Disability Benefits Research Articles

Incidence of sick leave and disability pension in adults with musculoskeletal pain and co-occurring long-term conditions: data from the Norwegian HUNT study and national registries

BackgroundMusculoskeletal pain is one of the leading causes of work productivity loss. Long-term conditions (LTCs) commonly occur alongside musculoskeletal pain. However, the incidence of sick leave and disability pension according to LTC status in people with musculoskeletal pain has not been previously described.MethodsWorking-age participants (20–65 years) with persistent musculoskeletal pain who participated in the HUNT3 Study (1995–97) were included. Twenty-five LTCs were classified into 8 LTC groups according to the International Classification of Diseases version 11. Data on sickness and disability benefits were obtained from the National Insurance Database and linked to the HUNT3 data using participants’ personal identification number. Age-adjusted incidence rates (IRs) (per 10,000 person-years) and hazard ratios (HRs) of sick leave during 5-year follow-up and disability pension during ~ 25-year follow-up were estimated with 95% confidence intervals (CIs) and presented according to LTC status.ResultsOverall, 11,080 participants with musculoskeletal pain were included. Of those, 32% reported one LTC and 45% reported ≥ 2 LTCs. During the follow up period, 1,312 participants (12%) received disability pension due to musculoskeletal conditions. The IR of sick leave and disability pension due to musculoskeletal conditions increased with number of LTCs. Specifically, the IR of sick leave was 720 (95% CI 672 to 768) in participants without any LTCs and 968 (95% CI 927 to 1,009) if they had ≥ 2 LTCs. The IRs of disability pension were 87 (95% CI 75 to 98) and 167 (95% CI 154 to 179) among those with no LTCs and ≥ 2 LTCs, respectively. The incidence of sick leave and disability pension due to musculoskeletal conditions was largely similar across LTCs, although the incidence of disability pension was somewhat higher among people with sleep disorders (IR: 223, 95% CI 194 to 252).ConclusionsAmong people with persistent musculoskeletal pain, the incidence of prematurely leaving the work force due to musculoskeletal conditions was twice as high for those with multiple LTCs compared to those without any LTCs. This was largely irrespective of the type of LTC, indicating that the number of LTCs are an important feature when evaluating work participation among people with musculoskeletal pain.

Promises and pitfalls for advancing the human right to education of children with disabilities in South Africa

In South Africa, the right to education is guaranteed by Section 29 of the Bill of Rights in the Constitution. The government is therefore obliged to develop policies, pass laws and establish programmes that promote and fulfil the right to education. Contrary to this, it has been argued that children with disabilities benefit less from the human right to education, as reflected by the number of children with disabilities currently attending school. This article aims to examine the gap between the promises made on the advancement of the human right to education of children with disabilities and the pitfalls experienced in fulfilling those promises. A literature review method was used to assess the access to education, and findings identify that inequalities in opportunities continue to occur not only because the government has not managed the key drivers of poverty but also due to a persistent lack of activism to address these issues.

Temporary disability pension recipients: Contextual stress factors and their effect on return-to-work-intention.

In the last decades, Germany has experienced a vast increase in the number of individuals applying for or receiving disability benefit. Only a small proportion of them intends to return to work. The present study aims to identify and describe the percentage of temporary disability pensioners, who have the intention to return to working life. The final sample consisted of 496 insured individuals who were receiving temporary disability pension from the Regional German Pension Insurance (DRV) at that time. Participation was voluntary and anonymous. The following self-report instruments were administered: a. Evaluation of Contextual Factors; b. German Symptom Validation Test (BEVA); c. German Patient Health Questionnaire (PHQ-9); d. Readiness for Return-to-Work German Scale (RRTW). The results revealed that approximately 6% of participants were at the stage of "preparation", 31.9% at the stage of "contemplation", and more than half of the participants were at the stage of "pre-contemplation" according to the RRTW. Comparing the groups of "pre-contemplation" (Group 1) and "contemplation+preparation" (Group 2+3), no statistically significant differences were found, except for age. In conclusion, further research is required to identify possible factors which could predict the stage of RRTW. New interventions are needed that can raise the motivation for and success in the return to work of disability pensioners.

