imagine that structural reforms could reduce the percentage of people with disabilities who primarily rely 

on the government for their support by 20 to 25 percent, perhaps 

more, improving their economic well-being at the same time. Unfortunately, however, it is far too risky to institute structural reforms 

on a timetable that would address the pending exhaustion of the 

SSDI Trust Fund based on what we now know. There is a high 

chance that the reforms would make people with disabilities significantly worse off, something that I know nobody wants to do, or 

they might accelerate growth in public expenditures for their support rather than reduce it, or they might do both. 

You know, Congress could pass legislation to put the country on 

a path towards successful restructuring. Structural change requires 

collaboration across agencies and across the corresponding congressional committees. I know that is difficult, but it is not unheard of. 

It has happened before. And it simply has to be done. 

States must also play a significant role. My written testimony 

outlines the elements of legislation that would help move that process forward. 

Today Congress faces very difficult choices with respect to SSDI 

and other programs that provide support to people with disabilities. 

The fundamental problems with the support system make it very 

likely that more difficult choices are in store for future Congresses 

if we don’t quickly start down a path that could lead to win/win 

policy reforms. Hence, I urge you maybe to initiate a process of 

long-lasting fundamental reforms to American disability policies 

and programs. 

Thank you. 

Chairman JOHNSON. We just might do that. Thank you for 

your testimony. 

[The prepared statement of Mr. Stapleton follows:] 


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Chairman JOHNSON. Ms. Ford, you are recognized. 


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STATEMENT OF MARTY FORD, DIRECTOR OF PUBLIC POLICY, 

THE ARC OF THE UNITED STATES, ON BEHALF OF THE CONSORTIUM FOR CITIZENS WITH DISABILITIES SOCIAL SECURITY TASK FORCE 

Ms. FORD. Thank you, Chairman Johnson, Ranking Member 

Becerra, and Members of the Subcommittee, for this opportunity to 

testify and for your attention to this very important disability program. 

SSDI is vital to people who are disabled during their working 

years and to their dependents. Earned benefits targeted to people 

with the most severe disabilities benefits are modest, averaging 

about $1,060 per month. For most people, SSDI benefits are at 

least 75 percent of their income. Along with related Medicare benefits, SSDI provides economic security and plays a vital role in helping people secure housing, food, health care, and other basic necessities. 

Beneficiaries are diverse. They can include a young person with 

severe visual or hearing impairment, or who has had a major head 

injury, or physical trauma, from an accident; a former daycare 

worker, teacher, accountant who has been diagnosed with advanced 

cancer or heart condition or MS; a former construction worker, machinist, salesperson, or nurse aide with a back injury and chronic 

debilitating pain or early onset of Alzheimer’s; a custodian, illustrator, or stock clerk with bipolar disorder, schizophrenia, or intellectual disability. 

Many beneficiaries have had repeated attempts to work, often exacerbating their impairments before finally turning to the Social 

Security system. Most have a combination of adverse vocational 

characteristics such as age, low educational attainment, and declining health. Many beneficiaries are terminally ill; about one in five 

men, and one in seven women die within the first 5 years of receiving benefits. Furthermore, while recent technological advancements 

and stronger civil rights laws have helped many people with disabilities work, others face diminishing opportunities as the modern 

work environment actually becomes more demanding and less forgiving. 

Given the challenges facing people with disabilities, their loss of 

income and often extreme poverty, Social Security is a vital part 

of the solution for them, not the problem. That is why it is so important that any measures to strengthen SSDI be carefully developed, tested, and evaluated to understand the effects on current 

and future beneficiaries. 

The CCD Social Security Task Force has developed principles to 

help guide any reforms to the Social Security system, including 

SSDI. These are outlined in my testimony and we have numerous 

recommendations which I will highlight: Develop a better wage reporting and recording system, and promptly adjust wage—adjust 

benefit payments to reduce overpayments; increase the substantial 

gainful activity level to that of people who are blind; establish an 

earnings offset in the SSDI program; provide a continued attachment to SSDI and Medicare so long as the person remains disabled. This is an element of the Work Incentive Simplification Program, or WISP. Improve the rules for impairment-related work expensed; support and strengthen programs designed to allow flexiVerDate Mar 15 2010 11:53 May 23, 2013 Jkt 080315 PO 00000 Frm 00037 Fmt 6633 Sfmt 6602 I:\WAYS\OUT\80315.XXX 80315

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bility for people who want to return to work, including programs 

authorized under the Ticket to Work Program. Improve opportunities for those who receive disabled adult child benefits; extend 

SSA’s Title II demonstration authority; extend the WIPA and the 

PABSS programs; and provide SSA with adequate resources to 

carry out all necessary program functions. 

Finally, we must secure the long-term financial future of SSDI. 

As chief actuary, Steve Goss testified that major demographic 

shifts, including the aging of the baby boomers and entry of women 

into the workforce in the 1970s and 1980s, explain most of the recent DI program growth and that expansion has been expected for 

decades. Fortunately, these trends are also expected to stabilize 

over the next few years. 

To meet the DI trust fund shortfall in 2016, we urge Congress 

to act expeditiously, as has been done in the past, to reallocate payroll taxes between DI and the OASI programs. Congress has reallocated funds between the two trust funds six times, using a narrow 

definition of reallocation and 11 times using a broad definition. Reallocation is a sensible solution that will maintain the confidence 

of workers in SSDI. 

Americans value Social Security and are willing to pay for it. Reallocation allows time to carefully develop, consider, and evaluate 

options for assuring the long-term solvency of both the OASI and 

the DI trust funds for generations to come. 

Thank you for this opportunity to testify. I look forward to answering any questions. 

Chairman JOHNSON. Thank you, ma’am. I appreciate your testimony. 

[The prepared statement of Ms. Ford follows:] 


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Chairman JOHNSON. Mr. Bertoni, welcome aboard. Please go 

ahead. 


