How Americans Game the $200 Billion-a-Year 'Disability-Industrial Complex'

[peky]

How Americans Game the $200 Billion-a-Year 'Disability-Industrial Complex'

If you're a regular reader of this blog, you know that America's health-care entitlements—Medicare, Medicaid, and Obamacare—are the biggest drivers of our exploding federal debt. What you may not know is that there is a fourth program, that pays disability benefits through the Social Security Administration, that is also growing at an alarming pace. While part of that growth can be explained by the aging of the U.S. population, the largest factor in the proliferation of disability spending comes from the fact that Congress has dramatically expanded the definition of who gets called "disabled." As a result, many able-bodied Americans have been granted government paychecks for life, crowding out our ability to direct needed resources to the genuinely infirm.
The story of the growth in federal disability spending has been percolating for years. The Great Recession of 2008 led to a spike in unemployment; many people who had difficulty finding work discovered that they might be eligible for Social Security disability benefits, benefits that would replace a significant portion of their previously earned wages, while also qualifying them for Medicare, our generous health-insurance program for the elderly. Today, the United States spends around $200 billion a year, literally paying Americans not to work.
   
http://www.forbes.com/sites/theapothecary/2013/04/08/how-americans-game-the-200-billion-a-year-disability-industrial-complex/

Here are a few "revealing" links. The first three are from the SS  administration and provide definitions and requirements. It is interesting to note that my cursory look failed to reveal a definition of "severe." The last link is but an example of many "business" who provide services to make sure you qualify for disability.
http://www.ssa.gov/dibplan/dqualify5.htm#a0=-1
http://www.socialsecurity.gov/hlp/isba/10/hlp-isba100-medev.htm
http://www.ssa.gov/disability/Documents/SSA-3381.pdf
http://www.disabilitysecrets.com/question5.html

[Joelene9]

  Colorado is tougher to get into Disability.  I tried due to the neuropathy keeping me being able to do a 4-8 hour job at regular hours.  I was rejected due to being out of the job market too long.  My Dr. and a lawyer tried to get me on but I cannot get on because I am fiscally responsible.  I will run out of money in less than a year left on my savings due to the mandatory enrollment in ObamaCare. The Mortgage was paid off years ago and my vehicle was paid for in cash long ago.  No debts.  Property ownership does count as income in most states and we seniors not yet qualified for Medicare/Medicaid/full ocial Security (age 66 at this writing) are targets for property seizure predators due to being behind in property tax, utilities, and other garnishable payments.  Each state handles the Federal disability and welfare payments differently.

  As in another thread I read elsewhere, an able-bodied, young "surfer dude" in California gets welfare and spends it on lobster dinner after a day on the beach. This fellow is reprehensible. There are those who are not citizens of this country who do not speak English who get welfare benefits. The men get the low-paying day labor jobs that is paid daily in cash that qualifies them for food stamps.  I get a lot of the full cart(s), 3-tier checkout at the grocer in my neighborhood.  First is the check or chit as I call it.  That chit has a list of items on them and the checkout person usually get the baby formula or other restricted items listed from the lock-up.  The second is the debit card.  This card will only accept the proper UPS codes listed scanned in afterwards.  The third is cash that was earned from those low-paying jobs for the other items not covered.  This is usually candy and soda pop.  I often look at the other people standing in the same line and do see the looks of disgust as well while we wait, and wait, and wait...

  Joelene

[kariann330]

Ohio has started cracking down too. There are now fewer 100% disabled diagnoses and more 75% or lower classifications that pay smaller checks, allow for part time work, usually 28-30 hours a week, and required reclassification every year to two years depending on diagnosis. If it's found during those reclassifications that you are stable on medications, you are put into a returning to the workforce program and after about 6 months your checks are cut off.

personally I'm all for it, along with required random drug testing....if I'm required to take random drug tests to pay into your checks, you should be required to take a test to keep getting it.

