Disability Insurance: America's $124 Billion Secret Welfare Program

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Disability Insurance: America's $124 Billion Secret Welfare Program
The number of former workers enrolled in the Social Security disability program has more than doubled in the last two decades, and the reasons why have little to do with the health of our workforce.
JORDAN WEISSMANN
MAR 25 2013, 3:25 PM ET

Imagine for a moment that Congress woke up one morning, realized that the United States was suffering from a paralyzing long-term unemployment crisis, and, in a moment of progressive pique, decided to create a welfare program aimed at middle-aged, blue-collar workers.

The one thing everybody could probably agree on is that it should help all those jobless 50-somethings find employment, right?

Well, as NPR's Planet Money argues in an eye-opening story, it turns out there already is a "de facto welfare program" for those struggling Americans. The problem is, instead of getting the unemployed back on their feet, it pays them to give up work for good.

I'm talking about Social Security's disability insurance program, which over 20 years has quietly morphed into one of the largest, yet least talked about, pieces of the social safety net. Since the early 1990s, the number of former workers receiving payments under it has more than doubled to about 8.5 million, as shown in Planet Money's graph below. More than five percent of all eligible adults are now on the rolls, up from around 3 percent twenty years ago. Add in children and spouses who also get checks, and the grand tally comes to 11.7 million.

That rapid, under-the-political-radar expansion has turned the program into a massive budget item. As of 2010, its monthly cash payments accounted for nearly one out of every five Social Security dollars spent, or about $124 billion. In 1988, by comparison, it accounted for just one out of eight Social Security dollars. Because disabled workers qualify for Medicare, they also added $59 billion to the government's healthcare tab.

Are disabilities just becoming more common? According to economists such as MIT's David Autor, the evidence says no. The workforce is indeed getting older, and thus more ailment prone. But Americans over 50, who make up most disability cases, report much better health today than in the 1980s. And demographers have found that the percentage of Americans older than 65 suffering from a chronic disability has fallen drastically since then. In the end, economists Mark Duggan and Scott Imberman estimate that, at most, the graying of America's workers explained just 4 percent of the increase in the rate of disability program participation for women, and 15 percent for men, through 2004.

Instead, it seems two things have happened: Qualifying for disability got easier, and finding work got harder. As the Planet Money piece puts it, "there's no diagnosis called disability." According to the letter of the law, disability recipients must prove they are too physically or mentally impaired to hold a job. And early in the program's life, the most commonly reported ailments were easy-to-diagnose problems such as heart-disease, strokes, or neurological disorders. But after the Reagan administration began trying to thin out the program's rolls in the early 80s, an angry Congress reacted by loosening its criteria. Suddenly, subjective measures like self-reported pain or mental health problems earned more weight under Social Security's formula. Today, the most common diagnoses are musculo-skeletal issues, such as severe back pain, and mental illnesses, such as mood disorders -- health problems where the line between a disability and a mild impairment is far blurrier.

Just as the bar for disability fell, the economy turned on the working class. Factories laid off their assembly workers. The service sector picked up the slack. Wages stagnated for anyone without a college diploma. These changes have made disability more attractive for reasons both obvious and subtle. Although program's payments are small -- the average benefit is a bit over $1,000 per month -- they're not much worse than a minimum wage job. Better yet, they're indexed to inflation, meaning they sometimes rise faster than wages, and come with generous government healthcare. For former blue-collar workers who feel they've lost all hope of finding employment, or who don't want to spend their last years leading to retirement standing all day at McDonald's, disability isn't a bad offer.

It's little surprise then that, as MIT's Autor notes, disability applications tend to rise and fall with the unemployment rate (as shown in his chart below), or that most applications come from workers who have recently lost jobs.

If you're a conservative, the reasons to worry about all this are obvious. There are probably a couple million people who could work if absolutely necessary, and are instead choosing to subsist on taxpayer money. The system, from that perspective, is simply being abused.

But the failures here should be obvious to liberals, too. If the job market is so miserably weak that these workers cannot find jobs -- that they are choosing to live in government-guaranteed poverty rather than take a chance on the labor market -- we need to find a better solution than paying them to sit while their skills atrophy. As of now, that's all we seem to be doing. Despite Clinton-era changes to the program that made it possible for participants to ease back into the work force without losing all their benefits, less than one percent of Americans who go on disability ever leave the program.

Moreover, that program, is headed for bankruptcy. As of last year, Social Security's disability trust fund was on pace to run dry by 2016, which would lead to an automatic 21 percent benefit cut affecting all of the program's participants, including the millions who truly can't work because of their impairments.

Like I said, even if we wanted a new welfare program for the struggling poor, this wouldn't be the way to run it.

http://www.theatlantic.com/business...as-124-billion-secret-welfare-program/274302/
 
UNFIT FOR WORK: The startling rise of disability in America

The NPR reporting that started all this new interest.
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'Adult Baby' Claims Disability Checks Will Continue Despite Coburn Complaint

And who can for get "Adult Baby vs Senator Coburn."

Spoiler, Adult Baby won.

<iframe width="675" height="900" src="http://www.foxnews.com/politics/2011/10/20/adult-baby-claims-disability-checks-will-continue-despite-coburn-complaint/" frameborder="0" allowfullscreen></iframe>
 
Is Disability the New Welfare?

Is Disability the New Welfare?
By Jonah Goldberg - April 3, 2013

The government in Britain recently did something interesting.

It asked everyone receiving an "incapacity benefit" — a disability program slowly being phased out under new reforms — to submit to a medical test to confirm they were too disabled to work. A third of recipients (878,000 people) didn't even bother and dropped out of the program rather than be examined. Of those tested, more than half (55%) were found fit for work and a quarter were found fit for some work.

