United States General Accounting Office

GAO Testimony

Before the Special Committee on Aging, U.S. Senate

For Release on Delivery

Expected at

9:00 a.m. EDT,

Wednesday,

June 5, 1996

SOCIAL SECURITY

Disability Programs Lag in

Promoting Return to Work

Statement of Jane L. Ross, Director,

Income Security Issues

Health, Education, and Human Services Division

G O A

years

1921 - 1996

GAO/T-HEHS-96-147

Social Security: Disability Programs Lag in

Promoting Return to Work

Mr. Chairman and Members of the Committee:

You asked us to discuss today ways to improve the Disability Insurance

(DI) and Supplemental Security Income (SSI) programs by helping people

with disabilities return to work. Each week the Social Security

Administration (SSA) pays over $1 billion in cash payments to people with

disabilities on DI and SSI. While providing a measure of income security,

these payments for the most part do little to enhance the work capacities

and promote the economic independence of these DI and SSI recipients. Yet

societal attitudes have shifted toward goals, as embodied in the Americans

With Disabilities Act (ADA), of economic self-sufficiency and the right of

people with disabilities to full participation in society.

At one time, the common business practice was to encourage someone

with a disability to leave the workforce. Today, however, a growing

number of private companies have been focusing on enabling people with

disabilities to return to work. Moreover, medical advances and new

technologies provide more opportunities than ever for people with

disabilities to work.

We found that the DI and SSI programs are out of sync with these trends.

The application process places a heavy emphasis on work incapacity, and

it presumes that medical impairments preclude employment. And SSA does

little to provide the support and assistance that many people with

disabilities need to work. Our April 1996 report shows, in fact, that

program design and implementation weaknesses hinder maximizing

beneficiary work potential.1

 Not surprisingly, these weaknesses also yield

poor return-to-work outcomes. Other work we are doing for you highlights

strategies from the private sector and other countries that SSA could use to

develop administrative and legislative solutions to improve return-to-work

outcomes. Indeed, if an additional 1 percent of the 6.3 million working-age

SSI and DI beneficiaries were to leave SSA’s disability rolls by returning to

work, lifetime cash benefits would be reduced by an estimated $2.9 billion.2

With this in mind, today I would like to focus on how the current program

structure impedes return to work and how strategies from other disability

systems could help restructure DI and SSI to improve return-to-work

1

This testimony is based on SSA Disability: Program Redesign Necessary to Encourage Return to Work

(GAO/HEHS-96-62, Apr. 24, 1996) and a forthcoming GAO report on return-to-work strategies in the

U.S. private sector, Germany, and Sweden.

2

The estimated reductions are based on fiscal year 1994 data provided by SSA’s actuarial staff and

represent the discounted present value of the cash benefits that would have been paid over a lifetime if

the individual had not left the disability rolls by returning to work.

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Social Security: Disability Programs Lag in

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outcomes. To develop this information, we surveyed people in the private

sector generally recognized as leaders in developing disability

management programs that focus on return-to-work efforts. We also

interviewed officials in Germany and Sweden because the experiences of

their social insurance programs show that return-to-work strategies are

applicable to a broad and diverse population with a wide range of work

histories, job skills, and disabilities. We also conducted focus groups with

people receiving disability benefits and convened a panel of disability

experts.

Background DI and SSI—the two largest federal programs providing cash and medical

assistance to people with disabilities—grew rapidly between 1985 and

1994, with the enrollment of working-age people increasing 59 percent,

from 4 million to 6.3 million, and the inflation-adjusted cost of cash

benefits growing by 66 percent. Administered by SSA, DI and SSI paid over

$50 billion in cash benefits to people with disabilities in 1994. To be

considered disabled by either program, an adult must be unable to engage

in any substantial gainful activity because of any medically determinable

physical or mental impairment that can be expected to result in death or

that has lasted or can be expected to last at least 1 year. Moreover, the

impairment must be of such severity that a person not only is unable to do

his or her previous work, but, considering his or her age, education, and

work experience, is unable to do any other kind of substantial work that

exists in the national economy.

