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‘Unfit For Work: The Startling Rise Of Disability In America’

I missed this NPR story, called “Unfit For Work: The Startling Rise Of Disability In America,” when it aired but it’s very interesting. It looks at the incredible increase in disability-insurance enrollment in the last 30 years (thanks to Jason Fichtner for the pointer). The story starts with this:

In the past three decades, the number of Americans who are on disability has skyrocketed. The rise has come even as medical advances have allowed many more people to remain on the job, and new laws have banned workplace discrimination against the disabled. Every month, 14 million people now get a disability check from the government.

The federal government spends more money each year on cash payments for disabled former workers than it spends on food stamps and welfare combined. Yet people relying on disability payments are often overlooked in discussions of the social safety net. The vast majority of people on federal disability do not work.[1] Yet because they are not technically part of the labor force, they are not counted among the unemployed.

As you may remember, a few months back, I posted this chart looking at the issue.

As you can see the trend has been ticking upward for a while. I also noted that:

Interestingly, the main reason for DI termination is that people reach full retirement age and begin collecting normal Social Security benefits. Only 4 percent of the terminations are due to improvement in people’s medical condition — which could be a potential place for some reform — and only 6 percent is due to people going back to work. 

A few months ago, Senator Coburn had a report called “Social Security Disability Programs: Improving the Quality of Benefit Award Decisions.” The report explains that the program’s process for deciding who is disabled is so bad it could be that as many as 25 percent of the decisions made are the wrong ones. Who wouldn’t be in favor of putting an end to that problem? The increase in the number of beneficiaries and the decrease in termination rate puts a tremendous stress on the agency’s resources and personnel. As a result, disabled Americans are waiting longer and longer before receiving the benefits they deserve. Many now wait as long as two years before having their application finalized. This system isn’t working and it should obviously be reformed. 

On a related point, the NPR story points out that in 2011 33.8 percent of people getting disability insurance suffer from back pains and other musculosketal problems. In 1961, only 8.3 percent did.

It also has this interesting bit:

In Hale County, there was one guy whose name was mentioned in almost every story about becoming disabled: Dr. Perry Timberlake. I began to wonder if he was the reason so many people in Hale County are on disability. Maybe he was running some sort of disability scam, referring tons of people into the program.

After sitting in the waiting room of his clinic several mornings in a row, I met Dr. Timberlake. It turns out, there is nothing shifty about him. He is a doctor in a very poor place where pretty much every person who comes into his office tells him they are in pain.

“We talk about the pain and what it’s like,” he says. “I always ask them, ‘What grade did you finish?’”

What grade did you finish, of course, is not really a medical question. But Dr. Timberlake believes he needs this information in disability cases because people who have only a high school education aren’t going to be able to get a sit-down job.

Dr. Timberlake is making a judgment call that if you have a particular back problem and a college degree, you’re not disabled. Without the degree, you are.

Over and over again, I’d listen to someone’s story of how back pain meant they could no longer work, or how a shoulder injury had put them out of a job. Then I would ask: What about a job where you don’t have to lift things, or a job where you don’t have to use your shoulder, or a job where you can sit down? They would look at me as if I were asking, “How come you didn’t consider becoming an astronaut?”

The whole thing is here. It has an interesting part on the link between unemployment rate and DI claims – claims rise and fall with the unemployment rate. In other words, it looks like, in some cases and in some places, DI may be actually used as unemployment insurance. 

Finally, the Private Enterprise Research Center at Texas A&M just put out these interesting maps looking at the geographic distribution of Social Security and Medicare beneficiaries, with one map on disabled enrollees.


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