[LeftistLeslie]

How Americans Game the $200 Billion-a-Year 'Disability-Industrial Complex'

If you're a regular reader of this blog, you know that America's health-care entitlements—Medicare, Medicaid, and Obamacare—are the biggest drivers of our exploding federal debt. What you may not know is that there is a fourth program, that pays disability benefits through the Social Security Administration, that is also growing at an alarming pace. While part of that growth can be explained by the aging of the U.S. population, the largest factor in the proliferation of disability spending comes from the fact that Congress has dramatically expanded the definition of who gets called "disabled." As a result, many able-bodied Americans have been granted government paychecks for life, crowding out our ability to direct needed resources to the genuinely infirm.
The story of the growth in federal disability spending has been percolating for years. The Great Recession of 2008 led to a spike in unemployment; many people who had difficulty finding work discovered that they might be eligible for Social Security disability benefits, benefits that would replace a significant portion of their previously earned wages, while also qualifying them for Medicare, our generous health-insurance program for the elderly. Today, the United States spends around $200 billion a year, literally paying Americans not to work.
   
http://www.forbes.com/sites/theapothecary/2013/04/08/how-americans-game-the-200-billion-a-year-disability-industrial-complex/

Here are a few "revealing" links. The first three are from the SS  administration and provide definitions and requirements. It is interesting to note that my cursory look failed to reveal a definition of "severe." The last link is but an example of many "business" who provide services to make sure you qualify for disability.
http://www.ssa.gov/dibplan/dqualify5.htm#a0=-1
http://www.socialsecurity.gov/hlp/isba/10/hlp-isba100-medev.htm
http://www.ssa.gov/disability/Documents/SSA-3381.pdf
http://www.disabilitysecrets.com/question5.html

While it is true that some people are using disability as a safety net when they probably shouldn't the reason for this behavior is that the safety nets to keep people out of poverty have been thoroughly gutted. These programs may be a substantial part of the budget but they happen in a context. For instance we have a private healthcare industry that rent seeks. Healthcare is the number one cause of bankruptcy, even if you have insurance. Obamacare was a flaccid half measure that has inefficiency baked in by people who wanted it to fail. We should have done what the rest of the world had done and expanded medicare to everyone, nationalizing the health insurance industry. There are innumerable reasons that someone might be forced to seek public assistance and few options for public assistance. Everyone has this stereotype of the welfare queen but the truth is that those aid programs are fleeting. Food stamps barely feed people. AFDC became TANF and workfare which takes single moms away from being able to take care of their children.

Ideally instead of hemming and hawing about some people on disability who shouldn't be we should take it much further. We should have a guaranteed minimum income, a standard of living that no american should have to live under. We have a surplus of labor, this should be a boon. But in free market capitalism, it mean wealthy people who own the capital, the means of production are better able to exploit people and encourage them to blame minorities and immigrants. We should aim to have a socialist economy where we abolish poverty and inequality.

[LeftistLeslie]

Ohio has started cracking down too. There are now fewer 100% disabled diagnoses and more 75% or lower classifications that pay smaller checks, allow for part time work, usually 28-30 hours a week, and required reclassification every year to two years depending on diagnosis. If it's found during those reclassifications that you are stable on medications, you are put into a returning to the workforce program and after about 6 months your checks are cut off.

personally I'm all for it, along with required random drug testing....if I'm required to take random drug tests to pay into your checks, you should be required to take a test to keep getting it.

Nobody should have to take a drug test, not you and not them. When Florida started testing welfare recipients (at the expense of the needy welfare recipients) it cost more money than it saved. It was a way of vilifying and stereotyping the poor. Just as your employer drug testing you is a means of your employer controling your life. Food and shelter should not be negotiable, I don't care if someone has a substance abuse problem.

[kariann330]

Nobody should have to take a drug test, not you and not them. When Florida started testing welfare recipients (at the expense of the needy welfare recipients) it cost more money than it saved. It was a way of vilifying and stereotyping the poor. Just as your employer drug testing you is a means of your employer controling your life. Food and shelter should not be negotiable, I don't care if someone has a substance abuse problem.

See I don't mind getting tested randomly and honestly I don't mind my tax dollars going to those who really need help. Now those who are just going to sell their benefits and buy weed, crack or heroin....that I have a huge problem with so yeah test them weekly for all i care, if they fail so much as once kick their butts off public assistance for a period of time.

[LordKAT]

Just don't forget how many chidren you are kicking off with them.

[Kylie]

Disability is a huge racket here in Missouri.  When I used to go visit my family in rural Missouri, it always amused me that half the town was on disability and the other half received government subsidies out the ass to grow corn and soybeans. None of them saw those as handouts, but they would complain up a storm about city folk on welfare.  I'm like anyone else, I don't mind my money going to people that truly need it, but I hate to hear of the abuse.  Here in St. Louis, we build billionaires football stadiums and give other billionaires money to build businesses near our baseball stadium.  Wal Mart won't build a store here without a tax credit.  I would much rather my money go to help someone in need.