Both programs use the same definition of disability but differ in important

ways. DI, established in 1956, is an insurance program funded by payroll

taxes paid by workers and their employers into a Social Security trust

fund. The program is for workers who, having worked long enough and

recently enough to become insured under DI, have lost their source of

income because of disability. Medicare coverage is provided to DI

beneficiaries after they have received cash benefits for 24 months. Almost

4 million working-age people (aged 18 to 64) received about $34 billion in

DI cash benefits in 1994.3

In contrast, SSI is a means-tested income assistance program for disabled,

blind, or aged individuals regardless of their participation in the labor

force. Established in 1972 for individuals with low income and limited

3

Included among the 3.96 million DI beneficiaries are 671,000 who were dually eligible for SSI disability

benefits because of the low level of their income and resources.

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Social Security: Disability Programs Lag in

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resources, SSI is financed from general revenues.4 In most states, SSI

entitlement ensures an individual’s eligibility for Medicaid benefits. In

1994, about 2.36 million working-age people with disabilities received SSI

benefits. Federal SSI benefits paid to SSI beneficiaries with disabilities in

1994 equaled $18.9 billion.5

Caseloads Have Changed

Since the Mid-1980s

The composition of the DI and SSI caseloads has undergone many changes

during the last decade. Between 1985 and 1994, DI and SSI experienced an

increase in the proportion of beneficiaries with impairments—especially

mental impairments—that keep them on the rolls longer than in the past.

By 1994, 31 percent of DI beneficiaries and 57 percent of SSI working-age

beneficiaries had mental impairments—conditions that have one of the

longest anticipated entitlement periods (about 16 years for DI). In addition,

the beneficiary population has become, on average, modestly but steadily

younger since the mid-1980s. The proportion of working-age beneficiaries

who are middle aged (aged 30 to 49) has steadily increased—from 30 to

40 percent for DI, and from 36 to 46 percent for SSI—as the proportion who

are older has declined.

Statute Provides for

Returning Beneficiaries to

Work

The Social Security Act states that as many individuals applying for

disability benefits as possible should be rehabilitated into productive

activity. To this end, people applying for disability benefits are to be

promptly referred to state vocational rehabilitation (VR) agencies for

services intended to prepare them for work opportunities. To reduce the

risk a beneficiary faces in trading guaranteed monthly income and

premium-free medical coverage for the uncertainties of competitive

employment, the Congress also established various work incentives to

safeguard cash and medical benefits while a beneficiary tries to return to

work.

Despite congressional attention to employment as a way to reduce

dependence, few beneficiaries leave the rolls to return to work. During

each of the past several years, not more than 1 of every 500 DI beneficiaries

has been terminated from the rolls because they returned to work.

4

Reference to the SSI program throughout this testimony addresses blind or disabled, not aged

recipients. General revenues include taxes, customs duties, and miscellaneous receipts collected by

the federal government but not earmarked by law for a specific purpose.

5

The 2.36 million SSI beneficiaries do not include individuals who were dually eligible for SSI and DI

benefits. The $18.9 billion consists of payments to all SSI blind and disabled beneficiaries regardless of

age.

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Social Security: Disability Programs Lag in

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Technological Advances

and Social Change Foster

Return to Work

While DI and SSI return-to-work outcomes have been poor, many

technological and medical advances have created more opportunities for

some individuals with disabilities to engage in work. Electronic

communications and assistive technologies—such as scanners, synthetic

voice systems, standing wheelchairs, and modified automobiles and

vans—have given greater independence to some people with disabilities,

allowing them to tap their work potential. Advances in the management of

disability—like medication to control mental illness or computer-aided

prosthetic devices—have helped reduce the functional limitations

associated with some disabilities. These advances may have opened new

opportunities, particularly for some people with physical impairments, in

the growing service sector of the economy.

Social change has promoted greater inclusion of and participation by some

people with disabilities in the mainstream of society, including children in

school and adults at work. For instance, over the past 2 decades, people

with disabilities have sought to remove environmental barriers that

impede them from fully participating in their communities. Moreover, ADA

supports the full participation of people with disabilities in society and

fosters the expectation that people with disabilities can and have the right

to work. ADA prohibits employers from discriminating against qualified

individuals with disabilities and requires employers to make reasonable

workplace accommodations, unless it would impose an undue hardship on

the business.

