Patterico's Pontifications


The Explosion of Social Security Disability

Filed under: General — Patterico @ 11:41 am

A recent episode of This American Life addressed the explosion of Social Security Disability claims over the last 20 years. We have 14 million people on this program and they don’t count in the unemployment numbers. So when you hear the pundits on TV talk about unemployment, picture 14 million people, many receiving checks for things like back pain, bipolar disorder, and other maladies that are common in the workforce. Realize that those 14 million people, collecting an average of $1000 per month plus free health care, are not part of the unemployment numbers you are hearing.

The episode is chock-full of interesting information and the whole hour is well worth your time, but I’ll try to summarize the points that jumped out at me. In 1984 Congress changed the definition of “disability” to include things like back pain and mental disorders, which are now the majority of disability claims. TAL visited a town where fully 25% of the inhabitants are on disability; yard sales are timed after the issuance of government checks because that’s when people can afford the items. In another town, a mill closed down in the town, and it sounds like pretty much everybody who had worked there checked out of the workforce.

Social Security disability claims have exploded, despite any corresponding decline in our health — and despite the passage of the Americans with Disabilities Act, which in theory ought to make it easier for people with disabilities to work. We even issue checks for children with learning disabilities, and their caregivers depend on the money . . . which keeps coming in, as long as they are still struggling in school. Do you think they continue to struggle in school? Many of these children quickly learn that even a part-time job as a teenager will cut the amount of their disability check, and they are thus discouraged from working, and learn to go on permanent disability when they reach adulthood. We are teaching generations of children to collect checks for a living. As the reporter says:

Kids should be encouraged to go to school. Kids should want to do well in school. Parents should want their kids to do well in school. Kids should be confident their parents can provide for them regardless of how they do in school. Kids should become more and more independent as they grow older and hopefully be able to support themselves at around age 18.

The disability program stands in opposition to every one of these aims.

But what about welfare reform? Didn’t we toss millions of people off the welfare rolls in the 1990s and beyond? Um, not exactly. We have, to a great extent, simply been moving them off the welfare rolls and onto the disability rolls. See, what we think of as “welfare” primarily comes out of state budgets — more so after the welfare reform law. So states save money when people get off the welfare rolls — even if they are simply moving onto federal disability rolls. With these incentives, it should not surprise you to learn that states contract with companies whose purpose is to comb the welfare rolls to find people who might qualify for federal disability. These companies have call centers, and small armies of people call these welfare recipients to ask: Can you think of any ailments you have that keep you from working? Does your back hurt? Do you have high blood pressure? Sleep apnea? Diabetes? Depression? Great! We’ll set you up with a doctor and we’ll help you apply for disability, and soon enough you’ll be collecting four times what you’re collecting now!

The head of one of these operations calls it “win/win.” The state wins because they get people off their welfare rolls. The individual wins because they collect a ton more money.

Somewhere in there it seems like there’s probably a loser, but he doesn’t mention those people. (Hi, federal taxpayers!)

And hey, if you are rejected for disability, don’t fret. The government pays lawyers who can successfully appeal a decision to deny disability. You read that correctly. If your lawyer wins an appeal of your denial of disability status, he collects a portion of your back pay, and that check is payable directly by the federal government to the lawyer. One lawyer interviewed had 30,000 clients and made $68 million last year appealing disability denials. Total payouts to lawyers exceed a billion dollars per year.

And what does one of these appeal hearings look like? Well, the lawyer goes into a court in front of an administrative law judge, makes his case, and then the government lawyer — oh wait! Silly me! There is no government lawyer! The lawyer stands to gain a lifetime payout of $300,000 or so, and the U.S. has absolutely nobody representing its interests. In theory, the ALJ is neutral, is an employee of Social Security, and doesn’t need the other side presented. But one of the judges interviewed said he often looks to the part of the courtroom where there ought to be a government lawyer, because he is at a loss as to what the other side of the story should be.

To Obama, of course, all of this is a feature, not a bug. It helps further his goal of redistributing money and making a majority of voters dependents on the welfare state, thus entrenching a permanent Democrat majority.

But to any sane person, a story like this makes you want to scream.

If you can’t devote an hour to listen to the story, go here for a summary of the story with a lot of well-presented graphs that show just how deep the problem runs. It’s really a great job by the folks at Planet Money and This American Life.

P.S. I probably would have posted about this anyway, as I’m a big fan of TAL, but I should note that elissa flagged the episode in comments, reminding me to do a post. Thanks, elissa.