[Felix]

Eh, I'm on disability as of about a year ago and I've given up trying to rationalize it to most people. I look like a healthy young man. My approval was based on a diagnosis of PTSD that persists in spite of consistent and ongoing attempts to get better. OCD, dissociative disorder NOS, autistic features, tics, mild permanent physical injuries, and ongoing exposure to violence were also taken into official consideration. If I weren't caring for a child, I would have just lived in the woods or something and not asked for SSI. I care more about ethics than comfort and this is the most ethical path for me.

Qualifying is not easy for anyone, and I would be surprised to see any evidence that disability fraud is a substantial problem. Dishonesty with the federal government is usually a felony.

[Miss_Bungle1991]

Eh, I'm on disability as of about a year ago and I've given up trying to rationalize it to most people. I look like a healthy young man. My approval was based on a diagnosis of PTSD that persists in spite of consistent and ongoing attempts to get better. OCD, dissociative disorder NOS, autistic features, tics, mild permanent physical injuries, and ongoing exposure to violence were also taken into official consideration. If I weren't caring for a child, I would have just lived in the woods or something and not asked for SSI. I care more about ethics than comfort and this is the most ethical path for me.

Qualifying is not easy for anyone, and I would be surprised to see any evidence that disability fraud is a substantial problem. Dishonesty with the federal government is usually a felony.

Well, unfortunately, a lot of people are really stupid. They think that if you aren't missing a limb (or multiple limbs), that you are scamming the system if you get any government assistance. Yes, you do have some people that do this and that's what people always seem to focus on: the scammers. Then they decide to throw everyone into the same basket. It's pretty disgusting.

[LeftistLeslie]

It costs more to test people than letting them have the money. I'd rather people have access to what they need than hem and haw that a small number of them are abusing it.

[kariann330]

How does that saying go.....oh yeah "if you don't have anything to hide why does it worry you"

Basically if you aren't abusing drugs and still want your benefits, pee in a cup...it's only fair because I have to do it to pay my taxes which fund that assistance you're getting.

[Miss_Bungle1991]

How does that saying go.....oh yeah "if you don't have anything to hide why does it worry you"

Basically if you aren't abusing drugs and still want your benefits, pee in a cup...it's only fair because I have to do it to pay my taxes which fund that assistance you're getting.

Yeah, yeah, yeah. You just beat the same dead horses. Why don't you give it a rest?

I'm sick and tired of these attitudes where people that are comfortable being sheep want everyone else to join in with the herd.

[traci_k]

60 Minutes just did an expose on an attorney down in Texas, I believe. Mr Disability he advertises. Has a doctor in the office who does the exams right there. Hardly ever loses a case.

In Illinois about 405 of prison guards are coming down with carpal tunnel syndrome from turning keys in automated lockups. Seems most cases go to a very accomodating adjudicating judge - disability granted.

There IS a whole lot of scamming so the people who need it and play it straight get shafted.

[LeftistLeslie]

How does that saying go.....oh yeah "if you don't have anything to hide why does it worry you"

Basically if you aren't abusing drugs and still want your benefits, pee in a cup...it's only fair because I have to do it to pay my taxes which fund that assistance you're getting.

Its more than peeing in a cup. In Florida, recipients had to cover the costs of the tests on their own. Mind you if they had money, they wouldn't be applying for public assistance. They would get refurbished later but that wound up costing more than the amount saved by kicking people off. Mind you, vanishingly few people were taken off public assistance.

But I don't think even that is the reason for the policy. It channels stereotyping of the poor as lazy and drug addicted and that being the reason for poverty. Its asking the wrong question. People of all income levels use drugs and the difference while there is fairly small: http://www.samhsa.gov/data/nhsda/1997main/nhsda1997mfWeb-119.htm#Table13.1  Also this might amaze you but rich people can be lazy too. Lots of them also do cocaine and marijuana.

It comes down to a false very victorian belief impression that poverty is a moral failing. Poverty is a result of society needing some people to be poor. If everyone worked hard in school, went to college (somehow) we would still need people to flip hamburgers and sweep floors. We would still have unemployed people because working is not a simple matter of making a choice to work but finding a employer who chooses to hire you. Poverty also performs a vital function in a capitalist economy is that it scares working people into tolerating abuses and exploitation by the capitalist class.  And when people need help, policy makers vilify them, getting people like you de-empathise with them, giving you a sense of superiority that you aren't lazy, you're special, you'll never be poor, you're moral so why should your tax dollars go to making people's lives less awful.

