The Human Costs of the Modern Disability-Industry Complex

SSASSAOver the weekend, I heard on NPR's Planet Money program a superb piece of reporting about the rise in the number of Americans receiving federal disability payments. The hour-long segment, "Unfit for Work," by Channa Jaffe-Walt thoroughly documents how changes in the U.S. economy combined with the disabilty system's perverse incentives are marginalizing many Americans. From the show:

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

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

The two big disability programs, including health care for disabled workers, cost some $260 billion a year.

What follows is a riveting and disheartening story of how the disabilty system "disappears" people from the workforce and making them permanently impoverished. Disability has become a defacto welfare system:

"That's a kind of ugly secret of the American labor market," David Autor, an economist at MIT, told me. "Part of the reason our unemployment rates have been low, until recently, is that a lot of people who would have trouble finding jobs are on a different program."

welfare/disabilityPlanet Money

As part of the disabilty-industry complex, Jaffe-Walt details how states are hiring firms like the Public Consulting Group to contact welfare recipients to see if they can gin up enough evidence for some kind of disabilty. If they can, then the recipients can be shifted from state welfare rolls onto the federal disability system. She reports:

The company gets paid by the state every time it moves someone off of welfare and onto disability. In recent contract negotiations with Missouri, PCG asked for $2,300 per person. For Missouri, that's a deal -- every time someone goes on disability, it means Missouri no longer has to send them cash payments every month. For the nation as a whole, it means one more person added to the disability rolls.

The result of these depressing trends is:

...going on disability means you will not work, you will not get a raise, you will not get whatever meaning people get from work. Going on disability means, assuming you rely only on those disability payments, you will be poor for the rest of your life. That's the deal. And it's a deal 14 million Americans have signed up for.

The whole program is well worth heeding.

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  • Tulpa (LAOL-PA)||

    Going on disability means, assuming you rely only on those disability payments, you will be poor for the rest of your life.

    Assuming you're not working under the table.

  • Bill||

    I have a cousin who I think is on disability from being "dipolar" or something. She constantly posts pictures from all of her vacations. Many are to see wildlife, eagles, etc. so are not necessarily expensive but she is always traveling and seems in excellent health and does not work as far as I know.

    I also have a friend from H.S. who's girlfriend just posted on FB that she got her disability. She's a 30 year old hypochondriac with so many unpaid bills he said he could never marry her (not that he's that keen on it any way) as he's afraid of debt.

  • sarcasmic||

    Heard some of that on the ride home today. It was well done.

  • BuSab Agent||

    I have a friend whose entire family (mother, sister,wife, all the kids) is on disability and not a single one of them has a physical disability. It's all bipolar anxiety crap.

  • Scruffy Nerfherder||

    I'd be questioning the "friend" designation.

  • BuSab Agent||

    Nope, he's still a friend. Known him since high school (in fact he was the last guy I dated before I started dating my (now) husband) and I recognize that he's a seriously fucked up loser and yes he will always be poor, but people who will help you redo your roof in autumn are to be treasured.

  • Irish||

    He'll help you redo your roof in autumn but he'd rather be impoverished on disability than get a job? This seems strange to me.

  • BuSab Agent||

    He is VERY strange. But you're right, he doesn't mind working on his own terms; he just hates having a boss, the government has deemed this particular character flaw as a "disability". This might have made him a good candidate for starting his own business, but he has the time and money management skills of a retarded beagle.

  • Death Rock and Skull||

    Or a normal pug?

  • ||

    This is sounding familiar to me as well. Let me guess that this guy could probably market himself as a freelancer, but he finds the idea of "selling himself" repulsive.

  • buybuydandavis||

    For the most part, people don't mind working. They mind the insecurity of not knowing if they will be able to pay the rent tomorrow.

    Guaranteed income and free time makes up for a lot of taxable income.

  • Scruffy Nerfherder||

    Looking at the graphs, it seems to me to be a larger problem than just shifting the applicants from welfare to disability. Welfare enrollment has been relatively static for the last ten years, but disability enrollment has increased by 50%. Unless they're able to shift welfare enrollees to disability at the same rate as new people sign up for welfare, then the problem is bigger than just cost-shifting. I'm guessing the standards for disability enrollment have gone down as well.

