The Declining Work and Welfare of People with Disabilities: What Went Wrong and a Strategy for Change Book

Acknowledgments vii

List of Illustrations viii

Introduction 1

Book Overview 6

Note to Readers 9

1 The Economic Status of People with Disabilities 10

Relative Economic Status of People with Disabilities 13

Summary 20

2 Lessons From Welfare Reform 21

Afdc: Goals and Outcomes 21

From Afdc to Tanf 24

Elements of Welfare Reform 26

Changing Incentives 28

Measuring Success 30

Lessons for Reforming Disability Policy 33

Summary 34

3 The Adult Disability Determination Process and Growing Adult Disability Rolls 35

Trends in Health and Work Disability 36

Defining and Measuring Disability 39

Other Drivers of Disability Caseloads 44

Summary 54

4 Disability Policy And Disability Decision Making 55

Disability Policy and Decision Making 56

Ssdi: Disability Path for Those Who Have Worked 57

Ssi-Disabled Adults: Disability Path for Those with Limited Work Histories 62

Summary 67

3 Lessons From Dutch Disability Policy Reforms 68

Disability Caseloads 69

Path to Disability Benefits in the Netherlands 70

Lessons for Reforming U.S. Disability Policy 81

Summary 83

6 Disability Policy For Children 85

Original Rationale and Program Evolution 86

Growth in the SSI-Disabled Children Program 87

Disability Policy Welfare Policy, and Disability Decision Making 95

Unintended Consequences and Long-Term Costs 100

Summary 101

7 Reforming U.S. Disability Policy 102

Learning from Welfare Reform 103

Learning from the Dutch Disability Reforms 104

Reforming U.S. Disability Policy 105

Reforming Ssdi 107

Reforming Ssi 113

Summary 115

Data Appendix 117

Sample Definitions 117

Business Cycles 119

Income Measures 119

Employment Measures 121

U.S. Program Caseloads and Costs 121

Dutch Program Data 122

Caseload-to-Worker Ratio 123

Notes 124

References 135

Index 145

About The Authors 153