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STATEMENT OF DANIEL BERTONI, DIRECTOR, EDUCATION, 

WORKFORCE, AND INCOME SECURITY, GOVERNMENT ACCOUNTABILITY OFFICE 

Mr. BERTONI. Good morning. Chairman Johnson, Ranking 

Member Becerra, Members of the Subcommittee. Good morning. I 

am pleased to discuss the future of Social Security disability programs, which paid nearly $180 billion to over 14 million individuals 

and their families last year. Given the size and cost of its programs, SSA must have current and appropriate criteria to assess 

whether a claimant’s medical condition precludes work in a national economy. 

In 2003, we designated SSA’s programs high risk in part because 

its programs did not reflect modern concepts of disability, where 

one’s medical condition and work capacity is assessed in conjunction with advances in medicine, technology, and current job demands. 

My remarks today are based on our June 2012 report and focuses 

on steps SSA is taking to modernize its disability determination 

criteria, especially in regard to how claimant’s functional capacity 

and other factors, such as assistive devices and workplace accommodations are considered. 

In summary, SSA has taken concrete steps to incorporate modern concepts into its disability criteria. First, in several areas the 

agency is now giving greater consideration to claimants’ functional 

capacity despite their medical condition to determine whether their 

impairment prevents work. For example, as part of SSA’s revision 

to its medical listings for the immune system the agency included 

several functional criteria, such as performing activities of daily living, maintaining social functioning and completing tasks in a timely manner. 

In general, the SSA officials and experts we spoke with supported incorporating a functional criteria as appropriate to facilitate a more accurate assessment of work disability. However, some 

caution that such an approach could result in more subjective assessments and pose challenges for decisional consistency. 

Despite these concerns, to better inform its efforts and incorporate functional information into it processes SSA is sponsoring 

research through the National Institutes of Health. Of note is an 

ongoing effort to develop a computer-based tool to more rapidly and 

reliably assess claimant function. Agency officials anticipate several benefits from this assessment tool, such as providing more 

timely, accurate, and consistent information on the impact of impairments and one’s ability to work. However, the agency has yet 

to determine when or how this tool will be integrated into its disability determination processes. 

Although these and other actions are promising, SSA has not 

fully incorporated other modern concepts into its disability criteria, 

such as the role of assistive devices and accommodations in mitigating barriers to work. In today’s work environment, assistive devices can help the visually impaired perform various tasks and accommodations such as increased wheelchair accessibility can enhance an individual’s ability to function in the workplace. 

SSA does incorporate assistive devices such as prosthetics for 

walking into the medical listings once they become standard in the 


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medical community, and examiner staff must evaluate a person’s 

ability to function with the devices in place. However, agency officials and other experts expressed concerned about more broadly incorporating such devices when they may not be widely available. 

In regard to workplace accommodations, the agency’s policy is 

not to consider them due to the inability to ensure they are actually being provided by employers or that they are effective. 

Officials were also concerned about the resources required to do 

such assessments, and that data on availability and use of accommodations was lacking. Although giving broader consideration to 

assistive devices and workplace accommodations is difficult, SSA 

may be missing opportunities to move further in this direction, especially for some populations such as young adults. Indeed, some 

have argued that there are common, inexpensive workplace supports to address work disability that can be reasonably incorporated into SSA’s disability criteria. And there may be opportunities for the agency to obtain this information directly from employers as it moves forward in developing its new occupational information system. SSA could also collect such information through its 

disability research consortium which will serve as a national resource for fostering studies on disability policy. 

We recommended that SSA conduct limited, focused studies on 

the feasibility of more fully incorporating certain assistive devices 

and accommodations into its disability determinations. Absent 

studies to ascertain how these tools are playing a role in helping 

individuals with disability stay at work or return to work and their 

cost in comparison to many years of disability benefits, SSA may 

be missing an opportunity to help individuals reengage in the 

workforce and to best target finite program resources. 

Mr. Chairman, this concludes my statement. I am happy to answer any questions you may have. Thank you. 

Chairman JOHNSON. Thank you, Mr. Bertoni. 

[The prepared statement of Mr. Bertoni follows:] 


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Chairman JOHNSON. Ms. Houghton, welcome. Please go ahead. 


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STATEMENT OF JILL HOUGHTON, EXECUTIVE DIRECTOR, U.S. 

BUSINESS LEADERSHIP NETWORK 

Ms. HOUGHTON. Chairman Johnson, Ranking Member Becerra, 

and Members of the Committee, thank you for the opportunity to 

be here today. My name is Jill Houghton. I am the Executive Director of the U.S. Business Leadership Network. We are a business 

network. We are nonprofit. We are nonpartisan, and we promote 

disability inclusion in the workplace, in the marketplace, and in 

the supply chain. Additionally, we run the Nation’s only certification for disability-owned businesses, and we are working with 

corporate America to do business with people with disabilities who 

are entrepreneurs. 

As Executive Director of the USBLN, I am here because our 

businesses, our members are deeply, deeply committed to recruiting, hiring, and retaining employees with disabilities. I should also 

share with you that my testimony is grounded in my personal experience. I ran the Ticket To Work and Work Incentives Advisory 

Panel from 2005 until 2008, when we sunset. I am also married to 

somebody with a spinal cord injury, who is on the Social Security 

Disability Insurance Program and successfully transitioned off the 

rolls. 

While our members are not experts on the Social Security program, one of the things that they firmly believe in is that we as 

a Nation have to move from focusing on disability from a medical 

perspective to focusing on a social perspective, focusing on talent. 

When we go to our members and we ask them if they are interested in hiring people with disabilities, unequivocally the answer 

is yes, but they don’t hire people with disabilities because they 

can’t work, they hire people with disabilities because they have the 

prerequisite skills and the needed supports in order to come in and 

get the job done. 

When we went to our members and we asked them about their 

challenges and their opportunities related to this issue, I will tell 

you that one of the number one issues, once they get over and they 

figure out that this is what they want to do, the question becomes 

where are—where is the supply? We represent the demand side of 

the equation and where is the supply? How do I find people with 

disabilities? And specifically, how do I find college students with 

disabilities? 