  • Bill||

    In 1995 there were 10 million on welfare + disability. Now there are only 9 million. I guess that's a bit of progress.

    But the disability keeps growing and is never talked about. And if you do, you are heartless. Plus by law no one has to talk about their medical issues so it will make it harder to get people off of or shame them.

  • Death Rock and Skull||

    Whatever happened with that ass-burgers redefining?

  • John Thacker||

    Yeah, and we see both growing at the same time in the early '90s, followed by welfare dropping quickly without disability growing, then welfare staying constant while disability grows.

    It's more complicated than just substitution.

  • Scruffy Nerfherder||

    I'm questioning the tone of the article. Am I supposed to feel bad for the people who have voluntarily/intentionally pigeonholed themselves into the disability program?

  • Paul.||

    I agree 100%. Disability is the goal for many Americans.

  • Torontonian||

    Especially those who are approaching to the end of their unemployment benefits and still can't find work.

    If they can't (or won't) get paid to work, they might as well get paid to not work.

  • Mike M.||

    Yes, just like you're supposed to believe that the inventions of man are causing imminent, catastrophic, runaway global warming, even though the midwest plains are having 15 inch blizzards in the spring.

  • Stormy Dragon||

    What about the ones who haven't "voluntarily/intentionally pigeonholed themselves into the disability program"?

  • Paul.||

    There have been people here who have been raising this question for years. I too heard NPRs report on the story.

    My question, why has NPR noticed this just now?

    The disability system in this country is a Scam. And I say that as someone with a family member who is a partial parapalegic, and is perfectly capable of working, but isn't sure she wants to because taking a job will stop the disability checks.

  • Rye or Die||

    The problem isn't loosing the checks, it's loosing insurance. Once your on disability for two years you qualify for Medicare. That's how they trap you. If you get a job and get off of disability you lose your insurance. That's all fine and dandy if you get a job with benefits and insurance. Good luck finding that in this environment. If you get such a job and get the insurance but you then get laid off your really up shit creek.

  • R C Dean||

    That's why disability is worse than welfare: its basically permanent.

    Aside from the insurance issue, once you're on disability, how do you get off without opening yourself up for a fraud investigation and recoupment?

  • Rye or Die||

    I don't think they care to be honest. They're just happy to not be paying any more

  • Bill||

    They say they got better.

  • Calvin Coolidge||

    Republicans turned me into a Newt!!

    ... well, I got better ...

  • Paul.||

    I think you're looking at it as a monolithic problem. It's much more diffuse than that. I agree with you about the insurance part-- but I didn't think about the insurance angle because the people I know who are on permanent disability don't have that problem. They'd just rather get a check for not working.

    Not everyone has no working prospects, or only qualifies for menial labor in a job with no benefits. Many are married and would have coverage under their spouse's insurance.

    I think the issue is one of supplemental income. I'll bet you'll find a lot of people on disability who have some other source of income, and the disability check supplements that. They could go to work, but why would they when the only effort necessary is the walk down to the mailbox to pick up the check.

  • LarryA||

    AFAIK almost all such payments are made by direct deposit.

  • Mickey Rat||

    Were the checks and insurance too tight?

  • buybuydandavis||

    This is the evil of social welfare payments.

    It's not that people are given money, it's that if these people try to get a job, try to move forward, the government will take away benefits faster than the new income comes in.

    The government puts these people in a bizarro parallel universe where you're punished for doing the right thing.

    Evil.

  • Stormy Dragon||

    Over the weekend, I heard on NPR's Planet Money program a superb piece of reporting about the rise in the number of Americans receiving federal disability payments.

    There was an extended version of the Planet Money report on This American Life that you might want to check out:

    http://www.thisamericanlife.or.....h-benefits

  • R C Dean||

    A combined chart, showing the totals of both welfare and disability, would be interesting.

    The company gets paid by the state every time it moves someone off of welfare and onto disability.

    I don't know which is worse: people in government have no frickin' idea how incentives work, or they know perfectly well.

