Transforming Disability into Ability

216 Pages·2003·2.55 MB·English

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Transforming Disability into Ability
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POLICIES TO PROMOTE WORK AND INCOME SECURITY n
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f Transforming
FOR DISABLED PEOPLE o
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in Disability into Ability
How OECD countries can reconcile the twin, but potentially contradictory, goals of disability policy
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has yet to be resolved. One goal is to ensure that disabled citizens are not excluded from society: D
that they are encouraged and empowered to participate as fully as possible in economic and social is
life, and in particular to engage in gainful employment, and that they are not ousted from the labour a
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market too easily and too early. The other goal is to ensure that those who are disabled or who il
i POLICIES TO PROMOTE WORK
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become disabled have income security: that they are not denied the means to live decently because y

of disabilities which restrict their earning potential. in AND INCOME SECURITY FOR
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DISABLED PEOPLE
This book provides a systematic analysis of a wide array of labour market and social protection A
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programmes aimed at people with disabilities. Analysing the relationship between policies and
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outcomes across twenty OECD countries, it gives the reader a better understanding of the it
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dilemmas of disability policy and of successful policy elements or packages. The report concludes

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that a promising new disability policy approach should move closer to the philosophy of O
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unemployment programmes by: IC
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– emphasising activation; T
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– promoting tailored early intervention; P
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– removing disincentives to work; O
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– introducing a culture of mutual obligations;
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– and, involving employers. T
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It finds that many countries’ policies already include some elements which are important R
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components in such a new approach.
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ISBN 92-64-19887-3
81 2003 02 1 P -:HSTCQE=V^]]\[:
The European Year of People with Disabilities
© OECD, 2003.
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Transforming Disability
into Ability
Policies to Promote Work and Income Security
for Disabled People
ORGANISATION FOR ECONOMIC CO-OPERATION AND DEVELOPMENT
ORGANISATION FOR ECONOMIC CO-OPERATION
AND DEVELOPMENT
Pursuant to Article 1 of the Convention signed in Paris on 14th December 1960, and which came
into force on 30th September 1961, the Organisation for Economic Co-operation and Development
(OECD) shall promote policies designed:
– to achieve the highest sustainable economic growth and employment and a rising standard of
living in Member countries, while maintaining financial stability, and thus to contribute to the
development of the world economy;
– to contribute to sound economic expansion in Member as well as non-member countries in the
process of economic development; and
– to contribute to the expansion of world trade on a multilateral, non-discriminatory basis in
accordance with international obligations.
The original Member countries of the OECD are Austria, Belgium, Canada, Denmark, France,
Germany, Greece, Iceland, Ireland, Italy, Luxembourg, the Netherlands, Norway, Portugal, Spain,
Sweden, Switzerland, Turkey, the United Kingdom and the United States. The following countries
became Members subsequently through accession at the dates indicated hereafter: Japan
(28thApril1964), Finland (28th January 1969), Australia (7th June 1971), New Zealand (29th May 1973),
Mexico (18th May 1994), the Czech Republic (21st December 1995), Hungary (7th May 1996), Poland
(22ndNovember 1996), Korea (12th December 1996) and the Slovak Republic (14th December 2000). The
Commission of the European Communities takes part in the work of the OECD (Article 13 of the OECD
Convention).
Publié en français sous le titre :
Transformer le handicap en capacité
Promouvoir le travail et la sécurité des revenus des personnes handicapées
Photo Credit: “Paris en fête” by Arielle de Milleville (Ateliers Personimages)
Personimages, a registered non-profit association, came up in1977 with the innovative idea of inviting disabled people to express
the wealth of their sensitivity in creative artistic workshops. To overseethe workshops, the Association calls upon dancers, stage
actors, musicians, sculptors and other artists. Participants are thus offered places where they can give free rein to their creative
talents.
By encouraging the disabled to express themselves in this way, Personimages contributes to their personal fulfilment while
fostering the principles of equality, solidarity and integration. A number of the people have produced some highly original
creations, including sculptures that have been exhibited the world over.
