Employment Outcomes for Social Security Disability Insurance Applicants Who Use Opioids

In this paper, we examine the relationship between self-reported opioid use and employment outcomes among Social Security Disability Insurance (SSDI) applicants. We followed a sample of 2009 applicants to SSDI for four years after the Social Security Administration (SSA) determined their application outcome. We drew our sample from SSA’s Structured Data Repository (SDR) and supplemented the SDR with other SSA administrative data sources that provide information on application outcomes, annual earnings, and deaths. We used a machine-learning method to identify opioids in medication text fields in SDR data. Our analysis addresses two questions: (1) How do employment and earnings patterns differ between SSDI applicants who did and did not use opioids at the time of application? and (2) What is the association between opioid use and employment outcomes among SSDI applicants? We estimated the association between opioid use at application and later employment outcomes through ordinary least squares regression, by using three measures of local opioid availability as instrumental variables and by a reduced-form ordinary least squares regression. Understanding these patterns and associations can improve understanding about the post-application economic well-being of SSDI applicants and may help policymakers identify ways to help this group.