What will it take to revise US disability benefits programs?

Great Debates
1

My impression is that two of our primary disability programs - Social Security and Veterans Administration - could use considerable improvement. But I’m seeing little to no indication that intelligent, measured improvements of either are contemplated. Instead, you see folk trying to essentially abolish, or greatly expand them.

I think there are great societal and economic costs to continuing the current programs as they are. If an individual is impaired and lacks a job, then I fully support providing them medical treatment, education, and vocational training/assistance. If the economy does not provide jobs paying a subsistence wage, then I’d prefer that the government support “workfare.” Yes, I understand that doing so is more expensive than simply cutting checks.

The portions of SSA disability regulations regarding vocational factors have not been tweaked for decades. SSA still requires reliance on the Department of Labor’s Dictionary of Occupational Titles - which was last updated in (I believe) 1991. An individual aged 50 is considered “closely approaching advanced age.” There are many ongoing attempts to examine and improve the application and adjudication process, but few apparent efforts to meaningfully update the program to reflect what “disability” really means in the 2d decade of the 21st century.

With respect to VA benefits, claims based on PTSD are exploding. Many veterans receive lifelong payments exceeding any wages they ever earned, with no set off against wages or SS benefits. Again, I support providing veterans health care and assistance rejoining society and the civilian workforce. And I don’t understand why we would wish to pay 100% disability benefits to a vet who is gainfully employed.

I’m not persuaded that it is desirable to designate huge numbers of individuals as “disabled” - with the implication that they will never be able to meaningfully contribute.

What do you think it will take to achieve meaningful revision of how we view and treat “disability.” Or am I mistaken in thinking such revision is needed/desirable?

(Note - In this thread I’m not discussing the Americans with Disabilities Act or suggesting a change in efforts to include all people. IME much confusion caused by the word “disability” being defined differently in different contexts. I put the word disability in quotes, merely to suggest that I am referring to that term as used by SSA/VA, as opposed to other contexts.)

2

Given your background, I was rather hoping you could tell us. :wink: IMHO, the answer is to boost retraining programs. Sending candidates back to school tends to weed out many of the malingerers and frauds. Most states are cutting retraining programs as a short-term budget measure, but this has serious long-term fiscal ramifications.

3

Well, I could identify 10s of no-brainers off the top of my head, but what I see as the biggest problem is identifying the political will to make any changes.

There are many people who benefit from having as many folk as possible be designated as disabled, and lobby HARD for continuance or expansion of the current systems: the recipients themselves; their representatives; aged/disabled/veterans’ interest groups; medical providers who get compensation for services provided to the “disabled” … I am unable to think of ANY group who is pushing for meaningful, sensible revisions.

In the current climate WRT veterans, I don’t see any urging to do anything other than to increase benefits flowing towards them. My impression is that some of the backlog is being paid down by granting very weak claims.

So much of the criticism from Congress is aimed at the process for evaluating SS disability claims, rather than the dubious underlying Act and regulations. And I’ve seen/heard nothing to suggest the Administration is pushing hard for meaningful reform. Instead, the focus is on automation/technology - improving the process, while reducing administrative costs (mostly staff and real estate). People regularly decry “fraud” - a miniscule problem, while rarely mentioning meritless claims. I’m loathe to consider it fraud simply because people who are capable of work see the system as offering easy money.

4

Much of what I see are people who could probably do some kind of work, but between their physical and psychological limitations and limited skillset (and sometimes their age) nobody wants to hire them. How to address illegal discrimination which still very much exists and affects people’s ability to support themselves in a very real way?

5

While I agree with the reform you propose, I take issue with lumping all disabled veterans into one pile. For VA disability compensation an ex-service member needs to have a disability (defined in 38 eCFR) and show that it is service connected. Disclaimer, I am a service connected disabled veteran, 13 years Army, MP, SF Engineer. Are there people that are taking advantage of PTSD, yes. Could I qualify for PTSD, probably, I’ve seen dead bodies. But I guess what I want you to understand is that it is “disability compensation”; someone served/defended this country and as a direct result of that service there body either no longer functions normally or no longer looks normal. Are you saying that those people should not be compensated for the damage to their body? Even if they can work full time and make a decent living? I knew a guy that lost his leg in Vietnam and continued on active duty, when he retired he would qualify for VA benefits. I also know a gut that lost an arm in Vietnam, he became a gov’t employee and was and SES. Should they not be compensated?

6

Let’s take the other side of the problem: an individual has a 6 month disability recovering from an accident. He doesn’t qualify for Social Security Disability. And a huge fraction of the population lives paycheck to paycheck. What does he get? Just some food stamps?