Personimages organises regular contacts with other like-minded European associations to share experiences and arrange artist
exchange programmes.
© OECD 2003
Permission to reproduce a portion of this work for non-commercial purposes or classroom use should be obtained
through the Centre français d’exploitation du droit de copie (CFC), 20, rue des Grands-Augustins, 75006 Paris,
France, tel. [phone], fax [phone], for every country except the United States. In the United States
permission should be obtained through the Copyright Clearance Center, Customer Service, [phone],
222Rosewood Drive, Danvers, MA 01923 USA, or CCC Online: www.copyright.com. All other applications for
permission to reproduce or translate all or part of this book should be made to OECD Publications, 2,rueAndré-Pascal,
75775 Paris Cedex 16, France.
FOREWORD
Foreword
D
isability policy faces twin but potentially contradictory goals. One is to ensure that disabled
citizens are not excluded: that they are encouraged and empowered to participate as fully as possible
in economic and social life, and in particular to engage in gainful employment, and that they are not
ousted from the labour market too easily or too early. The other goal is to ensure that those who are
or who become disabled have income security: that they are not denied the means to live decently
because of disabilities that (may) restrict their earning potential. How to reconcile these twin goals
has yet to be resolved.
The main objective of this report is to analyse the policies the participating countries have
designed to achieve these goals, and to look into the relationship and consistency between
compensatory and employment-oriented disability policies in each country. Policy packages that have
proven successful in promoting the employment of disabled people, reducing disability benefit
dependence and securing decent incomes for this population group are identified. The report
concludes that a promising new disability policy approach should move closer to the philosophy of
unemployment programmes by emphasising activation, promoting tailored early intervention,
removing disincentives to work, introducing a culture of mutual obligations, and involving
employers. It finds that many countries’ policies already include some elements that are important
components of such a new approach.
A report of this richness could not have been prepared without the active assistance of a
multitude of officials and collaborators in the twenty participating countries. Countries contributed
by providing answers to a demanding interdepartmental questionnaire and administrative data on
a wide array of disability-related social protection and labour market programmes, by participating
in an interim project working meeting, and by reviewing drafts of several interim products as well as
this final report. Some countries also helped in making national survey data accessible. Several
countries also provided financial contributions to this project, which was entirely funded from
voluntary offerings: Canada, Australia, the Netherlands, Norway, Switzerland and the United
States, as well as the European Commission.
The work was undertaken by a team in the Social Policy Division of the Directorate for
Education, Employment, Labour and Social Affairs. The project was co-ordinated and this report
drafted by Christopher Prinz, under the supervision of Monika Queisser. Data analysis was
undertaken and the tables and charts prepared by Maxime Ladaique, and administrative support
was provided by Victoria Braithwaite and Cécile Cordoliani. Mark Keese, Mark Pearson, Peter Scherer
and Philip de Jong also provided ideas and help at different stages of the project. This book is
published on the responsibility of the Secretary-General of the OECD.
