Introduces the Health Mismatch Index (HMI) — the share of workers in an occupation who report a health-related difficulty with a task that the Occupational Requirements Survey (ORS) marks as required for that occupation — constructed by linking Survey of Income and Program Participation (SIPP) health topical modules (1997–2010) to the Bureau of Labor Statistics (BLS)/Social Security Administration (SSA) ORS (2017). About 7% of working adults have at least one such mismatch. Occupation-level Tobit regressions show that a 10 percentage point (pp) higher HMI predicts a 0.45 pp higher share of workers entering Social Security Disability Insurance (SSDI) in the next 16 months, nearly doubling the mean. The HMI fell from 7.4% to 6.1% between 1997 and 2010 — despite workforce aging — suggesting the SSDI roll increase during this period would have been even larger absent the improvement in health-job fit.
0.045*** at 1+ difficulties. Nearly doubles the mean (0.49%). Effect is concentrated in workers 50–64 (0.099***) vs. 18–49 (0.022, n.s.).0.082***) and 3+ difficulties (0.103**), not 1+. Employers may accommodate single-difficulty workers but not multi-requirement mismatch."Jobs with higher rates of workers who experience at least one difficulty with a job requirement have a higher share of workers receiving SSDI benefits within a 16-month period."
"Although the share of the population receiving SSDI increased from 1997 to 2010, the Index fell from 7.4 to 6.1 percent, suggesting that the increase could have been higher if not for the decline in health mismatch."
A methodologically clean paper that fills a genuine gap: no prior study had operationalized the Step 4–5 vocational assessment at the population level using matched job-requirement and health-limitation data. The HMI is a creative construct. The key finding — that mismatch declined while rolls grew — is an important supply-side constraint on Disability Insurance (DI) explanations: it rules out worsening health-job fit as a driver of 1997–2010 growth, and provides a counterfactual (growth would have been even larger without the improvement). The ORS data are novel and well-suited to the question; the SIPP linkage is the right choice. Main limitation: the outcome window is only 16 months (the minimum common follow-up across panels), which likely understates the cumulative effect on SSDI since the onset-to-application lag can exceed two years. The Tobit specification is appropriate given zero-mass outcomes at the occupation level. The age-gradient finding (effect concentrated in 50–64) aligns well with the Vocational Grid's age thresholds and the conditional applicant framework.