So we created a National Student Advisory Council and we became really personally connected to this because one of our student 

leaders, Jimmy Curran, graduated from Temple University with a 

degree in finance. This kid is ready to set the world on fire. This 

is who my members are looking for. And Jimmy got a job as a market research analyst in Pennsylvania with a Blue Cross affiliate, 

and he called me up and he said, hey, I am going to work but he 

needed personal care assistant services. So his private insurance 

wasn’t going to pay for that. So he didn’t know about 1619(b) and 

all of the complicated work incentives and we helped him get connected, and so the good news is, Jimmy is working, and that is the 

good news. The bad news is that unless he gets bumped up to a 

really high level within the company he is going to have to stay at 

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going to become dually eligible. Now, from businesses’ perspective 

we have invested in Jimmy. We want Jimmy. We want to help 

Jimmy grow within the company, but it is going to be a challenge 

and he is going to have to come to making some tough decisions. 

So that is definitely a challenge that we face. 

Other challenges that we face, is there is a myriad of government 

programs out there and nobody knows how to navigate, right? I 

mean, people knock on businesses’ door from, you know, every nook 

and cranny talking about what people can’t do. We don’t want to 

know what people can’t do. We want to know what people can do. 

Certainly, there are challenges that our members hear about. 

They hear about employees that have issues with overpayments, 

that have issues with program eligibility, et cetera. The list goes 

on. 

So where are we succeeding? I will tell you where we are succeeding. We are succeeding because business—companies like 

Walgreens are standing up and making a corporate commitment to 

recruit, to hire, to retain people with disabilities, and they are 

teaching their peers. Countless companies, Lowe’s, Pepsi, Hershey, 

Merck. The list goes on and on and on of companies that are learning from each other that are committed to this. But it is not easy. 

I would tell you that, in conclusion, hiring people with disabilities gives business a competitive advantage. It is an advantage 

that business needs. We represent the demand side of the equation. 

We need the talents, the dedication, and the creativity of people 

with disabilities in the workforce, but equally important is we need 

policies and programs and investments that support this paradigm 

shift from a medical model to one that focuses on talent. 

Thank you. 

Chairman JOHNSON. Thank you, ma’am. I have visited 

Walgreens where they work those people, and there must have 

been 10 of them in there stocking shelves. It is neat to see people 

who are in that situation accomplishing something with their lives. 

It really is. 

[The prepared statement of Ms. Houghton follows:] 


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Chairman JOHNSON. Ms. Vogel, welcome. Please proceed. 


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STATEMENT OF NADINE VOGEL, FOUNDER AND PRESIDENT, 

SPRINGBOARD CONSULTING, MENDHAM, NEW JERSEY, ON 

BEHALF OF THE SOCIETY FOR HUMAN RESOURCE MANAGEMENT 

Ms. VOGEL. Thank you. Good morning, Chairman Johnson, 

Ranking Member Becerra, and distinguished Members of the Subcommittee. My name is Nadine Vogel and I appear before you 

today as a member of Society for Human Resource Management. 

SHRM’s members have a long history of promoting effective employment practices that advance equal opportunity for all people, 

including individuals with disabilities. I commend you for holding 

this hearing on the Disability Insurance Program and thank you 

for the opportunity to testify. 

Mr. Chairman, I am the Founder and President of Springboard 

Consulting in Mendham, New Jersey. At Springboard it is my professional goal to collaborate with organizations that encourage the 

hiring and retention of individuals with disabilities. On a personal 

level, my husband and I are both parents of two children who have 

special needs. I understand firsthand the issues that individuals 

that have disabilities and their families face, but I also understand 

the challenges that employers face in today’s economy. 

Every day in this country employer disability management strategies are helping employees stay on the job and off our strained 

Disability Insurance Program. Employers and HR professionals 

continue, however, to confront persistent gaps between the skills of 

unemployed workers and the skills sought by employers to fill specific positions. 

Recent SHRM research reveals that more than one-half of employers report difficulty recruiting for specific jobs today. Individuals with disabilities can fill these gaps. The challenge for employers is to develop an approach that recruits and retains these talented employees while successfully navigating Federal law and programs. 

In my experience both employers and employees want individuals with disabilities to remain at work or return to work as quickly as possible. The GAO has shown that the longer employees are 

out of work, the less likely they are to ever return. But there are 

many challenges for employers. While numerous Federal statutes 

and programs attempt to provide a transition from disability to 

work for these individuals, taken as a whole, they are very complicated to navigate. 

First, the Social Security Disability Insurance Program has great 

merits, but it was not originally created to handle all of the agerelated disabilities that come as a result of people living longer and 

staying in the workplace longer. In addition, the definition of disability for eligibility for SSDI is outdated. It reflects the medical 

model rather than a functional model. Contrary to SSDI definition, 

other Federal statutes use a different definition. At SHRM we prefer the Americans with Disabilities Act, or ADA, definition. It relies 

on the essential functions of the job, what someone can do rather 

than a more general job description or perhaps what they can’t do. 

Then our members report mixed experiences in utilizing the 

Work Opportunity Tax Credit and VOW to Hire Heroes Act Tax 

Credit as well as vocational rehabilitation protection and advocacy 


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for beneficiaries of Social Security and the Ticket To Work programs. Because of the complexity and the paperwork required to 

take advantage of these tax credits and programs, they are more 

geared towards benefiting large employers with HR departments, 

and even then can be extremely overwhelming. Despite the economic and statutory hurdles, employers have found many strategies successful in keeping employees with disabilities at work. 

First, when employers engage an employee early on in the return 

to work process it allows the organization to simultaneously meet 

business needs and reduce the financial impact of a prolonged absence to the employee and their family. 

Second, employers clearly define policies and jobs. Employers 

must ensure that the transition back to work programs have specific written guidelines, light duty, and regular duty job descriptions. 

Third, reasonable accommodations committees, or RACs, are becoming a very effective practice towards ensuring the fair and equitable end-to-end process of someone requesting an accommodation. 

And fourth, employers are providing creative accommodations 

and other simple solutions for these employees such as a keyboard 

tray to reduce carpal tunnel syndrome. Such accommodations can 

include workplace flexibility benefits such as defined flexible work 

schedules and even telecommuting. 

In closing, Mr. Chairman, I want to be clear that while some of 

these suggestions for disability management tactics may work for 

different employers, you know, you have to keep in mind that the 

suggestions here are circumstantial. So there is not one simple onesize-fits-all solution for every employer of every size or, for that 

matter, in every industry. 