  • Stormy Dragon||

    And I say that as someone with a family member who is a partial parapalegic, and is perfectly capable of working, but isn't sure she wants to because taking a job will stop the disability checks.

    As the show mentions, there's a weird interplay between education level and disability status. As a software engineer, being parapelegic would represent no burden at all to my ability to work. It'd be hard to claim a coal miner could easily continue working while paralyzed. Given that no more that a small fraction of the population is ever going to be a software engineer, how do you deal with that?

  • ||

    There is a large spectrum between coal miner and software engineer.

    In the end it doesn't matter, being disabled doesn't give you the right to rob other people.

  • Stormy Dragon||

    There is a large spectrum between coal miner and software engineer.

    Yes, but when you get into things like an inability to stand for long periods, inability to grab things with your hands, or inability to lift heavy objects, most jobs tend toward the "coal miner" ends of that spectrum.

    In the end it doesn't matter, being disabled doesn't give you the right to rob other people.

    Even if the government shouldn't be involved, it's still a problem that's going to have to be addressed. As the show indicated, the disability thing is really just part of a bigger issue: there is a growing set of people in modern society that the economy really has no use for. What do we do with those people?

  • Death Rock and Skull||

    "inability to stand for long periods, inability to grab things with your hands, or inability to lift heavy objects"

    Work at a call center or something.

    "there is a growing set of people in modern society that the economy really has no use for"

    The "growing" part has to do with the relaxing standards for what qualifies as a "disability"- mostly non-physical shit.

  • Stormy Dragon||

    According to the BLS, there are projected to be 338,400 new call center jobs in the country next year. Even if every last one of those is a disabled person, that's not even gonna make a dent in the numbers. And it also notes that employers are increasingly only hiring employees with a college education for those positions.

  • Stormy Dragon||

    Oh wait, my mistake. That 338,400 is the number of new positions for the next DECADE.

  • ||

    So what? Retraining.

  • lap83||

    "What do we do with those people?"

    The question should be: "What can I do?" If there is someone in your family who has no economic use, take care of them...unless they just seem to be taking advantage of you. If you don't have anyone in your family, but you still feel the need to help someone less fortunate....go find someone! There are more than enough privileged people to help the less privileged without needing to involve government. The problem is that pretending to care by going the long convoluted route of trying to enact legislation or raise awareness is a lot easier and less icky than physically helping another human being yourself.

  • Irish||

    Huge numbers of people, even relatively low income people, work in the service sector or office environments. There's a very small number of jobs left in this country of the 'coal miner' variety.

    Could a paraplegic be a lumberjack? No, but I couldn't be a lumberjack either since I don't know shit about lumberjacking. Which is why, you know, I'm not a lumberjack.

  • ||

    "Lumberjacking" strikes me as an unreasonably funny word.

  • Calvin Coolidge||

    "I couldn't be a lumberjack either since I don't know shit about lumberjacking. Which is why, you know, I'm not a lumberjack."

    Well, I wouldn't claim to be an expert myself, but, still, I'm a lumberjack, and I'm OK.

  • Stormy Dragon||

    Most service sector jobs open to unskilled labor wouldn't be open to a paraplegic either. Pretty much any retail job requires you to at least stand most of the day, if not walk around the help customers.

  • Death Rock and Skull||

    I can think of a lot of shit that doesn't require legs- for people willing to make the move from unskilled to "slightly skilled".

  • Stormy Dragon||

    In terms of types of jobs, yes. In terms of employment numbers? I doubt it. Can you name some specific jobs?

  • Stormy Dragon||

    And that's setting the aside the "or people willing to make the move from unskilled to 'slightly skilled'" as though most unskilled workers are only in that category out of stubborness.

  • Irish||

    Virtually all office work. I see people in wheelchairs working in the law office I work at all the time. Besides, this is a bit beside the point, since we're talking about the most extreme group of disabled people. The vast majority of that increase in people on disability are not paraplegics.

  • Stormy Dragon||

    THE VAST MAJORITY OF PEOPLE DON'T WORK DESK JOBS. JUST BECAUSE YOU DO SOMETHING DOES NOT MEAN IT REFLECTS THE MAJORITY OF HUMAN EXPERIENCE YOU NARCISSTIC BASTARD.