But that's Britain, where there's a long tradition of gaming the dole. Americans would never think of taking advantage of the taxpayers or misleading the government. Well, except for the couple dozen people who have pleaded guilty to scamming the Long Island Rail Road's federal disability system in a $1-billion fraud scheme. That would pay for a lot of White House tours.

Though hardly isolated, the LIRR scandal is an obvious black-and-white case of criminality. The real problem resides in a grayer area.

In 1960, when vastly more Americans were involved in physical labor of some kind, 0.65% of workforce participants between the ages of 18 and 64 were receiving Social Security disability insurance payments. Fifty years later, in a much healthier America that number has grown to 5.6%.

In 1960, 134 Americans were working for every officially recognized disabled worker. Five decades later that ratio fell to roughly 16 to 1.

Some defenders of the status quo say these numbers can be explained by the entry of women into the U.S. workforce, the aging of baby boomers and the short-term spike in need that came with the recession.

No doubt those are significant factors. But not nearly so significant as to explain why the number of people on disability has been doubling every 15 years (while the average age of recipients has gone down) or why such a huge proportion of claim injuries can't be corroborated by a doctor.

Nicholas Eberstadt of the American Enterprise Institute and the Harvard School of Public Health notes in his recent book "A Nation of Takers: America's Entitlement Epidemic" that 29% of the 8.6 million Americans who received Social Security disability benefits at the end of 2011 cited injuries involving the "musculoskeletal system and the connective tissue." Fifteen percent claimed "mood disorders."

It's almost impossible, Eberstadt writes, "for a medical professional to disprove a patient's claim that he or she is suffering from sad feelings or back pain." And that's assuming a doctor wants to disprove the claim.

In an illuminating and predictably controversial exposé for "This American Life," NPR's "Planet Money" team tried to figure out why, since 2009, nearly 250,000 people have been applying for disabilities every month (while we've averaged only 150,000 new jobs every month).

The answers fall on both sides of the gray middle.

One factor has to do with what correspondent Chana Joffe-Walt calls the "Vast Disability Industrial Complex." These are the sometimes shady, sometimes well-intentioned lawyers who fight to fatten the rolls of disability recipients. These lawyers get a cut of every winning claimant's "back pay." The more clients, the bigger the take. That's why they run ads on TV shouting, "Disabled? Get the money you deserve!"

Then there are the doctors. Joffe-Walt profiles one rural Alabama doctor who signs off on disabilities for pretty much anyone lacking a good education on the assumption their employment prospects are grim.

That points to the even bigger parts of the story. As the nature of the economy changes, disability programs are sometimes taking the place of welfare for those who feel locked out of the workforce — and state governments are loving it. States pay for welfare, the feds pay for disabilities.

There are those who are quick to argue that this is all bogus, there's nothing amiss with the disability system that greater funding and a better economy won't fix. Maybe they're right. One way to find out would be to ask every recipient to get a thorough examination, just as they did in Britain. Maybe the results here in the United States would be interesting too.

http://www.nationalreview.com/articles/344499/disability-new-welfare-jonah-goldberg
 
Disability claims skyrocket: Here's why

Disability claims skyrocket: Here's why
By Steve Hargreaves @CNNMoney
April 11, 2013: 11:38 AM ET

The number of Americans getting some type of disability check from the federal government is soaring.

Since 2003, there's been a 29% jump in Americans with little or no work experience getting disability payments, according to the Social Security Administration. Over the same time, there's been a 44% increase in disability claims by people formerly in the workplace.

Disability claims among veterans are up 28% since 2008, according to the Department of Veterans Affairs.

All told, the federal government spent nearly $250 billion in 2011 paying more than 23 million Americans some type of disability claim. That's about 7% of the overall population, and 16% of the workforce.

Those numbers don't even include people out on worker compensation claims -- which are mostly paid for by private companies. Five states also offer short term disability, and there are nearly 1 million workers receiving private disability insurance.

But the Social Security-administered program that pays disability claims will likely run out of money by 2016, forcing politicians to either cut Social Security benefits, raise taxes or, most likely, dip into general Social Security funds for the money.

There are many reasons for the increase in disability claims, most notably the recession, an aging population, advances in medical technology and a decade of war.

The recession: The economic downturn in 2008 and early 2009 is thought to be the major reason for the jump in disability payments to people who were formerly working.

"With every recession, we see a rise in the number of applicants," said Andrew Houtenville, an economics professor at the University of New Hampshire's Institute on Disability. "People are looking for options in terms of income support."

During the 2001 recession, disability claims from those who used to have a steady job shot up 13%, said Barry Lundquist, president of the Council for Disability Awareness, an insurance-industry funded organization. The growth in claims slowed during the subsequent boom years, but then skyrocketed during the most recent recession. In 2009, claims jumped 21%.

Lundquist said it is simplistic to characterize the jump in claims as people simply looking to substitute disability payments for unemployment.

"Most people really do want to work," said Lundquist.

But for some, it's really just not an option.

Aging population: The U.S. population has risen about 8% since 2003. In addition to more people, the population is also getting older as the baby boomers retire.

Older people tend to have more disability issues. And if someone in their late 50s or early 60s gets laid off and also has some sort of injury, they know it's going to be hard for them to find another job.

Still, Houtenville noted that disability claims are up among all age groups.

Welfare reform: Efforts in the 1990s to reform the nation's welfare laws had the perverse effect of pushing more people onto the Social Security program for people with little work history. That has continued.

States and municipalities actually set up screening centers to test welfare recipients for disabilities, said John O'Neill, director of employment and disability research at the Kessler Foundation, a non-profit focused on disability issues. If any were found, state workers helped the people apply for federal disability benefits.

"They shifted their costs onto the federal government," said O'Neill.