Returning to Work Following Hematopoietic Cell Transplantation: The Survivor's Perspective

While curing a patient's underlying disease is the primary goal of physicians performing hematopoietic cell transplantation (HCT), the ultimate objective is to provide patients with optimal post-HCT quality of life. For many survivors, this includes returning to work (RTW). We conducted a survey of 1- to 5-yr post-HCT survivors at our center to evaluate their perspective on facilitators and barriers to RTW as well as to gauge interest in potentially useful RTW support interventions. Survivors aged 18 to 65 yrs (n = 994) were sent an annual survey that included 36 supplementary questions about post-HCT RTW. Survey questions were selected from published national cancer survivor surveys and then modified specifically for HCT survivors. Three hundred forty-four (35%) survivors with a mean age of 53 yrs completed the survey, of whom 272 (79%) had worked prior to their diagnosis. Of those 272 patients, 145 (53%) were working currently and another 22 (8%) had attempted to go back to work following HCT but were not presently working. We found that having had an allogeneic versus autologous HCT (P = .006) was associated with a decreased likelihood of currently working, whereas frequent employer communication (>once a month) (P = .070) and having a more supportive employer (P = .036) were associated with a greater chance of currently working. Of survivors currently working, 45% reported that they had made one or more changes to their work schedule (e.g., flexible schedule or part-time work) or environment (e.g., work from home) upon RTW. Ninety-five percent of responders reported that they could have benefited from RTW support provided by the transplant center, but only 13% indicated that they had received it. Education on RTW challenges, information on disability benefits, and access to physical therapy were among the most requested support interventions. To improve post-HCT quality of life for survivors open to assistance, providers should address work status and goals, recognize barriers to successful return, and offer RTW support including working directly with employers. Allogeneic HCT survivors are particularly vulnerable to failing attempts to RTW and should be the target of retention interventions. A previously published manuscript on RTW guidance for providers of stem cell transplant patients endorsed by the American Society of Transplant and Cellular Therapy is available in Open Access and can be used as a tool to counsel and support these patients.

Culturally Responsive/Sustaining Transition for At-Promise Youth

At-promise students with disabilities benefit when educators implement culturally responsive/sustaining postsecondary transition practices. Yet, many educators lack the training and resources necessary to support culturally, ethnically, economically, and linguistically diverse youth and their families. To address this gap, the Culturally Responsive/Sustaining Transition Portfolio (CRSTP) assists educators, students, and families in preparing for postsecondary transition while respecting the values of families. This study assesses the usefulness of the CRSTP by training 45 preservice teachers on culturally responsive/sustaining transition practices using the CRSTP, and then having them reflect on the product and process using the 11-item online reflective survey. Educators reported the CRSTP was a promising tool for applying culturally responsive/sustaining transition practices, building relationships, and collaborating with students and families. Findings indicate the CRSTP guided students in developing self-awareness, self-advocacy, and goal planning. The evaluation of this promising and practical educational tool holds the potential to impact at-promise youth, families, and educators.

Examining bias in the award of Veterans Affairs (VA) disability benefits for posttraumatic stress disorder in women veterans: Analysis of evaluation reports and VA decisions.