Mr. Chairman, again, I thank you, I thank you the subcommittee 

for listening to my perspective, and I am happy to answer any 

questions. 

Chairman JOHNSON. Thank you, ma’am. 

[The prepared statement of Ms. Vogel follows:] 


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Chairman JOHNSON. You know, I have always thought the 

United States was a leader, but some of the testimony we have 

heard makes me feel like we are not doing enough. And I guess the 

question is, how does a program need to change to catch up with 

the world views on disability today? 

Dr. Stapleton, you say the fact that the Disability Insurance 

Trust Fund will be exhausted in 2016 and the erosion of the economic status of people with disabilities are signs of a failing public 

support system for working-age people with disabilities, despite the 

increasing Federal tax dollars that go into it, and you also say that 

the system is failing the taxpayers who pay for it, could you explain why you call it that, and tell me why they exist, if you can? 

Mr. STAPLETON. Sure, I would be happy to do that. This really 

goes back, I think, to things that you said in your opening comments. In 1956, when we established SSDI, it was intended to be 

a medical retirement program for people who were over the—it is 

on. Is that better now? 

Chairman JOHNSON. Yes. 

Mr. STAPLETON. Okay. Sorry. 

Chairman JOHNSON. I could hear you. We will get the cotton 

out of his ears. 

Mr. BECERRA. He needs an assistive device. 

Mr. STARK. You have new batteries. 

Mr. STAPLETON. I am not sure he qualifies. 

Mr. BECERRA. I can guarantee you he doesn’t. 

Mr. STAPLETON. So it was established as a medical retirement 

program for workers over the age of 50. And you know, at that 

time, it was probably pretty reasonable to determine whether 

somebody could continue to work based on their medical conditions. 

A lot has changed since then, and some of those changes are external to the program, advances in medicine and technology and the 

way that we work that are just mind-boggling from the perspective 

of 1956. And that, to my mind, has really made SSA’s task of trying to divide people into people who can work and people who can’t 

work based on medical conditions alone, a fool’s errand. You know, 

it is just if you want to know why that process doesn’t work very 

well, that is the core reason. 

Chairman JOHNSON. Well, dividing it is one thing but some of 

them tried to play the system, too. You know that. 

Mr. STAPLETON. Well, that may well be true. So at the same 

time those trends were occurring, you know, we expanded the 

availability of disability benefits, and the American people are very 

generous. They want to help people with disabilities. And the way 

that we did it, though, was to really expand on what we did with 

SSDI. So first we made it easier for young people to get SSDI benefits either by working a little bit or by becoming eligible as dependents of their parents and the same for disabled widows. And we 

also, you know, we eventually added Medicare benefits to the mix, 

made the benefits more valuable. 

The SSI program started in 1974. We used the same criterion, 

and again, expanded benefits, made Medicaid available to those 

who were on SSI in most States, for almost all people. 

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cant medical conditions do have challenges, they face difficult challenges in their lives, so we have set up a system which serves to 

funnel them into dependence on Federal programs as opposed to 

helping them take advantage of the productive capacity that they 

actually have. 

And so I think, you know, the root of the problem goes back to 

just following along and expanding on what we did in 1956 without 

taking a good look at the structure and thinking about how to 

change it. And as time has passed various things have happened 

that have affected the ability of some people with significant impairments to work. We have had a more competitive economy. We 

have had many recessions and as you know, every time we have 

a recession, a new batch of people comes on to SSDI. And once they 

get on, almost all of them stay there for the rest of their lives or 

until they are earning retirement benefits. So we just keep following people into the programs more and more, and we end up 

having to spend more and more for them. 

So I think, you know, I think in short, we are getting less for our 

money, and not really helping people with disabilities the way that 

we could help them with the same amount of money or even less. 

Chairman JOHNSON. Dr. Burkhauser, could you tell me what 

you think the primary policy goal of the national disability insurance ought to be and what should the taxpayers be paying for with 

their taxpayer dollars? 

Mr. BURKHAUSER. Well, I think the taxpayer should be paying 

for what was originally envisioned by the founders. The DI program should be a last resort income safety net for those unable to 

work. 

Now, in Europe, the way that works is that the government integrates government jobs programs with government transfer programs and they have gatekeepers that try work programs first. 

That is not the way we do business in the United States. We have 

much more faith in the private sector. But we have a DI program 

which basically hands out checks. And we have this very weird system. Think about this. You have to spend 2 years demonstrating 

that you can’t possibly work at any substantial gainful activity before someone in the government tries to help you to work. That 

doesn’t work. That is crazy. You don’t provide help for work after 

someone has proven they can’t work for 2 years. You need that to 

happen beforehand. The people who do that are the private-sector 

employers but they are getting the wrong signals because of the 

way we tax them to provide less training and accommodation than 

they can do. 

The Dutch had the same problem and what they did was to experience rate payroll taxes and require firms to provide the first 2 

years of benefits. That got the attention of the private sector. It is 

nice to say that the private sector takes care of a few people. That 

is good, but it is amazing the private sector how they respond to 

incentives. If you tell them you have got to pay for it if they go onto 

the long-term disability rolls, all of a sudden they will be taking 

care of a lot more people. Only 33 percent of employers now have 

long-term disability programs. I am not saying that we should 

mandate that. That is what some very good economists Autor and 

Duggan out of the Hamilton Group urged. I am suggesting let’s just 


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change the price signals so that people have to pay. When their 

workers go onto the disability rolls they have to pay more if more 

of their workers go on relative to firms that are doing the right 

thing and providing accommodation for them. 

Chairman JOHNSON. Thank you, sir. 

Mr. Becerra, you are recognized for 5 minutes. 

Mr. BECERRA. Thank you, Mr. Chairman. Thank you all for 

your testimony and food for thought. I thank you very much. Is it 

Houghton? 

Ms. HOUGHTON. Houghton. 