Medical advances: This is particularly relevant for military veterans. Thanks to better surgical techniques -- and body armor -- soldiers are ten times as likely to survive today's wars, according to the Veterans Administration. But soldiers often come home with severe injuries.

The recent decision to recognize post traumatic stress disorder as a disability has also lifted the number of benefits claims. The Veterans Administration noted that illnesses tied to the cancer-causing chemical defoliant Agent Orange used in Vietnam are also now viewed as a disability.

But medical advances aren't just helping soldiers. Premature babies have a better chance of living now, as are people who have a heart attack or stroke. However, surviving doesn't mean that people are entirely symptom-free.

"We're not just living longer, but we're living disabled longer as well," said Daniel Steenerson, president of Disability Insurance Services, a company what works with both insurance firms and disabled people.

Need for reform: Some of the increases in disability payments are arguably a good thing - like more veterans being covered.

But Houtenville said the Social Security disability program for former workers could be improved if there also was a short term disability program that encouraged people to return to work.

An increase in job training and education programs for the disabled would also help.

http://money.cnn.com/2013/04/11/news/economy/disability-payments/index.html?iid=Lead
 
America's Growing Social Security Disability Problem

America's Growing Social Security Disability Problem
By Richard Burkhauser
May 15, 2013

The latest Social Security Administration data document that Social Security Disability Insurance (SSDI) rolls reached a record high of 8.85 million in March 2013, an increase of 1.6 million or 21 percent since the start of the Great Recession in 2007.

This recession-induced growth exacerbates the long time trend in SSDI program growth that has resulted in its real expenditures increasing sevenfold, from $18 billion (2010 dollars) in 1970 to $128 billion in 2010, a trend the CBO reports will result in program insolvency as early as 2016.

This long running disability epidemic, which hit its pandemic stage in the aftermath of the 2007 recession, has almost nothing to do with a decline in the overall health of working age Americans or in the severity of their health-based impairments. Rather, it is primarily the consequence of fundamental flaws in the SSDI program and its administration which have increasingly made it a long term unemployment program rather than the last resort transfer program for those unable to work due to their health-based impairments that Congress intended it to be. These flaws become most evident during severe during economic downturns but will remain long after we recover from the Great Recession.

Most SSDI growth is driven by its incentive structure and the increasing difficulty of its administrators to determine disability (as discussed in my recent book, co-authored with Mary Daly, The Declining Work and Welfare of People with Disabilities (AEI Press, 2011) and in our point-counterpoint debate article in The Journal of Policy Analysis and Management).

SSDI's most fundamental structural flaw is its reliance on a flat payroll tax for funding which does not rise for firms whose workers disproportionately come onto SSDI rolls or fall for firms who take measures to instead keep them on the job. Hence firms have less incentive to accommodate or rehabilitate their workers at the most effective point for such treatments-when workers first experience a health shock that affects their ability to work.

Worse, an increasing share of workers coming onto the rolls are marginal cases. They might have been able to continue to work with an intervention at the very beginning. Instead, these workers make up the majority of new beneficiaries who are awarded benefits based on difficult-to-determine mental and musculoskeletal conditions or who have conditions that do not exceed the medical listing but are accepted based on vocational criteria (e.g. age, education, and work history).

The flawed program hurts millions of workers by forcing them to demonstrate they are unable to work before they can receive benefits. This stands in contrast to a program that partners with employers to intervene quickly, provide accommodation, and empower individuals with work impairments to remain engaged in work. Individuals who remain in the work force generally earn more than SSDI beneficiaries, while also benefitting from the social engagement and dignity that work can provide. For many beneficiaries, the cash and healthcare benefits of the program are poor replacements for continuing to work, and a timely intervention could make that possible.

Rather than focusing on removing those already on the SSDI rolls, it is time for Congress to consider more fundamental SSDI reforms that would better incentivize employers to provide workers with alternatives to an SSDI application when their impairment first occurs.

By experience rating the disability payroll tax to look more like Workers' Compensation (WC), firms would have greater incentives to hire private sector long-term disability insurers to better manage their workers when they first experience the onset of a health related work limitation. This would lead to greater accommodation and rehabilitation and a reduction in SSDI applications. This "work first" policy makes far better sense than current SSDI policies where workers must demonstrate that they cannot work before being offered incentives to work once they are on the program.

Under a reformed system, like that of the Dutch, payments would be awarded only after workers try to return to work-and after their employers try to accommodate their work limitations. Because firms would more directly bear the costs of disability, directing their workers onto the SSDI rolls would become increasingly expensive and decreasingly desirable. This together with a tightening of the most highly subjective health condition criteria, especially mental and musculoskeletal conditions, would help SSDI administrators make decisions more consistently and reduce uncertainty about eligibility.

Not all persons with disabilities can work, so it is important to maintain a last resort SSDI program that provides protection for these workers. But the reality is that SSDI has increasingly become the first, rather than the last resort for many new SSDI beneficiaries. The program's looming insolvency only increases the need for fundamental reform.

http://www.realclearmarkets.com/art...ocial_security_disability_problem_100322.html
 
Judges tell lawmakers they are pressured to approve Social Security disability claims

Judges tell lawmakers they are pressured to approve Social Security disability claims
By Stephen Ohlemacher,
Published: June 27

Driven to reduce a huge backlog of disability claims, Social Security is pushing judges to award benefits to people who may not deserve them, several current and former judges told Congress on Thursday.

Larry Butler, an administrative law judge from Fort Myers, Fla., called the system “paying down the backlog.”

A former Social Security judge, J.E. Sullivan, said, “The only thing that matters in the adjudication process is signing that final decision.” Sullivan is now an administrative law judge for the Transportation Department.

The House Oversight and Government Reform Committee is investigating why many judges have high approval rates for claims already rejected twice by field offices or state agencies. Two current and two former judges spoke at a subcommittee hearing.

