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The Disability Disaster

The era of the municipal bankruptcy is now upon us, but we may soon be entering the age of entitlement bankruptcies. An excellent piece in the Wall Street Journal spotlights major financial and administrative problems in Social Security’s disability program:

But many of the doctors haven’t practiced outside their specialty in decades, if at all, making the complexities of disability cases even harder to analyze, several doctors said. […]

The Social Security Disability Insurance program paid $124 billion in benefits in 2010, up from $55 billion in 2001. The backlog of pending appeals in September was 771,318, up from 705,367 in 2010 and 392,397 in 2001.

The disability application process has many layers, including hundreds of state-based field offices that accept applications and administrative law judges who weigh appeals.

As the piece makes abundantly clear, the problems in the program are manifold. Most disturbing however, are two key statistics: one percent of the American population applies for disability protections each year, and financial difficulties may bankrupt the program in under a decade.

Plainly, this is unsustainable, yet many of the more obvious solutions threaten to worsen the program’s other serious problem — poor and ineffective management. When streamlining a large and expensive bureaucracy, cutting back on employees and payroll are a common starting place. Yet the Social Security Administration’s attempts to do more with less seem to be backfiring, leading to underqualified doctors passing judgement on applications outside their area of expertise:

In targeting the doctors, the Social Security Administration says it is seeking to overhaul a part of the disability-review process that can be both expensive and slow.

But many doctors and former agency officials say the changes threaten the quality of decisions. Several doctors said medical opinions were now prone to inaccuracy since many specialists don’t have the backgrounds to make decisions outside their areas of expertise. The new policy could make doctors more likely to award benefits to those who don’t qualify and deny benefits to those who are entitled, these doctors said. […]

But many of the doctors haven’t practiced outside their specialty in decades, if at all, making the complexities of disability cases even harder to analyze, several doctors said.

This is problematic enough, but political pressure on review board doctors makes things worse. Any government program is bound to have its share of political interference, but the disability program is unusually vulnerable.   The review procedures are somewhat arbitrary and easily abused, and the article has multiple stories of doctors who were fired for refusing to make the “correct” decision on a disability case. Years of catastrophic mismanagement have brought the program to the brink of failure, and it is unclear how it can be fixed without major changes.

These problems are especially troubling because the disability program is a vital and important part of our social safety net. As we must, we will be raising the age of retirement and of eligibility for Medicare; that will make the need to provide for those who are unable to work more acute and proportionately more workers will become disabled as the age of retirement rises.

A system that is efficient to operate, sustainably financed, and gets help to those who need it while rejecting those who aren’t legitimately entitled is difficult to build — but getting that right is one of the things America must do as we gear up for the challenges ahead.

Whether you like big government or hate it, American government today costs too much and gets too little done.  At Via Meadia we want to hear more from politicians about how to make government work.

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  • dearieme

    You can’t literally bankrupt a program, can you? It’s just another out-of-control government expenditure heading, isn’t it?

  • Steve Smith

    Once, the American Dream consisted of owning a family farm. No longer would the family be subject to the whims of sharecroppers or banks calling in mortgage notes.

    Then as the population centers grew and corporations took on the role of feeding the nation, family farms became impractical. As such, the American Dream became home ownership in a suburb. No longer did one need to milk a cow when a milkman could bring fresh milk everyday for a small fraction of one’s corporate pay.

    But then the corporations began feed on themselves. No longer could one expect their grandchildren to remain close to home. Competition transferred some of the home-owning American Dreamers from place to place like itinerant lettuce pickers. Some towns dried up and the value of the American home fell. No longer did grandkids have any prospects for “good jobs” and the next American Dream was born.

    To be declared disabled.

  • Kenny

    You see, a program was made with good intentions, and the slugs rushed in with their hands out.

  • Huggy

    This has been a reoccurring problem for hundreds if not thousands of years. Various solutions have been tried with mixed success. Painful but necessary adjustments will happen but each solution will go through the normal political process. Some combination of voting, rioting, war, threats, and intimidation.

