G. Research on Related Topics

The legislative mandate for this report requires inclusion of information about relevant research on the Supplemental Security Income (SSI) program by the Social Security Administration (SSA) and others. Section 1 of this appendix describes SSA’s major recent and ongoing projects. Section 2 presents a bibliography of studies regarding SSI payment levels, recipients, and reform proposals published in the past 10 years by both public and private entities. See previous editions for information on prior SSI-related research available at https://www.ssa.gov/oact/ssir/index.html.

The Retirement and Disability Research Consortium (RDRC) was an interdisciplinary extramural research program funded by SSA through cooperative agreements with research centers at Boston College; the City University of New York; the University of Maryland, Baltimore County; the University of Michigan; the National Bureau of Economic Research; and the University of Wisconsin-Madison. The centers organized experts from around the country to produce research on Social Security programs and related topics. The RDRC was terminated in early 2025 to comply with Executive Order 14151.

One goal of the RDRC was to research and evaluate topics related to SSI and other Federal policies. RDRC working papers funded in FY 2022 include the following: Grooms, L’Esperance, and Smeeding (2022) simulate how the expanded Child Tax Credit affects the income and poverty of SSI child beneficiaries as well as adult beneficiaries. Costanzo et al. (2022) consider the responsibilities of parents of disabled children during their prime working years and later, incorporating a variety of benefits that SSA provides for such families. Berger et al. (2022) evaluate the effect of various SSA benefits on multigenerational households.

Studies for FY 2021 include the following: Bitler et al. (2022) examine the effect of food stamp eligibility on the economic security of SSI recipients. Livermore, Shenk, and Sevak (2021) examine how benefit suspension and overpayments affect SSI and SSDI beneficiaries. Swensen and Urban (2021) determine the effects of openings (and closings) of county mental health treatment facilities on SSI and SSDI applications and subsequent awards.

RDRC research funded in previous fiscal years included the following: Deshpande (2020) analyzes the channels through which SSI participation by children affects their outcomes as adults. Hembre and Urban (2020) collect data on local housing assistance policies—including whether they prioritize households facing disabilities—and examine the effects of these policies on SSI applications and participation. Hamman (2020) explores the shift toward community-based living (and away from nursing homes) since the 1980s, and the impact this shift has had on the SSI and the Medicaid long-term care programs. Hyde, Schwabish, O’Leary, and Luca (2021) document the local-area predictors of flows onto the SSDI and SSI programs and flows out of these programs due to work in order to understand the drivers of benefit application, benefit receipt prevalence, and beneficiary employment milestones. Dizon-Ross and Deshpande (2022) explore the effects of beliefs about the likelihood of SSI removal at age 18 on human capital investment.

Researchers within SSA, at other Federal agencies, and at academic institutions have conducted a number of studies that provide a better understanding of the SSI program, the elderly and disabled target populations, program interactions, and the role of the SSI program in the United States social safety net. Levere, Hemmeter, and Wittenburg (2025) examine the factors that influenced the decline in SSI applications during the COVID-19 pandemic, including administrative changes and economic stabilization initiatives. By contrast, for declines in child SSI applications, Levere, Hemmeter, and Wittenburg (2024) consider the effect of school closings during the pandemic. Weaver (2024) analyzes mortality rates among current and former SSI and SSDI program participants during the pandemic. Nicholas (2013) estimates the prevalence, characteristics, and poverty status of SSI recipients living with others on SSI (who are not an eligible spouse) in the context of their individual, family, and household units. Nicholas and Hale (2021) examine SSI and SSDI applicants and recipients who faced homelessness during 2007 to 2017. Rupp (2012) analyzes factors affecting initial disability allowance rates for the SSDI and SSI programs and finds that demographic and diagnostic characteristics of applicants and the local unemployment rate substantially affect the initial allowance rate. Wixon and Strand (2013) document how DDS data can be used to analyze outcomes at each step of the disability determination process. Bailey and Hemmeter (2014, 2015) used the 2008 SIPP matched to SSA administrative records to examine the characteristics of SSDI and SSI program participants. Messel and Trenkamp (2022) provide an update of participant characteristics based on CPS data. Another study used our administrative records from August 2005 through August 2007 to analyze SSI recipients who lived in counties and parishes affected by Hurricanes Katrina and Rita (Davies and Hemmeter 2010).

Another series of research studies examines the subsequent participation in the SSDI and SSI programs by individuals whose eligibility for those programs ceased through a continuing disability review because of medical improvements (Hemmeter and Bailey 2015). Hemmeter, Levere, and Wittenberg (2024, 2025) look at the role of childhood continuing disability reviews in explaining trends in child SSI enrollment.

Several studies examine the effect of information on SSI application and participation. Hemmeter et al. (2025) test the effects of providing additional information on potential eligibility on take up rates. More generally, Messel, Oluwole, and Rogofsky (2022) explore how well informed the general public is about the two disability programs administered by SSA.

Several studies focus on the long-term experiences of children and youth receiving SSI. Rupp, Hemmeter, and Davies (2015) looked at SSI children by year and age at award and analyzed transitions (e.g., onto SSDI, off SSDI and SSI, mortality) as they age into adulthood. Hemmeter et al. (2021) explore the longitudinal patterns of SSDI and SSI participation and mortality of child SSI awardees. Hemmeter et al. (2015) compare the outcomes of participants in the Marriott Foundation for People with Disabilities Bridges from School to Work program with non-participating SSI recipients. Hemmeter (2015) looks at the entry of youth onto the SSI program at age 18. Hemmeter, Mann, and Wittenburg (2017) look at State variation in post-age-18 redetermination outcomes. The Department of Labor’s Office of Disability Employment Policy conducted their SSI Youth Solutions project to identify ways to improve the outcomes for transition-age youth. Several of the proposals built on experiences from the Youth Transition Demonstration and the Promoting Readiness of Minors in SSI projects. Contreary and Honeycutt (2021) summarize the resulting 12 proposals, Honeycutt, Contreary, and Livermore (2021) compare and contrast them, and Honeycutt et al. (2021) provide evaluation options for each. Musse, Honeycutt, and Hemmeter (2024) look at how the Workforce Innovation and Opportunity Act of 2014 affected the employment and work incentive use of youth receiving SSI.