The number of people receiving Social Security disability benefits has increased by 44 percent in the past decade, pushing the trust fund that supports the program to the brink of insolvency.

Social Security officials say the primary reason for the increase is a surge in baby boomers who are more prone to disability as they age. Deputy Social Security Commissioner Glenn Sklar said that the vast majority of disability claims are initially denied.

“I think the data kind of speaks for itself,” Sklar told lawmakers.

To qualify for benefits, people are supposed to have disabilities that prevent them from working and are expected to last at least a year or result in death.

According to Social Security data, there were errors in 22 percent of the cases decided in 2011, Sklar said. He said some errors were procedural and did not necessarily result in incorrect decisions.

“The true wrong rate would be less than 10 percent,” Sklar said.

Nearly 11 million disabled workers, spouses and children get Social Security disability benefits. That compares with 7.6 million a decade ago. The average monthly benefit for a disabled worker is $1,130.

An additional 8.3 million people get Supplemental Security Income, a separately funded disability program for low-income people.

Social Security disability claims are first processed through a network of local Social Security Administration field offices and state agencies called Disability Determination Services. About two-thirds of initial claims are rejected, according to agency statistics.

If your claim is rejected, you can ask the field office or state agency to reconsider. If your claim is rejected again, you can appeal to an administrative law judge, who is employed by Social Security.

In 2007, the average processing time for a hearing was 512 days. Today it is 375 days, Sklar said. The agency has reduced the wait time even as the number of applications has increased.

But the judges who testified Thursday said the quality of their decisions has suffered.

So far this budget year, the vast majority of judges have approved benefits in more than half the cases they have decided, even though they were reviewing applications typically rejected twice by state agencies, according to Social Security data.

Of the 1,560 judges who have decided at least 50 cases since October, 195 judges approved benefits in at least 75 percent of their cases, according to the data analyzed by congressional investigators.

“The Social Security Administration has failed to take steps to address the problem of rapid disability growth, probably because the agency has failed to recognize many of the problems,” said Rep. James Lankford (R-Okla.), the subcommittee chairman.

None of the judges who testified spoke of being specifically ordered to award claims. Three said they had been pressured to decide cases without fully reviewing medical files.

The judges described a system in which there is little incentive to deny claims but lots of pressure to approve them. It requires more documentation to deny a claim than to approve one, said Sullivan, the former Social Security judge. Also, rejected claims can be appealed while approved claims are not.

“There’s a tremendous amount of pressure to push cases out the door as soon as possible,” Sullivan said in an interview after the hearing. “There’s a push to pay mentality.”

Butler, the current judge, told the subcommittee, “I think you need to look at the issue of paying down the backlog. It’s not media hype, it’s real and for six years it’s been going on.”

The union representing administrative law judges said judges are required to decide 500 to 700 cases a year in an effort to reduce the hearings backlog. The union said the requirement is an illegal quota that leads judges to sometimes award benefits they might otherwise deny just to keep up with the flow of cases, according to a federal lawsuit filed by the judges’ union in April.

The agency denies there is a case quota for judges and said the standard is a productivity goal.

If Congress does not act, the trust fund that supports Social Security disability will run out of money in 2016, according to projections by Social Security’s trustees. At that point, the system will collect only enough money in payroll taxes to pay 80 percent of benefits, triggering an automatic 20 percent cut in benefits.

Congress could redirect money from Social Security’s much bigger retirement program to shore up the disability program, as it did in 1994. But that would worsen the finances of the retirement program, which is facing its own long-term financial problems.

http://www.washingtonpost.com/polit...0a7e-df66-11e2-b2d4-ea6d8f477a01_story_1.html
 
The Changing Role of Disabled Children Benefits

The Changing Role of Disabled Children Benefits
Richard V. Burkhauser and Mary C. Daly
September 3, 2013

The U.S. federal government’s program that provides cash benefits to low-income families with a disabled child has grown rapidly over the past 25 years. This growth reflects changes in the implementation of the program rather than declines in children’s health or family income. Unfortunately, most disabled children from families that receive such benefits do not become employed when they grow up, so these policy changes may relegate these children to lifetime government support—probably near the poverty threshold—at the expense of taxpayers.

The federal Supplemental Security Income (SSI) program for disabled children provides cash benefits to low-income families with a disabled child. When the program began in 1974, about 71,000 disabled children received benefits, and program expenditures totaled around $40 million. As Figure 1 shows, the program is orders of magnitude larger today. In 2011, about 1.3 million disabled children received benefits at a cost of $9.3 billion. Program growth increased most rapidly immediately following the 1990 Supreme Court decision in Sullivan v. Zebley, which greatly expanded disability eligibility criteria for children. Welfare reform in 1996 tightened eligibility standards and slightly reduced the rolls for one year. However, since that time, recipients and expenditures have steadily increased.

In this Economic Letter, we summarize the factors behind this growth (for a detailed discussion, see Burkhauser and Daly 2011). Neither decreases in child health nor increases in the number of income-eligible families, are responsible. Instead, an easing of eligibility standards and the interpretation of these standards by Social Security evaluators are the probable drivers of the rise in the number of SSI disabled children beneficiaries.

Untangling caseload growth

Figure 1 shows the growth of the SSI disabled children program since its inception. In principle, several factors might explain this growth. Since SSI is an income-tested welfare program, one possibility is that more families with a disabled child are meeting the income eligibility threshold. Another is that the underlying health of U.S. children has deteriorated, increasing the number of children who meet the program’s disability criteria.

In practice it is difficult to verify whether growth in the income-eligible population has contributed to caseload growth. The SSI means-test rules are complicated, and no reliable, publicly available data on the number of children who meet them are available. Hence, researchers must estimate the number of children who, if they were disabled, would be eligible for benefits.