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TRANSFORMING DISABILITY INTO ABILITY – ISBN 92-64-19887-3 – © OECD 2003
TABLE OF CONTENTS
Table of contents
Chapter 1. Summary of Key Findings................................................................................... 7
1.1. Structure of the report.............................................................................................. 8
1.2. Empirical evidence.................................................................................................... 8
1.3. Disability policy challenges..................................................................................... 9
1.4. Policy conclusions..................................................................................................... 11
Chapter 2. Objectives and Analytical Framework.............................................................. 15
2.1. Introduction............................................................................................................... 16
2.2. Objectives of the project.......................................................................................... 18
2.3. Conceptual framework............................................................................................. 19
Chapter 3. Evidence on Income and Labour Force Participation..................................... 23
3.1. Identifying the working-age population with disabilities................................... 24
3.2. Income security: is the principal aim achieved?.................................................. 28
3.3. Work integration: is labour market participation satisfactory?......................... 33
3.4. Is labour force participation and income security explained by public policy? 38
3.5. Summarising the empirical evidence.................................................................... 53
Chapter 4. Compensation Policy Challenges....................................................................... 57
4.1. Permanence of disability benefits.......................................................................... 58
4.2. Disability benefit levels and benefit traps............................................................. 63
4.3. Coverage gaps............................................................................................................ 68
4.4. Benefit access............................................................................................................ 72
4.5. Age profiling in disability benefits.......................................................................... 78
4.6. Assessment procedures........................................................................................... 83
4.7. Sickness, disability and work-related injury......................................................... 89
4.8. Disability and unemployment................................................................................ 91
4.9. Disability and early retirement............................................................................... 96
4.10.Summarising the findings of the compensation policy analysis....................... 98
Chapter 5. Integration Policy Challenges............................................................................. 103
5.1. Legal framework for employment promotion...................................................... 104
5.2. Employer obligations................................................................................................ 106
5.3. Vocational rehabilitation and training.................................................................. 108
5.4. Special employment programmes.......................................................................... 112
5.5. Age profiling in integration programmes.............................................................. 116
5.6. Integration policy and active labour market policy (ALMP) analysis................ 119
5.7. Summarising the findings of the integration policy analysis............................ 122
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TRANSFORMING DISABILITY INTO ABILITY – ISBN 92-64-19887-3 – © OECD 2003
TABLE OF CONTENTS
Chapter 6. A Disability Policy Typology............................................................................... 125
6.1. Assessing policy approaches: a typology as a tool for comparative analysis.. 126
6.2. Comparing policy and outcome using the disability policy typology............... 130
Chapter 7. Recent and Forthcoming Policy Reforms.......................................................... 139
7.1. Extent and direction of recent reforms.................................................................. 140
7.2. Country-specific reform initiatives........................................................................ 143
7.3. A new reform strategy in Luxembourg.................................................................. 153
Chapter 8. Policy Conclusions................................................................................................ 155
8.1. Policy principles........................................................................................................ 156
8.2. The constraints under which disability policy operates..................................... 158
8.3. Reshaping disability policy based on mutual obligations................................... 159
Bibliography .............................................................................................................................. 171
Annex 1. Technical Annex..................................................................................................... 177
Annex 2. Classification for the Policy Typology................................................................. 185
Annex 3. Characteristics of Disability-related Benefit Sschemes................................... 193
Annex 4. Characteristics of the Approach to Employment Promotion.......................... 207
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TRANSFORMING DISABILITY INTO ABILITY – ISBN 92-64-19887-3 – © OECD 2003
ISBN 92-64-19887-3
Transforming Disability into Ability: Policies to Promote Work
and Income Security for Disabled People
© OECD 2003
Chapter 1
Summary of Key Findings
Abstract. Chapter 1presents key findings from the empirical analysis and
the conclusions drawn from it.
TRANSFORMING DISABILITY INTO ABILITY – ISBN 92-64-19887-3 – © OECD 2003
1. SUMMARY OF KEY FINDINGS
1.1. Structure of the report
In this chapter, the key findings from the empirical analysis and the conclusions
drawn from it are summarised. Chapter2sets out the objectives of the report and
introduces the conceptual framework (details on the approach followed and on some of its
limitations are to be found in Annex1).
Chapter3presents detailed findings from the comparative survey data analysis,
i.e.empirical evidence on the economic and labour market integration of working-age
disabled people. Chapter4looks at the compensation policies followed by countries,
making use of administrative programme statistics.1 This analysis includes, among other
things, the extent of age profiling in transfer schemes, the relationship between disability
benefits and unemployment and early retirement benefits and a discussion of benefit traps
and coverage gaps. Country-specific policy details on these matters are found in Annex3.
Chapter5analyses integration policy approaches, including age profiling in employment
programmes and new developments in employment-oriented disability policy. Country-
specific policy details related to these aspects are found in Annex4.
In Chapter6, a disability policy typology is developed, which is used to classify
countries according to their policy approach, and to analyse the relationship between
policy design and policy outcome. Classification details are found in Annex2. In Chapter7,
policy reforms during the1990s are analysed, and the most important recent country-
specific reform initiatives are described in some detail. In the last chapter, strategies for a
coherent disability policy mix are developed. An approach is suggested that tries to
overcome some of the problems and obstacles identified in the analytical chapters, and
that aims to reshape disability policy based on a framework of mutual obligations.
