David Autor reviews the Social Security Disability Insurance (SSDI) program in the United States, addresses issues and provides some policy implications to remedy problems. Autor begins with the question of why the SSDI rolls have increased so rapidly, while there has been no corresponding increase in physical disability or mental illness in the United States in per capita terms. A related factor is that beneficiaries of the SSDI program have received Medicare benefits in addition since 1965, which in turn has affected the already skyrocketing costs of Medicare. The Americans with Disabilities Act (ADA) of 1990 stresses the government’s goals not only of equality but of economic self-sufficiency, and in theory it should assist disabled people to remain in the workforce. But according to the author, in practice, the SSDI program has not been altered to reflect this goal. Instead it provides strong incentives to employers to terminate employment, and to workers to seek SSDI benefits. The author argues that incentives should be built into the system to encourage employers to be more accommodating and to encourage the disabled to remain in the workforce to as much as possible.