March 28, 2013

A Readers Perspective on Disability

Recently I wrote the article Disability is the New Welfare. I was discussing an article from NPR on the topic of increased numbers of people on disability programs. One reader named Joan wrote me a couple emails to give her perspective on the topic. The NPR piece seems to really only tell one side of the story and honestly came across a bit biased in that regard.   Joan made some good points and I thought it would of interest to hear what she had to say.

Joan's entire message is pasted below.  The only editing I did was to make direct hyperlinks to some informational sites she referenced and add one comment in italics.

This hits a nerve. I assume that you have received a lot of e-mails like mine today, too.

Most of the time, I love the research you do into arcane but relevant economic data. There is some truth that disability is perhaps overused--unfortunately, but it isn't for things like "back pain." Dig around and look at the unemployment numbers for people with different kind of disabilities. It is kind of surprising. (See the disability statistics link below.) Contemporary management will not employ people who require alternate schedules, modifications to work routines, a caregiver, assistant or coach with them at work, more compassionate discipline, or even different communication styles. Generally, these are things that require management training, but which do not cost money to implement.

How a state can "move" people from welfare to disability is a mystery to me. Yes, of course it makes financial sense for the state, but with limited exceptions every disability applicant has to be reviewed and has to submit extensive medical data. The average review time is 18 months, in some areas, because of backlogs due to federal budget cuts and increased numbers of applicants, the average length of application is three years (California, for example.)  [edit - I think this confusion was at least part my fault. In my article I referred to them getting on disability and the NPR article didn't go into the specifics of how welfare recipients get on disability.  I assume the agency just helps them through the process and it still requires the normal application, medical info, denials, appeals and waiting- Jim ]
Years ago, a Social Security employee told me that the length of the application process is intentional: they want to discourage  people from applying unnecessarily, in an 18 month period most people who can work will attempt to find something so that they can pay bills and eat. Those who have terminal illnesses will usually die before they get approved. It is rare for an applicant to be accepted on the first try. Most have to appeal, and for many conditions legal representation is essential. In 19 years on disability, I have met exactly one person who applied by herself and was accepted on the first try.

The SSA created the "compassionate allowances" list to eliminate the tragedy of people with cancer dying before being approved for disability. It also eliminated a lot of paperwork. Most of the conditions on the list are fatal, most are cancers and the majority of the remainder are fatal congenital conditions. In these cases, the application is done by a medical social worker in the hospital where the applicant is a patient.

On the other hand, the discrimination against bachelor's degree holders in SSA evaluations is true. There is similar discrimination against women, but it varies from administrative law judge to administrative law judge.  The assumption is that women can find someone to support them or get on TANF but that men cannot.

You may find the Disability Statistics website interesting and informative. It is a large dataset analysis group at Cornell. Please note that there are some data distortions based on flaws in the original data questionnaires. (See FAQ.) However, running the statistics generator for full-time/full-year employment (which includes a break-out for degree attainment) is very informative.

The corporation that "combs" welfare roles to find disability applicants is also getting paid by Social Security.  They job they do also entitles them to 1/3 of the "back settlement" for each successful applicant.  That is another three to 10 thousand dollars each.

Social Security does have its own lawyers.  That's what the administrative law judges are.  They work like a circuit appeals court.

Once you are on disability, you have a review every one, three or seven years.  Basically, you have to reapply at that interval.  The interval is determined by the type of disability and the "possibility for recovery."  If there is no possibility of "recovery," then you still have to be recertified every seven years.

Children that receive disability payments typically do so because of a congenital problem.   Their eligibility ends at 18 unless they are in school in which case it ends at age 22. Children receive SSI rather than SSDI (disability) and only if their parents have limited resources.   (financial eligibility for children)  Once a child turns 18, their condition is reevaluated using adult disability criteria.  The ability to succeed in school isn't a criteria.  The criteria (adjusted for developmental markers) have to do with being able to perform "ADLs,"  activities of daily living.  This is also true for adults.  

"Fixing" the disability system will not create employment for people with daily living and employment challenges.  Only changing the culture of employment will do that.  The changes will have to start in the management classes of the business schools everywhere in the US.  Unfortunately, the government can do little to change deeply ingrained prejudice against people who are different.

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