A major reason for the high unemployment rate among Social Security Administration (SSA) disability beneficiaries is fear and misunderstanding about the impact of employment on their benefits (United States General Accounting Office, 1996; Johnson-Lamarche and Baird, 1997). Beneficiaries often do not work or are underemployed because they fear a loss of benefits, especially healthcare coverage, or they are unaware of and/or misunderstand available work incentives built into the SSA disability programs (United States General Accounting Office, 1996; Johnson-Lamarche and Baird, 1997).
One response to this problem has been to help SSA disability beneficiaries to understand their benefits and make optimal decisions about employment through specialized benefits counseling. This refers to specialized expert staff that provide benefits screening, benefits advisement and benefits management for SSA disability beneficiaries regarding employment (Golden et al., 2000). Recently, SSA's State Partnership Initiatives, the Ticket to Work and Work Incentives Improvement Act, Benefits Planning and Outreach grants, and other Federal-State Vocational Rehabilitation programs (Golden et al., 2001) have promoted specialized benefits counseling services nationwide. Despite the extensive implementation of benefits counseling services, however quantitative outcome evaluation efforts have until recently been minimal, as measured by the current lack of published studies on their effectiveness. Like other states, Vermont has used its SSA-funded State Partnership Initiative to create a specialized benefits counseling service. The purpose of this paper is to report preliminary employment outcomes related to Vermont's program.
To evaluate Vermont's specialized benefits counseling program, we used a quasi-experimental study. Vocational Rehabilitation consumers who received specialized benefits counseling were compared with two matched comparison groups comprising concurrent and historical participants in the Division of Vocational Rehabilitation system who did not receive benefits counseling. We compared earned income for each group over four years.
The Benefits Counseling Intervention
The Vermont Work Incentive Initiative created specialized benefits counseling services in 1999. Six benefits counselors were co-located in Division of Vocational Rehabilitation (DVR) offices and Community Mental Health Center offices throughout Vermont. The benefits counselor positions were classified and organized as Vermont DVR staff and were compensated at a pay grade level equivalent to a vocational rehabilitation counselor. Benefits counseling is a newly emerging field in the rehabilitation arena. Therefore no formal benefits counseling certification or accreditation exists for these positions. As a result the project recruited and hired individuals from a variety of prior related backgrounds including public vocational rehabilitation, the state social welfare agency and the community mental health system. The benefits counselors were required to have a BA plus a minimum of 18 months experience in human service field. Applicants with over three years experience in related fields could apply without a BA. The staff provided benefits counseling services to persons receiving disability benefits from the Social Security Administration (SSA) under the Social Security Disability Insurance (SSDI) program and/or the Supplemental Security Income (SSI) program.
The benefits counseling services were individualized, longitudinal, and of variable intensity. The benefits counseling process consisted of three major practice domains identified by Golden et al (2000): benefits screening, advisement, and management. First, benefits screening involved researching and verifying the participant's current benefits status (including all benefits received) and determining what benefits issues might impact the participant's employment goals. …