Several studies have focused on the participation and outcomes of specific diagnostic or eligibility groups. Hemmeter and Davies (2019) document the mortality of infant SSI applicants. Guldi et al. (2018) and Hawkins et al. (2025) look at the relationship between low birthweight, SSI, and childhood outcomes. Woodford Martin (2019) compares the SSI receipt of low birthweight infants in two States. Guldi et al. (2024) look at maternal employment and low birthweight SSI receipt. SSA also sponsored a National Academies of Science, Engineering, and Medicine study on low birthweight and SSI (NASEM 2023). Anderson et al. (2020, 2021) compare trends in SSI awards to, and participation by, adults with autism, and Patnaik, Hemmeter, and Mamun (2021) examine the effect of the Promoting Readiness of Minors in SSI interventions on participants with autism. Messel, Swensen, and Urban (2023) address the growing number of people suffering severe mental illness by studying the relationship between mental health services and SSI and SSDI applications and awards. Costanzo, Vogel, and Hostetter (2025) examine families where a retired parent cares for a child with a disability.

Levere, Wittenburg, and Hemmeter (2022) explore the relationship between local area deprivation and child SSI participation. Meseguer (2018) considers how primary and secondary diagnoses are related in SSA's disability programs. Koudou and Dely (2022) provide a descriptive analysis of the Quick Disability Determination process used by SSA in determining disability for selected types of disability applicants.

Several studies highlight interactions between the SSI program and other Federal and State programs. Rupp and Riley (2016) focus on the effect of State variations in Medicaid enrollment policies for SSI recipients on Medicaid coverage and expenditures. Martin, Honeycutt, and Hemmeter (2020) document the earnings and SSA benefit outcomes after vocational rehabilitation applications of youth. Brucker and Garrison (2021) explore the connection between SSDI, SSI, and Federal rental housing assistance programs while Urban and Javapregasham (2021) look at the relationship between local public housing authorities and SSI participation. Muchomba and Kaushal (2021) look at the connection between Medicaid expansions and non-citizen SSI participation. Weathers, Kelly, and Hemmeter (2024) look at the use of Achieving a Better Life Experience (ABLE) accounts by SSI recipients. Pollack, Levere, and Guglielmo (2024) and Kim (2024) discuss the role of ABLE accounts for people with disabilities.

Additional studies have utilized data available from SSA's Disability Analysis File (DAF) and National Beneficiary Survey (NBS). The DAF was a research file compiled annually from 2004-2025 (and called the Ticket Research File through 2012) that brought together the agency's disparate administrative data resources for child and working-age adult beneficiaries who have received disability cash benefits from SSI; Old-Age, Survivors, and Disability Insurance (OASDI); or both programs since 1996. In 2025, we published a new chartbook based on DAF data titled, “DI & SSI Program Participants: Characteristics & Employment, 2021” (https://www.ssa.gov/policy/docs/chartbooks/di-ssi-employment/index.html). This chartbook examines the work activity of working-age adult Social Security Disability Insurance (SSDI) beneficiaries and SSI recipients before and after disability award. It covers work activity, employment expectations and characteristics, employment services, and factors affecting employment.

Through the NBS, we collected information that is not available from our administrative records from a representative sample of SSI and OASDI disability beneficiaries. Key items of interest in the NBS include work attitudes and work-related activities, health and functional status, education, health insurance, household composition, and sources of income. We implemented the first four rounds between 2004 and 2010, with a particular focus on the Ticket to Work program. More recent rounds in 2015, 2017, 2019, and 2023 added emphasis on beneficiaries who work, especially those who have experienced employment success to the point of benefit suspension. In 2025, we published a compendium of disability statistics from the 2019 NBS, “National Beneficiary Survey: Disability Statistics, 2019” (https://www.ssa.gov/policy/docs/statcomps/nbs/index.html). The publications provide descriptive statistics on the health, program and service participation, employment interest and activity, job characteristics, and benefits and employment interaction of SSI recipients and SSDI beneficiaries. We are developing an updated version of this publication using data from the 2023 NBS.

Other researchers and policy analysts within SSA and at other Federal agencies and academic institutions use the DAF and the NBS for general disability research. Research using DAF or NBS data includes several of the analyses described above as well as the following studies: Wittenburg et al. (2018) examine differences between survey and administrative data based estimates of employment and earnings for SSI and SSDI beneficiaries; Walker and Roessel (2019) analyze the characteristics of adult SSDI and SSI disability program beneficiaries with multiple impairments; Livermore et al. (2019) examine changes in SSI and DI beneficiary characteristics and employment-related experiences from 2005 to 2015; Cox (2019) studies the reasonable accommodation needs of SSI and SSDI beneficiaries; Anand and Honeycutt (2019) examine the relationship between receiving support for postsecondary education (college or vocational training) from State VR agencies and long-term outcomes for youth with mental health conditions; Baller et al. (2020) provide a follow-up assessment of the long-term impact of the Mental Health Treatment Study; and Layton et al. (2022) examine the effect of a specific Medicare reform in Texas on the quality of care received and the health of SSI beneficiaries. O’Leary and Roessel (2023) synthesize the previous evaluations of the Ticket to Work program and extend them by using the DAF to estimate the effects of services on program participants in relation to program costs, as is also described in the following section. Hyde and Harrati (2023) examine the alignment between self-reported disability receipt identified in the Health and Retirement Study and administrative data in the DAF. Bronchetti and McInerney (2023) examine the impact of work-related inquiries and illnesses on the timing of SSI, DI, and Workers’ Compensation and Ho et al. (2025, preprint) used DAF data in combination with other SSA data to compare the outcomes of individuals who participated in the Ticket to Work program to beneficiaries who did not, concluding that individuals participating in the program were more likely to reduce dependency on SSA benefits after controlling for confounding factors.