31 Responses to “The Explosion of Social Security Disability”

  1. Ding.

    Patterico (2efd47)

  2. Only 14 million? Surely we can do better.

    beer 'n pretzels (6ef50f)

  3. We practice in this area and are very frustrated that proving real disabilities is actually more difficult than these “softer” ones.

    SPQR (edb554)

  4. The disability program stands in opposition to every one of these aims.

    Considering that TAL airs on NPR, I’m surprised this got through their censors. I’m guessing the backlash will be brutal.

    beer 'n pretzels (6ef50f)

  5. Jesus was feeling generous one fine day so he walked into a bar and offered the 3 guys inside a personal miracle.

    The first guy asked to be cured of alcoholism. Shazam! Jesus touched his hand and he was cured and he never took another drink for the rest of his life.

    The second guy asked to be cured of lung cancer. Shazam! Jesus touched his hand and he put out his cigarette and never lit another one.

    The third guy pulled his hands back in horror and screamed out in fear, Don’t touch me, I’m on disability.

    ropelight (7e72cf)

  6. Jesus also once saw a beggar and asked if he wanted to be healed. He knew what was in the hearts of men and women.

    My son when he was still on the beat would run into families with kids at home, not in school because of “being disabled”. made him mad.

    But in other ways I don’t get it, as at times I had patients denied disablity who clearly warranted it. It seemed at times they flipped a coin to make their determination.

    MD in Philly (3d3f72)

  7. Why do you think all these “autism” diagnoses are cropping up?

    Kids and parents get all sorts of extra cash and benefits if their kids are diagnosed with these “disorders” that we used to call “acting like normal children”.

    SGT Ted (506d69)

  8. Being on SocSec, can I get disability too?
    I’ll need the extra cash to afford O-Care.

    askeptic (b8ab92)

  9. It’s a mixed bad- there is much truth to what Sgt. Ted says, which my son has observed, but I also know at least 3 families with children with severe autism who will always need custodial care, not to mention children with severe disabilies who certainly do warrant special assistance.
    but gee whiz, getting rid of the unreasonable ones would be great

    MD in Philly (3d3f72)

  10. OK, I’m like 20minutes into this episode and I have to ask. Did anyone else feel like the doctor is busy using federal government as a pseudo-charity to make himself feel better?
    This is the problem these days, people think giving away other people’s money make them “good people.” Meanwhile they’re trapping people in the embrace of the government.

    tsrblke (work) (64601c)

  11. I’m very glad to see you did a whole post on this, Patterico, and took the time to elaborate on it as well as encouraged people to listen to the whole program.

    Clearly, by the numbers and the threads, discussing SSM is an interesting, emotional, and sexy issue to many commenters here. But by orders of magnitude this out of control SSDI explosion issue is what has finally made me almost give up any hope that we can “keep” (in the words of the founders) our country. The government bureaucracies are unchecked and out of control. The decision making is counterproductive to our national survival. The published unemployment figures are a total sham. The public education system is broken.

    elissa (920973)

  12. It is also going on with Food Stamps, although the amount of food stamps is far less. I was menaing to link that story, but it was in the Wall Street Journal, not the New York Times.

    Someone did attempt to link it in another thread, but that;s behind a pay wall.

    To bypass the pay wall, click on this:

    Sammy Finkelman (d22d64)

  13. Comment by elissa (920973) — 3/28/2013 @ 2:35 pm

    They are very busy not wasting crises, after they make them.

    MD in Philly (3d3f72)

  14. According to Perry, this is a good thing, you heartless unfeeling bastages.

    JD (b63a52)

  15. Speaking to part of the mental illness issue there is a world of variation in bipolar, from up and down mood swings to psychosis and points in between. Lumping all that together as one illness for the purposes of disability is, well, crazy.

    Theoretically it’s all supposed to be carefully reviewed. The reality is a lot more arbitrary. I’ve met enough people who are mostly functional but still on full disability that I’ve become utterly cynical about the entire business.

    Lazarus (11cbb3)

  16. I guess I’m swimming upstream on this one. I may be forced to file for disability. You know the old line, “The spirit is willing, but the flesh is weak”? That is my case. I’m a type 2 diabetic, with weight, hypertension, and degenerative back problems. My colon was taken out in 88, A lymphoma off my arm 5-6 years ago, and my gallbladder somewhere a year or so ago. I’m on meds for Alzheimer’s, and arthritis and carpal tunnel are setting in, too.

    The Payroll manager asked me why I did’t declare years ago when I could barely walk in the door of the place. I said, “no, I couldn’t do that. I have kids to support.”