Studies have raised concerns about possible inequities in the U.S. Department of Veterans Affairs (VA)'s awards of disability for posttraumatic stress disorder (PTSD) to women. However, the diagnoses and opinions made by disability examiners have not been studied. A sample of 270 initial PTSD examination reports and corresponding VA decisions were studied. Compared to men, women veterans were as likely to be diagnosed with a service-related mental disorder, χ2(1, N = 270) = 2.31, p =.129, odds ratio (OR) = 1.79, 95% CI [0.84, 3.80], and be granted service-connection, χ2(1, N = 270) = 0.49, p =.483, OR = 1.28, 95% CI [0.65, 2.51]. Women veterans were considered to have more psychiatric symptoms, Z = -2.05, p =.041, r =.16, and more psychiatric impairment, Z = -2.48, p =.013, r =.20, but the percentage of disability awarded by the VA did not differ, χ2(1, N = 270) = 0.49, p =.483; OR = 1.28, 95% CI [0.65, 2.51]. Secondary analyses implicate the role of military sexual trauma and premilitary trauma in explaining sex differences in symptoms and impairment. The findings indicate that neither opinions by examiners nor corresponding decisions by the VA regarding service connection reflect a negative bias toward women veterans. Results indicate that unbiased examinations lead to equitable VA claims decisions for women veterans. Future studies of the VA PTSD disability program nationally, including examination procedures and VA policies and implementation, will promote equity for women veterans in the PTSD claims process.

Application of restorative neurostimulation for chronic mechanical low back pain in an older population with 2-year follow up

IntroductionData on the Medicare-aged population show that older patients are major consumers of low back pain (LBP) interventions. An effective approach for patients with mechanical LBP that has been refractory...

Labour supply and survivor insurance in the Netherlands

This paper investigates the effects of survivor benefits (SB) on the labour supply of widows. Using rich administrative data on the Dutch population and a reform that considerably restricted eligibility to SB, we identify the causal effect of SB on labour supply. Using a regression discontinuity design strategy based on the cohort-based implementation of the reform, we show that labour income after spousal death increased significantly following the reform (+110 euros, +23%). The effects are driven by changes in labour force participation and hours worked by widows. We also find evidence of program substitution, with widows relying more on disability, unemployment and welfare benefits as a result of the reform. This increase in alternative benefits further limits the reduction in total income caused by the reform by an average of 60 euros. Regarding the heterogeneity of the labour supply response, we find that widows with a relatively higher need for self-insurance increase their labour supply relatively more.

Association between maternal employment status and presence of children with major congenital anomalies in Denmark

ImportanceThe burden of caring for children with complex medical problems such as major congenital anomalies falls principally on mothers, who in turn suffer a variety of potentially severe economic consequences. As well, health consequences of caregiving often further impact the social and economic prospects of mothers of children with major congenital anomalies (MCMCAs). Evaluating the long-term economic consequences of extensive in-home caregiving among MCMCAs can inform strategies to mitigate these effects.ObjectiveTo assess whether MCMCAs face reduced employment and increased need for disability benefits over a 20-year period.DesignA population-based matched cohort study.SettingDenmark.ParticipantsAll women who gave birth to a singleton child with a major congenital anomaly in Denmark between January 1, 1997 and December 31, 2017 (n = 23,637) and a comparison cohort of mothers matched by maternal age, parity, and infant’s year of birth (n = 234,586).ExposuresLiveborn infant with a major congenital anomaly.Main outcomes and measuresThe primary outcome was mothers’ employment status, stratified by their child’s age. Employment status was categorized as employed, outside the workforce (on temporary leave, holding a flexible job, or pursuing education), or unemployed; the number of weeks in each category was measured over time. The secondary outcome was time to receipt of a disability pension, which in Denmark implies permanent exit from the labor market. We used a negative binomial regression model to estimate the number of weeks in each employment category, stratified by the child’s age (i.e., 0–1 year, > 1–6 years, 7–13 years, 14–18 years). A Cox proportional hazards regression model was used to compute hazard ratios as a measure of the relative risk of receiving a disability pension. Rate ratios and hazard ratios were adjusted for maternal demographics, pregnancy history, health, and infant’s year of birth.ResultsDuring 1–6 years after delivery, MCMCAs were outside the workforce for a median of 50 weeks (IQR, 6–107 weeks), while members of the comparison cohort were outside the workforce for a median of 48 weeks (IQR, 4–98 weeks), corresponding to an adjusted rate ratio [ARR] of 1.05 (95% confidence interval [CI], 1.04–1.07). During the first year after delivery, MCMCAs were more likely to be employed than mothers in the comparison cohort (ARR, 1.08; 95% CI, 1.06–1.10). At all timepoints thereafter, MCMCAs had a lower rate of workforce participation. The rate of being outside the workforce was 5% higher than mothers in the comparison cohort during 1–6 years after delivery (ARR, 1.05; 95% CI, 1.04–1.07), 9% higher during 7–13 years after delivery (ARR, 1.09; 95% CI, 1.06–1.12), and 12% higher during 14–18 years after delivery (ARR, 1.12; 95% CI, 1.07–1.18). Overall, MCMCAs had a 20% increased risk of receiving a disability pension during follow-up than mothers in the matched comparison cohort [incidence rates 3.10 per 1000 person-years (95% CI, 2.89–3.32) vs. 2.34 per 1000 person-years (95% CI, 2.29–2.40), adjusted hazard ratio, 1.20; 95% CI, 1.11–1.29].Conclusion and relevanceMCMCAs were less likely to participate in the Danish workforce, less likely to be employed, and more likely to receive disability pensions than mothers of unaffected children. The rate of leaving the workforce intensified as their affected children grew older. The high demands of caregiving among MCMCAs may have long-term employment consequences even in nations with comprehensive and heavily tax-supported childcare systems, such as Denmark.