Mr. BECERRA. Ms. Houghton, I liked your testimony because 

more than anything else I think you show that there is a lot of energy and enthusiasm to try to make a difference. And I think that 

goes a long way. Much of this is believing in some of these folks 

that they can go back to work and helping inspire them to have 

the confidence to go back to work, and so I hope that you stay in 

touch with us as we try to figure out how to improve the DI system. Anything that you think will work, you know, the best ideas 

that can come from the business community, our business leaders 

who are trying, making the effort to try to get folks into the workforce, the collaborative efforts that can take place between the business community and the Federal Government, please share that. 

And Ms. Vogel, you as well, also expressed some of that. I hope 

that what you will do is push us, push the envelope because what 

we do have to do is figure out a way to partner on this. 

We are entering the stage where that baby boom generation is 

hitting that point where they are most prone to be disabled. And 

that is why I think the chart, Dr. Burkhauser, that you used was 

a bit deceptive. We have twice as many women in the workforce 

today than we had back in 1975 when you start to show an increase in the size of the disability workforce. We have all of those 

baby boomers who in 1975 were babies, young kids, who are now 

at that point where they are either retiring or not able to work because they may have become disabled. And so I think we have to 

look closely because I don’t think anyone here would say that the 

folks that are receiving disability benefits don’t have a disability. 

It is whether they have a disability that would keep them from 

working, and what we have to try to do is help those who should 

be able to work, who with a little bit of incentive, with a little bit 

of confidence, people who say, I trust that you can get back to 

work, I am going to show you that I am committed to you as your 

employer to help you get back to work, can probably inspire some 

of these folks who are probably a little depressed on occasion when 

they can’t get to work to say, you know what, you believe in me, 

I am going to believe in me again. And I think that is where we 

crack this nut which has led to this concern for the Disability Insurance Program. But I hope no one would make the claim that it 

is time to get rid of the Disability Insurance Program because for 

the most part, we need some help for some of these folks. 

So, Ms. Houghton, I wanted to just make sure I am clear, because you pointed out the case of a young man who has got some 

real opportunities, but most of the folks who apply for disability insurance benefits don’t even have a high school diploma. Right, my 

understanding is—statistics I am looking at her—is two-thirds of 


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DI beneficiaries have only a high school diploma or less. So they 

are not as fortunate. They haven’t been to the point where they 

have that college degree. 

Nearly 70 percent of disability beneficiaries are 50 years or older, 

so they are not at the very beginning of their work career. These 

are folks who are in the sunset of their work career and, as we 

know, even Americans who are not disabled who are over 50 are 

having a hard time today getting a job because the market is very 

tough. And so I think we have to remember that this is a population that has a disability severe enough that in many cases, as 

I think Miss Ford mentioned, many of them die within a few years 

of applying for the benefit. These are not folks who would just need 

to have a computer, you know, typing tray so they can avoid carpal 

tunnel syndrome. These are folks who in a few years may not even 

be on this Earth. And so what we are trying to do is pick out the 

ones that while they have a severe disability we think with a little 

bit of accommodation, and I think Mr. Bertoni, your testimony was 

essential here because you pointed out how modern science, technology has made things possible today that 30 years ago we 

couldn’t have done. And the only proof you need to see is our 

wounded warriors who are coming back and doing remarkable 

things having been maimed and injured in so many different and 

grievous ways. 

Mr. Bertoni, let me make sure. GAO we rely on to give us the 

scoop on this stuff, the facts. We are talking about folks who are 

disabled, right. There is no question these are folks who are disabled in some capacity. 

Mr. BERTONI. Correct, for the most part. Obviously, there are 

folks who get in under certain means that aren’t, but that is on the 

margins. 

Mr. BECERRA. And so it is now an issue of how do we make the 

Social Security Administration, working with this Disability Insurance Program, be as effective as possible partnering with the business community to try to make sure that we can transition those 

who still have the capacity to work to get them back to a job. Part 

of it is the training and education that might be necessary to get 

some of these folks who are disabled, a spinal problem, but yet still 

able to do a number of things, back into the workforce. So part of 

this will involve more than just Social Security. It is going to involve the workforce training aspect of what government working 

with the private sector can do. And so I hope what you will do is 

continue to give us information about how there are opportunities 

where we can partner with the business sector to make sure that 

technology and training will get some of these folks back to work. 

Mr. BERTONI. Sure, this must be a partnership. It is not all 

about the Social Security Administration. There are many entities 

in government, State and local, that can help in this effort, as well 

as the business community. What I just heard is that the focus on 

capacity versus incapacity, and a cultural shift that return to work 

and stay at work is not only socially, but economically beneficial to 

individuals as well as employers. That is something that we need 

to sort of move further in that direction. 

Mr. BECERRA. Thank you, Mr. Chairman. I yield back. 


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Chairman JOHNSON. Thank you. Mr. Berg, you are recognized 

for 5 minutes. 

Mr. BERG. Thank you, Mr. Chairman. I thank the panelists for 

being here. I mean, obviously, I look at this chart and, you know, 

we need to look at how we do things different. You know, if you 

say 1956 was when the system was set up, that was 56 years ago. 

I mean, clearly things have changed dramatically. In our own State 

we looked through WSI, or Worker’s Compensation, and we actually found one of the huge successes is when there was an injury 

empowering the employer to identify it immediately, getting proper 

care, and then keeping that person in that workforce. I mean, here 

is their peers, their friends, and rather than going home or some 

other environment for 30, 60, 90 days or 6 months, we found that 

when you are in that other environment you got used to that and 

that was your normal. And so the idea is to keep them in that 

workplace. 

And so I guess I have a couple of questions, and it is kind of two 

different groups here. There is a group that of course is not in the 

workforce and has disabilities, and we need to, you know, really 

need to look at those, but I am thinking about the ones that are 

in the workforce and, you know, if you could, Dr. Burkhauser, just 

kind of talk and you did touch on that, the incentives. My question 

is, how do we go from here to there without creating an environment where employers are going to say, you know what, I don’t 

want to have to pay an extra tax or penalty here, so I am not going 

to hire someone with a potential disability. So maybe just talk 

briefly about that transition, and then I would like to talk about 

other incentives for people that are new to the workforce with disabilities and how we can create some incentives there. 