In 2021, SSA held a meeting to discuss the lessons from its portfolio of demonstrations. The meeting included over 30 experts providing analysis and commentary on several SSI and SSDI demonstrations and lessons from other programs. Nichols, Hemmeter, and Goetz Engler (2021) compiled the papers from that meeting. Nichols and Hemmeter (2021) provide an introduction and overview of SSA's policies and demonstrations. Barnow and Greenberg (2021) discuss the design of evaluations, Weathers and Nichols (2021) provide recommendations to improve the use of demonstrations, and von Wachter (2021) discuss heterogeneity in impact estimation. Gregory and Moffitt (2021) provide lessons related to return-to-work programs while Hollenbeck (2021) provides an overview of early-intervention policies. Wittenburg and Livermore (2021) discuss issues related to youth transition and the SSI program. Sundar (2021) provides lessons related to case management and benefits counseling and Wood and Goetz Engler (2021) cover implementation lessons.

The Ticket to Work and Work Incentives Improvement Act of 1999 (the Ticket Act) required the Commissioner of Social Security to provide independent evaluations to assess the effectiveness of the Ticket to Work program. We completed our first evaluation of the Ticket to Work in 2013 through an independent evaluation contractor, Mathematica Policy Research, Inc. As part of this evaluation, Mathematica produced a range of research, which was grouped into seven reports.

Overall, the original Ticket to Work evaluation found that beneficiaries who use Ticket to Work (TTW) generally like the program, that the program has increased use of return-to-work services, and those who participate in Ticket to Work have better outcomes than those who return to work without the help of SSA-financed employment services. However, we also found that the increase in service use and better outcomes by participants had not translated into measurable net increases in benefit suspension or termination for work or a measurable increase in the number of months spent in suspension or termination for work. This suggests that, at that time, the Ticket to Work primarily extended the types of services that were available under the program that preceded Ticket to Work, where services were offered only through State vocational rehabilitation agencies, and achieved the same level of success as before Ticket to Work. More beneficiaries are getting these services under TTW, but the success rate had not measurably changed.

We extended our original evaluation of the TTW program in several ways after 2013. In 2018, we completed a study to determine the administrative cost of TTW by examining the cost of SSA staffing and contract resources for the TTW program. We conducted a workload assessment to determine the number and grade level of staff working on TTW and to allocate the time of each staff member between TTW specific activities. We then developed fully loaded salaries for each staff position to estimate the actual costs of administrative workloads for TTW, then combined those costs with TTW contracting costs to estimate the total staffing cost (O'Leary and Roessel 2018).

We also collaborated with researchers from the General Services Administration to test new Ticket mailings that notify beneficiaries of their eligibility to participate in the TTW program. We mail TTW notices to beneficiaries approximately 2 months after the award and at the 12-month and 36-month anniversary dates post-award. The TTW Notice Optimization project sought to increase participation in the TTW program by developing an evidence-based approach to target eligible beneficiaries. The project tested changes to Ticket notices including the types of notices sent, the language used, and the timing of notices. The notices were mailed over 18 months, from September 2020 through February 2022. Neither the redesigned notices, nor the changes to the intervals when notices were mailed to beneficiaries, had a statistically significant effect on Ticket assignments. However, these changes had a statistically significant effect on the number of telephone inquiries to our Ticket Program Manager about the TTW program.

More recently, we completed a study assessing the return on investment for the TTW program (O'Leary and Roessel, 2023). This analysis provides a summary of prior findings relative to TTW goals and adds new graphical and regression analyses of TTW outcomes and impacts vs. costs. More specifically, this analysis compares TTW findings to goals as described in the TTW legislation, clarifies the findings from the 2013 evaluation regarding the net impact of the TTW program, provides the cost and outcome information requested by those with TTW oversight, and refines the outcome analysis by using regression techniques with selection bias adjustments.

We funded a new independent evaluation in 2023 to assess the extent to which the TTW program is effective and efficient and to identify opportunities for program improvements. We are analyzing existing SSA data and will collect new data through a survey of all Ticket Act service providers and beneficiary interviews. The current evaluation is scheduled to be completed in 2027.

The Youth Transition Demonstration (YTD) established partnerships to improve employment outcomes for youths age 14-25 who receive (or could receive) SSI or OASDI payments based on their own disability. The YTD projects included service delivery systems and a broad array of services and supports to assist youth with disabilities in their transition from school to employment and to help them gain economic self-sufficiency.

YTD began in 2003, with seven projects in six States. In 2007, we piloted new projects in five States, choosing three new projects in Florida, Maryland, and West Virginia. These three projects joined three (Colorado; Bronx County, New York; and Erie County, New York) of the original seven projects in a random assignment study. This study will produce the first evaluation of the empirical evidence of the effects of youth transition programs and modified SSI work incentives.

The modified SSI program rules that we tested under the YTD included five program waivers.

The YTD projects in Colorado and New York ended in 2010. The Florida, Maryland, and West Virginia projects ended in 2012. We have released the 12-month, post-random-assignment reports for all the sites to the public.

Two of the six projects showed an increase in employment three years after random assignment. Florida and Bronx, New York showed positive impacts on paid employment during the year after participants entered the evaluation. In Florida, 23 percent of participants in the program group worked for pay during that year, compared with just 13 percent of control group members. Because several youths took advantage of the modified program rules (listed in bullets above), participants of five of the six projects had higher total income from earnings and disability benefits in the third year after random assignment. These impacts ranged from $1,010 higher total income in West Virginia to $1,729 higher in Bronx, New York. The YTD showed that substantial doses of well-designed service to youth with disabilities can improve key transition outcomes in the medium term.

In 2018, three follow up analyses were completed and published. One paper summarized the effects of the YTD interventions three years after random assignment (Fraker et al. 2018). The second paper examined implementation and outcomes in one specific site, the West Virginia Youth Works site (Cobb, Wittenburg, and Stepanczuk 2018). This examination provides a potential case study for other States interested in expanding services to youths with disabilities. The effects at this site were large relative to those of previous SSA demonstrations. Mamun et al. (2018) used YTD data to show that early work experience increases the probability of being employed two years later. We will follow participants using administrative data and conduct cost-benefit analyses at specified periods to test the longer-term outcomes of these projects.