Short-term impacts of Universal Basic Income on population mental health inequalities in the UK: A microsimulation modelling study.

Population mental health in the United Kingdom (UK) has deteriorated, alongside worsening socioeconomic conditions, over the last decade. Policies such as Universal Basic Income (UBI) have been suggested as an alternative economic approach to improve population mental health and reduce health inequalities. UBI may improve mental health (MH), but to our knowledge, no studies have trialled or modelled UBI in whole populations. We aimed to estimate the short-term effects of introducing UBI on mental health in the UK working-age population. Adults aged 25 to 64 years were simulated across a 4-year period from 2022 to 2026 with the SimPaths microsimulation model, which models the effects of UK tax/benefit policies on mental health via income, poverty, and employment transitions. Data from the nationally representative UK Household Longitudinal Study were used to generate the simulated population (n = 25,000) and causal effect estimates. Three counterfactual UBI scenarios were modelled from 2023: "Partial" (value equivalent to existing benefits), "Full" (equivalent to the UK Minimum Income Standard), and "Full+" (retaining means-tested benefits for disability, housing, and childcare). Likely common mental disorder (CMD) was measured using the General Health Questionnaire (GHQ-12, score ≥4). Relative and slope indices of inequality were calculated, and outcomes stratified by gender, age, education, and household structure. Simulations were run 1,000 times to generate 95% uncertainty intervals (UIs). Sensitivity analyses relaxed SimPaths assumptions about reduced employment resulting from Full/Full+ UBI. Partial UBI had little impact on poverty, employment, or mental health. Full UBI scenarios practically eradicated poverty but decreased employment (for Full+ from 78.9% [95% UI 77.9, 79.9] to 74.1% [95% UI 72.6, 75.4]). Full+ UBI increased absolute CMD prevalence by 0.38% (percentage points; 95% UI 0.13, 0.69) in 2023, equivalent to 157,951 additional CMD cases (95% UI 54,036, 286,805); effects were largest for men (0.63% [95% UI 0.31, 1.01]) and those with children (0.64% [95% UI 0.18, 1.14]). In our sensitivity analysis assuming minimal UBI-related employment impacts, CMD prevalence instead fell by 0.27% (95% UI -0.49, -0.05), a reduction of 112,228 cases (95% UI 20,783, 203,673); effects were largest for women (-0.32% [95% UI -0.65, 0.00]), those without children (-0.40% [95% UI -0.68, -0.15]), and those with least education (-0.42% [95% UI -0.97, 0.15]). There was no effect on educational mental health inequalities in any scenario, and effects waned by 2026. The main limitations of our methods are the model's short time horizon and focus on pathways from UBI to mental health solely via income, poverty, and employment, as well as the inability to integrate macroeconomic consequences of UBI; future iterations of the model will address these limitations. UBI has potential to improve short-term population mental health by reducing poverty, particularly for women, but impacts are highly dependent on whether individuals choose to remain in employment following its introduction. Future research modelling additional causal pathways between UBI and mental health would be beneficial.

