November 8, 2022

A New Link Between Opioids and Disability

Picture a worker who has an injury so traumatic that he or she is rushed to the emergency room. A doctor prescribes an opioid to ease the pain.

A new working paper adds to the growing evidence that taking opioids, even when necessary, can have serious long-term consequences for workers’ career paths.

Michael Dworsky at RAND found that workers who received prescription opioids after visiting Colorado emergency rooms were far more likely to enroll in Medicare before turning 65 than people who didn’t get a prescription to treat an injury. Starting Medicare before 65 almost always indicates that someone has left the labor force and is receiving benefits from Social Security Disability Insurance, the primary social program for workers with disabilities.

Dworsky reached similar findings in three different analyses, which used Medicare enrollment within four years of an emergency room visit as a rough proxy for whether workers are receiving the federal disability benefits.

People who had taken opioids prior to being injured were the most likely to leave the labor force. After an emergency room visit resulted in a new opioid prescription, more than 2 percent of the previous users wound up on Medicare and disability – a rate that is four times higher than for traumatic-injury patients who had never previously taken opioids.

Dworsky also examined the morphine-equivalent doses that were dispensed to patients over time. The probability of receiving prescription opioids spiked immediately after workers’ injuries and then stabilized at a higher level than before the injuries. …Learn More

November 1, 2022

How Older Workers Adapt to New Disability

One in four workers who are still healthy in their mid-50s will experience a disability in the next few years that will make working more difficult.

Sometimes the disability stems from a sudden medical problem such as a heart attack, but many disabilities are just the accumulated wear and tear on aging bodies or chronic medical conditions that get worse.

Whatever the cause, a new study in the journal Research on Aging finds that late-life disabilities often force older workers into early retirement. Nearly three-fourths of the workers who experienced a new disability in their late 50s or early 60s had left the labor force before their full retirement age. Among the people who didn’t have a disability, only a third had stopped working.

The researchers also looked more closely at those with disabilities who did continue to work. Were they able to transition into a new job or occupation that might accommodate their condition? Do they earn less?

The answer to both questions seems to be yes.

Linking a long-running survey of older Americans with occupational data, the researchers checked in on the workers who did not have a disability at age 55 to see how they were faring at 59, 63 and 67. Occupational changes were fairly common when they remained in the labor force after developing a disability.

This might mean moving from a physically demanding construction job to Uber driver or from school teacher to editor of educational materials. Finding a job in a different occupation potentially creates a bridge that accommodates the older workers’ desire to keep working and delay retirement.

At age 59, for example, two-thirds of the people with disabilities who stayed in the labor force had switched occupations, compared with less than a third of the other workers. Once a disability sets in, “staying in the same occupation is difficult,” the researchers concluded.

The people who develop a disability sometime after their mid-50s also earn perhaps 15 percent less than those who are disability-free at 67. …Learn More

August 9, 2022

Encouraging People with Disabilities to Work

Having a physical or mental disability can make it impossible to work. But for people with disabilities who are able, it’s crucial they get the support they need so they can work and feel productive, self-sufficient, and part of a larger community.

So who are they? A new study identifies a small but promising group who are initially awarded monthly cash assistance from the Supplemental Security Income (SSI) program and eventually qualify for Social Security Disability Insurance (SSDI).

The researchers call them SSI-first beneficiaries because the SSI payments come first and then the workers migrate over to SSDI and sometimes quit their jobs.

If identified early, these individuals could be encouraged to remain in the labor force after their SSDI benefits start or even leave the federal benefit rolls.

The researchers found that people who were receiving SSI and eventually entered SSDI had more success working – and more promise for staying in the labor force – when compared with one other group: SSI awardees who did not enter SSDI.

For example, three out of four SSI-first recipients, who later were awarded SSDI, had worked in the five years after their SSI payments started. This compares with just one in five people receiving SSI who did not enter SSDI later.

In another indication of their employment potential, a third of SSI-first recipients had their SSDI benefits suspended because their earnings were relatively high. It was rare for people receiving only SSI to jeopardize their benefits this way.

To be eligible for both the SSI and SSDI programs, the federal government caps the earnings of workers with disabilities at $1,350 per month. …Learn More

July 6, 2021

Hard for People on SSDI to Resume Work

The federal government runs numerous small-scale experiments across the country to explore ways to help people on Social Security disability ease back into work to reduce the benefits being paid.

In a recent webinar, researchers discussed the extreme challenges of designing programs that are effective, given the inherent disadvantages – from the disabling condition itself and discrimination to having less education – that people with disabilities face in the job market.

After close examination of several programs, the researchers found that the primary goals of most demonstration programs are very difficult to achieve: reducing disability benefits or increasing the earnings of people on disability who have sporadic or part-time work. But they also suggested that the programs would be deemed more successful if policymakers would broaden the goals to include the improved well-being of people with disabilities.

To increase their employment, Kilolo Kijakazi, deputy commissioner of retirement and disability policy at the U.S. Social Security Administration, said it’s critical to first address inequities in the job market.

Research shows that many people on disability express an interest in working but face multiple barriers. Employers aren’t always willing to make the workplace accommodations needed to hire them. People on disability also tend to be older than most workers and may face age discrimination. Others have been discouraged by past work experiences, and finding transportation to and from a job is often a challenge.

Although a minority of all Americans with disabilities are working, the 2020 unemployment rate among people with a disability who are either working or looking for a job was 12.6 percent. However, unemployment among Black Americans with disabilities was 16.3 percent. The rates were also very high for Asian-Americans and Latinos with disabilities –  15.7% and 16.8 percent, respectively.

“We need to develop policies and programs that address these inequities,” Kijakazi said.

Robert Moffitt at Johns Hopkins University analyzed several back-to-work programs, including the use of counselors and financial incentives. He found that the programs are extremely difficult to implement well and that participation is fairly low.

Although they do help some individuals, he concluded, “Most of the efforts to increase employment, earnings and labor force engagement of [disability] beneficiaries have been disappointing.” …Learn More