Our findings from YTD influenced the development of the Promoting Readiness of Minors in SSI (PROMISE) project, a joint initiative of SSA and the Departments of Education, Health and Human Services, and Labor that funds model demonstration projects in several States to promote positive outcomes for children with disabilities who receive SSI and their families (described in section g).

To determine whether adult disability applicants qualify for benefits, our adjudicators follow a sequential five-step evaluation process. At steps four and five, where we decide many of our claims, we require information about work in the national economy to determine whether claimants’ impairment-related limitations would prevent them from working. Currently, we base these medical-vocational decisions primarily on the occupational information found in the Department of Labor’s (DOL) Dictionary of Occupational Titles (DOT) and its companion volume, the Selected Characteristics of Occupations. Although DOL did not design the DOT for our use, we incorporated many of its concepts and definitions into our regulations and policy. DOL stopped updating the DOT in 1991 and later replaced it with the Occupational Information Network (O*NET), a system that was developed as a career exploration tool. Because O*NET does not measure strength and physical requirements in the way that the DOT does and SSA disability rules require, it is not a replacement for the DOT in SSA’s disability adjudication process. We could not identify any other existing Occupational Information System (OIS) that would meet our unique needs.

In July 2012, we signed an Interagency Agreement with the Bureau of Labor Statistics (BLS) to test the feasibility of using the National Compensation Survey (NCS) platform to collect updated occupational information about the skill level, physical, environmental, and mental and cognitive requirements of work. With input from SSA, BLS ultimately developed the Occupational Requirements Survey (ORS) to collect the updated occupational data that SSA needs. This information, along with specified information from other occupational sources, will provide us with updated data about work for disability adjudication and inform current and future vocational policy.

In FY 2013 and 2014, BLS conducted feasibility testing and worked with us to improve the survey tools and testing protocols. In FY 2015, we began developing the web-based IT platform, the Vocational Information Tool (VIT), to house and allow adjudicators use of the occupational data. BLS also conducted a nationwide pre-production test, and, at the end of the fiscal year, began production data collection using the ORS. In FY 2016, BLS completed the first year of ORS data collection and continued testing to resolve any issues raised by earlier data collection. In May 2016, BLS began the second year of collection.

In FY 2017, BLS completed the second year of data collection. BLS released the first-year ORS estimates in December 2016 and the combined first- and second-year estimates in November 2017. In FY 2018, BLS completed the initial three-year data collection wave (Wave 1), which they published in February 2019. In FY 2019, BLS completed the first year of the first five-year wave update (Wave 2), using a new sample design that better captures information across occupations. After each publication, SSA analyzed the public ORS estimates and, in FY 2019, began analyzing BLS microdata extensively. Microdata are unit-level data from each respondent to the ORS before the data is aggregated, summarized, and published as occupational estimates. SSA is using the analysis—as well as research on the residual functional capacity (RFC)—to evaluate the feasibility of updating its disability policy. RFC describes the most an individual is able to do, despite functional limitations resulting from a medically determinable impairment(s) and impairment-related symptoms. It is an administrative determination of an individual’s capacity to perform work-related physical and mental activities.

In FY 2020, BLS completed the second year and published estimates from the first year of Wave 2. SSA and BLS discussed and determined joint program development activities to ensure that the ORS estimates published by BLS meet SSA’s needs. At the end of FY 2020, BLS began data collection for the third year of Wave 2. SSA activities related to VIT development included developing functionality that will facilitate matching claimant limitations to ORS requirements to assist adjudicators in determining whether work exists in the national economy in significant numbers that an individual can perform.

In FY 2021, BLS completed the third year and began the fourth year of Wave 2 data collection. In December 2020, BLS published ORS estimates for the combined first and second-year data collection samples. VIT development included upgrading the system’s architecture to comply with SSA’s new user experience framework and conducting detailed user experience testing.

In FY 2022, BLS completed data collection for the fourth year and began collecting the fifth and final year of Wave 2. BLS published estimates for the combined first, second, and third years of ORS data collection samples in November 2021. SSA and BLS assessed the results of BLS testing and research on previously proposed Wave 3 measurement changes and came to an agreement on the final changes to be implemented for Wave 3. SSA and BLS worked together to develop the Wave 3 sample design methodology and SSA continued its analysis of the ORS microdata.

In FY 2023, BLS completed Wave 2 data collection and began collecting the first year of Wave 3 collection. In November 2022, BLS published data from the combined first four years of Wave 2. BLS also completed and submitted the Wave 3 OMB clearance package after SSA review. The 60-day notice seeking public comments related to the ORS third wave was published in the Federal Register in December 2022. OMB approved the ORS clearance for the third wave in June 2023.

In FY 2024, BLS published the final Wave 2 data collection set, substantially increasing the number of estimates as compared to Wave 1. The occupations represented in the estimates accounted for 93 percent of civilian workers in the national economy. The agencies reached agreement on final measurement objectives and detailed requirements for supplemental ORS estimates in June 2024 and BLS published two supplemental data products for SSA in August. BLS also completed and published the first year of Wave 3 data collection and began collecting data for the second year.

In FY 2025, BLS completed the second year and began the third year of Wave 3 data collection. In November 2024, BLS published data from the first year of Wave 3. On January 6, 2025, SSA published SSR 24-3p: Titles II and XVI: Use of Occupational Information and Vocational Specialist and Vocational Expert Evidence in Disability Determinations and Decisions. This SSR rescinded and replaced SSR 00-4p by removing the requirement for our adjudicators to identify and resolve conflicts between the occupational information provided by Vocational Specialists (VSs) and Vocational Experts (VEs) and the information in the DOT and explains in detail that the agency will allow VSs and VEs to rely on more recent vocational resources, including the Occupational Requirements Survey (ORS).

In FY 2026, BLS will publish the third year of Wave 3 data collection and begin collecting data for the fourth year. In January 2026, BLS published data from the combined first two years of Wave 3.