One way to do this is to estimate the income-eligible population using the U.S. poverty line. Figure 2 shows the results of this exercise. Our estimates are based on multiples of the U.S. Census Bureau poverty line for a family of three, which was $18,106 in 2011. The top line shows caseloads as a fraction of all children below the U.S. Census Bureau poverty line each year, indicating what the take-up rate would be if only families below the poverty line were income eligible. Since the maximum SSI income test level is likely to be above the poverty line for many families, we also compute what take-up rates would be if household income eligibility were set below 125%, 150%, and 200% of the poverty line.

Not surprisingly, estimates of the percentage of eligible children receiving SSI disabled children benefits in any given year vary with estimates of the income-eligible population. It is lowest for the most generous view of the size of the eligible population, 200% of the poverty line, and highest for the most conservative view, 100% of the poverty line. But no matter which income eligibility estimate we use, the take-up rate has risen significantly over time. This pattern holds across all our measures of income eligibility, confirming that income-eligible population growth has not been a dominant driver of the rise in caseloads and expenditures.

Another possibility is that the underlying health of children explains program growth. Identifying such a trend is quite difficult. However, the limited information on trends in child health and functional limitation suggest little change over time. Figure 3 shows the percentage of children ages 5 to 17 with an activity limitation reported by a parent according to poverty status. There has been little change in functional limitations among any of these status groups, including those who may be income eligible. These data are limited, but they do not indicate that changes in child health explain the growth over time in the SSI disabled children rolls.

Other factors driving program growth

When Congress originally enacted the SSI disabled children program, it recognized the difficulties of applying the standards of the adult Social Security Disability Insurance program to children. Thus, Congress determined that a child should be considered disabled for program purposes if “he suffers from any medically determinable physical or mental impairment of comparable severity” to a disabling impairment in an adult. Between 1974 and 1989, the child disability determination process neither included functional assessment, nor accounted for equivalents of adult vocational factors. The program experienced only modest growth and served children with severe physical and intellectual disabilities.

However, in 1990 the Supreme Court ruled in Sullivan v. Zebley that a functional limitation component parallel to that in the adult program must be included in the initial disability determination process for children. In response, the Social Security Administration added two new bases for finding children eligible for benefits: functional equivalence, which was set at the medical-listing level of the disability determination process; and an individualized functional assessment, which was designed to parallel vocational assessment for adults. These assessments lowered the level of severity required for children to be eligible for SSI benefits, allowing applicants who did not meet the medical-listing criterion to be found disabled if their impairments were severe enough to limit their ability to engage in age-appropriate activities, such as attending school (GAO 1994, 1995).

In 1996, as part of welfare reform, Congress revisited the definition of disability for children. It created new standards that were similar in spirit to those for adults, but were unique to children. Legislators intentionally tightened the eligibility criteria by raising the threshold for being functionally impaired and removing certain behavior-related limitations, such as maladaptive-behavior disorder, from the functional-listing criteria. Thus, the post-1996 standard represents a broader measure of disability than the one applied when the program began, but a narrower standard than the one used between 1990 and 1996. This reduced caseloads per 1,000 children across all our measures of the income-eligible population for one year.

Changes in disability rules for children applying for SSI noticeably affected caseloads. But the way SSI administrators interpreted these rules also had an impact. Administrators found themselves interpreting more subjective eligibility criteria. The outcome can be seen in the percentage of SSI disabled children awards for two categories: intellectual disability and other mental conditions. These represent extremes of the distribution between medically measurable and more-subjectively-determined conditions. In 1983, approximately 37% of new beneficiaries qualified based on intellectual disability. Only 5% had other mental conditions. By 2003, over half of new enrollees qualified based on other mental conditions, and that rose to over 55% in 2009.

Welfare reform also contributed importantly to SSI disabled children caseload growth among low-income families after 1996. Reform ended the Aid to Families with Dependent Children (AFDC) program, replacing it with Temporary Assistance for Needy Families (TANF). TANF came with time limits and work requirements. These reforms had a big effect on the SSI disabled children program. The SSI program does not directly provide services to children with disabilities, nor tie benefits to obtaining such services. It simply provides cash benefits to families with low incomes and a disabled child. In that sense, it is like AFDC or TANF, but with the additional stipulation that a family must include a child judged to have a disability.

Researchers have recognized that the populations served by TANF and the SSI disabled children program overlap and have looked for evidence of program interactions. They have found that the typical SSI disabled children applicant family is headed by a low-income single mother who is also eligible for TANF. SSI disabled children benefits are larger than TANF benefits and lack the TANF work requirement. Thus, single mothers have an incentive to apply for SSI disabled children benefits. There is evidence that the greater the difference in benefits, the more likely they are to do so (see Garrett and Glied 2000, Kubik 1999, and Wiseman 2010). Moreover, in contrast with the old AFDC program, states have an incentive to move TANF families to the SSI disabled children program. This allows them to shift costs from their TANF federal block grants to a fully federally funded program (see Burkhauser and Daly 2011 and Joffe-Walt 2013).

In sum, the 1996 welfare reforms strictly limited access of low-income families to cash benefits and shifted more of the financial burden of support for such benefits onto the states. This created additional incentives for families with potentially eligible children to seek SSI disabled children benefits and it motivated states to help them. When these factors combined with relatively lower and more subjective eligibility standards, the SSI disabled children program was poised to grow.

