There are 14 million Americans who are out of work yet don’t show up in the monthly unemployment statistics. The federal government spends more money each year on cash payments for this group than it spends on food stamps and welfare combined. They are part of the hidden social safety net. They are the disabled former workers.
Whether you’re disabled often depends on your education level and what types of work you can do:
“We talk about the pain and what it’s like,” he says. “I always ask them, ‘What grade did you finish?'”
What grade did you finish, of course, is not really a medical question. But Dr. Timberlake believes he needs this information in disability cases because people who have only a high school education aren’t going to be able to get a sit-down job.
Dr. Timberlake is making a judgment call that if you have a particular back problem and a college degree, you’re not disabled. Without the degree, you are.
Determining who is disabled isn’t a clear cut process:
As far as the federal government is concerned, you’re disabled if you have a medical condition that makes it impossible to work. In practice, it’s a judgment call made in doctors’ offices and courtrooms around the country. The health problems where there is most latitude for judgment — back pain, mental illness — are among the fastest growing causes of disability.
Disability has become a de facto welfare program for people without a lot of education or job skills:
There used to be a lot of jobs that you could do with just a high school degree, and that paid enough to be considered middle class. I knew, of course, that those have been disappearing for decades. What surprised me was what has been happening to many of the people who lost those jobs: They’ve been going on disability.
[. . .]
If there’d been a mill for Scott to go back to work in, he says, he’d have done that too. But there wasn’t a mill, so he went on disability. It wasn’t just Scott. I talked to a bunch of mill guys who took this path — one who shattered the bones in his ankle and leg, one with diabetes, another with a heart attack. When the mill shut down, they all went on disability.
Even kids can get disability and, as with the adults, their families don’t want to stop getting the check from the government:
Let’s imagine that happens. Jahleel starts doing better in school, overcomes some of his disabilities. He doesn’t need the disability program anymore. That would seem to be great for everyone, except for one thing: It would threaten his family’s livelihood. Jahleel’s family primarily survives off the monthly $700 check they get for his disability.
Jahleel’s mom wants him to do well in school. That is absolutely clear. But her livelihood depends on Jahleel struggling in school. This tension only increases as kids get older. One mother told me her teenage son wanted to work, but she didn’t want him to get a job because if he did, the family would lose its disability check.
The Clinton-era welfare reforms may have shifted people from welfare to disability:
Part of Clinton’s welfare reform plan pushed states to get people on welfare into jobs, partly by making states pay a much larger share of welfare costs. The incentive seemed to work; the welfare rolls shrank. But not everyone who left welfare went to work.
States pay consultants to help them find people to shift from welfare to disability:
A person on welfare costs a state money. That same resident on disability doesn’t cost the state a cent, because the federal government covers the entire bill for people on disability. So states can save money by shifting people from welfare to disability. And the Public Consulting Group is glad to help.
PCG is a private company that states pay to comb their welfare rolls and move as many people as possible onto disability. “What we’re offering is to work to identify those folks who have the highest likelihood of meeting disability criteria,” Pat Coakley, who runs PCG’s Social Security Advocacy Management team, told me.
Disability programs are very expensive:
. . . federal disability programs became our extremely expensive default plan. The two big disability programs, including health care for disabled workers, cost some $260 billion a year.
People at the Social Security Administration, which runs the federal disability programs, say we cannot afford this. The reserves in the disability insurance program are on track to run out in 2016, Steve Goss, the chief actuary at Social Security, told me.
You’ll want to read the rest of NPR’s riveting—and depressing—report.