  • Death Rock and Skull||

    You seem to be confusing poor job market and poor worker skills and education with disabilities. Disability welfare is not a solution to those things.

  • General Butt Naked||

    I think your caps lock key is broken, Stormy.

    I'd argue that one of the unintended consequences of the ADA is that employers are more likely to pass on a qualified candidate that is disabled because they have a fear of being sued.

  • Death Rock and Skull||

    Some non-physical jobs:

    Cashier
    Clerk
    Ticket Window
    Software
    Graphic Design
    Artist
    Sculptor
    Call Center
    Telemarketer
    Assembling Things
    Repairing Things
    Film Critic
    Blogger
    Consulting
    Toll Booth
    Parking Attendant
    Author
    Receptionist
    Radio Personality
    Busker

  • Stormy Dragon||

    Great so you have jobs that aren't actually non-physical (repairing things? You think you can be, say, a car mechanic or an HVAC repairman in a wheel chair?) or are so uncommon it's hard to believe you meant it as serious suggestion (yeah, radio hosting. THAT will solve the disability problem).

    The few left as legitimate options (cashiers, telemarketer) won't even begin to cover the vast majority of the disabled.

  • Death Rock and Skull||

    There are things that can be repaired without walking around, like electronics. Speaking from experience of working in a shop, where disabled people had jobs.

  • Calidissident||

    Likewise the vast majority of people on disability aren't paraplegics

  • General Butt Naked||

    @Cali

    Yup. Although my experience doesn't "REFLECTS THE MAJORITY OF HUMAN EXPERIENCE" I'm form southwest PA, and getting on SSI is a goal of many.

    Like others have said, there are many that get on because they have ambiguous "diseases". I've known a few that had irritable bowel syndrome that were healthy, but found croakers (quacks that give narcs) to sign off on pills and disability chex. It's funny that the people that supposedly have IBS can get the awesome opiates, but my dad who's actually sick has to get by on vicodin.

  • Irish||

    HOW CAN YOU MAKE CLAIMS ABOUT ANYTHING WITHOUT HAVING A PERFECT UNDERSTANDING OF THE TOTALITY OF HUMAN EXPERIENCE?!?! DON'T YOU KNOW THAT PUBLIC POLICY SHOULD BE CONSTRUCTED ENTIRELY AROUND THE .05% OF HUMANITY THAT IS PARAPLEGIC?!?!?!

  • Stormy Dragon||

    There's 3.3 million people 15 or older who need a wheelchair in the US.

    By comparison, there are 2.8 office clerks in the US.

    Please explain why the former is an "extreme group" that can just be ignored, while the later is so common that just anyone should be able to get?

  • General Butt Naked||

    "15 or older" isn't really helpful. If 99% of those are 100 years old then the jobs argument is not worth having.

    A good number would be the wheelchair bound between 18 and 60.

  • Torontonian||

    "By comparison, there are 2.8 office clerks in the US."

    Wow.. we have 2 clerks in my office alone.

  • mgd||

    We have the other eight tenths.

  • Death Rock and Skull||

    Police Dispatcher
    Police Station Clerk
    Government Secretary
    Case Worker
    Human Resources
    Judge

  • Irish||

    You're an unbelievable idiot. The vast majority of work can be done in a wheel chair in a modern economy, you fucking idiot. And that's one of the most extreme examples. I had a serious leg injury that confined me to a wheelchair and I was still able to work the kitchen at a McDonalds. That was harder to do in a wheelchair than most work in a service sector. Guess what Stormy? The vast majority of work in a service economy, which is essentially what America is, can be done with much more serious disabilities than you claim.

    I don't know how someone can be as stupid as you and breathe much less post on the internet, you simpering nitwit. You also call me a narcissistic bastard based on like two posts, probably because you're such a butt hurt shitheel that you can't make an argument rationally without exploding into impotent progtard rage.

    You also fail to take into account my second point, that people who are confined to wheel chairs are a small percentage of people on disability, and using the most extreme examples is not how you construct good public policy.