Unintended consequences and long-term costs

The data suggest that the rise in SSI disabled children caseloads and costs are primarily policy driven. The question is, is this a bad thing? Even though it is costly to provide benefits to low-income families via this program, it is a redistribution of income to a mostly poor and near-poor population. The problem is, this redistribution has an important unintended consequence. Many beneficiary children from low-income families are so profoundly disabled that they would never be able to enter the workforce as adults. But others, especially the less clear-cut cases that have driven growth since the Zebley decision, might be able to hold a job with appropriate accommodation and training. However, once these children are on SSI, they rarely come off. Hemmeter, Kauff, and Wittenburg (2009) find that nearly two-thirds of SSI disabled children beneficiaries move directly onto SSI disabled adult rolls. Very few attempt to work thereafter. Moreover, only about 60% of those who do not move directly onto SSI disabled adult rolls are employed at age 19. Thus, most SSI disabled children beneficiaries graduate from the program into what is likely to be permanent status as an SSI disabled adult beneficiary. And, if they are denied these benefits, they turn to other forms of welfare. This outcome is unintended. But it is quite costly both for the beneficiaries, who live their lives at or near the poverty threshold, and for taxpayers, who fund lifetime benefits.

Richard V. Burkhauser is a professor of policy analysis at Cornell University.

Mary C. Daly is a senior vice president and associate director of research in the Economic Research Department of the Federal Reserve Bank of San Francisco.

http://www.frbsf.org/economic-resea...ly-benefits-ssi-supplemental-security-income/
 
Social Security overpays $1.3 billion in benefits: GAO

Social Security overpays $1.3 billion in benefits: GAO
By: Joel Seidman
Published: Friday, 13 Sep 2013 | 10:35 AM ET

An upcoming GAO report obtained by NBC News says the federal government may have paid $1.29 billion in Social Security disability benefits to 36,000 people who had too much income from work to qualify.

At least one recipient collected a potential overpayment of $90,000 without being caught by the Social Security Administration, according to the report, which will be released Sunday, while others collected $57,000 and $74,000.

The GAO also said its estimate of "potentially improper" payments, which was based on comparing federal wage data to Disability Insurance rolls between 2010 and 2013, "likely understated" the scope of the problem, but that an exact number could not be determined without case by case investigations.

To qualify for disability, recipients must show that they have a physical or mental impairment that prevents gainful employment and is either terminal or expected to last more than a year. Once approved, the average monthly payment to a recipient is just under $1,000.

There is a five-month waiting period during which monthly income cannot exceed $1,000 before an applicant can qualify for disability, as well as a nine-month trial period during which someone who is already receiving benefits can return to work without terminating his or her disability payments.

The GAO said that its analysis showed that about 36,000 individuals either earned too much during the waiting period or kept collecting too long after their nine-month trial period had expired. The report recommended that "to the extent that it is cost-effective and feasible," the Social Security Administration's enforcement operation should step up efforts to detect earnings during the waiting period.

In fiscal 2011, more than 10 million Americans received disability benefits totaling more than $128 billion. The GAO's report estimates that less than half of one percent of recipients might be receiving improper payments.

A spokesperson for the Social Security Administration said the agency had a "more than 99 percent accuracy rate" for paying disability benefits. "While our paymen taccuracy rates are very high, we recognize that even small payment errors cost taxpayers. We are planning to do an investigation and we will recoup any improper payments from beneficiaries."

"It is too soon to tell what caused these overpayments," said the spokesperson, "but if we determine that fraud is involved, we will refer these cases to our Office of the Inspector General for investigation."

http://www.cnbc.com/id/101032599
 
U.S. disability rolls swell in a rough economy

U.S. disability rolls swell in a rough economy
By Michael A. Fletcher,
Published: September 20

MILLINOCKET, MAINE — The huge mills along the Penobscot River roared virtually nonstop for more than a century, turning the dense Maine forests into paper and lifting the thousands of men who did the hot and often backbreaking work into the middle class.

But the mills have struggled in recent years, shedding thousands of jobs. Now this area, whose well-paying jobs provided an economic foothold for generations of blue-collar workers, has become a place where an unusually large share of the unemployed are seeking economic shelter on federal disability rolls.

Between 2000 and 2012, the number of people in Penobscot County receiving Social Security disability benefits skyrocketed, rising from 4,475 to 7,955 — or nearly one in 12 of the county’s adults between the ages of 18 and 64, according to Social Security statistics.

The fast expansion of disability here is part of a national trend that has seen the number of former workers receiving benefits soar from just over 5 million to 8.8 million between 2000 and 2012. An additional 2.1 million dependent children and spouses also receive benefits.

The crush of new recipients is putting unsustainable financial pressure on the program. Federal officials project that the program will exhaust its trust fund by 2016 — 20 years before the trust fund that supports Social Security’s old-age benefits is projected to run dry.

The growth of the disability rolls has accelerated since the recession hit in 2007. As the labor market tightened, workers with disabilities that employers previously accommodated on the job — painful hips, mental disorders, weak hearts — were often the first to go. Finding new work often proved difficult, causing many to turn to the disability rolls for support.

The migration of so many people from work to the disability rolls is raising concern among lawmakers in Congress that the program is being stretched beyond its original intent of providing a safety net for former workers whose medical problems make them unable to work.

Last week, the Government Accountability Office found that the program made $1.3 billion in potentially improper payments to people who had jobs when they were supposedly disabled. The allegedly improper payments represent less than 1 percent of disability payments.

While fraud remains a concern, policymakers say the program’s biggest vulnerability is the subjective criteria that create a large gray area for applicants. A worker with physical impairments that are difficult to document precisely, like a bad back, can tolerate the condition while on the job but claim it as a reason to go on disability if he falls out of work for a prolonged period.

Many recipients first go on unemployment, which can last a few months or even more than year. Disability, by contrast, can pay out benefits for decades. The vast majority of recipients never return to work.

“The disability program is increasingly becoming a long-term unemployment program,” said Richard Burkhauser, a Cornell University professor who co-wrote a book on disability policy and has testified before Congress about the program. “We see a lot of it now because of the effects of the recession.”