    I don’t know how long I have left in the workforce. Girlfriend wants me to declare and get it over with. I’m still fighting, but I’m keeping the last round for me.

    PCD (f79160)

  17. a lot of the piggies on disability are cops and highway patrol douchebags and such, at least here in california

    they have this trick in California of getting disabled right before retirement and then they like triple dip or whatever

    my friend C knows how it works cause his stepdad was pulled aside before retirement and coached on how to get the sweet sweet bennies

    I think he had to fall off a motorcycle or something, but it was worth it

    happyfeet (8ce051)

  18. Comment by PCD (f79160) — 3/28/2013 @ 8:04 pm

    It’s there for people who need it. If you put into the system, no reason to worry when you need it.

    It’s the people with “back problems” we see lifting big TV’s out of their car trunk we have problems with.

    MD in Philly (3d3f72)

  19. In my patients it is very rare for someone to fail to win disability status on appeal. The system is rigged for the lawyers, win with one or be lost in the paperwork without one. I’ve had truly disabled people be unsuccessful until finally hiring an attorney to win the case and skim off cash.

    I’m often surprised by awards, having many minimally affected patients winning the lifetime lottery, but in this morass I’m not asked for my opinion.

    Teflon Dad (818dd7)

  20. Yeah, it would take a government lawyer litigating the case for someone to ask your opinion, Teflon Dad. The appellant’s lawyer sure isn’t going to.

    Patterico (2efd47)

  21. I can tell you for certain there are children terrified of “getting better” because they believe their disability check will be stopped. The mom and dad (lower case intentional) are living off the child’s disability check. The kid has been inpatient more than once this year already due to life-threatening complications.

    Stashiu3 (1680c0)

  22. The Wall Street Journal had the story yesterday about the huge rise in food stamp SNAP usage among Americans and how, in the past, food stamp usage declined when the economy improved, but it isn’t doing so this time.

    A handy chart here notes the explosion in food stamp SNAP costs, even though the per-person benefit hasn’t increased significantly, due to the explosion in the number of people on food stamps SNAP.

    The Democrats have been fighting tooth-and-nail over every single penny cut from federal spending, after having presided over a huge expansion of the federal government. According to the President’s own projections, projects total federal spending of over 22% of Gross Domestic Product, for as far into the future as he could project, levels not seen since the end of World War II. And why shouldn’t they: such huge spending increases have bought off enough voters to re-elect an otherwise failed President, and there’s no particular reason to believe that such won’t continue to do so, right up until the whole house of cards collapses.

    The Dana who isn't on welfare (3e4784)

  23. 18, MD, got a few friends in Iowa? I need some able bodied people to take an OLD big screen TV to the curb. Not Kidding. My high school QB brother and my son had dropped this monster once.

    PCD (1d8b6d)

  24. People who are considered “disabled” are often entitled to other government benefits as well (increased food stamp/SNAP benefits, EAEDC benefits, just off the top of my head). Without getting into the morass of regulations and how being labelled “disabled” changes things, let me merely say that there are a whole slew of other government benefits that go along with that disability status, which makes it even harder for people to become independent.

    bridget (55e4a2)

  25. Shouldn’t people on disability be included in unemployment stats? This post thinks so.

    Nik (55a9bd)

  26. When I was 7 months old my mom was in a major automobile accident with me in the car. Back then they didn’t have car seats and her car didn’t have seat belts. Since then I have back pain all my life. Two days ago it was bad enough that I stayed home from work. At 4 my left thumb was severed and sown back on. Since late 1993 I’ve had a tremor in my right hand that has gotten progressively worse. The hand shakes which causes me shoulder pain, or does the shoulder cause my hand to shake? If I press down on my shoulder the tremor reduces or stops. I’m legally considered 8 percent disabled. I didn’t work for 18 months because of my tremor and shoulder. The drug I take to reduce the tremor makes me sleepy, so on the way to work I buy a diet soda to keep me awake.

    When it ran out I got a job. I didn’t want to stop working in the first place, the doctor told me I wasn’t allowed to work despite my desire to work. When I went back to work I wasn’t sure if I’d be able to work, which is one of the reasons I took a 25 percent cut in pay from my last job. I’d rather work in pain than stay home in pain. It gives me purpose and I my income is higher.

    Tanny O'Haley (4c5a96)

  27. I don’t think anyone here is disputing that there are many cases of legitimate physical disability which often prevent good people from continuing to work in their preferred careers– disabilities which therefore serve to deprive them the pride of providing for their families without government assistance. It is wrong to paint these people with the same brush as the takers and the abusers of the system as was so shockingly documented in the TAL piece.