    How do you manage to chew without drooling all over yourself? How do you manage to post on the internet without ruining your keyboard as your brains dribble out of the hole they made during the lobotomy?

    These are serious questions, and I await your answer.

  • Stormy Dragon||

    The vast majority of work can be done in a wheel chair in a modern economy, you fucking idiot

    No, it can't.

    You also fail to take into account my second point, that people who are confined to wheel chairs are a small percentage of people on disability, and using the most extreme examples is not how you construct good public policy.

    As I noted upstream, people in wheel chairs outnumber office workers in this country. The fact you think the larger group is a "small percentage" while the smaller group qualifies as "The vast majority of work" demonstrates how completely screwed up your view of the economy is.

    It's great you earned a nice white collar job in a law office. You deserve to benefits of your labor, but that shouldn't stop you from realizing you're the exception in our society, not the rule.

  • General Butt Naked||

    As I noted upstream, people in wheel chairs outnumber office workers in this country.

    Are you saying that there are only 2.8 million office jobs in the whole US?

    That's fuckin' crazy.

    The shark: you've jumped it.

  • Stormy Dragon||

    Occupational Employment and Wages, May 2011 43-9061 Office Clerks, General: 2,828,140

    Again, you substituting your personal experience for reality (i.e., most of the people I know are office workers, therefore most people are office workers).

  • Death Rock and Skull||

    "Office clerks, general" does not cover anywhere near the amount of office positions there are. Also, fuck the BLS.

  • Stormy Dragon||

    Yeah, Yeah, and Romney's going to win in an electoral landslide. Because who needs actual measurements, when I know in my heart that reality is wrong.

  • Mickey Rat||

    "Could a paraplegic be a lumberjack?"

    Why not? Are you suggesting he should be discriminated against?

  • daveInAustin||

    There's also an econtalk interview with David Autor who was also in the This American Life piece.

  • prs130||

    I was going to say the same thing. A real eye-opener. Listen to the whole thing, people.

  • Torontonian||

    Concur... the audio interview is around an hour long, and well worth the time invested.

  • Rye or Die||

    You can't even enjoy the splendor of daytime tv without getting bombarded with ads for disability lawyers.

  • Jesus H. Christ||

    I'm "legally blind". When I was younger, I was on SSDI. Working is a pain in the ass when receiving disability payments. You report your previous month's earnings, then they take that amount, or a percentage thereof, out of the next check month check. Spouses report as well. I'm not saying it shouldn't be means tested, it absolutely must be. The way it's done, however, is hard on marriages and discourages looking for work. Luckily I'm just wired to want to work so that's what I do, but other people need more of a push.

  • SumpTump||

    Dude that sounds like a lot of fun ddue.

    www.AnonPlanet.da.bz

  • Paul.||

    OT: Enjoy your only term, sir:

    http://blogs.seattletimes.com/.....gislature/

  • fish||

    In Washington? I smell landslide victory for carbon jr.!

  • Don Mynack||

    Hmm...14 million on disability, 11 million of which are deadbeats who have self-selected to no longer be productive. Meanwhile, 11 million productive workers who are already here want citizenship...how about an even swap? 5 years notice that their citizenship will be revoked, and they will be deported to some place that will gladly take a one time payment from us to accept an educated former American. Sounds like a plan!

  • Sevo||

    ..."to accept an educated former American."...
    Entirely too well educated. In ways of gaming government payouts.
    Hey, Hollande! Need more free-loaders?

  • Death Rock and Skull||

    I changed my mind about the "safety net". I moved it up a few pegs on the prioritized list of government shit to get rid of.

  • Ornithorhynchus||

    I've been on disability before (a combination of endocrine disorders that caused constant fatigue, wildly fluctuating blood sugar, and occasional dehydration). The incentives are really screwed up. Doing even occasional part-time work means getting your payments slashed, so there's absolutely no benefit in looking for work that you can do. And you're not allowed to have more than $2000 in savings. If you do get a job and quit receiving the disability, but then you find yourself unable to continue working, it can take a couple of years to get back on the disability. So if they have a condition that fluctuates, it's not surprising that people would choose to stay on disability forever and not even look for work.

    The whole system seems designed to keep you dependent.