Effectiveness, cost-effectiveness and return on investment of individual placement and support compared with traditional vocational rehabilitation for individuals with severe mental illness in the Netherlands: a nationwide implementation study

ObjectivesTo assess the effectiveness, cost-effectiveness and return on investment of individual placement and support (IPS) implemented through a reimbursement strategy on a nationwide scale compared with traditional vocational rehabilitation (TVR)...

Specifics of the calculation by medical organizations of benefits for temporary disability to persons under civil law contracts

The article is devoted to the peculiarities of the calculation by organizations of temporary disability to persons employed under civil law contracts. It was noted that the state, introducing from January 1, 2023, payment of benefits not only to persons working under labor contracts,but also under civil law contracts and author’s order agreements, thereby strengthens social support for such citizens, provided that their earnings for the previous year were at least the federal minimum wage under the employment contract. Thus, the rights of employees under civil law contracts contract in terms of social insurance in case of temporary disability have become equal to the rights of persons working under the employment contract since 2023, and the amount of sick leave is determined in the same way. The article considers the requirements for the earnings of persons working under civil law contracts for receiving temporary disability benefits. The stages of calculating the size of this allowance by the insured are disclosed, as well as practical examples are given. Conclusions based on the results of the study.

Long-term unemployment subsidies and middle-aged disadvantaged workers’ health

This paper examines the labour market and health effects of a non-contributory long-term unemployment (LTU) benefit targeted at middle-aged disadvantaged workers. To do so, we exploit a Spanish reform introduced in July 2012 that increased the age eligibility threshold to receive the benefit from 52 to 55. Our results show that men who were eligible for the benefit experience a reduction in injury hospitalisations by 12.9% as well as a 2 percentage points drop in the probability of a mental health diagnosis. None of the results are significant for women. We document two factors that explain the gender differences: the labour market impact of the reform is stronger for men, and eligible men are concentrated in more physically demanding sectors, like construction. Importantly, we also find evidence of a program substitution effect between LTU and partial disability benefits. Our results highlight the role of long-term unemployment benefits as a protecting device for the (physical and mental) health of middle-aged, low-educated workers who are in a disadvantaged position in the labour market.

Law, political economy and war reparation: The case of Bosnia and Herzegovina

AbstractWhat are the after‐effects of the Bosnia and Herzegovinian (BH) transition from a post‐socialist, post‐genocide, and post‐ethno‐nationalist state into a European liberal democracy? This article makes a case for war reparation and argues that while poverty reduction has not been among the stated aims of transitional justice mechanisms, it is of critical importance to study war victims' deprivation in the context of historical patterns of structural injustice and examine liberal reconstruction policies that failed to provide compensation and legal redress for gross violations of human rights and serious violations of humanitarian law. The article uses the historical sociology approach as a method of analysis to investigate how moving away from a socialist to a capitalist economic model, from war to peace, and from one party political system to liberal democracy has resulted in structural injustice and growing levels of poverty that adversely impact most vulnerable Bosnians. The article presents an argument that the lack of post‐war reparation programs, coupled with an inadequate emphasis on political regime change, poverty reduction programs and social and economic rights such as access to welfare, cash assistance, food, transportation, education, pension, and disability benefits to ensure the quality of living is detrimental to everyday lives of war victims and people who live at the bottom of the society.

