Disability, Social Security, and the missing context

As a trustees report comes out, a This American Life piece provides an unfortunate example of incomplete reporting

Today, the trustees of the Social Security system will issue their annual report card on the trust funds that pay retirement, survivor, and disability benefits to millions of Americans. For the last few years, these reports have typically noted shortfalls, which the media in turn, have often portrayed as gloom-and-doom scenarios of impending disaster.

If the past is a guide, a full discussion of the options for closing those shortfalls will again be missing. Stories will tend to reinforce the belief among many Americans that these programs will not be there for them, which is most likely dead wrong. Full context, in short, will be missing.

I hope that’s not the case this time around, but we don’t have to look far for recent examples of missing context when it comes to Social Security. Take “Unfit for Work—the startling rise of disability in America.” Please. The program was produced by This American Life and Planet Money, and aired on public radio at the end of March.

That piece left the impression that freeloaders are gaming Social Security’s disability program, that disability benefits are becoming welfare payments to support those out-of-work, and that the disability program is fast becoming an increasingly expensive safety net. In preparation for this year’s trustees’ annual report, it’s worth taking a second look at “Unfit for Work,” which generated zillions of comments in the blogosphere and serious pushback from knowledgeable people that challenged its premises. Reviewing where that piece went off the track should be a big help to reporters trying to get this year’s trustees’ story right.

The piece resonated widely, particularly with those already open to the Social Security-is-going-bankrupt story. At a recent Medicare workshop for journalists in St. Petersberg, I pushed Judith Lave, a University of Pittsburgh health economics professor, for her sources of information about disability. “My source of information is NPR,” she replied. Back home, a dinner guest, a smart professional woman I know, happened to mention how dismayed she was that disability benefits had become the new welfare checks. Her source: the Planet Money/This American Life piece, which had run the day before.

In his column on Time’s Swampland blog, Joe Klein wrote:
“Welfare abuse has shifted to Social Security.” Washington Post editorial writer Charles Lane acknowledged that some of the program growth comes from an aging workforce but added:

A growing body of economic and journalistic evidence suggests that SSDI reduces work incentives, because of its permissive eligibility criteria and relatively high benefits, as compared to low-wage workers’ potential earnings.

The reporter of “Unfit for Work,” Chana Joffe-Walt, seemed to omit crucial information on her way to passing on unfavorable impressions about the program, gleaned in part from a visit to one of the poorest counties in the US, Hale County, Alabama, where one in four residents are on Social Security disability and where Joffe-Walt says the definitions of who gets on and who doesn’t are “squishy.”

Throughout her piece, she seems to suggest it’s easy to qualify for benefits. It isn’t. To qualify, a person must have a disability so severe that it prevents him or her from doing any significant work anywhere in the country. The disability must be expected to last at least a year or result in death. The process requires extensive medical documentation. The Social Security Administration makes the final determination, which can take months, if not years.

Less than half of applicants for disability get it. According to the Center for Budget and Policy Priorities, whose analyses often focus on the impact of federal policies on low-income people, only about 400 Social Security disability applicants out of 1,000 are successful, and two-thirds of those get benefits only after an appeal. And the successful ones get benefits only after a five-month waiting period. None of this made it into her report.

Nor did she note the ratio of people who are disabled to people who get disability benefits, important context. According to the neutral, non-partisan National Academy of Social Insurance (NASI), 8.8 million workers received disability benefits at the beginning of this year. In 2010, 29.5 million adult Americans reported having some kind of disability.

The Center’s Kathy Ruffing questioned the use of Hale County, which the report used to generalize its conclusions. Ruffing pointed out that the country has an older, less-educated workforce, and an economy based on forestry, mining, and manufacturing, which tend to spawn more work-related disabilities than service industries. In Hale County, Joffe-Walt met up with Dr. Perry Timberlake, who examines candidates for disability benefits and makes judgment calls about their qualifications while asking about their schooling. Joffe-Walt reported “Dr. Timberlake is making a judgment call that if you have a particular back problem and a college degree, you’re not disabled. Without the degree you are.”

She also drew from another reporting experience in Aberdeen, WA, discussing how workers went on disability after a mill had closed. Her reporting led her to some conclusions about the relationship between disability benefits and work:

Disability has also become a de facto welfare program for people without a lot of education or job skills. It wasn’t supposed to serve this purpose. It’s not a retraining program designed to get people back onto their feet. Once people go onto disability, they almost never go back to work.

Joffe-Walt didn’t report that many of these disabled workers have life-threatening conditions. According to NASI, 1 in 5 men and nearly 1 in 6 women die within five years of going on the disability program. She notes that “people who leave the workforce and go on disability qualify for Medicare,” but she failed to point out that there is a two-year waiting period to receive Medicare benefits once they qualify for disability benefits. In my own work, I have seen seriously ill people cry during interviews because they had no way to pay for the healthcare they needed during that long waiting period.

At the end of her piece, Joffe-Walt noted that the “reserves in the disability insurance program are on track to run out in 2016.” She says Social Security’s chief actuary, Steve Goss, is “confident” that Congress will act to keep the payments coming, and that he and his colleagues have worked out a temporary fix until 2033. She didn’t dive into the options for reform, although there are a number of them, and they are too rarely discussed.

Her conclusions drew a strong backlash from across the spectrum—from former Social Security commissioners to academics (such as University of Chicago professor Harold Pollack) to Beltway policy shops, like the centrist Center for Budget and Policy Priorities or the more liberal Center for Economic and Policy Research.

In an open letter, eight former Social Security commissioners said “‘Unfit for Work’ failed to tell the whole story and perpetuated dangerous myths about the Social Security disability programs and the people helped by this vital system.” In their letter, they acknowledged that disability claims had risen significantly, but noted that growth had been predicted as early as 1994—the result of more women in the workforce and baby boomers reaching the years when disability sets in.

On the blog of the Century Foundation, and in a Q&A with The Washington Post, Pollack, who a disability expert, pushed back hard against the assertions made in the piece. Pollack wrote on the blog:

The misfortunes of people wrongly denied benefits, the problem of sick people bleeding money as the ponderous bureaucratic process moves along, the plight of disabled people stuck on the Medicare waiting period—these matters were left unexplored.
After rereading “Unfit for Work,” I agree with the critics. The piece did a disservice to an important safety net crucial to the survival of some of the sickest people around. It could have been a useful service had it explained what disability benefits ars—social insurance, not welfare. And that the Social Security program has encountered funding shortfalls 11 times before, and these were always fixed by reallocating payroll tax revenues among the trust funds to account for demographic shifts. As the eight former Social Security commissioners put it in their letter, Social Security actuaries predicted similar action would be needed in 2016, and “they were right on target.”

All this is important context for covering the trustees’ report and beyond.

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Trudy Lieberman is a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR's healthcare desk, which is part of our United States Project on the coverage of politics and policy. She also blogs for Health News Review. Follow her on Twitter @Trudy_Lieberman. Tags: , , , ,