Evaluations of Social Security Disability Insurance (SSDI) applications consider health
and vocational factors such as age, education, and work experience to determine whether
individuals can meet workplace demands. Understanding the extent to which health and job
demands contribute to SSDI application and receipt is important for policy solutions that seek to
reduce the share of workers on DI benefits. However, disentangling their relative contributions
is challenging, because selection into occupation by health is often unobserved and data on
occupational demands for employment histories are limited.
In this study, we triangulate between these factors by using a rich set of data linkages
from the Health and Retirement Study (HRS). First, we ask whether differences in SSDI
application, receipt, and denial are a function of the occupational demands of applicants’
employment histories. Second, we examine whether these differences can be explained by life
course factors that affect occupational selection. Finally, we explore the role of health in the
selection process by using genetic data as a proxy for underlying health. We find the following:
Structural and social inequities that influence access to opportunity, including race and childhood
socioeconomic status (SES), are more strongly associated with the probability of SSDI
application than workplace demands. The exception is a positive psychosocial work
environment that gives individuals greater control over how to best meet the demands of their
jobs, which is negatively associated with SSDI application.
Conditional on SSDI application, physical, mental, and sensory job demands display
stronger associations with SSDI approvals and denials than structural or social factors.
Higher genetic risk for depression, cardiovascular disease, high BMI, dementia, and rheumatoid
arthritis are independently associated with SSDI application and approval.