Virtual Bonds: A Systematic Review of Online Social Networks and Intellectual Disabilities

This systematic review investigates the intersection of online social networks and individuals with intellectual disabilities, with a focus on identifying the specific platforms and features used, exploring their impact on social inclusion and interaction, and offering practical recommendations for improved support mechanisms. The study reveals that individuals with intellectual disabilities commonly engage with mainstream social networking platforms. These platforms facilitate social connections, community building, and increased opportunities for participation. Additionally, individuals with intellectual disabilities benefit from empowerment through self-expression, as evidenced by the positive sharing of achievements and talents. The recommendations derived from the systematic review emphasize practical strategies to enhance support mechanisms, including improving accessibility features, implementing user-friendly design, promoting privacy controls, and providing educational resources. In conclusion, "Virtual Bonds" contributes valuable insights into the dynamic relationship between individuals with intellectual disabilities and online social networks. The findings underscore the positive impact of these platforms on social inclusion, while the recommendations provide actionable steps to optimize accessibility and support mechanisms, ultimately enhancing the digital experience for individuals with intellectual disabilities.

Live More Prosperously By Enjoying Old Age Using Pension Funds

In this research method I took a case study at PT. Taspen Surabaya is based on article 58 of Law Number 11 of 1992 concerning pension funds which explains that anyone is prohibited from intentionally causing the payment of an amount of money to the Pension Fund that deviates from the regulations and participating in transactions involving an increase in pension funds. PT. Taspen is an initial service before the customer recipient is confirmed as a Pension Fund recipient. In the articles that I have written, everything is based on case studies that I have conducted, namely using the interview method. The results and discussions show the organizational structure of PT. Taspen Surabaya as well as services provided to civil servants, including work accident insurance programs. This program includes protection against the risk of work accidents in the form of treatment, compensation, and disability benefits. In addition, a pension insurance (ENT) program is included, which is related to retirement age and death insurance.

A life course perspective on the NEET phenomenon: long-term exclusion across cohorts, gender, and social origin among young adults in Norway

ABSTRACT This study addresses the limitations of the NEET indicator (Not in Education, Employment, or Training) as a measure of the risk of social exclusion. Applying a life course analytical framework and sequence analysis to administrative data from Norway, we investigate the link between NEET status and longer-term exclusion across cohorts, gender, and social origin. Young adults with at least one year of NEET status at ages 22–25 (N = 125 804) are followed for ten years (age 22–31), spanning the years 1993–2017. Results show a mixed picture for individuals with early-career NEET status: 38 percent fare well over the long term, while over one-third face persistent challenges of long-term exclusion or reliance on permanent disability benefits. A deterioration of longer-term prospects, stronger among men than women, is observed across cohorts. An initial large gender gap in long-term exclusion probability in men´s favor disappears in the youngest cohorts. Social inequalities remain stable over time. Findings support recent research emphasizing NEET category heterogeneity. Static measures may both exaggerate and underestimate the challenges faced by different sub-populations. The risk of long-term exclusion changes markedly over time, showcasing how the NEET indicator's sensitivity as a measure of at-risk youth depends on the historical-institutional context.

The importance of a healthy lifestyle despite chronic pain: Prospective cohort with 11-year register follow-up

The purpose of the study was to investigate to which extent a healthy lifestyle in female healthcare workers with chronic pain contributes to reducing the risk of disability pension. We conducted a prospective cohort study with an 11-year registry follow-up.Overall, 2386 Danish female healthcare workers with chronic pain completed a questionnaire about work and lifestyle (leisure-time physical activity, smoking, and body mass index (BMI)). Data on disability benefit payments were obtained from the Danish Register for Evaluation of Marginalization. Two models (minimally and fully adjusted for different potential confounders) were tested using the Cox proportional hazards model.During the follow-up period, 17.9% of the healthcare workers obtained disability pension. Low levels of leisure time physical activity (reference: moderate level) increased the risk of disability pension in the minimally (Hazard Ratio: 1.38 (95% CI: 1.14–1.69)) and fully adjusted models (Hazard Ratio: 1.27 (95% CI: 1.04–1.56)). Being highly physically active, as opposed to being moderately active, did not confer additional protection. Additionally, a positive association was observed between smoking and disability pension in the minimally adjusted model (Hazard Ratio: 1.27 (95% CI: 1.05–1.54)). BMI was not an influential factor. In female healthcare workers with chronic pain, at least moderate levels of physical activity is a protective factor for disability pension. Effective promotion strategies should be designed for both workplace and non-workplace settings.

