One of the most maddening Big Lies we hear from the conservative side of the political spectrum is that disabled individuals who receive benefits from any government source, specifically from Social Security, are committing fraud, are just freeloaders, that they want to get money from other people without having to do any work. In recent history, this goes back at least to Reagan’s mythical “Welfare Queen” driving her Cadillac.
Not only does this mentality persist, and even flourish, today, but it goes back a lot further than Ronald Reagan. In Plymouth Colony, Miles Standish reputedly told the Puritan colonists, who were not renowned for their charitable natures, “If you don’t work, you don’t eat.” A lot of people probably said something similar over the centuries. In 2 Thessalonians 3:10, the author (Probably Paul, who never had a clue about Christ’s true teachings) said that “If a man will not work, he shall not eat”. I have read that some fundies think Christ himself said this. Hard to reconcile that with the miracle of the loaves and fishes.
This is the sort of thinking we are up against when we talk about people who are disabled, as defined by the rather difficult to meet Social Security rules, being able to draw benefits they paid for, just like retirees pay for their benefits, through FICA taxes.
A couple of nights ago I did a search on “Social Security Disability Beneficiaries Are Fraudulent Freeloaders” and got quite a few hits. One of them was a well known conservative discussion forum which had a thread from a few months ago on this topic.
The oiginal post was what looked like a exact quotation from a Social Security publication entitled Benefits For People With Disabilities, to which the original poster had added the words “(How you can get away with living off someone else’s loot.)”
His only addition was “Just apply.”
The first response was a one syllable word, meaningless in any context word. I thought of a neanderthal grunting in agreement.
The original poster took that one word reply and did somehow get some meaning from it. I can’t imagine how, unless he was already primed and needed someone to get him started:
don’t get me started. The most fraud ridden programs on the face of the Earth. And, I believe, has ruined people lives and generations. I have seen perfectly healthy people go on these programs and then have no reason to get up in the morning. When a man has no purpose in life, his life is already over.
Some anonymous responder (didn’t even have the guts to make up a screen name) jumped in with both clod-hoppers.
I know a guy who lives in Texas and is drawing disability from the Government every month. He is now working, under the table, in Arkansas and drawing his disability.
Why don’t I report it? People have done so before on others who are violating the system and nothing happened. So, why bother. The Soc. Sec. employees don’t care. This is job security for them.
This one really offended me. I would like to point out that Social Security employees do care. The best fraud case I ever had was reported by a neighbor of the person committing the fraud, who was outraged when she found out that her neighbor was getting money under one Social Security Number and working under another one. She had two. The SSA system at that time would not have caught her otherwise. Thanks to that honest American, an expensive fraud was stopped and a criminal went to jail. I guess that the anonymous person quoted above isn’t an honest American.
yeah if you can get a crooked doctor to collude, you’re on a big dole. the gummit does not have the bandwidth to police even most of this stuff.
The government does have the “bandwidth” to police crooked doctors. I won’t go into how, but during my time taking disability claims, there were a number of doctors who were barred from submitting medical evidence for applicants. At least one that I can remember went to jail.
Welfare programs did and do similar things. The trap is sometimes more insidious because of how part time work is factored into the benefit formula — often leading beneficiaries to conclude it is financially most advantageous to do nothing at all.
For both Social Security and Supplemental Security Income, this is not true. Both programs have a variety of work incentives designed to help disabled individuals who want to try and return to work (and there are a lot of them) and to provide a meaningful safety net to those who try but can’t make it. I’d refer you to the Social Security Red Book, but I know you wouldn’t read it and might instead use it as toilet paper.
The next respondent told her story. Her inherent meanness shows through.
I have 2 family members who ruined their lives going on SS. Depression was the reason & IMHO they were more depressed since they had nothing to do. My brother had hep c, depression from it & went on it. He could have worked but took the easy way out. Ended up dead from all the drugs he got & becoming drug addict. My brother in law’s marriage ended & he couldn’t cope with it. Even though he was cheating, he felt he should have ended it not her. He was taking all kinds of drugs but not the way he should have. He put a bullet into his head & he lived. So now he is blind & even more depressed. Both of these men could have worked & tried to work through their problems. I still wonder why they didn’t. Instead they hurt all of us around them.