Mr. BURKHAUSER. So if you go to an experience rating system, 

which is in fact what you talked about with Worker’s Compensation, you are really encouraging the kinds of things you would like 

to see. You would like to see a safer workplace. You would like to 

see employers that are more likely to provide accommodation or rehabilitation. In my work we have shown, for instance, that workers 

who experience the onset of disability on the job are more likely to 

get an accommodation than workers who experience an accommodation off the job. Why is that, because Worker’s Compensation has 

an experience rating system. The DI system doesn’t. So that is the 

important point. 

But you are absolutely right that this will make employers more 

cognizant of the risks of employing someone with a disability, and 

if they perceive that if you already have a disability you are more 

likely to move on to the disability rolls there could be a problem 

there. So what you can do is you can simply either give employers 

a tax credit for hiring such workers or not have those workers in 

your pool so that it is not included and use those for general revenues. 

So there is a way to get around that problem and I certainly 

agree it is an issue and we should worry about it. But I think the 

important point here is that, I am not talking about pie in the sky 

when I am talking about getting the disability rolls changed. 

In 1981, only 33 percent of people who said they had a work limitation in the data that the current population survey were on the 


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DI rolls; 33 percent. Today, there is no real change in the underlying conditions of these folks, but 52 percent are on the DI rolls. 

And it is not the case that this chart is deceptive, because actually, 

Autor and Duggan, who are at MIT and Princeton, have done work 

looking—and showed that the three points that were made about 

demographics only account for about 25 percent of the rise in DI; 

75 percent is due to the programs changes both in the rules and 

in their interpretation. That is not me. That is the Brookings Institution folks who are saying exactly the same thing. 

Mr. BERG. Ms. Houghton, thanks for your enthusiasm and passion, but also how can we inspire, promote employers to seek out 

workers and incorporate them? Is there some specific thing in addition to what you have already outlined? 

Ms. HOUGHTON. The best thing that we know, the best thing 

that we are finding is that business learns from each other. I 

mean, I think if we look at the tax credits that exist that are already in existence, business isn’t taking advantage of them because 

it is too much government red tape. And so in large part, they are 

going unutilized. So it is definitely something that we need to look 

at. Can we tell you specifically what it needs to be? 

Mr. BERG. Thank you all. I yield back, Mr. Chairman. 

Chairman JOHNSON. Thank you. 

Mr. Stark, do you care to make comments. 

Mr. STARK. Thank you, Mr. Chairman. I thank the panel for 

their interesting observations. I would first of all like to try to 

make it the protocol in this committee—I am not succeeding too 

well—that we strike from our lexicon the word ‘‘disability.’’ There 

are very few people in this world who are breathing and among the 

quick who are disabled. Many of them have disadvantages, and I 

like that so much better. I have a son with a disadvantage, and he 

can explain it to you. And he can explain what he has to do to compensate for it, but under no circumstances would he be considered 

disabled. And I think that is true for almost all except those people 

who are really just in a vegetative state and unable to speak or 

function for themselves. And that isn’t many. I think if we look at 

the disadvantages that they can be overcome, and that, as many 

of you have suggested, employers will find work for them. I think 

Dr. Stapleton mentioned that with the increase in technology we 

are not talking about as many people having to work with their 

backs and their hands, which often is a case where a disadvantage 

can end it, but where people can work with their minds, some people who are mute, some people with sight disadvantages, some people with—all can be put to work using other skills in this day and 

age. 

We have job shortages, and one of the things that we hope is 

that the economy coming back will encourage this. But where we 

come from in California with the tremendous growth there of technical work, I worked for many years with Steve Jobs and worked 

on computer programs that Apple did that actually could help people with autism function in a community. We were just beginning 

when Steve died to deal with dyslexia, and finding ways for people 

there, many of whom we find now we have a Dyslexia Caucus, 

Members of Congress who are dyslexic, and didn’t know it may be 

until they got out of college, or have children, but we have learned 


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to deal with that. And my son with dyslexia can tell you about the 

other brilliant people in the world, Whoopi Goldberg, Charles 

Schwab, the thoracic—head of the thoracic surgeons, these are all 

people with several years ago we thought was a quote ‘‘disability.’’ 

It is not. It is a disadvantage. But as someone, the chairman and 

I, the chairman will catch up with me one of these days, but as you 

learn, after—20 or 30 years after you are past the retirement age, 

you hope that people don’t catch on to what your disadvantages are 

and you can keep functioning. We like our jobs, and so far we have 

fooled the public, and the chairman has done a better job of that 

than I have. So we are still here, and limping or getting along with 

our disadvantage. And I hope, I just hope that all of you will encourage people. Employers will find, and they are not in the business of running charities. They are not going to go out and just 

search for someone just because they happen to be in a wheelchair 

or because they happen to need certain assistance. They want people who can perform and we can provide them. We may have to 

provide some extra education but that saves us all money and it 

gives us real social benefits. 

So I appreciate all of your interest in this and, Chairman, I am 

pleased that you have brought this to our attention because I think 

it is something that deserves much attention both from the government and private industry. Thank you very much. 

Chairman JOHNSON. Thank you, sir. 

Mr. Brady, you are recognized. 

Mr. BRADY. Thank you, Mr. Chairman, thank you for holding 

these series of hearings. The disability program is so important, 

but I don’t think it is just fine. You know, I don’t think just modest 

changes will save this program. I think it is financially flawed. I 

think it is structurally flawed. I think it is operationally flawed, 

and at the heart of it is that we are addressing a 21st century challenge looking at it through a 1950s lens. So much has changed and 

we have to, if we are serious about saving this program, make 

some bold moves, Republicans, Democrats together, to put it on 

sound footing again. 

You know, I think to illustrate the change all of us watched the 

Olympics, watched Oscar Pistorius from South Africa compete 

probably in a way that many disability judges would have said you 

have no chance for significant gainful employment. Here he is competing at the highest level. Not that all of those on disability can 

do that, but it exemplifies what a sea change has occurred. 