The implosion of the Dutch surveillance welfare state

AbstractFrom the 1990s onwards, fraud detection has become an increasingly important focus in the design and implementation of a variety of welfare schemes, including unemployment benefits, social assistance benefits, pensions, and personal care budgets. This culminated in the 2014 Fraud Act, which introduced a system of high sanction in all cases of benefit fraud, even if they were causes by administrative errors. In 2020 a parliamentary investigation committee concluded that the Dutch government had violated the foundational principles of the rule of law through the way suspected fraudsters with childcare allowances had been treated. This so‐called Childcare allowances affair undermined the support for the harsh approach to fraud and led to a series of proposals to reform the Dutch ‘surveillance welfare state’. The Dutch Childcare allowances affair is an interesting case of a social policy crisis because its origins are not external events but lie in the regular implementation of policies that have been approved and supported rather widely by politicians, policymakers and street‐level bureaucrats. In this article, we define and apply the concept ‘institutional implosion’ to analyse the Childcare allowances affair and its consequences. Moreover, we argue that the implosion in this affair follows from an extension of the target group from ‘non‐deserving’ to ‘deserving’ citizens. Whereas the Fraud Act primarily was aimed towards recipients of unemployment, disability and social assistance benefits, a change in the system of childcare allowances extended the scope of the Fraud Act to an almost universal group of parents that use childcare facilities.

Unequal Effect of Educational Attainment on Reducing Poverty and Welfare; Diminished Returns of American Indian/Alaska Native Populations.

American Indian and Alaska Native (AIAN) communities face pronounced economic and health disparities compared to White Americans, a situation rooted in long-standing historical injustices and segregation. The theory of Minorities' Diminished Returns (MDR) provides insight beyond the traditional focus on socioeconomic status (SES) disparities, such as educational attainment. It suggests that the beneficial outcomes of educational achievements on health and economic status are less substantial for marginalized and racially non-White groups compared to White Americans. This study investigates the applicability of the MDR theory to AIAN populations by examining whether the positive effects of education on poverty reduction and the decreased risk of disability benefit dependency are weaker for AIAN adults relative to their White counterparts. Utilizing data from the 2022 National Health Interview Survey (NHIS), this cross-sectional study analyzed a cohort of 20,743 adults, comprising 20,474 White and 269 AIAN individuals. We assessed the relationships between educational attainment, poverty level, and the likelihood of receiving disability benefits. A structural equation model was employed, with receipt of disability benefits as a latent factor influenced by racial background (AIAN) as a potential moderator, education as the main predictor, and poverty level and self-rated health as mediators. Gender, age, employment status, marital status, and Hispanic ethnicity served as additional covariates. Findings indicate that higher educational levels are generally associated with a lower likelihood of receiving disability benefits, mediated by improved health and economic status. Nonetheless, the interaction between race (AIAN) and education significantly influenced economic outcomes, subsequently affecting the risk of receiving disability benefits. This suggests that Whites benefit more economically from education than AIAN individuals do. The study underscores the MDR theory's relevance to the disparities in educational outcomes related to poverty risk and receiving disability benefits among AIAN populations. The challenges AIAN individuals face in leveraging their educational achievements for economic gain relative to Whites may be attributed to pervasive racism and discrimination within various sectors, including employment and education. Addressing these disparities necessitates policy interventions that ensure educational returns are equitable across racial groups, with a focus on equal access to resources and opportunities.