The goal of the Homeless with Schizophrenia Presumptive Disability (HSPD) Pilot Demonstration is to improve the economic well-being of adult SSI applicants who are both homeless and diagnosed with schizophrenia or schizoaffective disorder. We partnered with clinicians and case managers in California from the Health Services Agencies of San Francisco and Santa Cruz counties, the Department of Public Health of the City of San Francisco, and the Department of Mental Health of Los Angeles County, who are actively assisting their clients to navigate the SSI application process and have established relationships with patients diagnosed with schizophrenia and schizoaffective disorder who are also homeless. There were two main features of the project: (1) the SSI application assistance; and (2) the use of presumptive disability (PD). The clinicians and case managers assisted these individuals with gathering supporting medical evidence, coordinating medical appointments, and submitting the SSI application. Along with the SSI application, a Presumptive Disability Recommendation Form, created for this pilot demonstration, was also submitted. Clinicians from the community agencies certified that the applicant met the SSA criteria for a diagnosis of schizophrenia or schizoaffective disorder. To provide economic relief to the applicant while we processed the application, we awarded up to 6 months of SSI payments to the applicant based on PD. Applicants were not required to pay back these payments if we ultimately denied their applications, as long as we did not deny the applications for non-medical reasons; therefore, there must be a high degree of probability that the applicant was disabled when we conferred PD SSI payments. Our field offices generally make PD findings only for specific disability categories, which do not include schizophrenia or schizoaffective disorder.

Project implementation began in April 2012, with a goal of recruiting at least 200 participants. We met this enrollment goal and completed the implementation phase in April 2014. The community partners identified 260 individuals to assist through the SSI application process. Among the 238 we are using for our evaluation, we approved 223 of these applicants, denied 14, and 1 had no decision.

In our evaluation (Bailey, Engler, and Hemmeter 2016), we examined whether the program improves the administration of the SSI application and determination process. The evaluation is based on a quasi-experimental design, in which we compared outcomes for applicants who receive assistance and PD payments with applicants from a previous period and applicants in surrounding areas. Within this framework, we examined differences in initial allowance rates, appeals, failure-to-cooperate denials, processing times, total payments, exits from SSI, mortality, and the need for consultative exams. Relative to the comparison groups chosen in the surrounding geographic areas, in an earlier period, and in the same locations, we found that the pilot led to higher allowance rates at the initial adjudicative level, fewer requests for consultative examinations, and reduced time to award.

Promoting Readiness of Minors in SSI (PROMISE) was a joint project between SSA and the Departments of Education (ED), Labor, and Health and Human Services. The goals of the project were to improve the provision and coordination of services and supports for children with disabilities who receive SSI and their families in order to achieve improved education and employment outcomes. The targeted outcomes included completing postsecondary education and job training to obtain competitive employment in an integrated setting that may result in long-term reductions in the child recipient’s reliance on SSI. In 2013, ED funded model demonstration projects in five individual States (Arkansas, California, Maryland, New York, and Wisconsin) and one consortium of States (Arizona, Colorado, Montana, North Dakota, South Dakota, and Utah, collectively referred to as Achieving Success by Promoting Readiness for Education and Employment, or ASPIRE) for 5 years. SSA was responsible for evaluating PROMISE.

Each PROMISE project enrolled at least 2,000 youths ages 14-16. The projects provided youths randomly assigned into the treatment group services including: case management; benefits counseling; career and work-based learning experiences; and parent/guardian training and information. Youths randomly assigned to a control group received the services usually available in their communities.

The PROMISE evaluation included process, impact, and cost-benefit analyses. Enrollment began in April 2014 and ended in April 2016. All projects stopped providing services by September 2019. Project-specific process analyses (Anderson et al. 2018; Honeycutt, Gionfriddo, Kauff et al. 2018; Kauff et al. 2018; Matulewicz et al. 2018; McCutcheon et al. 2 018; Selekman et al. 2018) and eight special topic reports (Honeycutt, Gionfriddo, and Livermore 2018; Honeycutt and Livermore 2018; Levere et al. 2020; Patnaik, Harrati, and Musse 2022; Farid et al. 2022; Hill, Patnaik, and Musse 2022; Dale et al. 2023) describe how the projects were implemented, describe how PROMISE compares with and uses other transition policies and practices, describe how families’ service use is related to early youth outcomes, explore the pathways participants took toward education and employment, describe the education and work experiences of participants, show how COVID-19 affected the findings, describe how youth used Medicaid services, and summarize the lessons from PROMISE. An interim impact and services report was released in 2019 (Mamun et al. 2019). Livermore et al. (2020) summarize the lessons learned from these reports. Additional summaries and analyses from the interim report are also included in Patnaik et al. (2021). Patnaik et al. (2022) presents the longer-term impacts and cost-benefit analyses of PROMISE. Overall, the interventions only improved a few of the primary outcomes. Two programs increased youth employment rates and three increased youth income; there were no reductions in SSI payments over the evaluation period. There were some improved labor market outcomes for youth with intellectual disabilities and in families where parents also received SSI or SSDI. Over the five-year evaluation period, net benefits for all programs’ overall costs exceeded the measured benefits.

The individual projects and partners also produced research on the projects. A special edition of the Journal of Vocational Rehabilitation included a number of project-specific articles produced by the projects. Schlegelmilch et al. (2019) describe the relationship between work incentive benefits counseling and work in Wisconsin. Golden et al. (2019) describe the community of practice model used in New York State. Hartman et al. (2019) look at employment rates in Wisconsin. Ipsen et al. (2019) look at engagement in services at ASPIRE. Crane et al. (2019) describe the engagement strategies used in Maryland. Williams et al. (2019) look at the predictors of work activities in Arkansas. Luecking et al. (2019) report on lessons about intervention fidelity from Maryland. Enayati and Shaw (2019) estimate bounds on the return on investment for PROMISE projects. Tucker et al. (2019) describe the parent and guardian interventions implemented in California. Saleh et al. (2019) describe the characteristics of effective partnerships in New York State. Chambless et al. (2019) report on the implementation of self-determination training in ASPIRE. Gold et al. (2019) discuss general strategies for recruiting participants across the projects. Anderson, Schlegelmilch, and Hartman (2019) illustrate a cost-benefit analysis in Wisconsin. Anderson and Golden (2019) provide an overview of the special edition.

