It's the easy-to-fake disorders that keep going up
We might as well start smoking again!
"We smoke less, wear seat belts more, and have less asbestos, lead, mercury, and DDT in our
lives. We have an array of medicines and pain killers we didn’t used to have, and there are non-invasive surgical techniques, titanium hips, MRIs, etc, etc. And, for those who are disabled, life should be easier now. We have ramps for most sidewalks, ramps to get us into the workplace, super-wide lavatories, an assortment of “workplace accommodations,” and 20 handicapped parking spaces for each disabled person. Disability rates – real ones – have to be going down." 1
Yet, the number of people getting monthly Social Security disability checks is NOT going down - it's going up - way up; and at a rate that greatly outpaces the growth in the working population. Maybe cigarettes weren't so bad, after all.
REAL disability rates have been falling like a rock
Before you pick up that pack of cigarettes, however, take solace in the fact that - indeed, the real rate of disability impairment is falling - hard. During the last 20 years, modern technology has resulted in huge
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decreases in disability in virtually all cases where the disability could be objectively verified. For example, in a widely-acclaimed study released in 2001, two researchers (Manton and Gu) reported that disability among the elderly had declined by an astounding 25% from 1982 through 1999 (the last year of the study).2 And a 1998 Rand study performed by Freedman and Martin found dramatic declines, based on four "measures of functional limitations...that more closely approximate true physiological capabilities...."3 Other studies - NOT linked to disability financial awards - report the same sharp drop in disability rates.4
Two types of ailments
If we probe a little deeper, we see that the sharp decline in real disability rates has had some impact on Social Security claims. The growth in the awarding of benefits for verifiable impairments has been moderate. The problem lies with the other group of ailments - the easy-to-fake disorders. Claims for these ailments are skyrocketing.
GAO's list of suspicious ailments
A list of the easily-faked disorders is available, courtesy of the GAO. Through interviews with "medical consultants and medical relations officers - disability specialists at SSA headquarters, and investigators who specialize in disability fraud," the GAO developed the following list of the impairments considered to be "susceptible to being feigned or exaggerated:" 5
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Organic mental disorders |
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Schizophrenic disorders |
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Affective (mood) disorders |
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Anxiety disorders |
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Personality disorders |
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Somatoform disorders |
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Mental retardation |
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Epilepsy |
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Blindness and low vision |
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Chronic pulmonary insufficiency |
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Disorders of the back |
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Disorders of muscle and ligament, etc. |
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Sprains and strains |
Chief among the suspicious disorders are certain types of mental impairments.
We're all getting crazy!
Claims for mental impairments now account for 1/3 of all worker disability awards. The number of such awards increased from 122,900 in 1997 to 191,700 in 2003. That reflects a compounding rate of
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increase of 7.7% each year - an increase that is more than 5 times greater than the rate of increase in the total number of workers (less than 1.5%). Mind you, we are not talking about dollars here. We might expect there to be lots of inflation in the area of medical treatments. We are talking about the percentage of workers who claim to be "crazy," to put it indelicately. This just doesn't make sense unless there is some weird, contagious illness that is affecting our brains.
In the non-worker programs (the Supplemental Security Income disability programs), the trends are even worse. Adult mental illness awards increased from 150,200 in 1997 to 205,900 in 2003, and juvenile mental illness awards nearly doubled from 62,500 in 1997 to 117,300 in 2003. That's a compounding yearly rate of increase (for the kids) of over 11%.
No. We're not saying that all or most people claiming mental illness are faking!
Don't send us nasty e-mails. We already realize that many people genuinely suffer from mental impairments, and other diseases that are hard to verify. It's the malingerers that we are focusing on.
Why don't Social Security disability awards reflect the lower, real disability rates?
There are many reasons for this problem, and they are discussed in detail in How Social Security Picks Your Pocket (by Joe Fried, Algora Publishing, 2003). Here are a few of them:
| Believe it or not, claimants are not required to seek vocational rehabilitation. (They used to be; the law was recently changed.) This may be the reason why only 1 in 500 disabled workers recovers and returns to work. |
| Claimants are not required to get treatment - even non-surgical treatment that might eliminate the disability. |
| No one reconciles Social Security disability rates to objective and verifiable medical impairment incidence rates. This should be done annually. |
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Although the Code requires objective medical findings that support a claimant's representations, the enforcing regulations are weak on this point. It appears that, in some cases, claims are awarded entirely on the basis of claimant statements. |
| We don't define disability in the context of the aids, assistance, and other "reasonable accommodations" that employers are required to provide. The law needs to be amended in this regard. |
| Appeals decisions are kept completely secret, so the public is unaware of some of the outrageous and bone-headed decisions made by appeals adjudicators. Their decisions should be published, even if individual names need to be redacted. |
| In many cases, being disabled pays more than working. This is due to illogical benefit calculations that need to be modified. |
| We send monthly checks to the parents of disabled children, but we never follow-up to see if the money is being spent on the children. |
To hear Joe Fried and Jan Mickelson discuss the disability mess (the
Mickelson in the Morning Show on NewsRadio 1040 WHO Des Moines), click the radio box to your right
(recorded on 3/4/05).
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1. How Social Security Picks Your Pocket, by Joe Fried, Algora Publishing (New York, 2003).
2. Kenneth G. Manton and Xiliang Gu, “Changes in the Prevalence of Chronic Disability in the United States black and nonblack population above age 65 from 1982 to 1999” [online] Proceedings of the National Academy of Sciences, vol. 98, issue 11, 22 May 2001– [cited 13 April 2002], 6354–6359; available from http://www.pnas.org/cgi/reprint/111152298v1.pdf.
3. “Trends in Functional Limitations: Are Older Americans Living Longer and Better?” [online] (Rand Center for the Study of Aging, 1998– [cited 13 April 2002]); available from http://www.rand.org/publications/RB/RB5021/.
4. Timothy Waidmann, John Bound and Michael Schoenbaum, “The Illusion of Failure: Trends in he Self-Reported Health of the U.S. Elderly” [online] The Milbank Quarterly, vol. 73, no. 2, 1995– [cited 14 April 2002], Abstract; available from http://www.milbank.org/730206.html., and
Timothy A. Waidmann and Kenneth G. Manton, “International Evidence on Disability Trends Among the Elderly” [online] (The Urban Institute as contractor for the U.S. Department of Health and Human Services, 18 June 1998– [cited 13 April 2002]), Executive Summary; available from http://aspe.hhs.gov/daltcp/reports/trends.htm.
5. “Supplemental Security Income: Additional Actions Needed to Reduce Program Vulnerability to Fraud and Abuse,” HEHS-99-151 (U.S. General Accounting Office, September 1999).