Current Program

Structure Impedes

Return to Work

The cumulative impact of weaknesses in the design and implementation of

the disability programs is to understate beneficiaries’ work capacity and

impede efforts to improve return-to-work outcomes. Despite a changing

beneficiary population and advances in technology and medicine that have

increased the potential for some beneficiaries to work, the disability

programs have remained essentially frozen in time. Weaknesses in the

design and implementation of the DI and SSI programs, summarized in table

1, have impeded identifying and encouraging the productive capacities of

those who might benefit from rehabilitation and employment assistance.

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Social Security: Disability Programs Lag in

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Table 1: Summary of Program Design

and Implementation Weaknesses Program area Weakness

Disability

determination

“Either/or” decision gives incentive to promote inabilities and

minimize abilities.

Lengthy application process to prove one’s disability can erode

motivation and ability to return to work.

Benefit structure Cash and medical benefits themselves can reduce motivation to

work and receptivity to VR and work incentives, especially when

low-wage jobs are the likely outcome.

People with disabilities may be more likely to have less time

available for work, further influencing a decision to opt for benefits

over work.

Work incentives “All-or-nothing” nature of DI cash benefits can make work at low

wages financially unattractive.

Risk of losing medical coverage when returning to work is high for

many beneficiaries. 

Loss of other federal and state assistance is a risk for some

beneficiaries who return to work.

Few beneficiaries are aware that work incentives exist.

Work incentives are not well understood by beneficiaries and

program staff alike.

VR Access to VR services through Disability Determination Service

(DDS) referrals is limited: restrictive state policies severely limit

categories of people referred by DDSs; the referral process is not

monitored, reflecting its low priority and removing incentive to

spend time on referrals; VR counselors perceive beneficiaries as

less attractive VR candidates than other people with disabilities,

making them less willing to accept beneficiaries as clients; and the

success-based reimbursement system is ineffective in motivating

VR agencies to accept beneficiaries as clients.

Applicants are generally uninformed about VR and beneficiaries

are not encouraged to seek VR, affording little opportunity to opt

for rehabilitation and employment.

Studies have questioned the effectiveness of state VR agency

services since long-term, gainful work is not necessarily the focus

of VR agency services.

Delayed VR intervention can cause a decline in receptiveness to

participate in rehabilitation and job placement activities, as well as

a decline in skills and abilities.

The monopolistic state VR structure can contribute to lower quality

service at higher prices, and recent regulations allowing alternative

VR providers may not be effective in expanding private sector VR

participation.

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Work Capacity of DI and

SSI Beneficiaries May Be

Understated

The Social Security Act requires that the assessment of an applicant’s

work incapacity be based on the presence of medically determinable

physical and mental impairments. SSA maintains a Listing of Impairments

for medical conditions that are, according to SSA, ordinarily severe enough

in themselves to prevent an individual from engaging in any gainful

activity. About 70 percent of new awardees are eligible for disability

because their impairments meet or equal the listings. But findings of

studies we reviewed generally agree that medical conditions are a poor

predictor of work incapacity.6

 As a result, the work capacity of DI and SSI

beneficiaries may be understated.

While disability decisions may be more clear-cut in the case of people

whose impairments inherently and permanently prevent them from

working, disability determinations may be much more difficult for those

who may have a reasonable chance of work if they receive appropriate

assistance and support. Nonmedical factors may play a crucial role in

determining the extent to which people in this latter group can work.

Program Weaknesses

Impede Efforts to Improve

Return-to-Work Outcomes

The “either/or” nature of the disability determination process creates an

incentive for applicants to overstate their disabilities and understate their

work capacities. Because the result of the decision is either full award of

benefits or denial of benefits, applicants have a strong incentive to

promote their limitations to establish their inability to work and thus

qualify for benefits. Conversely, applicants have a disincentive to

demonstrate any capacity to work because doing so may disqualify them

for benefits. Furthermore, the documentation involved in establishing

one’s disability can, many believe, create a “disability mind-set,” which

weakens motivation to work. Compounding this negative process, the

length of time required to determine eligibility can erode skills, abilities,

and habits necessary to work.