Emenheiser et al. (2020) provide an overview of PROMISE. Schlegelmilch et al. (2020) provide a qualitative analysis of several case studies in Wisconsin. Anderson et al. (2021) describe the vocational rehabilitation counselors’ use of technology in the Wisconsin PROMISE project. Hartman et al. (2021) look at the relationship of PROMISE and vocational rehabilitation in Wisconsin. Livermore et al. (2020) describe how PROMISE can provide insights to the transition system. Golden et al. (2021) provides a taxonomy of case management strategies based on the New York State PROMISE project. Jones et al. (2019) examines the relationships between individual development accounts and various elements of the Wisconsin PROMISE project and its participants. Patnaik, Hemmeter, and Mamun (2021) compare the experiences of PROMISE participants with and without a diagnosis of autism spectrum disorder.

The Supported Employment Demonstration (SED) evaluated whether offering evidence-based packages of integrated vocational, medical, and mental health services to recently denied disability applicants promotes employment, self-sufficiency, and improved mental health and quality of life. The project focused on individuals aged 18 to 50 who expressed a desire to work and who had recently been denied disability benefits (SSDI or SSI) while alleging a mental illness.

With the cooperation of 30 community health centers across the country, SED enrolled and randomly assigned 3,000 participants into one of three groups: 1) The Full-Service Treatment Group; 2) The Basic-Service Treatment Group; or 3) The Control Group (usual services). Participants assigned to the Full-Treatment Group received Individual Placement and Support (IPS) services, a nurse care coordinator, systematic medication management, and assistance with cost sharing for medications and behavioral health and work-related expenses. Participants assigned to the Basic-Service Treatment Group also received the IPS services and assistance with behavioral health and work-related expenses, but did not receive the services of a nurse care coordinator providing medication management support. Participants assigned to the control group could use all standard behavioral health or employment-related services available at the community health center and received a local community resources information book.

SED’s 15-month recruitment and participant enrollment began in early FY 2018. Participants received 36 months of intervention services after entry. Field operations ended in FY 2022 and included technical assistance, training, and data collection activities for process and outcome evaluations.

The demonstration ended in 2023. The Final Impact and Cost-Benefit Analysis Report revealed that Full-Service and Basic-Service treatment groups had significantly higher employment rates than control group participants. Treatment group members worked more and earned more during the study compared to usual services recipients. Cost-benefit findings showed the benefits did not outweigh costs during the intervention period for either the Full-Service or Basic-Service participants. However, analyses do suggest that the net benefit figure may not adequately capture the net benefits of the intervention, given findings that showed declining trends in service costs and increasing trends in earnings over time. A longer follow-up period would facilitate confirmation of this dynamic. Final analyses of application or entry into SSDI/SSI programs found no significant differences in SSDI/SSI allowance rates among the Full-Service, Basic-Service, or Usual Services groups; Allowance rates were roughly 15% in each of the three study groups during the study and appeals to denials were documented for nearly 50% of participants in each of the three study groups. A number of journal articles have been published about the demonstration thus far (Borger et al. 2021; Metcalfe and Drake 2021; Riley et al. 2021; Taylor et al. 2021; Metcalfe and Drake 2024). SSA and external researchers continue to explore possible follow-up analyses.

SSA partnered with the Office of Evaluation Science (OES) at the General Services Administration and its predecessor in the White House’s Social and Behavioral Science Team (SBST) to test “nudge”-style behaviorally informed notices. In 2015, SSA partnered with the SBST to test whether a new notice could encourage SSI recipients to report changes to their earnings in a more accurate and timely manner. The researchers found that SSI recipients receiving the letters were 34 percent more likely to have reported earnings for the previous months (Zhang et al. 2023).

Several research studies indicate that a large number of low-income seniors do not receive SSI even though they are potentially eligible for payments. In FY 2017, SSA, in partnership with OES, conducted a pilot to identify what specific language, if any, has the greatest effect on SSI participation among potentially eligible low-benefit OASDI beneficiaries. In September 2017, we sent one of four differently worded notices to randomly selected groups of low-benefit OASDI beneficiaries meeting the study criteria. We used program records on the rates of SSI applications and awards to measure the effect of the notices on SSI applications as compared to a control group, who did not receive a notice (Hemmeter et al. 2025). We found the letters increased applications by about 5 percentage points (a relative increase of over 1000 percent) and increased awards by about 1.5 percentage points (a relative increase of over 860 percent). External researchers are analyzing the data to determine if there are downstream health effects.

As noted in the Ticket to Work Evaluation section, the Ticket to Work Notice Optimization project sought to increase participation in the Ticket to Work program. Jilke et al. (2020) tested whether behaviorally informed changes to the notices SSA sends to Title II Disability Insurance beneficiaries and SSI recipients to inform them about the Ticket to Work program and changing the timing of those notices resulted in increased Ticket assignments with Employment Networks or vocational rehabilitation agencies. SSA began sending the new notices at revised intervals to the treatment groups in September 2020 and completed the mailings in February 2022. SSA worked with the General Services Administration to assess the impact on Ticket to Work participation over the 18 months following each mailing cohort.

The Promoting Work through Early Interventions Project (PWEIP) is a collaborative initiative between SSA and the Administration for Children and Families (ACF) within HHS. The goal of the PWEIP is to identify, select, and evaluate programs likely to improve the employment and economic outcomes for individuals who have current or foreseeable disabilities. This includes those who are tied to U.S. safety net programs, have little or no work history, and have not yet applied for SSI or SSDI. Evaluations of these programs will include impact assessments and implementation research, with a select number of evaluations which will also include a cost analysis. In FY 2019, we developed a jointly financed cooperative arrangement with ACF and transferred $25 million to support the evaluation of and service provisions for selected intervention programs. PWEIP plans include rigorous evaluations of programs and analyses of outcomes related to employment, earnings and benefit receipt.

