Improving Employment Outcomes for People with Psychiatric Disorders and Other Disabilities. C. Demonstrations by the Social Security Administration to Improve Return-to-Work and Reduce Participation in Disability Programs


There is considerable policy concern about and interest in interventions designed to help SSI and SSDI beneficiaries find or resume work. We identified two rigorous evaluations of interventions targeted to SSI or SSDI beneficiaries that have been conducted in the last ten years. The quasi-experimental evaluation of SSA's TTW program assessed the impact of the program on service enrollment and employment. TTW allows beneficiaries to deposit a "Ticket" with one of a range of public or private employment service providers, including state VR agencies. The program expanded beneficiary choice of SSA-sponsored service providers over the traditional system, in which SSA reimbursed only state VR agencies for serving beneficiaries. Initial findings of the TTW evaluation did not show significant impacts of the program on beneficiary employment, but later findings showed that TTW and related programs are having a limited but positive effect on employment for SSI and SSDI beneficiaries, and have motivated some beneficiaries to pursue employment (Livermore et al. 2013). Although relatively few beneficiaries continue to be enrolled in TTW, those who use TTW and other programs have better employment outcomes than those who do not.

Fraker et al. (2013) are currently conducting an evaluation of the Youth Transition Demonstration (YTD), a rigorous experimental evaluation of six employment-support projects designed to identify interventions that will improve the educational and vocational outcomes for youth (ages 14-25). Approximately 880 youths at each site who agreed to participate in the evaluation were randomly assigned to treatment or control-groups. Each of the YTD sites offered individualized work-based experiences, including internships, job shadowing, job coaching, and competitive paid employment; waivers of various SSI rules to promote employment; and benefits counseling to teach youths about these work incentives. The sites also offered empowerment training to help participating youth learn to make their own choices (as opposed to having a parent or guardian direct those choices). The control-group received standard disability program work incentives and whatever alternative services were available in their communities.

The YTD evaluation is tracking employment, earnings, and receipt of disability benefits. Preliminary results one year after study enrollment vary by site. Three of the six sites had a significant positive impact--of between 9 and 19 percentage points--on whether the youth had held a job. One of these sites also showed significant impacts on total earnings (a difference of $524 and $306 in annual earnings) (Fraker et al. 2011). The other three sites showed no significant impacts one year after enrollment.

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