7

Personally I think the OP is lumping 2 distinct things into the same basket. SSDI != VA disability.

8

This, I think, is key. I’m not familiar with the US SSDI system, really, except that my late wife did receive a monthly payment from it. But in the UK, we have something of a problem because benefits are routinely denied on the basis that a claimant could, theoretically, do some sort of work.

And yes, they could, theoretically, do some sort of work. A 55 year old former roofer who’s had a heart attack and can’t safely climb ladders any more could, perhaps, work in a call centre. But this takes no account of labour market conditions: would said 55 year old actually be employed by someone? The theoretical ability to do some work is fairly irrelevant if there’s no-one who’d take the person on.

9

I’m not suggesting that military personnel who are injured during their service ought not receive some compensation. I AM, however, questioning the amount of that compensation, how long it lasts, and how widely it is distributed. I suppose I am also questioning the definition of “disability.” Given the nature of the job, it seems quite problematic if “seeing dead bodies” will be sufficient to trigger widespread disability claims.

Paul Parkhead - I agree that economic conditions are an issue. But I’m not sure the appropriate way to deal with economic conditions is through the disability program. I would suggest welfare, unemployment benefits, retraining/education, or even subsidized public employment would be more appropriate. Moreover, under the US SS disability program, an individual’s inability to obtain work and employers’ hiring practices are (supposed to be) irrelevant to the determination of whether that individual is disabled. 20 CFR 404.1565(c).

The program does assume that vocational adversities increase as an individual ages. Using your example, absent some unusual factors, the 55 year old ex-roofer would qualify as disabled if he were limited to sedentary (or light) work. My personal feeling is that those age categories should be adjusted upwards.

10

SSDI takes that into account; there is a five step process that initially looks at whether the claimant can perform his/her old job, and then whether the claimant can perform any job that exists in significant numbers where the claimant lives.

11

A veteran that lost a leg below the knee is entitled to $587.36 a month based on eCFR 38, chapter 4, section 5165
Amputation
5165 At a lower level, permitting prosthesis 40

Is that an outrageous amount? I think not. And that is for life, and also the amount may be higher based on the number of dependents.

Are there veterans exploiting the system, yes, is that number high, possibly. But they aren’t doing it for things for a missing leg. Are there problems with the way that the VA defines disabilities, yes. Should we as a country not pay compensation to veterans that were damaged during their service, no.

Should a veteran that lost part of a leg while in service not be compensated for that loss irregardless of their salary after service? once again NO.

As far as SSI goes, why is the tax capped at $118K?

For 2015, the maximum amount of taxable earnings is $118,500.

Really?

Side note: If I was smarter I’d figure out how to post links to my cites.

12

Um… you do realize that not everyone can be “fixed”, correct? There are some people for whom there is no further medical treatment, and education/training/etc. is not going to make them employable. What are they supposed to do, crawl off into a corner and die?

Where are these “workfare” jobs supposed to come from? If there aren’t enough jobs for the able-bodied where will we get jobs for the less than perfect?

>sigh<

Welfare as we used to know it no longer exists, and hasn’t since the mid-1990’s Geez, people, it’s been 20 years.

NO adult gets welfare anymore in the sense being paid monthly monthly for being poor. Families with children can sometimes get TANF, for a limited time (5 years last I heard). That’s IT. Period. Everything else is stuff like food stamps and subsidies like Section 9 for housing (where the person is still expected to fork over real money for part of the rent) or help with utilities.

Unemployment benefits normally last only 6 months, maximum. What are these people you’re talking about supposed to do after 6 months, crawl off into a corner and die? Absolute maximum is 99 weeks - under two years. Again, what do they do AFTER that time? Because someone who is disabled won’t magically stop being disabled because 99 weeks have passed.

Retraining? As what?

Government jobs? When a lot of levels of government can’t pay their current obligations right now (looking at Illinois pension problems, among other things, as just an example) where is the money for that going to come from?

In other words - sure, kid, you’re disabled… now go stand (or sit in your wheelchair) in line with everyone else who can’t find work. Good luck, kid, you’ll need it because when able-bodied can’t find work the disabled are well and truly screwed.

I get that you have some objection to paying money for life to someone regardless of whether or not they have a paying job. However, are you aware that being disabled means you tend to incur costs beyond those of the able-bodied? It could be medications, needed adaptive equipment, all sorts of things. When it’s connected with doing a job - such as a wounded soldier - maybe you should regard it as the government paying (some) of those daily/monthly/yearly costs that otherwise would not have been imposed on the person if they haven’t been injured on the job.