Sickness and disability outcomes are still disappointing in most countries, with low employment rates and high benefit dependence, calling for further often unpopular reforms. In the past 10‐15 years, countries have started to shift their approach away
from merely paying benefits to people with disability towards helping them stay in, or return to, work. This chapter outlines the main directions of recent reforms across the OECD and explores the question whether or not changes have gone far enough to reduce benefit dependency
and increase employment rates. The chapter concludes that i) policy matters: reform has had a major impact on the observed outcomes, especially the disability beneficiary rate; and ii) policies are moving in the right direction, with considerable convergence
of policies despite continued structural differences. However, in most countries more needs to be done.