The number of beneficiaries in the Social Security Disability Insurance (SSDI) program has been increasing rapidly and the total benefits paid even more rapidly. Transitions out of SSDI into the work force remain stubbornly low. As a result, the SSDI Trust Fund will be exhausted by 2016, likely resulting in across the board delays in benefit payments to disabled workers unless Congress legislates a fix. An alternative to reducing benefits, narrowing eligibility or increasing payroll taxes is to divert or delay SSDI entry via interventions that keep workers in the labor force. However, a major challenge is to identify populations where interventions can be cost effective.

We assembled data on all California workers experiencing the onset of a disabling condition, combining both workers’ compensation data on all occupational disabling conditions and California State Disability Insurance (SDI) data on all non-occupational disabling conditions. This dataset is unique among US jurisdictions.  A number of states collect occupational disability data, but a large majority of long-term disabling conditions are non-occupational and no comprehensive, or even representative, data has been available for this population. We obtained data for both populations for 2007-2012 identifying the onset and duration of disability, primary and secondary diagnoses, worker wages, demographic characteristics, and employer characteristics. 

These data cover 5 million disability spells and more than 3 million workers. We use survival analysis to evaluate, individually and in combinations, the impact of diagnoses, worker demographic characteristics, and employer characteristics on the likelihood that a worker, at any point in a disability spell, will remain on disability benefits for at least one year—those most likely to enter SSDI.

We then apply these results to identify the medical conditions and worker and employer characteristics, as well as the timing of services, that offer the best potential for cost-effective interventions to be tested in future pilot projects aimed at returning disabled workers to the labor force before they transition to SSDI.