And if they were remained depressed, and broke, and untreated, and still using drugs, this would have improved their lives how, exactly? This is a sad story, and I am sorry for your loss, though I don’t think you are. You seem to be content to feel sorry for yourself and to blame their loss on the fact that they were able to obtain help with their disabilities. They probably needed representative payees, and perhaps conservators.
The next responder was also just plain mean.
There are so many stories like that..the unintended consequences of our “compassionate society” My ass. There is no compassion in enabling someone not to ever reach their potential as humans. We are a dying civilization.
The reason we are in a “dying civilization”, as you call it, is that people like you take no interest in preserving it, or in helping those who honestly need help. What would you do instead? Take them out back and shoot them?
Then there were a couple of posts from people who complained about how hard it was for “truly” disabled people to become qualified. I guess they didn’t read the comments of those who responded before them. Didn’t they know that to the other responders who wrote in this thread there are no “truly disabled” people, only freeloaders who are looking to be paid because they don’t want to work? Two or three posters commented on people “they knew of” who had said their children had attention deficit hyperactivity disorder (ADHD) and automatically had gotten this approved, and that it was a lifetime meal ticket for the child. This is bull. More on this later.
One of these responders used two particularly hateful lines that I thought bore repeating. He said, at the beginning of his post, “Obesity and lack of self worth are the rewards of disability for anyone still capable in any way.” He ended his post with, “Like you we watched other family members over the years take disability and they died a slow death of self loathing.
These were followed by two or three posts where the responders blamed everything on crooked doctors who live to push pills on unsuspecting patients who would otherwise be entirely healthy.
There were several more “me too” posts where the responder had a story similar to one of the ones already posted. For the sake of brevity, and sanity, I shall skip them, except for one. This one was from a person who claimed to be a psychiatrist in practice for twenty five years. As we all know, one can claim to be anything on the Internet. As a (conservative — is there any other kind?) radio talk show host who used to be on the air here once said, “I can stand in my garage and honk, but that doesn’t make me a Buick.”
The tragedy you describe is entirely in keeping with my 25 years of experience in psychiatry.
I still see a few Medicare patients these days if they are over 65, but, if they are younger than that and have Medicare because of a “psychaitric disability” other than schizophrenia, I don’t even consider evaluating them for possible acceptance into my practice.
I’m also clear, in writing, with prospective patients that I consider my job as a doctor to consist of diagnosing and treating illness, not improving people’s cases in any sort of legal or social agency scenarios, and that I don’t cooperate in such cases beyond simply sending records if they are subpoenaed.
I am also clear with prospective patients that my practice is limited to people who want to get well, and that this motivation is directly undermined whenever disability payments are involved. It has been my clear experience in 25 years in this field, that 1. Nothing is more addictive than a monthly check from the government, and 2. Because of that, especially in cases of depression or substance abuse, there is no chance that I can help them get well once they go down the road of disability.
With the small amount of productivity expected in many jobs these days, I am also of the firm opinion that almost anyone who can make it in to my office and talk with me for a while is also able to find and function in a job of some sort.
The road to great suffering has been paved with with false compassion.
Now for some information from the reality based world. Social Security has two disability programs which it administers, Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) Disability. Both of these programs have the same, identical definition of disability, which I have stated elsewhere in this blog, but will state again.
A person is disabled for Social Security purposes if he or she:
1. Has a medically determinable physical or mental impairment;
a. Which has lasted or is expected to last for at least one year, or;
b. Will result in death.
Medically determinable means just that. The condition has to be one for which there is medical evidence. It has to be medically provable. It cannot just be based on allegation.
A disabling condition is also one which prevents one from engaging in substantial gainful activity (SGA). I will not to into that here, but will instead refer you to my post Question #3 – How Does Work Affect SSDI Benefits which discusses in some detail when work is SGA and when it is not.
