Congress is currently placing considerable emphasis on returning disabled-worker beneficiaries to work. However, going back to work is only the first step in the complex process of program termination due to work and trust fund savings. Not only must the beneficiary get a job, but also the work effort must be sustained at what is considered a substantial gainful activity (SGA) level by the disability program (so that an SGA termination will result) and a reasonable living condition must be achieved by the beneficiary(so that the person is motivated to continue working and lose benefits). This articles focuses on those factors that affect the ability of the beneficiary to sustain such a work effort. Combined with previous findings about returning to work, we begin to see the overall effect of the factors on work efforts.

Beneficiaries who have physical therapy rehabilitation have a higher tendency to start working and a lower tendency to stop. Those with vocational training or general education have a higher tendency to start working, but these factors do not help to sustain the effort. Beneficiaries who were helped with job placement have a higher tendency to start work, but they also have a higher tendency to stop. If beneficiaries knew about the trial-work period, but not about either the extended period of eligibility or Medicare continuation, then they had a higher tendency to start work and a higher tendency to stop. However, if they knew about all three work-incentive provisions, then the tendency to work was not affected.

The United States and six other countries (Germany, Denmark, Norway, Sweden, Israel, and the Netherlands) are participating in a cross-national study of work incapacity and reintegration under the auspices of the International Social Security Administration. The purpose of the study is to identify those medical and nonmedical interventions that are most successful in helping persons disabled due to a back condition return to work. The study involves a baseline survey and two follow-up surveys over approximately 2 years.

This article reports on the findings from the baseline survey conducted in the United States. It compares the responses of persons from four study groups (the Social Security Administration's Disability Insurance (DI) beneficiaries and Supplemental Security Income (SSI) recipients, and temporary disability insurance (TDI) recipients from two States—California and New Jersey). The article discusses the potential influence of certain characteristics on the capacity for work reintegration. Study findings suggest that the characteristics of TDI recipients with back disorders may differ in some respects from those of recently entitled DI or SSI beneficiaries with similar impairments, and that there may be some correlation between work resumption and factors such as education, occupation, work-related demands, and the presence of other chronic diseases.