They are playing you. The capitalist class, the owners of the means of production who exploit all of our surplus values are playing you to vilify the people in our society with the least amount of power as the cause of your problems so you won't notice them taking far far far more of your tax dollars on stuff they want: on lucrative government contracts, corporate welfare, wars of aggression to secure markets and resources, exempting themselves from paying those same taxes. And they get all of this while snorting coke and looting pensions with total impunity.

Moreover, this is DISABILITY we're talking about. You have this image in your head of good for nothing slackers. Look at the people going to the food bank, people who are suffering from malnutrition: families, kids, adults with disabilities. For many also, poverty is temporary but they do need help to get by. We're shipping more good jobs overseas and people are getting left behind.

[Miss_Bungle1991]

They are playing you. The capitalist class, the owners of the means of production who exploit all of our surplus values are playing you to vilify the people in our society with the least amount of power as the cause of your problems so you won't notice them taking far far far more of your tax dollars on stuff they want: on lucrative government contracts, corporate welfare, wars of aggression to secure markets and resources, exempting themselves from paying those same taxes. And they get all of this while snorting coke and looting pensions with total impunity.

Moreover, this is DISABILITY we're talking about. You have this image in your head of good for nothing slackers. Look at the people going to the food bank, people who are suffering from malnutrition: families, kids, adults with disabilities. For many also, poverty is temporary but they do need help to get by. We're shipping more good jobs overseas and people are getting left behind.

Exactly!

I remember when I went down to the DFR to get information on medical insurance back in 07' (A program that I was kicked off of thanks to this whole thing that has been going on with health care recently..thanks a lot. But that's a discussion for another thread). But when I was there, I heard this over and over from other people while waiting to be called in. "I've worked my whole life and now my hours are being cut" or "I've worked my whole life and I lost my job from being outsourced." These weren't people that are 'gaming the system'. These were people that believed in the system and were chewed up and spat at by the corporate scum at the end of the day.

Then you have people that judge them for dealing with something that was beyond their control.

Sickening.

[Dee Marshall]

Then you have people that judge them for dealing with something that was beyond their control.

Kind of like us.

[Kylie]

I personally have in mind family members and family friends who i know game the system.  In two southeast missouri farming towns, i know it is not an isolated anomaly.  Saying it is a racket in all of Missouri was an overstatement, but so is saying that anyone who is frustrated with the abuse automatically judges everyone on disability.  I personally don't have an opinion about people on disability overall.  I assume most are on the up and up, but I also know firsthand that it is taken advantage of.  Those people who take advantage of it are taking away from people that need it.  Why wouldn't everyone be mad about that?

[Colleen M]

I've actually got a professional opinion on the American Social Security disability system. 

The worst part, for me, is knowing how varied the judges are in their opinions at the hearing level.  You get judges pushing 90% approval rates, and you get judges around 10% approval rates.  I'm not expecting the variance to only happen after three decimal places, but is some kind of system in the system too much to ask?  I know of several judges who will, for example, turn down an 18 year old and award benefits to a 49 year old with lesser impairments because the judge is biased to believe that older people are disabled but youngsters are not.  I used to know where to find a judge who awards benefits to every claimant who is smart enough to answer "Yes" to, "Are you a god-fearing man/woman?"  I honestly don't see much racism or sexism in decisions, but some of the trends you do see are just weird.  Heck, just look at how approval numbers vary so much by state.     

State agencies doing the initial and reconsideration determinations are basically programmed to have somebody hit disability by the numbers or have their boss crawl up their butt with a microscope.  There's a suspicion that only favorable decisions get audited. 

I see the claimants who may not be disabled by the rules, but I understand why they believe they can't work.  I see the group who really aren't disabled, but it's simply pitiful knowing they're just healthy enough to work and be completely miserable with no quality of life doing it.  I see the blue-collar crowd who worked until their bodies fell apart.  I see the people who did something stupid and will pay the price for the rest of their lives.  I see the people who will pay the price the rest of their lives for somebody else doing something stupid.  And I see the moron junkies who just can't figure out why their heart goes into fibrillation every time they snort cocaine as well as the drunks who think DTs are a seizure disorder.  I see the people who would cheerfully crawl a mile over ground glass for their day in court, and I see the ones who skip their hearings because they're drunk.  I see people who can't manage benefits because they internalize what the TV says, people who can't manage their own benefits because they'll spend it all on crack, and innocent people who have the person responsible for their benefits stealing the money for their own drug habit.  Rest assured, whatever group you think of when you think of disabled people exists, and it exists in significant numbers.  When you get into an argument with somebody and have a stereotype thrown in your face, rest assured that group really exists in significant numbers too.