Social Security does not make its own disability determinations. Each state has a department called Disability Development Service, whose principal job is making disability determinations for SSA. They are, in effect, contractors. The states already had such agencies in existence before SSA began paying disability benefits, in 1965. Their job then was to determine if applicants for state aid based on blindness or disability met the state’s definitions of these disabilities.
SSA decided that, rather than reinvent the wheel, it would use the existing framework. It did, however, write rules for the state to follow when deciding SSA disability cases. If you want to see the instructions for yourself, please refer to Disabiity Insurance.
This part of POMS from chapter 201 through chapter 295 gives DDS its primary instructions for processing SSA’s initial claims for disability. What I have referred you to here is part of SSA’s Program Operations Manual System (POMS) which are the instructions for all employees of SSA and other agencies which do work for SSA. I did this to show that SSA doesn’t just determine disability by throwing darts at a sign marked “yes” and “no.” No making it up on the fly. No magic 8-Ball.
SSA claims representatives (CRs) do have a part to play in the process. They interview the applicant, and obtain the names and addresses of all treating sources and also any agencies thay may have medical records pertaining to the alleged impairments. The CRs also get as complete a list of impairments as possible. Each alleged impairment needs to be developed by DDS. The last thing the CR does, after the interview is over, is to complete a form on which he or she records observations about the applicant. Does the applicant have any difficulties with things like walking, sitting, speaking, hearing, answering questions appropriately, writing, and so forth. The CR also records general observations about the applicant. His height and weight. Overall physical appearance. Were there any physical signs of the alleged impairments? Were there things such as shaking, paleness or flushing, sweating, inattentiveness, inappropriate responses or actions. Did these appear to be genuine or was the applicant “acting crazy” for the interviewer.
The applicant and his doctors must supply medically acceptable proof that the alleged disabiling impairment meets the degree of severity shown in POMS. Proof isn’t just a form or a letter from the doctor; it is a copy of his or her entire file. Sometimes, the proof that the applicant’s doctors send is incomplete or doesn’t cover the issues. In that case, DDS will send the applicant to another doctor for what is called a consultative exam (DDS pays for it) to obtain missing medical evidence. After these steps, if the medical evidence does establish that the impairment is a disability, as defined by SSA, the applicant is determined to be disabled.
If the applicant alleges several impairments, but none of them is severe enough by itself to be considered a disability, as SSA defines it, the analyst must consider whether or not the combination of impairments, taken together, does make a determination of disability possible.
If neither of these yield a determination of disability, then the analyst must consider vocational factors, such as age, education level and training received, previous work experience, and other similar factors, to see whether or not there is any job that exists in sufficient numbers in the local economy that the applicant can do given what limitations he or she was able to establish. In some cases, the analyst can determine that there is no job that the applicant, given his impairments, can do, and this will result in a finding of disability. This particular basis is used very rarely, however.
Once the analyst makes the determination, disabled or not disabled, it is approved or disapproved by a reviewer who is himself or herself a doctor.
Despite all these ways to establish disability, DDS ends up denying about 70% of initial claims for disability that it processes. SSA doesn’t hand out disability benefits like candy.
The following is for the yahoos who were griping about ADHD.
112.11 Attention Deficit Hyperactivity Disorder: Manifested by developmentally inappropriate degrees of inattention, impulsiveness, and hyperactivity.
The required level of severity for these disorders is met when the requirements in both A and B are satisfied.
A. Medically documented findings of all three of the following:
1. Marked inattention; and
2. Marked impulsiveness; and
3. Marked hyperactivity;
B. For older infants and toddlers (age 1 to attainment of age 3), resulting in at least one of the appropriate age-group criteria in paragraph B1 of 112.02; or, for children (age 3 to attainment of age 18), resulting in at least two of the appropriate age-group criteria in paragraph B2 of 112.02.