    But the faux disability money takers– the abusers of the SSDI system (both individuals and shady lawyers)–quite clearly are able to be so successfully corrupt because they are encouraged rather than thwarted by the corrupt system itself. This must be stopped. One way to raise awareness in the public might be for congress to force the monthly “non-working due to disability” numbers of working-age people to be included in the published unemployment data. This would show that the United States has, and for some time has had permanent depression level unemployment, not 8%.

    I am regularly amazed by how many otherwise seemingly intelligent people truly do not know why the highly select components that go into the jobs and unemployment reports make for idiotic, false, useless numbers. I suspect judging from my impression of the IQ’s of many Congress critters, that manyof them have no clue about these numbers either. Hey! recovery summer!! Obama says so!!!

    elissa (572ec5)

  28. I have a friend who is a career high-school teacher in CA. She didn’t like her job any more because of crowded classrooms and being forced to pass bad students that did zero schoolwork. The system is definitely a mess and unrewarding for good teachers. This causes her to have stress. She is now on disability because of stress. Having a nice time living a paid, stress-free lifestyle. Fit, tan, healthy, and plenty of in-home massages. “Get it if you can”, seems to be the mantra.

    JGlanton (069626)

  29. Comment by bridget (55e4a2) — 3/29/2013 @ 8:44 am

    Without getting into the morass of regulations and how being labelled “disabled” changes things, let me merely say that there are a whole slew of other government benefits that go along with that disability status,

    True, but there are also people who benefit from serving the disabled.

    which makes it even harder for people to become independent.

    I would say even a 10% tax would be enough to stop it.

    Have you ever heard of anyone counseling small part time jobs? There is no suchh counseling.

    And remember, Medicaid has clawbacks. Technically it may amount to a loan.

    Sammy Finkelman (d22d64)

  30. Sammy Finkelman: I’m not sure I understand the point of your comments.

    Yes, Medicaid has clawbacks – but (a) I wasn’t talking about Medicaid, and (b) Medicaid clawback provisions (at least by my understanding) tend to not look at future income so much as past transfers. The clawback provision will take in things that you’ve already given away, not things that you will earn in the future.

    (If I’m missing some Medicaid provision, please let me know.)

    bridget (55e4a2)

  31. On a related note Britain is belatedly and halfheartedly trying to get some control of their “disability dole”. “But Mr Duncan Smith has admitted, as revealed by The Telegraph, that ministers have effectively given up trying to reduce the overall welfare bill and that the government is simply trying to “manage” the rise in payments”.

    900,000 choose to come off of their sickness benefit ahead of tests rather than undergo a tough medical test.
    The 878,300 who decided not to have an official assessment of whether they were fit for work was more than a third of the total number of people claiming sickness-related benefits.
    The statistics also revealed that some claimants cited conditions such as “blisters”, “sprains and strains” and “acne” as preventing them from having a job.
    More than 46,120 people claimed incapacity benefit because of “behavioural disorders due to the use of alcohol” while 29,130 claimants cited drug use.
    Ministers said the figures showed the full extent of how millions had been “trapped on welfare” for decades.
    Grant Shapps, the Conservative Party chairman, said the old system was “evil” and accused Labour of using sickness benefits to “hide the unemployed” when the party was in power.
    The statistics emerged ahead of a raft of controversial changes to the benefits system which will come into force this week – including the “bedroom tax” which sees council and social housing tenants facing reductions to their benefits if they have empty rooms in their homes.
    Also coming in is an overall benefits “cap”, which will prevent any household receiving more than £26,000 a year in total benefit payments – a figure set to reflect the average gross salary of a full-time worker.

    More than 2 million people who previously claimed sickness payments are gradually being assessed to determine whether they are eligible for the main incapacity benefit, Employment and Support Allowance (ESA).
    If they are not, and cannot find work, they have to claim the less generous Jobseekers Allowance (JSA).
    Mr Shapps said: “One of the cruelest things about this welfare system, which had developed over decades…is that it traps people who want to work hard and get on in life with no other option but to be trapped into a life on welfare.
    “It’s cruel, I think the system had actually become literally cruel, even evil to people. People suspected for a long time that incapacity benefit had been used by the previous government to hide the unemployed.
    “Nearly a million people have come off incapacity benefit…before going for the test. They’ve taken themselves off. My big argument here is this is not these people were trying to play the system, as much as these people were forced into a system that played them.”

    elissa (9e3aa8)

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