Articles from prior issues of The Advocate

November/December, 1999

GAO Studies “Back-To-Work” Programs in Europe and US
by Paula Christofoletti, New Hampshire DDS

CAROL PETERSON, FROM THE GENERAL Accounting Office presented an overview of back to work programs in the US and in Europe. She shocked us by saying that a billion dollars a week are spent on disability benefits. These programs have done little to increase independence. Just 1% of the population who is on benefits goes back to work. The GAO has started several initiatives. Ms. Peterson advocates for more referrals to Vocational Rehabilitation programs. At the same time, if the beneficiary seeks VR services, he needs to be assured that his benefits will be retained. There is less chance of the older beneficiaries opting for VR services, because retirement is imminent. But transition from disability to Vocational Rehabilitation for younger individuals is a viable option.

Ms. Peterson said that there are now changing attitudes in the workplace regarding people with disabilities. However, there has been little motivation on the part of the beneficiary to get off the rolls because many beneficiaries have developed a negative mind set. Good daily habits that impact on work performance have become eroded. Some beneficiaries are unaware of the services they could access. Some beneficiaries take part-time jobs and stay on benefits. Some beneficiaries fear that if they go back to work, they will lose their medical benefits. Studies show that few beneficiaries and few claimants are referred to VR or are informed of VR services. However, in the private sector of our country, there are disability managers who help co-workers return to work.

In other foreign countries, Germany and Sweden in particular, there are similar programs to get the disabled back to work. These programs have been successful because there has been an early intervention in the life of the person with a disability. Return to work is facilitated by the disability manager. Work capacity is identified early on, as well as establishing structure of cash and medical benefits. It is accepted that the longer that an individual is away from work, the less motivated that individual will be to return to work. We need to provide timely rehabilitation services including assistive devices, medical services and medical benefits, as well. Programs with these services have been very effective in Sweden and in Germany. Peterson indicated that we need to reconstruct the current Federal programs now in place. Although we provide cash benefits, we do not provide other necessities including more comprehensive medical benefits which would motivate the beneficiary to return to work. SSA has already initiated a Return to Work Pilot program in twelve states, which are still in the very early stages. The Work Incentives Improvement Act (S.331) passed the Senate 99-0. The Ticket to Work and Work Incentives Improvement Act of 1999 (HR 1180) passed the House of Representatives 412-8. Advocates are now asking that Congress provide the funding to enact this legislation. Particularly, advocates are asking that there be inclusion of Medicaid provisions with state grant programs as mandatory funding rather than discretionary funding. There is much to accomplish before our U.S. program is as effective as those in Europe where the people with disabilities are permanently taken off the roles and returned to meaningful and gainful work activity. Carol Peterson’s presentation was very thought-provoking and visionary, as well.