Anand and Ben-Shalom 2016 — Paths Taken By New Awardees of Federal Disability Benefits

Summary

Using Social Security Administration (SSA) administrative data (Disability Analysis File, 1996–2012) for a cohort of 2001 awardees followed 10 years, Anand and Ben-Shalom document the most common milestone paths taken by Disability Insurance (DI)-first ($n=550{,}535$) and Supplemental Security Income (SSI)-first ($n=286{,}574$) awardees. The central finding is one of near-total inertia: $80\%$ of DI-first awardees and $53\%$ of SSI-first awardees reached no milestones of any kind beyond the initial award, death, or full retirement age (FRA) within 10 years. Sustained work exits are rare; medical recovery is rarer still; and the beneficiaries most likely to attempt a return to work are concentrated among the young, the educated, and those with affective or psychiatric diagnoses.

Key Claims

• Inertia dominates DI: $32.5\%$ of DI-first awardees had no milestone at all; $27.6\%$ reached only FRA; $19.7\%$ only died — combined, $79.8\%$ of DI-first paths.
• Inertia also large for SSI: $25.3\%$ no milestones; $14.7\%$ death only; $12.5\%$ FRA only — $52.5\%$ of SSI-first paths.
• Work exit rare: Only $3.1\%$ of DI-first awardees had benefits terminated or suspended $12+$ months for work (sustained exit); $7.4\%$ completed a Trial Work Period; $17.2\%$ of SSI-first had positive countable earnings but only $2.3\%$ had a sustained work suspension.
• Medical recovery rare: $2.2\%$ of DI-first and $3.8\%$ of SSI-first awardees recovered medically within 10 years.
• DI–SSI crossover: $6\%$ of DI-first awardees subsequently received SSI (financial deterioration); $24.6\%$ of SSI-first awardees subsequently received DI (reflects simultaneous applications and the 5-month DI waiting period).
• SSI incarceration elevated: $7.6\%$ of SSI-first awardees had an incarceration milestone ($\geq 1$ month) vs. $1.6\%$ of DI-first — reflecting SSI's more disadvantaged population.
• Predictors of work paths: Younger age ($<45$), higher education (above high school (HS)), and affective/psychiatric/intellectual disability diagnoses are overrepresented in work-related paths for both DI-first and SSI-first awardees. Musculoskeletal disorders are overrepresented in the FRA-only (age-out) path.

Concepts Introduced or Extended

• Disability Insurance Program
• DI Beneficiary Mortality
• Substantial Gainful Activity

Entities Mentioned

• Priyanka Anand
• Yonatan Ben-Shalom
• Social Security Administration

Quotes

"80 percent of DI-first awardees and 53 percent of SSI-first awardees either achieved no additional milestones of any kind in the 10 years after their initial award or died or attained full retirement age before reaching any other milestone."

"Outreach promoting a return to work could be targeted to those whose characteristics are associated with a likelihood of taking work-related paths. Caution is recommended, however, in concluding that individuals who have historically not been likely to take such paths are not good candidates for return-to-work programs."

My Take

The paper's value is quantitative anchoring rather than causal inference — it is a purely descriptive cohort study with no identification strategy. But the statistics are striking and rarely cited together: the dominant program experience is entry and persistence, not exit. The finding that only $3.1\%$ of DI-first awardees achieve sustained work exits is the appropriate empirical baseline against which any return-to-work intervention should be measured. The DI-SSI crossover ($24.6\%$ of SSI-first later receive DI) is a programmatic detail with cost implications that is often overlooked in analyses that treat the two programs as independent. The 2009 recession occurred mid-follow-up window, so work-related milestones likely reflect both structural barriers and cyclical suppression — the limitation acknowledged in the paper.