In addition, work incentive provisions are complex, difficult to

understand, and poorly implemented. SSA does not promote them

extensively, and as a result, few beneficiaries are aware that work

incentives exist. Despite providing some financial protection for those

who want to work, work incentives do not appear to be sufficient to

overcome the prospect of a drop in income for those who accept low-wage

6

For example, S.O. Okpaku and others, “Disability Determinations for Adults With Mental Disorders:

Social Security Administration vs. Independent Judgments,” American Journal of Public Health, Vol.

84, No. 11 (Nov. 1994), pp. 1791-95; and H.P. Brehm and T.V. Rush, “Disability Analysis of Longitudinal

Health Data: Policy Implications for Social Security Disability Insurance,” Journal of Aging Studies,

Vol. 2, No. 4 (1988), pp. 379-99.

Page 6 GAO/T-HEHS-96-147
Social Security: Disability Programs Lag in

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employment. Neither do they allay the fear of losing medical coverage and

other federal and state assistance that beneficiaries who return to work

may face. Studies have identified the risk of losing medical coverage as a

major barrier to beneficiaries’ returning to work. Beneficiaries who work

and continue to earn countable income above certain amounts will

eventually lose medical coverage even though they have not necessarily

improved medically or obtained affordable coverage elsewhere.

Finally, VR has played a limited role in the DI and SSI programs, in part

because of restrictive state VR policies and limits on alternatives to

providers in the state VR system. Beneficiaries are generally uninformed

about the availability of VR services and are given little encouragement to

seek them. Moreover, the effectiveness of state VR services in securing

long-term financial gains has been mixed at best.

Return-to-Work

Strategies From Other

Systems Contrast

Sharply With Federal

Disability Programs

In contrast to SSA’s disability programs, which have changed little over the

years, some firms in the private sector are developing new approaches to

manage the size and composition of their caseloads. Known as disability

management, these approaches embody a proactive strategy for

controlling disability costs by helping employees with disabilities return to

work as soon as possible.

Disability managers in the U.S. private sector spend money on

return-to-work efforts because they believe such efforts are sound

investments that reduce disability-related costs. Studies have estimated

that the full cost of disability to employers ranges from about 6 to

12 percent of payroll. Such costs include insurance premiums, cash

benefits, rehabilitation benefits, and medical benefits paid through

workers’ compensation and employer-sponsored disability insurance

programs. Companies may also incur additional expenses for training and

using temporary workers and retraining employees with disabilities when

they return to work. When businesses help workers with disabilities return

to the workplace, they are able to reduce some of these costs.

Social insurance programs in Germany and Sweden also invest in

return-to-work efforts, and their experiences show that the utility of

return-to-work strategies is not limited to the private sector. Our analysis

of practices advocated and implemented by the U.S. private sector and

other countries reveals three common strategies in the design of their

return-to-work programs:

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• Intervene as soon as possible after a disabling event;

• Identify and provide necessary return-to-work services and manage cases;

and

• Structure cash and medical benefits to encourage return to work.

The practices underlying these strategies are summarized in table 2.

Disability managers we interviewed emphasized that these return-to-work

strategies are not independent of each other and work most effectively

when integrated into a comprehensive return-to-work program.

Return-to-work strategies and practices may hold potential both for

improving federal disability programs by helping people with disabilities

return to productive activity in the workplace and, at the same time, for

reducing program costs.

Table 2: Strategies and Practices in the

Design of Return-to-Work Programs of

the U.S. Private Sector and Other

Countries

Strategies Practices

Intervene as early as

possible after an actual or

potentially disabling event.

Address return-to-work goals from the beginning of an

emerging disability.

Provide return-to-work services at the earliest appropriate

time.

Maintain communication with workers who are

hospitalized or recovering at home.

