Objectives. We analyzed the relationship between macroeconomic conditions, measured as unemployment rate and social security spending, from 4 social security schemes and total spending due to sickness and disability. Methods. We obtained aggregated panel data from 13 Organization for Economic Cooperation and Development member countries for 1980-1996. We used regression analysis and fixed effect models to examine spending on sickness benefits, disability pensions, occupational-injury benefits, survivor's pensions, and total spending. Results. A decline in unemployment increased sickness benefits spending and reduced disability pension spending. These effects reversed direction after 4 years of unemployment. Inclusion of mortality rate as an additional variable in the analysis did not affect the findings. Conclusions. Macroeconomic conditions influence some reimbursements from social security schemes but not total spending.