In FY 2020, we worked with ACF to identify and select programs to participate in ACF’s Building Evidence on Employment Strategies (BEES) and Next Generation of Enhanced Employment Strategies (NextGen) projects, both of which received approval for PWEIP.

In FY 2021-FY 2022, ACF proposed ten programs to SSA for consideration; eight of these programs were approved. The four programs under BEES use the evidence-based Individual Placement and Support (IPS) model of supported employment as the key intervention. The approved programs (along with their participating states) include IPS: for individuals using Federally Qualified Health Center services (IL and NH); for individuals with Substance Use Disorders (OK and OH); for participants receiving TANF and SNAP assistance (WA); and for justice involved individuals within 30 days of re-entering communities (IA, TN, OK, SC, and IL). The other four approved programs include the Central City Concern (OR), the Mental Outreach for Mother program (MA), Bridges from School to Work (GA, MD, TX, NY, CA, PA, and DC); and Community Integrated Services (PA). The Central City Concern program, part of the BEES project, is a large housing and employment center with an outpatient clinic providing general healthcare and employment, housing, and recovery services for individuals with substance use disorders who enter from a detoxification center. The Mental Outreach for Mothers program, under the NextGen project, utilizes an evidence-based practice (EBP) model to provide employment services. It focuses on teaching self-regulation skills and stress management techniques to women who have mental illnesses and are caregivers for children under the age of 18.

The Community Integrated Services program (PA), under the NextGen project, assists employers in adopting employment practices that allow workers with mental or physical disabilities to be productive. It assesses the interests and capabilities of job seekers, helps match them with jobs available with the employer, provides support during the hiring and onboarding process, and continues to offer assistance as needed. The final NextGen project, Bridges, is an employer-driven program that delivers job readiness instruction, placement, and post-placement support for young adults with disabilities in eight urban areas.

Due to COVID-19, all eight programs experienced delays in implementation. Some programs adapted by scheduling later start dates for enrollment, while others expanded their referral pool for prospective participants. ACF and SSA agreed to expand enrollment timeframes by at least three months for programs in the recruitment phase. As a result of the pandemic, the overall timeline for the standing programs was adjusted, delaying implementation and extending the recruitment period. The enrollment phase for all jointly funded programs ended December 2024. Final evaluations of the projects are expected in FY 2027.

The Analyzing Relationships between Disability, Rehabilitation and Work (ARDRAW) Graduate Student Research Program provided one-year stipends to graduate-level students to conduct supervised independent research on rehabilitation, work, and disability topics. The objective of the program was to generate innovative research with fresh perspectives on disability and to cultivate new scholars in the disability research fields. The ARDRAW program consisted of two parts: an award for program management services and the individual stipend awards to students (the program management piece is necessary since SSA cannot make research awards to individuals). In FY 2025, SSA awarded the Board of Regents of the University of Wisconsin System to manage the ARDRAW program. The awardee planned to work with SSA to hold the competition for student researchers, make stipend awards, and host a series of webinars to promote the program to prospective applicants and their mentors. However, SSA terminated the ARDRAW program in FY 2025 to comply with Executive Order 14222 Implementing the President’s “Department of Government Efficiency” Cost Efficiency Initiative.

SSA began the Interventional Cooperative Agreement Program (ICAP) in 2021. ICAP funded cooperative agreements to collaborate with States, foundations, and other non-Federal groups and organizations who had the interest and ability to identify, operate, and evaluate interventional research. The research and interventions under this program targeted: 1) promoting self-sufficiency by helping people enter, stay in, or return to the labor force, including youth; and 2) coordinating planning between private and public welfare agencies to improve the administration and effectiveness of the SSDI, SSI, and related programs.

We made the first round of cooperative agreement awards in September 2021 to the Kessler Foundation and the State of Georgia Criminal Justice Coordinating Council (CJCC). The Kessler Foundation was awarded $3 million to conduct a randomized controlled trial of the Vocational Resource Facilitation Demonstration (VRFD) employment intervention for adults who have experienced a brain injury or spinal cord injury in New Jersey. VFRD enrollment began in 2023, and the project is scheduled to end in 2026. The CJCC was awarded $1.3 million to conduct a feasibility study of the implementation of the SSI/SSDI Outreach, Access, and Recovery (SOAR) in Georgia County Jails Pilot (SGCJP) with inmates with serious and persistent mental illness. SGCJP enrollment began in 2024, and the project is scheduled to end in 2026.

We made the second round of awards in January 2023 to Mathematica and Westat. Mathematica was awarded $3 million to conduct the Youth Transition Exploration Demonstration (YTED), a randomized controlled trial to assess the impact of an employment intervention for youth with disabilities who are transitioning into the adult workforce in the Greater Philadelphia area of Pennsylvania. YTED enrollment began in 2025, and the project is scheduled to end in 2027. Westat was awarded $3 million to conduct the Supportive Housing and Individual Placement and Support (SHIPS) Study, a randomized controlled trial to assess the impact of combining supportive housing with Individual Placement and Support (IPS) supported employment services for recently homeless people experiencing a range of disabilities and mental health conditions. SHIPS recruitment began in 2024 and the project is scheduled to end in 2027.

We made the third round of awards in September 2023. We made two awards, one to the State of Colorado Department of Labor and Employment (CDLE), and one to the University of Chicago. The CDLE was awarded $3 million to conduct the Interagency Cooperative Action Network (ICAN) Demonstration, a randomized controlled trial to evaluate the impact of assisting potentially eligible individuals in their efforts to acquire SSI or SSDI benefits while they are actively engaged in employment or actively seeking employment. The University of Chicago was awarded $3 million to conduct a three-phased randomized controlled trial to evaluate the impact of promoting the take-up and use of Achieving a Better Life Experience (ABLE) account for SSI recipients to improve their financial security and self-sufficiency, and ultimately their employment outcomes. This study was called the Developing Opportunities for ABLE Account Holders (DOABLE) Demonstration. These projects were terminated by the government for convenience in 2025.

