A recent series that aired on National Public Radio (NPR) stations across the U.S. on Planet Money, This American Life, and All Things Considered ("Unfit for Work: The Startling Rise of Disability in America" and "Trends With Benefits") paints a misleading and often inaccurate picture of the Social Security programs that serve as a vital lifeline for millions of Americans with severe disabilities.
The Consortium for Citizens with Disabilities (CCD), which I had the honor of chairing for the past 3 years, has released a statement responding to the series, signed by over 120 organizations, and joined by other major national coalitions, including the Coalition on Human Needs, the Children's Leadership Council, and the SSI Coalition for Children and Families.
As series reporter Chana Joffe-Walt noted in the final segment, "there is no question these programs play a really important role in the lives of lots of people," going on to say, "the fact that these programs do support so many Americans and growing numbers of Americans makes it all the more important to actually look at them and say, what are they doing, how are they designed, are they functioning well, what role are they playing?" I could not agree more. However, taken as a whole, the series may have left many listeners with an incomplete and misinformed impression of the Social Security programs and the vital role they play in the lives of people with disabilities.
Before leaping to conclusions, let's consider the facts.
Who receives Social Security disability benefits?
According to the U.S. Census about 57 million, or 1 in 5 Americans, live with disabilities, and about 38 million or 1 in 10 has a severe disability. The Social Security disability programs provide vital support only to those with the most significant disabilities -- about 14 million children and working-age adults.
Like the rest of our nation's Social Security system, Disability Insurance, or SSDI, is funded through payroll contributions by workers and employers. SSDI provides benefits to workers who have contributed enough via payroll taxes to be "covered" and who become significantly disabled before reaching full retirement age. Supplemental Security Income, or SSI, provides support to low-income children and adults with severe disabilities, as well as low-income seniors.
About 40 percent of applicants are awarded benefits under the law's strict disability standard. Beneficiaries have severe impairments and health conditions. Many are terminally ill. Despite their impairments, many report eagerness to do some work, and some do work part-time. But research indicates that the average earning potential of beneficiaries with "work capacity" is a few thousand dollars per year--hardly enough to support oneself.
As with adults, most child applicants are denied SSI, and only those with medically documented impairment that results in "marked and severe functional limitations" qualify for benefits. Just 1.7 percent of U.S. children receive SSI--fewer than 1 in 4 U.S. children with disabilities. Contrary to misconceptions, doing poorly in school is not a basis for SSI eligibility. Poor performance in school may be an indicator of a learning disorder or other mental impairment, but on its own is not sufficient to qualify a child for SSI. Likewise, doing well in school doesn't mean a child will lose benefits. Academic performance is just one evidentiary factor among many considered in evaluating a child's eligibility for SSI.
How do benefits help people with disabilities?
Benefits are extremely modest - averaging just over $1,100 per month for SSDI and just over $520 per month for SSI - but keep millions of people with disabilities from deep poverty and homelessness. As noted by the Center on Budget and Policy Priorities (CBPP), for most adult disability beneficiaries SSI and SSDI make up all or most of their income. On an extremely limited budget, most benefits go to basics like food, clothing, medical care, and housing.
The SSI childhood disability program - one focus of "Unfit to Work" - plays an essential role in helping families address the often crushing expense of caring for a child with a severe disability, and the reality that some parents are unable to work full-time due to overwhelming caregiving responsibilities. Together with Medicaid, SSI makes it possible for many children to remain at home with their families instead of needing to be in an institution to receive their care.
What about "invisible" disabilities?
According to the World Health Organization, in rich nations like the U.S. many people are living longer--but with more disability. Today the leading causes of disability both in the U.S. and abroad are largely invisible: mental illness and musculoskeletal disorders. Yet denial of such "invisible" disabilities remains sadly common. "Unfit to Work" epitomizes this denial, questioning whether individuals who "look healthy" ought to be receiving disability benefits, and declaring that disabilities visible to the naked eye (e.g., injuries suffered in a car crash) are "unambiguous," whereas impairments less readily observable to an onlooker are somehow "squishy." Is someone with cancer or a veteran with Traumatic Brain Injury (TBI) less deserving of disability benefits than someone with a visible disability? This logic also dismisses the millions of Americans with mental impairments ranging from intellectual disability to Autism to Post-Traumatic Stress Disorder (PTSD) to schizophrenia (among many others), just because their impairments exist beneath the skin.
What explains the growth in the disability programs?
As noted by Kathy Ruffing at CBPP, Social Security's Chief Actuary Steven Goss, and Brad Plumer at The Washington Post, the recent growth in SSDI is largely due to demographics. Two factors have played the largest role: baby boomers entering their high-disability years and women entering the workforce in large numbers in the 1970s and 1980s so that more are now "insured" for SSDI based on their own prior contributions.
The increase in the number of children receiving SSI benefits in the past decade is similarly explained by the increase child poverty. From 2000 to 2011, the number of poor children skyrocketed from about 11 million to over 16 million, and more than 1 in 5 U.S. children live in poverty today. Since SSI is a means-tested program, more poor and low-income children mean more children with severe disabilities are financially eligible for benefits. Importantly, the share of low-income children who receive SSI benefits has remained constant at about 3 to 4 percent.
Additionally, as highlighted by Elizabeth Lower-Basch at the Center on Law and Social Policy (CLASP), there is no evidence of a large-scale shift from Temporary Assistance for Needy Families (TANF) to SSI. In fact, the decline in TANF enrollment from 1996 to 2011 is more than 20 times the magnitude of the increase in SSI child enrollment during that period. Evidence for a shift from TANF to SSDI is also lacking. The share of SSDI disabled worker beneficiaries with dependent children has actually fallen since 1996 (when TANF became law), from nearly one-third to about 20% in 2011. While loss of TANF might lead a person to apply for SSI or SSDI, being poor is not enough to qualify for disability benefits--an applicant must also meet the strict disability standard.
What will the future bring for the Social Security disability programs?
As the baby boomers age into retirement, the number of new SSDI beneficiaries awarded benefits has already begun to level off and is projected to decline further in the coming years. The number of children receiving SSI has also decreased from 2011-2013 and is projected to decline further over the coming decade.
Media accounts frequently sensationalize the DI trust fund's projected shortfall. History tells a less dramatic story. Since Social Security was enacted, Congress has "reallocated" payroll tax revenues across the Old-Age and Survivors Insurance (OASI) and DI trust funds - about equally in both directions - some 11 times to account for demographic shifts. In 1994, the last time such reallocation occurred, SSA actuaries projected that similar action would next be required in 2016. They were right on target. Experts at CBPP and SSA's Chief Actuary have urged Congress to take action to ensure long-term solvency, as it has on several prior occasions.
Over the years, CCD and others have put forward many recommendations for how the Social Security disability programs can more effectively serve their missions: increasing economic security for people with severe disabilities, and enabling them to live independently and with dignity. It's saddening to see reporting that risks scapegoating the very system that is a lifeline for millions of Americans with severe disabilities. Instead let's focus on strengthening these vital programs.