You know, I was reading through some of the information we 

had in the report from CBO that makes the point over the last 20 

years, despite the Americans with Disabilities Act, despite equal 

access to employment, all of the reasonable accommodations that 

businesses are making, the strides in medical treatments and surgeries and prosthetics, the fact that we have moved to a service 

economy, seventy percent of the jobs in most of our congressional 

districts are service jobs that pay an average of about $60,000, the 

financial job, Ms. Houghton, you are describing, so these are jobs 

you can raise a family on. Yet, while we have made all of that 

progress and the environment is changing, the employment rate 

among people with disabilities has declined by almost half. So as 

the environment has gotten better at the workplace, the number of 


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those with disabilities who actually find jobs has actually been cut 

in half over 20 years; not just recent periods, 20 years. And many 

of those increasing disability claims are from younger workers with 

either mental or musculoskeletal disorders, which evidence shows 

have the best chance of staying in the workplace. 

So having said all of that, the question is, how do we solve it? 

And with the time I have remaining, Ms. Houghton, you in your 

testimony, you talked about changing the lens of how we look at 

those with disabilities from what you term a deficit-based or medical model to a talent or social model. I don’t understand what that 

means. Can you explain better what it is and how you would apply 

that to a solution on disability? 

Ms. HOUGHTON. Thank you, Mr. Brady. The medical model 

looks at an individual and what they can’t do, so we see that. We 

see that in the media portrayals of people with disabilities, and we 

see it when a person with a disability—when we talk about business hiring people with disabilities and we say that they are doing 

it because it is a nice thing to do. Okay. The social model focuses 

on the talent perspective, and says that the individual is—when 

provided accommodations, when viewed for what they can do, that 

it is about what the person can do and the talent that they bring 

to the job. 

Mr. BRADY. Do you think the system we use today in disability 

reflects that view? 

Ms. HOUGHTON. No, I do not. 

Mr. BRADY. Anywhere close? 

Ms. HOUGHTON. I think we have been talking that the system 

was created in 1956, and that it was a different era; the medicine, 

science, technology was different. 

Mr. BRADY. I think Mr. Bertoni’s point, there has been some 

movement in that direction, but fairly small, so the question I 

would ask, and we are almost out of time, unfortunately, is what 

is the most significant change we could make to actually bring that 

about? 

Ms. VOGEL. I think that there are three changes in particular 

that we want to consider. So from a SHRM perspective, we need 

a harmonization of the various definitions of disability. If you look 

across the ADA, FMLA, everybody has different definitions. I think 

if we can harmonize those definitions and make it simpler, I think 

that is number one. 

Number two, we should look at the interplay of ADA, FMLA, 

Worker’s Comp, allowing ADA to really trump. And the reason, to 

your point, is because that is more about what people can do. How 

do we provide an accommodation so that you can be successful. 

Looking at it from the standpoint of workplace solutions, productivity tools, that is really what an accommodation is. And that is 

that social model. 

And I think the third piece is that we need to find a way to have 

much more aggressive collaboration between the employers and vocational rehabilitation. Voc rehab does not understand employers 

and what their perspectives are on providing services. We need to 

educate both sides, but do it in a way that is collaborative and that 

they are talking to each other on a very regular basis. 


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Mr. BRADY. Can I ask this, Mr. Chairman, I am out of time, but 

can I ask these folks, you know, in your testimony you lay out 

much of that, but if there are some other thoughts we need to have 

as a committee, could you all submit that to us, to Chairman Johnson and Ranking Member Becerra? Would that be okay, Mr. Chairman? 

Chairman JOHNSON. That is a good point, thank you. Mr. 

Marchant, you are recognized. 

Mr. MARCHANT. Thank you, Mr. Chairman. My observation 

after these five hearings, Mr. Chairman, is that SSDI has become 

a destination for many of the workers and they spend 2 years proving through the court system that they are, in fact, disabled and 

cannot work, and then when they get that designation, then it 

opens the door to not a job, not training, but it opens the door to 

qualifying for food stamps. It opens the door for qualifying for assistance with their utilities. It opens the door for subsidized housing, and so all of the doors that seem to get opened once you 

achieve this destination, all of that ends up disincentivizing the 

person to go to work. And then when the person—and I have a 30- 

year old son that is a T–6 paraplegic, has a college education, as 

many training programs as a parent can get their child training 

programs, isn’t designated as SSDI, but goes to a job application 

and finds out that the health care—that the company looks at a 

particular disability and sees, how am I going to put this person 

on my health care? How am I going to accommodate this? And so 

the SSDI designation ends up being that is where you go, that is 

where you stay until you can either go off of it at age 62, or go to 

65, or get to Medicare. And it is just basically, instead of a way station where you go and stay because you need the support system 

there while you are trying to do better and you are trying to get 

a new career, or just start a career, it seems to me that all of the 

disincentives that business would never put into its system exist 

here. And so it is not really a safety net anymore. And the thing 

that is there, and this is for the panel, is there a specific designation that when you qualify for disability, SSDI, there is a specific 

written designation that you get and do you possess that until it 

is taken away from you? Do you have to have that? I know for food 

stamps and utility assistance and stuff like that if you will just 

present that document, I mean, there is no other documentation 

needed. 

Ms. Ford. 

Ms. FORD. Well, as has been stated for the different programs, 

there are different definitions of disability. So, you know, certain 

eligibility will open doors, as you mentioned, for other programs 

but you wouldn’t necessarily have to have SSDI for the other programs. I would mention that when the health exchanges are available in 2014 that may relieve some of the pressure for people to 

go into the SSDI program. We are all sort of waiting to see whether 

that happens, whether people might be able to have their need for 

health insurance or Medicare covered by using the health exchanges in 2014 rather than having to go into the SSDI program 

to get in that doorway after 29 months into Medicare. So that may 

actually be a way to take some of the pressure off the DI program 

in the future. 


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Mr. MARCHANT. What is the amount of money that can be 

earned by someone that qualifies for SSDI outside of that stipend 

per month? Does it fluctuate with the person, or the State, or—— 

Ms. FORD. This is actually one of the proposals that we have. 