Here are paragraphs 112.02.B.1 and 112.02.B,2:
B. Select the appropriate age group to evaluate the severity of the impairment:
1. For older infants and toddlers (age 1 to attainment of age 3), resulting in at least one of the following:
a. Gross or fine motor development at a level generally acquired by children no more than one-half the child’s chronological age, documented by:
1. An appropriate standardized test; or
2. Other medical findings (see 112.00C); or
b. Cognitive/communicative function at a level generally acquired by children no more than one-half the child’s chronological age, documented by:
1. An appropriate standardized test; or
2. Other medical findings of equivalent cognitive/communicative abnormality, such as the inability to use simple verbal or nonverbal behavior to communicate basic needs or concepts; or
c. Social function at a level generally acquired by children no more than one-half the child’s chronological age, documented by:
1. An appropriate standardized test; or
2. Other medical findings of an equivalent abnormality of social functioning, exemplified by serious inability to achieve age-appropriate autonomy as manifested by excessive clinging or extreme separation anxiety; or
d. Attainment of development or function generally acquired by children no more than two-thirds of the child’s chronological age in two or more areas covered by a., b., or c., as measured by an appropriate standardized test or other appropriate medical findings.
2. For children (age 3 to attainment of age 18), resulting in at least two of the following:
a. Marked impairment in age-appropriate cognitive/communicative function, documented by medical findings (including consideration of historical and other information from parents or other individuals who have knowledge of the child, when such information is needed and available) and including, if necessary, the results of appropriate standardized psychological tests, or for children under age 6, by appropriate tests of language and communication; or
b. Marked impairment in age-appropriate social functioning, documented by history and medical findings (including consideration of information from parents or other individuals who have knowledge of the child, when such information is needed and available) and including, if necessary, the results of appropriate standardized tests; or
c. Marked impairment in age-appropriate personal functioniong, documented by history and medical findings (including consideration of information from parents or other individuals who have knowledge of the child, when such information is needed and available) and including, if necessary, appropriate standardized tests; or
d. Marked difficulties in maintaining concentration, persistence, or pace.
Is that specific enough for you. The POMS reference is DI 34005.112 Mental Disorders. Go down to Listing Code 112.11.
Over the course of a 22 year career with Social Security, I processed a lot of disability claims. I interviewed people who were clearly disabled, and others who were just as clearly not. You can’t do this for a living for any length of time and not develop a feel for who is disabled and who is not. The cases of mine who were approved by DDS were usually the ones I had felt would likely be approved. One thing we all heard over and over again from applicants was their feeling of shame to be asking for “help” or “charity.” The reason they feel this way is because of a lifetime of pounding they get from many from the right wing that claiming to be disabled and taking benefits for it, benefits that they paid for while working, is shameful, and that they are second class citizens, less than human, worthy of being discriminated against. And they believe it. Many disabled people I talked to also told me that, given a choice, they would rather work than put up with the attitude they faced every day as a disabled person. I know one person very well who had (and still has) a very superior intellect, who became disabled with multiple sclerosis, worked for years despite having MS but showing symptoms, and either having people treat her thereafter as if she were, in her words, “mentally retarded” or else telling her that she looked just fine; that there was nothing wrong with her at all. One of her coworkers told her once that she should just kill herself. Eventually she could no longer work and filed for SSDI. She still has people treat her as if she is mentally retarded or tell her that she looks fine and that there is nothing wrong with her. That is the society we live in.
People like these posters in this discussion forum, and the many others who think like them, are not speaking from ignorance. They are speaking from malice. Their words hurt people. They should just shut up. But they have an agenda to promote, so they won’t just shut up. They will keep pushing their agenda without caring about whom they destroy in the process. One thought always comes to me when I contemplate these people — everyone gets sick eventually. Everyone has pain and suffering and life limitations at some point. When it happens to them, they will be treated in the same despicable manner as they have treated others by their children and grandchildren, by their erstwhile friends, and by others in society who share the same way of thinking they propound so vociferously now. They will meet themselves.