1.2. Empirical evidence
Working-age disability policies target a large and heterogeneous group. One-third of this
group have severe disabilities, and people with congenital disabilities are a small minority.
The diversity of this group is at the root of most of the policy challenges that face policy
makers attempting to improve the living conditions of disabled people.
Income security is high in many OECD countries: income levels of households
containing disabled people are generally broadly similar to that of the population as a
whole. The relative economic well-being of households is correlated with the structure of
the disability benefit system and the benefit level paid: countries with individual benefit
entitlements for the entire disabled population (i.e.full population coverage) and high
earnings-related insurance benefits have the highest relative incomes of disabled people,
while those with a strong focus on means-tested programmes have the lowest –but public
spending on benefits is considerably lower in the latter group.
High income security is to a certain extent explained by high incomes of other
household members. Personal incomes of disabled people depend primarily on their work
status. Average work incomes of those disabled people who have a job are almost as high
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TRANSFORMING DISABILITY INTO ABILITY – ISBN 92-64-19887-3 – © OECD 2003
1. SUMMARY OF KEY FINDINGS
as average work incomes of people without disabilities. Disabled people without a job have
considerably lower personal financial resources.
While employment is crucial for determining personal income resources, the
employment rates of working-age disabled persons are rather low. This is particularly true
for severely disabled people, and also generally for disabled people over age50and
disabled people with low levels of educational attainment. Special employment
programmes for people with disabilities play a minor role in determining disabled people’s
employment rates in general, but in some countries such programmes seem to make an
important contribution to the employment of severely disabled people.
As employment rates of disabled people are low, benefits also play an important role
in guaranteeing income security. Disability benefits are the main component of benefit
income for working-age people with a disability. Permanent retirement benefits are also an
important source of income for a considerable proportion of the working-age disabled
population (either early or regular retirement, depending on the country). Unemployment
benefits play a much less important role overall, despite relatively high non-employment
rates among this group.
Perhaps surprisingly, recognising oneself as severely disabled does not imply receiving
disability benefit, and vice versa. Many people on disability benefits do not claim to have a
disability, while at the same time many people who subjectively classify themselves as
severely disabled and do not work receive no benefits.
1.3. Disability policy challenges
Disability benefit recipiency rates are high in many countries. Nonetheless, the majority
of people with disabilities (disabled according to self-assessment) do not report receipt of
such benefits. Growth in disability benefit recipiency slowed recently. This is explained by
reforms affecting benefit access, which have led to a stabilisation or even a decline in
annual rates of benefit inflow in most countries, in particular since1995.2
Outflow from disability benefits is very low in virtually all countries, despite
considerable cross-country differences in regulations on reviewing entitlements, the
availability of partial benefits, work incentives, etc. This is one reason why disability
benefit recipiency rates have been rising. The low outflow partly reflects that regulations
on reviewing benefit entitlements are not stringently applied and that there is a low take-
up of work incentives.
Countries with high benefit levels generally tend to have high recipiency rates. But
recently, countries with lower benefit levels have had equally high rates of inflow, and the
rates of outflow have also been comparable. Similarly, countries with several grades of
benefits for partial disability are among the group with high benefit recipiency rates. In
these countries, one in three new awards is for partial disability.
Despite high rates of benefit recipiency, problems of exclusion from disability benefits
remain, due partly to not fulfilling insurance requirements and partly to failing the
(household) means test. In countries with a dual benefit system, i.e.insurance benefits for
the labour force and means-tested disability benefits for those not qualifying for insurance
benefits, the increasing proportion of recipients on means-tested benefits indicates an
aggravation of this problem.
Women are generally under-represented on insurance programmes and over-
represented on means-tested benefit programmes. This is not the case in some schemes
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TRANSFORMING DISABILITY INTO ABILITY – ISBN 92-64-19887-3 – © OECD 2003