We think there should be a way that a person is always better off 

earning money when they are a beneficiary rather than not earning 

money. And that is what happens in the SSI program, but not in 

the DI program and that has been one of our proposals for a couple 

of decades now. But right now, it is the SGA level, the—what is 

it, $1,000, approximately $1,000 a month, and after a trial work period your benefits will end. You will have a certain grace period of 

about 36 months, and those benefits can be reinstated if you stop 

work. It is very complex, and that is the problem. And there are 

lots of people who go into the DI program who need it when they 

need it, but find later that once they have stabilized, once they 

have come to grips with the change in their life, whatever has 

brought them to the DI program, whether it is an illness, an accident, whatever, they come to grips with the changes. They are 

ready to go back to work. They have got the enthusiasm that Jill 

has expressed, and they want to go back to work. But the barriers 

are in their way for, as you are describing, and we need to find a 

way to remove those barriers so that these kinds of technical and 

very complex problems can be done away with. 

Now, Social Security has put forward a proposal that would actually help do that. It is called the Work Incentive Simplification Program, or WISP, that we are encouraging that we should pilot to 

make these work incentives very, very simple so that people don’t 

get caught up in all the worrisome details and they are not afraid 

to go to work and potentially lose a critical support if they fail. So 

that there aren’t complications going back and forth, and that they 

will be better off if they do try to go to work and find out whether 

they can make it. So we think that would be an important work 

simplification and work incentive. 

Mr. MARCHANT. Thank you, Mr. Chairman. 

Chairman JOHNSON. Thank you. Mr. Smith, you are recognized. 

Mr. SMITH. Thank you, Mr. Chairman. Dr. Burkhauser, it appeared you disagreed when Ms. Ford was advocating for the reallocation of funds to the DI trust fund. Would you like to address 

those concerns? 

Mr. BURKHAUSER. I think that simply papering over the problems with DI by borrowing money from the retirement trust fund 

to the DI trust fund really misses the point; that there are real 

things going on that need to be adjusted. So while it is true that 

compared to the problems of the retirement system as a whole, and 

compared to the healthcare system, perhaps a disability system 

would only cost us $120 billion a year isn’t such a big thing. But 

I think it is a big thing and it is a big thing because what we are 

doing is we are actually as Stapleton talked about, we are making 

people with disabilities worse off by the current system that we 

have. We are luring them into a disability program, either SSI or 

DI, that once in the system, as we just heard, it is very difficult 

to come out, very difficult to earn enough money to get around 

that. 


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What we need to do is stop putting people on the disability rolls 

who in fact could work. Stop making them demonstrate that they 

can’t work before we do a Ticket To Work where we are trying to 

provide them with work. What we need to do is figure out how to 

get those people, the early interventions, well before they move on 

to the DI rolls. These are sort of basic points that have to be taken 

care of and they can’t be papered over by a financial trick of moving one trust fund money from one side to the other. 

Mr. SMITH. Thank you. 

Mr. Bertoni, Dr. Stapleton suggests that we do not yet have sufficient evidence to support the detailed structural changes to the DI 

program. Among other things, he proposes pilot projects to get better data and practice as part of a strategy of disability reform. 

What would you say if you could reflect a bit on your perspective 

of Social Security’s track record with conducting demonstration 

projects? 

Mr. BERTONI. I would agree that there needs to be more study 

and analysis of some of these proposals to ensure that we are examining the best of the proposals, what they intend to do, but also 

be cognizant of the potential unintended consequences that can 

occur and get in front of those before we roll out any new system, 

or process. But in terms of SSA’s demonstration authority and 

their track record, we have issued at least a couple of reports on 

this, most recently in 2008, looked at 14 demonstrations that they 

conducted over a period of a decade, and five of those were terminated due to real limitations. Four were completed, and of those 

nine, none of those yielded any policy data that could be useful to 

Congress. The remaining five were ongoing and we certainly had 

some concerns with those. That was at a cost of about $155 million 

with another projected cost of $220 million going forward for the 

remaining five. The key there was that they just didn’t have sufficient protocols and guidance to design, implement, and evaluate 

these initiatives. And as a result, they went by the boards for the 

most part. 

We have recommended that they put some more structure 

around that, especially to protect against sort of changes in the administration, where folks in a new administration might come in, 

terminate perhaps some projects that could have promise, and 

sometimes we found that those terminations were not data driven. 

We really didn’t see a clear rationale. And that is just not good. 

That is just taxpayer money that is not well spent. 

So in terms of track record, not very good. They have instituted 

some recommendations that we have asked them to do. We haven’t 

revisited it. But in our most recent effort to look at their efforts to 

update their medical listings and develop our occupational information system we reported in that report that from a technical standpoint they are pretty thin in terms of expertise and resources to do 

some of these pretty aggressive projects. 

Mr. SMITH. So if we did move forward with a pilot program, 

should Social Security be tasked with such an effort? 

Mr. BERTONI. I think that would depend on what model you 

chose to pursue. It doesn’t necessarily have to be the entity that 

would run these projects. This could be done in other agencies, 

other, you know, other levels of government, States, private sector. 


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So I think it is really you have to think about what you want to 

do, what the elements of that reform system might look like and 

then decide who would be, you know, responsible for the pilot. But 

clearly, if you stay within the confines of the current mouse trap 

and try some things within the current system, SSA would likely 

have a role there. I think they would probably leverage the outside 

research community. 

Mr. SMITH. Thank you, my time is expired. I yield back. 

Chairman JOHNSON. Thank you for your comments. Without 

objection, I would like to insert into the hearing record the recent 

report from the Congressional Budget Office entitled: Policy Options for the Social Security Disability Insurance Program. 

Without objection, so ordered. 

[The prepared report follows:] 


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f 

Chairman JOHNSON. Thank you all for being here today. We 

are going to conclude the testimony because we are on a short fuse 

on the floor, and I want to thank all of you for insightful comments. Thank you so much, and thank our members for participating today. 

I think you are all committed, as I am, to securing the future of 

our disability program. We have got to fix it. That is just one more 

program we have to fix in this government. 

With that, the subcommittee stands adjourned. Thank you all for 

being here. 

[Whereupon, at 11:00 a.m., the subcommittee was adjourned.] 

[Questions for the Record follow:] 


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f 


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f 

[Submissions for the Record follow:] 


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CFE, Statement 


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f 


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SSSC, Statement 


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Æ 


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