As I wrote in a previous blog post, the Social Security Disability Insurance program is suffering a funding shortfall that is exacerbated by a complex bureaucracy and lack of political will for reform. According to the latest Statistical Report on Social Security Disability, there are 12.1 million individuals currently receiving disability benefits, 8.9 million of them previous workers. Those who rely on the SSDI may have vast medical problems or suffer from paralysis, or they may be people with herniated discs that are incapable of performing non-labor-intensive jobs as a result of limited education. Hard, physical labor jobs once defined the middle class, but these jobs have been disappearing for decades as factories and mines close or ship overseas, sending their deteriorating workers running to the federal government for assistance, thanks to a lack of transferable skills or relevant experience for less physically demanding jobs. This has, in essence, changed the makeup and diagnoses categories of disability beneficiaries as well.
More women file for disability and rely on benefits for a substantial part of their income. The number of women in the workforce has grown substantially since the late 1900s, and this alone contributes significantly to the number of workers reliant upon disability benefits. In 2010, 4.4 million women received SSDI, 23 percent of women on SSDI were in poverty and for 58 percent, their SSDI benefits constituted 75 percent of or more of their income. Compare this to 2013, when 4.8 million women received SSDI, 23 percent were still in poverty, and 60 percent had their SSDI benefits constituted 75 percent or more of their income.
Most of the jobs that have driven individuals to disability in the past have been “blue-collar” jobs that women were not associated with. So what accounts for the fact that women file disability claims at a rate faster than men, other than the reason that more women are now in workforce?
Disability diagnoses have changed. In 1961, the three most prominent disabilities among SSDI beneficiaries were heart disease/stroke at 25.7 percent, other at 22.4 percent, and neurological disorders at 16 percent. By 2011, however, back pain and musculoskeletal problems accounted for 33.8 percent of diagnoses, while mental disorders and developmental disabilities came in second at 19.2 percent, and heart disease/stroke at 10.6 percent.
While it is surprising that mental disorders now rank as the second most common diagnoses among beneficiaries, relaxed criteria for disability several decades ago likely made more claimants eligible in the category of mental disorders. When it comes to mental illness and developmental disorders, the diagnoses in previous decades were not as accurate, and some didn’t even exist 40 years ago. The number of children on Supplemental Security Income, which is intended for adults and children who are poor and disabled, is almost seven times the size it was in 1975, demonstrating the increase in learning disability diagnoses. Further, the deinstitutionalization of those with mental disorders likely also raised the incidence of SSDI enrollment for those with such disabilities.
The disability insurance application approval rate has remained fairly constant since 1991, but the number of applicants has increased vastly; those in southern states and/or with low income are the most likely to be approved.
This despite medical advances, technological developments and ADA regulation that should allow more people to have fulfilling work lives despite their disabilities. In addition to reforms to the program itself, perhaps it’s time to question whether attempts to integrate those with disabilities into beginning and continuing productive work lives have really been successful.
Laura Wiltshire is a research associate at the National Center for Policy Analysis.