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Mixed-methods Study on Work-disabled Adults Who Do Not Apply for Social Security Disability Benefits

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Abstract

Take-up gaps in safety net programs, which have been long documented in the United States and elsewhere, are an important policy question as nontake-up compromises the equity objectives and efficacy of programs. The Social Security Disability program is an example of this: More than 20 million adults report a work disability, but only around 11 million currently receive disability benefits through the Social Security Disability Insurance or Supplemental Security Income programs. This comprehensive mixed-methods study examines the characteristics and decision-making around benefits applications among adults with self-reported work disability who have never applied for disability benefits. Analysis of survey data suggests that the availability of personal and socioeconomic resources, including younger age, educational attainment, spousal support, and income may act as buffers to feeling the need to apply for disability benefits. Greater cognitive resources, in particular quantitative and verbal reasoning skills, were associated with a greater likelihood of not applying. Qualitatively, we find that high transaction costs involved in disability applications coupled with the widespread perception of low approval rates may be a critical deterrent for eligible individuals. Uncertain and lengthy medical processes after disability onset were also frequently reported as a central deterrent. Stigma about receiving disability benefits does not emerge as a factor in application behavior, although a change in self-concept involving an adjustment to benefit-receiving, work-disabled status was cited as a deterrent to claiming. These insights could inform targeted interventions to reduce barriers to take-up of benefits among potentially eligible adults.

Key Findings

  • Younger age, higher educational attainment, being married, and higher income are associated with lower likelihood of applying for Social Security disability benefits. These social and economic resources may act as buffers to feeling the need to apply for disability benefits.
  • Greater cognitive resources, notably quantitative reasoning skills, were associated with a greater likelihood to not apply for disability benefits. People with greater cognitive abilities are likely to have access to a greater amount of diverse employment opportunities to maintain their standard of living, and might be less pressed to rely on government assistance.
  • The themes that emerge from the qualitative inquiry broadly align with those of other research that has examined the information, transaction, and social costs of applying for benefits.
  • High transaction costs involved in disability applications coupled with the widespread perception of low approval rates may be a critical deterrent for potentially eligible individuals.
  • Uncertain and lengthy medical processes after the onset of disability were also frequently reported as a central deterrent to applications. Previous literature recognized the high direct cost of obtaining the requisite medical records for a claim. However, other complexities of health care interactions come clearly to light through the qualitative interviews, including, for certain individuals, the difficulty of obtaining diagnostic and prognostic information on the extent to which the impairment limits work in the long term. These complexities, as our participants revealed, have a direct bearing on their application decisions.
  • External or societal stigma about receiving disability benefits does not appear to be a factor in application behavior among our qualitative sample, although a change in self-concept involving an adjustment to benefit-receiving, work-disabled status was cited as a deterrent to claiming.

Citation

Rabinovich, Lila, Doerte U. Junghaenel, and Tabasa Ozawa. 2023. “Mixed-methods Study on Work-Disabled Adults Who Do Not Apply for Social Security Disability Benefits.” Ann Arbor, MI. University of Michigan Retirement and Disability Research Center (MRDRC) Working Paper; MRDRC WP 2023-477. https://mrdrc.isr.umich.edu/publications/papers/pdf/wp477.pdf

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Project

Paper ID

WP 2023-477

Publication Type

Working Paper

Publication Year

2023