  • Non Omnis Moriar

    “At Via Meadia we want to hear more from politicians about how to make government work”

    Frankly, politicians are the reason government doesn’t work.

  • Some Sock Puppet

    I’m one of the broken toys whose last and only hope was to go on disability. If I lose this I’ll try and go back to work. But I don’t really see much of a future there with how badly everything’s been going.

    I should have been on it decades ago, but I didn’t have that mindset. I was one of the first of the “ADD males” to be medicated into obedience by demand of the school. I assure you, it has consequences. Massive doses of Amphetamines over 3 years led to 100 lbs of weight loss and multiple suicide attempts. They fried my brain.

    I just kept trying new jobs over and over and inevitably something would go wrong and I’d break down and wonder how I was going to provide for my wife.

    Lyme’s laid my physical capabilities low. I’m a large man, I used to be strong as an ox, which made up for other problems. I could always find manual labor. But then the illegals flooded the markets.

    The Lyme’s also played havoc with my mind. My memory is shot. Where I was a wunderkind with computers, I now struggle to get by.

    Anyway, all that to say this. This program is my only hope of having something, anything to cover medications that make life bearable.

    I have more to give this world. To leave it a little better than when I found it. I know I do. I just need the time to get there. I want to help fix this country. I volunteer. I attend church. I love my wife and support her as best I can. I struggle to get us independent from the grid as we live near NYC.

    And I’m a fiscal conservative. I believe these programs do some good, but they need to be managed properly and be sustainable. I’m now on my third round of discussing with SSD that I have never been on workers comp while collecting SSD payments. This is taken care of every six months, but then it resurfaces. It is tiresome, wasteful, stressful, and just plain stuck on stupid. I wait on hold with central SSA phone for a minimum of 30 minutes every time I call.

    If I call the local office it’s 30 minutes plus before someone just picks up the phone and hangs up, starting it all over again.

    Oddly enough, the people who talk about the sustanability of nature and how the earth can’t go on forever have no problem running the government on the opposite model.

  • Jbird

    Just further proof that the government (at least the Federal Government) shouldn’t be in the business of charity. Seems to me local and religious charities would be better positioned to determine who “deserves” charity and who doesn’t. That may seem heartless and it’s ripe for it’s own abuses, but indiscriminate, centrally planned charity provide perverse motivations and will bankrupt the government.

  • Roy

    Disability is one of the most necessary parts of the whole SS system, I know it is much abused, but if you are going to have any single entitlement this is it. You can plan your retirement, this won’t be gotten rid of, for every abuse case their will be a case that is truly heartbreaking.

  • Aliceandthechesirecat

    Spending on Pentagon projects account for almost half of what we spend as a nation. The Social Security system is by law self funding and required to remain solvent. We don’t need to spend, as we have been spending on the military industrial complex in order to maintain a secure nation. We should cut pentagon spending in order to ensure domestic stability by bolstering our safety nets. It would help is the obstructionist [obscene epithet denoting contemptuous view of Tea Party deleted– ed] House would realize that what it is doing in obstructing the jobs bill is tantamount to treason, and as good Americans they should stop plotting to destroy America. For now they are the ENEMY of this great state of ours.

  • tsotha

    Spending on Pentagon projects account for almost half of what we spend as a nation.

    This is wrong. Defense actually comes to about 20% of federal government outlays.

  • steve smith

    “social security is self sustaining”


    I thought I was sustaining it. The average 65 year old is forty-five times wealthier than the average 35 year old. So go ahead and hate the tea party, even if the Democrats continue to support the most regressive tax in the history of the United States, “Social Security as we know it.”

    T. Boone Pickens once remarked that the energy trade deficit was the largest wealth transfer in the history of the world. I don’t know the amount of wealth transferred to the current Winnebago generation, but it’s got to be a close second to the Saudis.

  • FrancisChalk

    SSDI is rife with fraud as is everything related to “the disabled.” How many parking slots reserved for “the disabled” are there in a mormal paking lot? And how many times do we see what appears to be totally non-disabled people using these “handicapped” parking slots? The whole “disabled” thing is 99% dishonest and 1% honest.

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