The Retaining Employment and Talent After Injury/Illness Network (RETAIN) demonstration was a collaborative effort by the U.S. Department of Labor (DOL) and the Social Security Administration (SSA) to help workers stay in the labor force after they experience an injury or illness. The goal of RETAIN was to implement and test programs that used early-intervention stay-at-work/return-to-work (SAW/RTW) strategies with adult workers who had recently experienced the onset or worsening of an injury or illness that challenged their ability to work. In Phase 1, which began in 2018, DOL awarded funds to eight state agencies to develop and pilot test programs to help those who experience a potentially disabling condition stay at work or return to work. In Phase 2, which began in 2021, DOL competitively selected five of these states (Kansas, Kentucky, Minnesota, Ohio, and Vermont) to fully implement such programs (named RETAINWORKS, RETAIN Kentucky [RETAIN KY], Minnesota RETAIN [MN RETAIN], Ohio RETAIN [OH RETAIN] and Vermont RETAIN [VT RETAIN], respectively). The five RETAIN programs began enrolling participants in late 2021 and early 2022 and continued enrollment for evaluation purposes through mid May 2024.

Under contract to SSA, Mathematica conducted an independent evaluation of the RETAIN programs. The overarching goal of the evaluation was to build evidence on the effectiveness of early intervention SAW/RTW strategies in helping people with an injury or illness stay connected to work, avoid entry into SSA’s disability programs, and experience better health and economic well-being. The evaluation had several components, including rigorous assessments of the programs’ implementation and their impacts on enrollee outcomes in the months immediately following enrollment and in the first year after enrollment. This report presents findings from participation, impact, and benefit-cost analyses for each of the five RETAIN programs. Each RETAIN program used a random assignment study design, such that some enrollees were in a treatment group that could use RETAIN services and the others were in a control group that could use limited or no services besides those typically available in the community.

The report findings cover a one-year follow-up period and are based on Mathematica’s analysis of programs’ enrollment and service use data, state unemployment insurance wage records, SSA program data, a follow-up survey of RETAIN enrollees that Mathematica conducted about 12 months after enrollment, and program cost data. The one-year follow-up period reflects data availability, evaluation timing, and a time horizon over which impacts on key outcomes such as SSDI applications could be expected to emerge. An earlier report (Patnaik et al. 2025) summarized impacts on service use, employment, and health outcomes based on an early follow-up survey that Mathematica conducted about two months after enrollment.