Identify and provide

necessary return-to-work

assistance effectively.

Assess each individual’s return-to-work potential and

needs.

Use case management techniques when appropriate to

help workers with disabilities return to work.

Offer transitional work opportunities that enable workers

with disabilities to ease back into the workplace.

Ensure that medical service providers understand the

essential job functions of workers with disabilities.

Structure cash and medical

benefits to encourage return

to work.

Structure cash benefits to encourage workers with

disabilities to rejoin the workforce.

Maintain medical benefits for workers with disabilities who

return to work.

Include a contractual provision that can require the

worker with disabilities to cooperate with return-to-work

efforts.

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Social Security: Disability Programs Lag in

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Early Intervention Critical

to Return to Work

Disability managers we surveyed stressed the importance of early

intervention in returning workers with disabilities to the workplace.

Advocates of early intervention believe that the longer an individual stays

away from work, the less likely return to work will be. Studies show that

only one in two workers with recently acquired disabilities who are out of

work 5 months or more will ever return to work. Disability managers

believe that long absences from the workplace can reduce motivation to

attempt work.

Setting return-to-work goals soon after the onset of disability and

providing timely rehabilitation services are believed to be critical in

encouraging workers with disabilities to return to the workplace as soon

as possible. Contacting a hospitalized worker soon after an injury or

illness and then continuing to communicate with the worker recovering at

home, for instance, helps reassure the worker that there is a job to return

to and that the employer is concerned about his or her recovery.

Identifying and Providing

Return-to-Work Services

Effectively

Another common strategy is to effectively identify and provide

return-to-work services. This approach involves investing in services

tailored to individual circumstances that help achieve return-to-work goals

for workers with disabilities while avoiding unnecessary expenditures.

In an effort to provide appropriate services, many in the private sector

strive to identify the individuals who are likely to be able to return to work

and then identify the specific services they need. In doing so, each

individual should be functionally evaluated after his or her medical

condition has stabilized to assess potential for returning to work. When

appropriate, the private sector uses case management techniques to

coordinate the identification, evaluation, and delivery of disability-related

services to individuals deemed to need such services to return to work.

Transitional work allows workers with disabilities to ease back into the

workplace in jobs that are less physically or mentally demanding than

their regular jobs.

The private sector also stresses the need to ensure that physicians and

other medical service providers understand the essential job functions of

workers with disabilities. Without this understanding, the worker’s return

to work could be delayed unnecessarily. Also, if an employer is willing to

provide transitional work opportunities or other job accommodations, the

treating physician must be aware of and understand these

accommodations.

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Work Incentives Facilitate

Return to Work

Finally, disability managers responding to our survey generally offered

incentives through their programs’ cash and medical benefit structure to

encourage workers with disabilities to return to work. Disability managers

believe that a program’s incentive structure can affect return-to-work

decisions. The level of cash benefits paid to workers with disabilities can

affect their attitudes toward returning to work because, if disability

benefits are too generous, the benefits can create a disincentive for

participating in return-to-work efforts. Disability managers also believe

employer-sponsored medical benefits can provide an incentive to return to

work if returning is the way that workers with disabilities in the private

sector can best ensure that they retain medical benefits.

Although the structure of benefits plays a role in return-to-work decisions,

disability managers emphasized that well-structured incentives are not

sufficient in themselves for a successful return-to-work program.

Incentives must be integrated with other return-to-work practices.

Disability managers also generally advocated including a contractual

requirement for cooperation with a return-to-work plan as a condition of

eligibility for benefits. They believed such a requirement helps motivate

individuals with disabilities to try to return to work.

Return-to-Work

Outcomes Could Be

Improved Through

Restructuring

Return-to-work strategies used in the U.S. private sector and other

countries reflect expectations that people with disabilities can and do

return to work. The DI and SSI programs, however, are out of sync with this

return-to-work focus. Improving the DI and SSI return-to-work outcomes

requires restructuring these programs to better identify and enhance

beneficiary return-to-work capacities. While there is opportunity for

improvement, it should be acknowledged that many beneficiaries will be

unable to return to work. In fact, almost half of the people receiving

benefits are not likely to become employed because of their age or

because they are expected to die within several years. For others, work

potential is unknown; but research suggests that successful transitions to

work may be more likely for younger people with disabilities and for those

who have greater motivation and more education.7

7

For example, J.C. Hennessey and L.S. Muller, “The Effect of Vocational Rehabilitation and Work

Incentives on Helping the Disabled-Worker Beneficiary Back to Work,” Social Security Bulletin, Vol.

