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Illustration by Krieg Barrie

Disabling security

Social Security | Hundreds of thousands of Americans are gaming Supplemental Security Income-and doing great damage to themselves and their children

Issue: "2011 Daniel of the Year," Dec. 17, 2011

Dec. 13 is the fifth anniversary of the death of a 4-year-old, Rebecca Riley. She died on the floor of her parents' Massachusetts bedroom. She was one more victim of governmental compassion.

Eight million Americans now receive SSI, Supplemental Security Income, because the Social Security Administration deems them unable to hold a job now or at some point in the future. Washington will typically give each person so classified about $700 per month. Rebecca Riley's parents received about $30,000 because administrators had deemed them and their two older children "disabled" because of "mood swings" and attention deficits.

Last year, after extended legal wrangling, jurors found the parents guilty of murdering Rebecca by giving her a fatal overdose of a drug taken for bipolar disorders. Their goal, prosecutors said, was to increase their income by having their 4-year-old also diagnosed as disabled. To do that they had to make sure that she ingested lots of powerful medicine garnered by way of a prescription-wielding doctor.

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Rebecca Riley's death was an extreme circumstance, but many of the 1 million children who garner SSI income for their parents are also on drugs that many of them do not need. Even the Boston Globe, which usually cheerleads for more governmental welfare, has seen something wrong. The Globe editorialized this past May that "the damage done to children who are misclassified as mentally ill is incalculable: Some linger in special ed classes when they are capable of accelerated work; others come to believe themselves to be impaired when no such impairment exists."

Some SSI recipients need help-sometimes much more help than they receive. But many do not, and their subsidies signify a new national development. In the past, Americans rich and poor were known for having a can-do, never-give-up attitude. Now, the poor benefit from saying cannot do and never-start-up. In the past, Americans were sometimes known for bragging: We tried to seem better than we are. Now we have incentives to seem worse than we are.

When Congress in 1972 made disabled children eligible for SSI payments, the goal was to help poor parents who lost wages by taking time off from work to care for children with muscular dystrophy or cerebral palsy. Politicians spoke of families having additional expenses such as wheelchairs or taxi rides to hospitals.

Fair enough-but psychologists asked, why not us? They argued that depression can be as disabling as a bad physical ailment. True enough, but while medical exams reveal physical cancers, psychological ones are often judgment calls-which means that some money-seekers can game the system when they want the money that a diagnosis can generate.

Rebecca Riley's parents and hundreds of thousands of others learned how to do just that. Some learned by word-of-mouth, but others gained tutelage from "eligibility service providers" hired by hospitals and health insurers eager to pay their bills by getting poor patients onto SSI. When Washington decreed that at least 10 percent of preschoolers in Head Start programs needed to be disabled, that also created an incentive to have more children so classified.

How much gaming goes on? Last year Boston Globe reporter Patricia Wen did a terrific job of accumulating specific detail. She interviewed Geneva Fielding, 34, a single mom for 18 years with three sons, who opposed putting a child on psychotropic drugs, but concluded, "To get the check ... you've got to medicate the child." Wen tracked down a mother whose 2-year-old is now on SSI after being diagnosed with speech delay and potential signs of autism: "It's an easier and better form of welfare. You get more money, and they don't check up on you."

That mom was receiving $600 per month from SSI because she had obtained a diagnosis of depression. The bankable diagnosis she received for her toddler meant $700 more and an apartment upgrade. "I can move out," she happily told Wen, even as she described the cost to her spirit: "SSI sucks you in. Most people get lazy."

That entrance into a corrupt system, even with awareness of the personal damage, is poignantly frequent among some of the teenagers on SSI. One 15-year-old told reporter Wen she wanted to work, but if she did "they'll take money away from my mom. She needs it. I don't want my mom's money to go down." A young man said he wanted to work but "I'm afraid to lose the check. It's attached to me." (No wonder both of them are depressed.)

Wen met many who think of getting a job but then visualize being laid off: They compare that uncertainty to the eternal security they think a government check affords them. She also observed that unmarried fathers have learned news they can use: Authorities can garnish work wages for child support but not SSI checks.

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