  • Rye or Die||

    very much this. A couple years ago I ended up in the hospital after a brain hemorrhage. I was 27 at the time. I was put on long term disability through my employer while still in the hospital. At the nearest opportunity my insurance company had me file for SDI. I was still in rehab and my whole left side was paralyzed. I can get around fine now and have most of my movement back. Because of a lack of peripheral vision I can't drive in my state. When I went to meet with an "Occupational case worker" about returning to work she offered up a slate of more government programs to sign on with. When she found out I didn't qualify because of my savings she told me to go out and spend all my money so I could qualify.

  • Sevo||

    "When she found out I didn't qualify because of my savings she told me to go out and spend all my money so I could qualify."
    The incentive here is all too obvious: You and people like you represent her paycheck.

  • Rye or Die||

    It gets better. When I arrived for the appointment she was on her cell phone making a personal call. Later when she was going down a checklist of things I might be qualified for that I thought I'd be capable of doing I said I could probably do her job and help other people in my situation. Mind you I am normally as sarcastic as fuck but I was being genuine. She got really defensive and told me she could be making six figures in the private sector if she wanted to. I bid her a good day, rolled my eyes, and knew I was on my own.

  • Broseph of Invention||

    You mean she wasn't making six figures working for the government? They must have some real tightwads running that show.

  • Anonymous Coward||

    You should do the honorable thing you can: close your eyes, crawl over to an available government teat, and suck it until the milk runs dry.

    Progs look at you askance when you ask the question of why would government workers want to get you out of poverty when their whole raison d'etre is to "manage" the cases of poor people. The more poor people there are, the more cases there are, the more their existence is justified, leading to more case workers, bigger budgets, more taxes, and so on and so forth.

  • ||

    Right. In engineering you do occasionally meet people who proudly talk about automating themselves out of a job. But the vast majority of workers want to make sure they are busy all the time because if someone notices they aren't busy, they are likely to get laid off.

  • ||

    When she found out I didn't qualify because of my savings she told me to go out and spend all my money so I could qualify.

    In theory you could spend your money on a hard asset, such as jewelry, which you could later sell. It would be protected from inflation too.

  • SumpTump||

    Dude is so talking some serious business over there.

    www.MaxAnon.tk

  • General Butt Naked||

    Hell yes he is, Stump. Hell yes.

  • iwhitney163||

    I would like you to checkout this Amazing Proven System... That a Construction Worker Uses To Generate Over $2000 a Month On Auto-pilot promoting affiliate programs via clickbank. Get the Exact System video course. http://www.miniurl.com/s/7DV

  • Rasilio||

    "Going on disability means, assuming you rely only on those disability payments, you will be poor for the rest of your life."

    So?

    You forget that for a lot of people money is not a motivator, sure they need money, enough to survive but past that it is just not a motivator for them.

    Take for example an acquaintance of mine, he is very active in the steampunk community as an artist and costume/gadget designer, he is on disability because of ADD and Anxiety disorders. In reality he is more than talented enough to get a job as a graphic designer, and has worked as one in the past, what he doesn't do is show up on time or put any effort into projects which don't inspire him so he kept getting fired until no one else was willing to take a chance on him any more.

    So now, he spends his time creating really cool art projects for the steampunk community and even gets paid for some of it and while he is poor he is happy because he is doing what he loves. Without the disability payments he would not be happy because he'd be forced to do what he hates just to pay the bills.

    None of this is to say that we should be subsidizing his lifestyle, I've argued with him often that he is basically stealing, but trying to argue that he is being trapped in a life of poverty is not going to hold any water, he is simply leeching off of the welfare state to be able to live the slacker life he wants to live.

  • ||

    Too true.
    There are a lot of people who are basically happy with a minimum amount of income. For many of these people, the amount they can get from disability is all they need. Get a few roommates, share a house, bootleg movies and video games, and you're set. What else do you really need?

  • ||

    I have heard that if you get on disability, you basically can't get off of it. If you become "undisabled", you have to pay back the money you got from disability.

    I don't know if this is actually true. it could be a myth that people on disability use to excuse never getting off of it even if they can.

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