The program, which is mostly funded by the Social Security payroll tax, paid out $135 billion in 2012, and it has spent more money than it has collected in payroll taxes every year since 2009, according to the Congressional Budget Office. People on disability can receive Medicare after two years, regardless of age, which adds another $80 billion to the program’s tab.

The trust fund has teetered financially as recently as the early 1990s, and Congress solved the problem by transferring money from the fund supporting Social Security retirement benefits. But with that program also on increasingly shaky financial ground as baby boomers retire, it remains to be seen how lawmakers contend with the looming shortfall.

Maine mill jobs vanish

The explosive growth of the disability rolls represents a new reality for Millinocket, a town that had been synonymous with blue-collar prosperity since the Great Northern Paper Co. opened the largest paper mill in the world here in 1900.

The company built a second mill in East Millinocket in 1906, and before long, Millinocket was known as “the magic city” because of its seemingly miraculous expansion.

The good times were still rolling when Eugene LaPorte graduated from high school in 1973. He went straight to work in the mill, and for years it looked like a great move: LaPorte became a supervisor, and at his peak, he had close to a six-figure salary.

“Who needed a college education?” LaPorte said. “I was living the dream.”

But that was before the company’s fortunes changed. In 1990, Great Northern was purchased in a hostile takeover and later went into bankruptcy. Most recently, a private equity firm, Cate Street Capital, has been struggling to revive its operation.

The vast majority of workers were let go. Once, the company employed 4,500 workers. Now, the count is down to about 400, according to local job-training officials.

LaPorte, 58, lasted until 2011. By then, he was battling a series of heart ailments, including a heart attack that struck while he was at work on Christmas Eve 2009. He also had asthma and diabetes.

Other laid-off workers have gone to the Eastern Maine Development Corp., the local job-training center, where they have learned the skills to work as technicians or nurses or in other jobs.

“People have to find a niche,” said Jon R. Farley, director of economic and workforce development at the job training center.

LaPorte wanted to return to the only job he knew. But he had no luck getting back in. He suspects that had a lot to do with his medical history. Finally, his wife, who runs a small trophy business, hit him with a dose of reality.

“They think you’re disabled,” she told him. “Why don’t you put in for it?”

At first, he resisted. But, he noted, he knows a “lot of people who have applied.” Finally, LaPorte filed for disability and, given his long list of chronic ailments, he was approved unusually quickly — in a matter of months.

An expanding program

When President Dwight D. Eisenhower signed the Social Security disability program into law in 1956, it was envisioned as a safety net for people ages 50 to 64 who could not continue working because of long-term medical problems.

The age criterion has since been broadened. Applicants are subjected to a detailed process in which Social Security examiners, administrative law judges and sometimes the federal courts pore over their medical records to evaluate their claims.

But many of the judgments are ultimately subjective: More than half of awards go to applicants who claim musculoskeletal disorders or mental impairments that are often hard to document conclusively.

The number of people on the disability rolls has been growing rapidly even though workers report being ever healthier in surveys. They are also less likely than ever to have physically demanding jobs.

The nation’s aging population explains part of the increase. As workers age, they are more likely to develop physical or mental impairments. Maine, for example, has one of the nation’s oldest populations and has long been among the national leaders in the proportion of working-age people receiving disability.

The growth in the number of women in the workforce — which expanded the number of people covered by the program — is also seen as a factor in disability’s expansion. Changes in program eligibility in 1984 made it easier to qualify for the program with maladies such as pain and depression.

Lawmakers are concerned that some states have encouraged unemployed workers with disabilities to apply for the program, shifting the economic burden for the jobless to the federal government.

A recession option

But the most salient factor in the program’s explosive growth, many economists say, is the difficult job market — particularly for people with few educational credentials.

“The Social Security disability program has become an economic option for many people,” said John Dorrer, an economist and former acting commissioner of the Maine Department of Labor. “As a result of the economic downturn, a whole lot of unskilled males 50 and over were bounced out of the labor force.”

For decades, the number of applicants has almost always increased during economic downturns.

“The bad economy has coincided with baby boomers hitting the disability-prone years,” said Daniel W. Emery, a disability lawyer in South Portland, Maine. “Most people want to work. But employers are less apt to make accommodations when the economy is down. One thing I always ask people is whether they liked their jobs. Often, people just tear up when you ask them that.”

Benefits are hardly generous. They average $1,130 a month, and recipients are eligible for Medicare after two years. But with workers without a high school diploma earning a median wage of $471 per week, disability benefits are increasingly attractive for the large share of American workers who have seen both their pay and job options constricted.

In 2004, nearly one in five male high school dropouts between ages 55 and 64 were in the disability program, according to a paper by economists David Autor and Mark Duggan. That rate was more than double that of high school graduates of the same age in the program and more than five times higher than the 3.7 percent of college graduates of that age who collect disability.

“When you are faced with job loss, what do you do?” said Andrew Houtenville, director of research for the University of New Hampshire’s Institute on Disability. “This is not necessarily shirking. To be on disability insurance, you have to have a pretty serious condition. If you have a severe disability and a job is no longer available in your region you go to disability, and you get stuck there.”

These days, LaPorte spends a lot of his free time riding his Harley-Davidson motorcycle to bike rallies around New England. He enjoys the freedom, but he said he would prefer to be working than collecting a government check.

“I wanted to go to work,” he said. “I love making paper. Fifty-eight is a ridiculous age to retire.”

http://www.washingtonpost.com/busin...91915c-1575-11e3-804b-d3a1a3a18f2c_print.html
 
Disability of 2-year-old raises questions on federal aid programs

Disability of 2-year-old raises questions on federal aid programs
By Alfred Lubrano, Inquirer Staff Writer
POSTED: November 05, 2013

In her coat, Maziah Mills-Sorrells looks like any other 2-year-old, an animated sprite, all bounce and spirit.

