Cover Story

Be less than you can be

"Be less than you can be" Continued...

Issue: "Reaping a whirlwind," Aug. 24, 2013

Despite all the good intentions at the time ADA became a law, the overriding federal message to people with disabilities is: We don’t expect you to work. More than $19 of every $20 in federal disability funds goes to support or increase dependency, not to help disabled persons find work and develop their skills. 

Liberals should be distressed by the huge gap between ADA predictions and reality. Conservatives should be equally distressed by the way federal disability programs have undercut the 1995 Republican Revolution’s one big claim of success: welfare reform, which reduced by half the number of people on Aid to Families with Dependent Children (and changed AFDC’s name to Temporary Aid to Needy Families). It turns out, though, that TANF was temporary for hundreds of thousands because they moved onto the disability rolls.

THE BEST LAID PLANS: President Bush signs ADA on the South Lawn of the White House on July 26, 1990.
Associated Press/Photo by Barry Thumma
THE BEST LAID PLANS: President Bush signs ADA on the South Lawn of the White House on July 26, 1990.
THE BEST LAID PLANS: David Cox (right) helps a friend who suffers from degenerative disc disease with his grocery shopping.
Greg Schneider/Genesis
THE BEST LAID PLANS: David Cox (right) helps a friend who suffers from degenerative disc disease with his grocery shopping.
REAL NEED: Keallie Wozny
Stephen Wozny
REAL NEED: Keallie Wozny
NOT AN ABSTRACT PROBLEM: McFarland and his daughter.
Handout
NOT AN ABSTRACT PROBLEM: McFarland and his daughter.

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Some stats: From ADA’s passage in 1990 to 1997, the first year after welfare reform, the number of SSI recipients increased by nearly 1 million, with most of them claiming disability. A General Accounting Office survey in 1997 found 12 percent of households that lost AFDC benefits began receiving SSI, and hundreds of thousands more moved to SSDI. By 2002, former AFDC/TANF recipients made up one-third of all the women on SSI. Ten years after ADA’s passage, the U.S. Commission on Civil Rights found that “When access to benefits is expanded the employment rate of individuals with disabilities drops.”

The SSDI/SSI rolls also expanded as disability definitions loosened. In earlier years officials granted disability claims on the basis of objective medical evidence concerning hearts, lungs, paralysis, and so forth. After welfare reform the most common claimed disability was bone and muscle pain, especially lower back pain—and that’s hard to prove or disprove. Disability awards for “back pain” over the past three decades have increased at least fivefold. We’ve seen a similar increase in disability awards because of mental disorders, including “feelings of guilt or worthlessness” and “difficulty concentrating.” About 60 percent of all disability awards now are for back pain or mental illness.

Some of those awards are for severe problems. I’ve gone through 77 pages of medical records and correspondence sent me by Virginian Keallie Wozny, 54. She had severe scoliosis that went untreated until it was too late to do a full correction, so surgeons fused her spine with about a 65% curve. She wanted to be a nurse, but her back did not allow her to bear the weight of patients, so she went into respiratory therapy and eventually began work at a local hospital. 

Wozny learned to lean—against a wall, against the corner of a night stand, against a bed frame. She leaned whenever she could to take pressure off her back. She fought against pain, sometimes stopping at a bathroom up the hallway to cry privately. She developed osteoporosis in her mid-40s and lost three inches in height as her fused spine slowly broke down and her curve increased to 75 degrees. She had more fusion surgery but was never pain-free. She reluctantly applied for SSDI in 2007 and, after a final hearing that lasted only three minutes, gained approval.

Wozny’s need was real, but the federal Office of the Inspector General recently reported that many SSDI applicants “purposely withhold or fabricate information to collect government benefits they are not entitled to receive.” A U.S. Senate investigation concluded that “insufficient, contradictory, and incomplete evidence” underlies one-fourth of all disability insurance decisions, with “nondisabled persons” often joining the rolls. Rep. Darrell Issa, R-Calif., and two other senior members of a House committee declared in March, “Federal disability claims are often paid to individuals who are not legally entitled to receive them.”

How many? Hard to say, but the Government Accountability Office recently examined data from a dozen states and concluded that 62,000 individuals determined by the Social Security Administration (SSA) to be fully disabled had “received or had renewed commercial drivers licenses.” A 2012 paper from the RAND Center for the Study of Aging found one in four SSDI applicants in 2005 and 2006 actually employed, and more than half probably would have been two years later had they been denied SSDI benefits.

SSA has not done a full study of its SSDI and SSI recipients, but the British government did one of its officially disabled residents in programs similar to the American ones. Asked to submit medical tests to confirm disabilities, one-third of recipients dropped out of the program rather than submit to an examination. Of those tested, doctors found 55 percent fit for work, and an additional 25 percent fit for some work. 

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