Does Stricter Disability Screening Lead to Improved Targeting on Long-term Health and Employment Outcomes?

Chiara Campana (), Pierre Koning () and Maarten Lindeboom ()
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Chiara Campana: Vrije Universiteit Amsterdam
Pierre Koning: Vrije Universiteit Amsterdam
Maarten Lindeboom: Vrije Universiteit Amsterdam

No 18799, IZA Discussion Papers from IZA Network @ LISER

Abstract: While evidence points at potentially strong effects of stricter screening and tightening eligibility criteria for Disability Insurance (DI), little is known about their targeting effects: are screened-out workers also those with better future health and more ability to work? To shed light on this, we employ Regression-Discontinuity-in-Time regressions that compare the long-term outcomes of DI application cohorts just before and after a reform in the Netherlands. The reform led to stricter screening in the sickness period before DI application and reduced the number of applicants by 33%. Up to 18 years after application, we find persistently lower survival rates and lower employment rates of post-reform cohorts. Using detailed information on the future chronic diseases of these cohorts and the application diagnoses, we next construct indices capturing long-term expected survival (a “Survival Health Index†, SHI) and long-term employment prospects (a “Work Ability Index†, WAI). We find that the self-screening induced by the reform was stronger for applicants with work disabilities than for health disabilities. This is largely due to a decline in applications of workers with mental and musculoskeletal health conditions .

Keywords: Disability Insurance (DI); health; mental health; screening; targeting (search for similar items in EconPapers)
JEL-codes: H2 I3 (search for similar items in EconPapers)
Date: 2026-07
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