But when Maziah's mother, Essie Mills, took the child's coat off in front of their apartment the other day, Maziah's left arm dropped lifelessly, her hand scraping the cement porch.

Maziah didn't feel it, just as she felt nothing last year when she fell and broke that same arm.

Afflicted with a rare condition known as Klumpke's palsy, Maziah has had a paralyzed arm since she was injured during childbirth. Doctors say it's permanent.

Maziah and her parents live in poverty in West Philadelphia. They have tried and failed to get child-disability benefits from the Social Security Administration. Officials won't comment on why.

They receive Medicaid, which pays for many of Maziah's medical bills, including a surgery that couldn't help her. But children with disabilities cost their families $6,000 to $20,000 a year in out-of-pocket expenses beyond medical costs, experts say.

Soon the family will be be going to federal court in Philadelphia in yet another attempt to obtain benefits they say they need to live life with a seriously disabled child.

"I won't give up," said Mills, 24, who works 50 hours a week at two health-care jobs and lives with Maziah's father, Raashid Sorrells, also 24, who was just laid off from a fast-food job. Family income is now at $17,000, well below the poverty level.

The Mills-Sorrellses have been attempting to negotiate an opaque and little-understood federal bureaucracy created to help low-income parents pay for the costs of raising a child with severe disability.

The Supplemental Security Income (SSI) childhood disability program, part of the Social Security system and created during the Nixon administration, gives around $10 billion a year in benefits to low-income families with children under age 18. Maximum monthly checks are $710.

To receive SSI benefits, a family with two parents can't have more than $3,000 in assets, and can't make more than double the poverty level, experts say. (The poverty level for a family of three is $19,530.)

Around two-thirds of benefits go to children with mental conditions, federal data show. The program denies benefits to six out of 10 children.

"SSI rules are byzantine and too strict," said Susan Parish, a professor of disability policy at Brandeis University in Massachusetts. "Deserving families aren't getting benefits."

A Social Security spokesman, B.J. Jarrett, said the agency adheres to definitions and rules set up by Congress to determine whether a person is disabled. He added the program is "one of the most accurate" in the government.

In 2012, 1.3 million low-income children received SSI, fewer than 25 percent of all children with disabilities, said Rebecca Vallas, deputy director of government affairs for the National Organization of Social Security Claimants' Representatives, a nonprofit that represents attorneys.

Overall, 14 percent of low-income families with disabilities receive SSI, said Jonathan Stein, the Community Legal Services attorney representing Maziah.

Ironically, SSI has a reputation among conservatives and some media as a better-than-welfare money machine easy to game.

Not true, SSI experts say.

"There's more myth than fact about disability programs," Vallas said. Anecdotal news reports of children faking disabilities to fool examination doctors are laughable, she added.

It isn't clear why Maziah was turned down three separate times by SSI, since officials both in Harrisburg and Social Security headquarters in Baltimore will not comment on her case.

She is suffering from nerve damage that occurred when she was stuck in her mother's birth canal and was pulled out forcibly, said Mills, who, in a separate case, is suing the hospital where Maziah was born for the injury.

Stein quoted a Social Security Administration judge as conceding that Maziah "has no strength and very limited motion" in her left arm, and is "unable to participate in bilateral playful activity due to non-functional left hand." Further, the judge is quoted as saying, Maziah "has balance issues that affect her ability to move about independent of support." But the same judge found that her condition was not severe enough to warrant payment of benefits.

Stein said he can't understand why those impairments don't qualify the child for benefits. He added that he wants the case to "reveal the failings in the system of saying paralysis of the arm is serious, but not very serious."

Maziah can't climb stairs alone, change her clothes, put on shoes, or be potty-trained because of the damage, her mother said. She's beginning to throw tantrums out of frustration, Mills added.

Research shows that families caring for children with disabilities are more than twice as likely as other families to face homelessness, lack of food, and utility shutoffs.

"We don't have many clothes for her," Mills said, standing in the family's bedroom where parents and child sleep. "She has no sneakers, I won't be able to give her Christmas presents, and I'm $1,300 behind on the rent. I can't take her to her therapy when I want because I'm working every day and every weekend.

"I just don't know what we'll do."

http://articles.philly.com/2013-11-...plemental-security-income-low-income-families
 
Re: Disability of 2-year-old raises questions on federal aid programs

fuck this bullshit propaganda,

the financial market mafia, because that is what they are do NOT let the brooks brothers suits fool you...

we hear so little about the scandals they cover up, and so much about the money that is owed to the people...


we need articles on how the mafia went corporate to rob us blind and shove propaganda up our ass...
 
Re: Disability of 2-year-old raises questions on federal aid programs

fuck this bullshit propaganda,

the financial market mafia, because that is what they are do NOT let the brooks brothers suits fool you...

we hear so little about the scandals they cover up, and so much about the money that is owed to the people...


we need articles on how the mafia went corporate to rob us blind and shove propaganda up our ass...


Deflection and misdirection.


kings%20of%20welfare.fin2_.jpg
 
Re: Disability of 2-year-old raises questions on federal aid programs

fuck this bullshit propaganda,

the financial market mafia, because that is what they are do NOT let the brooks brothers suits fool you...

we hear so little about the scandals they cover up, and so much about the money that is owed to the people...


we need articles on how the mafia went corporate to rob us blind and shove propaganda up our ass...
First of all, no one cares.

We have multiple threads about this stuff and it's filled with mainstream news sources. The scandals and cover-ups aren't being hidden, no one cares.

Next, that has nothing to do with the unofficial permanent unemployment program called Disability Insurance.
 
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