The Social Security Disability Insurance (SSDI) program is growing at an unsustainable pace. Over the past 40 years the number of disabled worker beneficiaries has increased nearly sixfold, rising from 1.5 million in 1970 to 8.2 million in 2010. Rapid growth in the rolls has put increasing pressure on program finances. The rapid rise in SSDI caseloads and costs are made more worrisome when put in the context of the broader goals of the program--to protect the economic well-being of people with disabilities. On this front, the last 20 years have been especially disappointing. Since the passage of the Americans with Disabilities Act of 1990 (ADA), employment rates for those with disabilities have declined considerably and household income of these individuals has remained flat. Increasingly, people with disabilities are substituting SSDI benefits for labor market earnings, limiting their connection to the growth in the overall economy and making them net withdrawers rather than net contributors to the tax base during their working-age. This outcome challenges the finances of the SSDI program and is at odds with the view of disability codified in the ADA, namely that people with disabilities are able and willing to participate in the labor market. As such, it suggests that it is time for fundamental change in the SSDI program. Fundamental reform is needed to restore solvency to the U.S. disability insurance system and to support continued employment and greater self-sufficiency among workers with disabilities. (Contains 1 figure and 5 footnotes.)