58, No. 1 (spring 1995), pp. 15-28; R.J. Butler, W.G. Johnson, and M.L. Baldwin, “Managing Work

Disability: Why First Return to Work Is Not a Measure of Success,” Industrial and Labor Relations

Review, Vol. 48, No. 3 (Apr. 1995), pp. 452-67; and R.V. Burkhauser and M.C. Daly, “Employment and

Economic Well-Being Following the Onset of a Disability: The Role for Public Policy,” paper presented

at the National Academy of Social Insurance and the National Institute for Disability and

Rehabilitation Research Workshop on Disability, Work, and Cash Benefits (Santa Monica, Calif.:

Dec. 1994).

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Studies have shown that a meaningful portion of DI and SSI beneficiaries

possess such characteristics. The DI and SSI disability rolls have been

increasingly composed of a significant number of younger individuals.

Among working-age SSI and DI beneficiaries, one out of three is under the

age of 40.8

 In addition, in 1993, 35 percent of 84,000 DI beneficiaries

expressed an interest in receiving rehabilitation or other services that

could help them return to work, an indication of motivation. Moreover, a

substantial portion—almost one in two—of a cohort of DI beneficiaries

had a high school degree or some years of education beyond high school.9

The literature also suggests that lack of work experience is a significant

barrier to employability.10 A promising sign is that about one-half of DI and

one-third of SSI working-age beneficiaries had some attachment to the

labor force during the 5 years immediately preceding the year of benefit

award.11

Even those who may be able to return to work will face challenges. For

example, some may need to learn basic skills and work habits and build

self-esteem to function in the workplace. Moreover, the nature of some

disabilities may limit full-time work, while others may cause logistical

obstacles, such as transportation difficulties. Finally, employer resistance

to hiring people with disabilities and tight labor market conditions,

particularly for low-wage positions, could constrain employment

opportunities.

Nevertheless, there are compelling reasons to try new approaches. As

mentioned, our review of the disability determination process shows that

the work capacity of an individual found eligible for DI and SSI benefits may

be understated. And this country has experienced medical, technological,

and societal advances over the past several years that foster return to

work. But weaknesses in the design and implementation of the DI and SSI

programs mean that little has been done to identify and encourage the

productive capacities of beneficiaries who might be able to benefit from

these advances.

8

Annual Statistical Supplement, 1995 to the Social Security Bulletin (Aug. 1995).

9

J.C. Hennessey and L.S. Muller, “Work Efforts of Disabled-Worker Beneficiaries: Preliminary Findings

From the New Beneficiary Followup Survey,” Social Security Bulletin, Vol. 57, No. 3 (fall 1994), pp.

42-51.

10Berkeley Planning Associates and Harold Russell Associates, “Private Sector Rehabilitation: Lessons

and Options for Public Policy,” prepared for the U.S. Department of Education, Office of Planning,

Budget, and Evaluation (Dec. 31, 1987).

11M.C. Daly, “Characteristics of SSI and SSDI Recipients in the Years Prior to Receiving Benefits:

Evidence From the PSID,” presented at SSA’s conference on Disability Programs: Explanations of

Recent Growth and Implications for Disability Policy (Sept. 1995).

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Restructuring of the DI and SSI programs should consider the

return-to-work strategies employed by the U.S. private sector and social

insurance programs in Germany and Sweden. Lessons from these other

disability programs argue for placing greater priority on assessing

return-to-work potential soon after individuals apply for disability benefits.

