%0 Report
        %A Campana, Chiara
%A Koning, Pierre
%A Lindeboom, Maarten
        %T Does Stricter Disability Screening Lead to Improved Targeting on Long-term Health and Employment Outcomes?
        %D 2026
        %8 2026 Jul
        %I Institute of Labor Economics (IZA)
        %C Bonn
        %7 IZA Discussion Paper
        %N 18799
        %U https://www.iza.org/publications/dp18799
        %X 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 .
        %K Disability Insurance (DI)
%K health
%K mental health
%K screening
%K targeting