The Interaction of Health, Genetics, and Occupational Demands in SSDI Determinations

Evaluations of Social Security Disability Insurance (SSDI) applications are based not only on poor health, but in many cases, consider the vocational factors of age, education and work experience to determine whether individuals can work. SSDI determinations based on these factors have grown threefold since 1985 (Michaud, Nelson, and Wiczer 2016). Yet little is known about the relationship between SSDI activity and the ability to meet occupational requirements (Rutledge, Zulkarnain, and King 2019). Moreover, there is strong evidence that morbidity and mortality are distributed unequally across occupations (Marmot et al. 1991), perhaps because differential work environments may exacerbate disability but also because individual-level underlying health is unlikely to be randomly distributed across occupations (Mackenbach et al. 2017).
Together, these phenomena result in complex relationships of SSDI determinants with both the independent and joint effects of health and occupational demands. Disentangling the contributions of these forces is challenging, because selection into occupations by health is often unobserved and because data on occupational demands for employment histories is limited. We propose to triangulate between these factors by using a rich set of data linkages from the Health and Retirement Study, including linkage to the Social Security Administration (SSA) disability application file (831 file), and the Department of Labor’s O*Net job classification system.