The priority in the DI and SSI programs, however, is to determine the

eligibility of applicants to receive cash benefits, not to assess their

return-to-work potential. In conjunction with making an early assessment

of return-to-work potential, the programs should place greater priority on

identifying and providing, at the earliest appropriate time, the medical and

vocational rehabilitation services needed to return to work. But under the

current program design, medical and vocational rehabilitation services are

provided too late in the process. Finally, the programs should be designed

to ensure that cash and medical benefits encourage beneficiaries to return

to work. Presently, however, cash and medical benefits can make it

financially advantageous to remain on the disability rolls, and many

beneficiaries fear losing their premium-free Medicare or Medicaid benefits

if they return to work.

Although SSA faces constraints in applying the return-to-work strategies of

other disability programs, opportunities exist for better identifying and

providing the return-to-work assistance that could enable more of SSA’s

beneficiaries to return to work. Even relatively small gains in

return-to-work successes offer the potential for significant savings in

program outlays.

Conclusions In our April 1996 report, we recommended that the Commissioner take

immediate action to place greater priority on return to work, including

designing a more effective means to identify and expand beneficiaries’

work capacities and better implementing existing return-to-work

mechanisms. In line with placing greater emphasis on return to work, we

believe that the Commissioner needs to develop a comprehensive

return-to-work strategy that integrates, as appropriate, earlier intervention,

earlier identification and provision of necessary return-to-work assistance

for applicants and beneficiaries, and changes in the structure of cash and

medical benefits. As part of that strategy, the Commissioner needs to

identify legislative changes that would be required to implement such a

program.

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Mr. Chairman, this concludes my formal remarks. I would be happy to

answer any questions from you and other Members of the Committee.

Thank you.

Contributors For more information on this testimony, please call Cynthia Bascetta,

Assistant Director, at (202) 512-7207. Other major contributors included

Carol Dawn Petersen, Senior Economist; Barbara Bordelon, Brett

Fallavollita, and Ira Spears, Senior Evaluators; and Kenneth Daniell and

Ellen Habenicht, Evaluators.

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Related GAO Products

SSA Disability: Program Redesign Necessary to Encourage Return to Work

(GAO/HEHS-96-62, Apr. 24, 1996).

PASS Program: SSA Work Incentive for Disabled Beneficiaries Poorly

Managed (GAO/HEHS-96-51, Feb. 28, 1996).

SSA’s Rehabilitation Programs (GAO/HEHS-95-253R, Sept. 7, 1995).

Social Security Disability: Management Action and Program Redesign

Needed to Address Long-Standing Problems (GAO/T-HEHS-95-233, Aug. 3,

1995).

Supplemental Security Income: Growth and Changes in Recipient

Population Call for Reexamining Program (GAO/HEHS-95-137, July 7, 1995).

Disability Insurance: Broader Management Focus Needed to Better

Control Caseload (GAO/T-HEHS-95-164, May 23, 1995).

Supplemental Security Income: Recipient Population Has Changed as

Caseloads Have Burgeoned (GAO/T-HEHS-95-120, Mar. 27, 1995).

Social Security: Federal Disability Programs Face Major Issues 

(GAO/T-HEHS-95-97, Mar. 2, 1995).

Supplemental Security Income: Recent Growth in the Rolls Raises

Fundamental Program Concerns (GAO/T-HEHS-95-67, Jan. 27, 1995).

Social Security: Disability Rolls Keep Growing, While Explanations

Remain Elusive (GAO/HEHS-94-34, Feb. 8, 1994).

Vocational Rehabilitation: Evidence for Federal Program’s Effectiveness is

Mixed (GAO/PEMD-93-19, Aug. 27, 1993).

Vocational Rehabilitation Program: Client Characteristics, Services

Received, and Employment Outcomes (GAO/T-PEMD-92-3, Nov. 12, 1991).

Social Security: Little Success Achieved in Rehabilitating Disabled

Beneficiaries (GAO/HRD-88-11, Dec. 7, 1987).

Social Security: State Vocational Rehabilitation Agencies’ Reimbursement

for the Disabled (GAO/HRD-87-36BR, Feb. 3, 1987).

(106514) Page 16 GAO/T-HEHS-96-147
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