We made the fourth round of awards in September 2024 to the Maryland Department of Disabilities, which was awarded $4.5 million to conduct the Assisting Children to SSI (ACTS) demonstration project. The ACTS intervention team planned to utilize a predictive model to identify and select Maryland children receiving Medicaid who had a high probability of being eligible for SSI but were not already receiving SSI. They planned to provide the participants with different levels of assistance and measure SSI-related outcomes based on the level of assistance provided. This project was terminated by the government for convenience in 2025.

The Ohio Direct Referral Demonstration (ODRD) is a joint demonstration with the Ohio State agency, Opportunities for Ohioans with Disabilities (OOD). The goal of ODRD is to test the effectiveness of providing direct referrals to vocational rehabilitation services for 18 and 19 year-olds who are, or may become, SSI or SSDI beneficiaries. Participants in the demonstration include individuals ages 18 and 19 at the time of enrollment, who are either (1) applying for SSDI or SSI or (2) undergoing an age-18 redetermination of SSI eligibility. OOD’s Division of Disability Determination (DDD) and the Bureau of Vocational Rehabilitation (BVR) will share information to conduct ODRD. OOD and SSA will each contribute staff time to the demonstration and SSA will not incur additional costs.

The Ohio DDD began recruitment in January 2020. Recruitment has ended. The final report is expected to be completed in 2026.

In FY 2018, SSA awarded a Blanket Purchase Agreement (BPA) aimed at providing an alternate research channel for policy and program assessments and studies including research on SSI program related topics.

In FY 2019, SSA awarded two studies relevant to the SSI program through the BPA:

In FY 2020, SSA awarded two studies relevant to the SSI program through the BPA:

We received the final reports on these studies in July 2021.

In FY 2021, SSA did not award any relevant studies through the BPA.

In FY 2022, SSA awarded research for two studies (final reports received in FY 2023):

In FY 2024, SSA awarded a new 5-year BPA contract to allow us to more quickly award multiple research projects simultaneously to support policy and program assessment, to include SSI related programs, and studies related to social science, medical, or vocational rehabilitation topics.

In FY 2024, we funded the following project:

In FY 2025, we funded the following project (contract currently underway):

In FY 2026 we are funding the following project (contract currently out for solicitation):

The Beyond Benefits Study analyzed the services and support needs for successfully returning to work (or staying at work) for individuals who exited or were likely to exit SSI or SSDI due to medical improvement. In addition to in-depth interviews and focus group with participants, a large survey collected responses from 4,000 individuals in this cohort about these issues. Additionally, a small motivational interviewing program focused on reducing ambivalence or alleviating barriers to employment, was piloted and completed with 50 participants to provide context for the study. The BBS contract ended in FY 2025. SSA staff will conduct an analysis of the data in 2026 and 2027.

The GIFTT tests the effect of providing privately funded guaranteed income (GI) payments to adults with cancer in active treatment. It will inform SSA’s understanding of how prespecified and recurring charitable payments affect individuals with cancer who may apply for or already receive SSI, including any changes to health outcomes, earnings, and reliance on SSA benefits. We have a no-cost cooperative agreement with the University of Pennsylvania and Humanity Forward Foundation to implement and evaluate GIFTT. One Family Foundation funded the GI payments. Humanity Forward Foundation administered the GI payments and provides benefits counseling. The University of Pennsylvania recruited participants and is conducting the evaluations.

Enrollment for GIFTT began in April 2023 and was completed in September 2024. At enrollment, all participants were required to have an annual household income at or below 200 percent of the Federal Poverty Line, be in active cancer treatment in the Philadelphia area, and reside in certain counties in Pennsylvania.

Participation is voluntary and individual participants provided informed consent. The control group did not receive GIFTT payments; they receive the typical supports available to patients with cancer at their hospital, including a referral to a social worker or navigator. The intervention group received GIFTT payments of $1,000 per month for 12 months, along with benefits counseling. To implement this intervention, we are waiving certain program rules for treatment group participants and their spouses and children in the same household including: 1) exclusion of GIFTT payments from income when determining eligibility and payments, and 2) exclusion of GIFTT payments from resources for up to four years, during the 12 months of receipt of GIFTT payments plus a period of three years after receipt of the final GIFTT payment.

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Hemmeter, Jeffrey, Michael Levere, and David C. Wittenburg. “Explaining Variation in Child SSI Receipt: The Role of Medical CDRs.” AEA Papers and Proceedings 115 (2025): 114–119.

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Honeycutt, Todd, David Wittenburg, Kelli Crane, Michael Levere, Richard Luecking, and David Stapleton. SSI Youth Formative Research Project: Considerations for Identifying Promising and Testable Interventions. Washington, DC: Mathematica Center for Studying Disability Policy, November 2018.

Honeycutt, Todd, David Wittenburg, Michael Levere, and Sarah Palmer. Supplemental Security Income Youth Formative Research Project: Target Population Profiles. Washington, DC: Mathematica Center for Studying Disability Policy, September 2018.

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Hyde, Jody Schimmel, Joseph Mastrianni, Yong Choi, and Jae Song. Trends in Obesity Among Social Security Disability Applicants, 2007–2013. DRC Working Paper No. 2016-02, Mathematica Center for Studying Disability Policy, February 2016.

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Jilke, Sebastian, Rekha Balu, Elizabeth Bell, Jeffrey Hemmeter, Onika Richardson, and Elana Safran. Ticket to Work Notice Optimization Project. AEA RCT Registry 0006380. September 10, 2020.

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Keith, Rosalind, Sarah Croake, and Meagan Ager. Process Analysis Report for the Retaining Employment and Talent After Injury/Illness Network (RETAIN) Demonstration. Washington, DC: Mathematica Center for Studying Disability Policy, 2024. https://www.mathematica.org/publications/process-analysis-report-for-the-retaining-employment-and-talent-after-injury-illness-network.

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2026 Annual Report of the SSI Program