I am also struck by how many people aren't receiving benefits because they don't know they should at least apply.  Not just disability, either.  Food stamps, community/teaching hospital services, never mind the people who think they need to be found disabled before they get a simple handicapped parking placard.  If you think the solution to people not taking advantage of existing programs is more programs for them to not take advantage of, you're not paying attention.  We really need to educate people better on what's out there before doing anything else.   

I must admit, I see so many people struck by the flying fickle finger of fate, and I see so many kids who just never had a real shot at life, that when you show me somebody with a substance abuse problem, they don't really tend to have first shot at my sympathy.  This also applies to the people with COPD who won't stop smoking.  Personally, I'd like to see the rules written so a positive drug test was a disqualifier.  Being pro-active and paying for the tests is a waste of money, IMO.  If substance abuse is a problem, it will get them in the hospital and it will get them noticed.  Just have Medicaid and Medicare refuse to pay for any treatment if substance abuse is one of the listed diagnoses.  Then have them refuse payment for SSI/SSDI benefits based on that.  Incidentally, you'd be amazed how many people are on disability due to hospitals pushing it to cover bills generated under EMTAALA. 

Of course, I also work side by side with a bunch of people who don't feel any differently about people with crippling substance abuse issues than those with crippling genetic defects, so I must admit there's a certain validity to an informed opinion disagreeing with me.             

[LeftistLeslie]

Substance abuse problems and people who have them are really frustrating to deal with. Its easy to feel resentment towards this person who could do so much better if only they would lay off the substance. Seems like a simple problem with a simple solution, and yeah, people with substance abuse issues have a responsibility to do what they have to do to get treatment and sometimes they even need a kick in the butt.   But there are other factors at work. One of my favorite studies that was ignored in its own time but has more recently gotten more attention was the Rat Park study.

http://en.wikipedia.org/wiki/Rat_park

Rat Park was a study into drug addiction conducted in the late 1970s (and published in 1980) by Canadian psychologist Bruce K. Alexander and his colleagues at Simon Fraser University in British Columbia, Canada.

Alexander's hypothesis was that drugs do not cause addiction, and that the apparent addiction to opiate drugs commonly observed in laboratory rats exposed to it is attributable to their living conditions, and not to any addictive property of the drug itself.[1] He told the Canadian Senate in 2001 that prior experiments in which laboratory rats were kept isolated in cramped metal cages, tethered to a self-injection apparatus, show only that "severely distressed animals, like severely distressed people, will relieve their distress pharmacologically if they can."[2]

To test his hypothesis, Alexander built Rat Park, an 8.8 m2 (95 sq ft) housing colony, 200 times the floor area of a standard laboratory cage. There were 16–20 rats of both sexes in residence, an abundance of food, balls and wheels for play, and enough space for mating and raising litters.[3]:166 The results of the experiment appeared to support his hypothesis. Rats who had been forced to consume morphine hydrochloride for 57 consecutive days were brought to Rat Park and given a choice between plain tap water and water laced with morphine. For the most part, they chose the plain water. "Nothing that we tried," Alexander wrote, "... produced anything that looked like addiction in rats that were housed in a reasonably normal environment."[1] Control groups of rats isolated in small cages consumed much more morphine in this and several subsequent experiments.

The two major science journals, Science and Nature, rejected Alexander, Coambs, and Hadaway's first paper, which appeared instead in Psychopharmacology, a respectable but much smaller journal in 1978. The paper's publication initially attracted no response.[4] Within a few years, Simon Fraser University withdrew Rat Park's funding.[5]

Do read more in the article and the references. What makes this applicable is it shows that its not just the substance that these people are using. There is often some issue in these people's lives that they are trying to escape from. You can see this in people who have been exposed to alcohol. No one denies that alcohol is addictive. In fact, it has some of the most dangerous withdrawal symptoms. But one thing that is very noteworthy about alcohol is how massively popular it is and how the majority of people exposed to alcohol do not actually become addicted to it. The same goes for gambling, cocaine, and other substances and behaviors that are known to be highly addictive.

But some people do. Is becoming addicted in the first place itself a moral failing? I'm not convinced. Its not just a matter of making a choice to do drugs or gamble as many people do that. There is an environmental or genetic trigger as well.