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

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 selfreported 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, workdisabled 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.