Huh? I saw RJ's and commented on them. I saw bbauska's and commented on them. I never said that none are being offered. Just that some people seem to be more focused on complaining about the problem than concrete practical solutions.

But hey, maybe you think that getting an independent second opinion is 'cockamamie'.

On the MIT study, I thank you for finding something that acknowledges (and goes to the trouble of quantifying) the effect of the ageing population. While in the opening pages the researchers say that it has ‘little’ effect, that is not the same as having ‘no’ effect, so I read on. Later they describe it as a ‘modest’ effect and put a number to it - 6% of the increase. Further, Table 3 shows three demographic effects that underly the data:

1) The rate of disability claims for people aged 50-64 is always higher than it is for younger cohorts
2) The rate of disability claims for people aged 50-64 increased in the 20 years 1983-2003 for subdivisions by gender and education level
3) In virtually every subdivision, the number of percentage points that the rate has increased for people aged 50-64 is greater than for the younger age groups, and in every single subdivision showing age groups, the increase is more than the average for that gender/education level subdivision

The other aspect that the report has highlighted, which I will mentally add as number 6 on my list of contributory factors to a rise (but not the whole rise) over the past 50 years is one that should have been obvious to us all, but perhaps we are blind to being by and large male. The proportion of women in the workforce increased greatly, meaning that more women are eligible to claim (because in order to be able to start claiming, one has to have been in qualifying work for 5 out of the past 10 years). Again, in every single category on Table 3 see bar one (High School drop-outs aged 50-64), the percentage point increase in the rate of female claimants is higher than for equivalent males.

The MIT report also references obesity having been a trend, as well as reduced mortality rates, and while they do not quantify those effects and describe them as ‘minor’, again that suggests to me that the effect is non-zero.

It seems to me that you are still labouring under the delusion that I have sought to explain away all of the increase with one theory (or as it now stands, six theories). That is not true, as I have explained (although I seem to have missed that apology for 'misreading' my post).

Still, that MIT research (which may be out of date, based on using 10 year old data), does show that there are demographic effects, and effects from the increase in women working, as well as alluding to other impacts from overall health trends. It would be of more interest to get a better idea of the true extent of the problem - after all, it would be useful to know whether particular solutions are worth it before adopting them.

GMTom wrote:Sorry I did not see any suggestions by either Danivon or RJ. I did see a mention of possible random checks but that doesn't seem like a solution to the problem. The system awards too much too easily, it is not set up with real disability in mind as has been pointed out over and over not to mention all these other programs being abused. Cracking down on who is eligible and what actual conditions that make work IMPOSSIBLE to start with is the real answer

Indeed.

So, given it's obviously too hard for you to go back and find them yourself (let alone notice them to begin with, even though one of your posts appears in between them on the same page), here are the suggestions from RJ and myself again.

Ray Jay wrote:In response to Danivon's question on what we should do about it:

There are a few obvious things that we should do right away:

1. If the states are making decisions on disability, then they need to have skin in the game and pay some of the cost. Otherwise incentives are not properly aligned.
2. The government should hire an attorney to represent itself. Right now, the individual on disability has an attorney whereas the federal government does not. The poor judge often decides with the attorney because there isn't adequate rebuttal of the point. (Ironically, the government pays for the individual's attorney, but doesn't hire its own.) I've been in several court hearings where either side's attorney can make it seem like they are 100% correct. It's quite amazing how good some lawyers can be.
3. Once people go on disability, there should be monitoring of the program to see whether they can stay on disability.
4. I would consider turning it into a state program. I know that's something that Paul Ryan has suggested.

and..

danivon wrote:I also have a few other suggestions:

5. Evidence from a doctor to be verified by a second opinion, preferably through an independent/court appointed doctor
6. Making sure that people who are out of work and can't get it have an alternative to claiming disability
7. Different levels of disability benefits depending on the severity (not sure if this already happens or not)
8. In-work disability benefits, so that there is less of a disincentive to getting a job, and also to enable people to get to work
9. Encouragement for employers to make it easier for people with disabilities to work

danivon wrote:It seems to me that you are still labouring under the delusion that I have sought to explain away all of the increase with one theory (or as it now stands, six theories). That is not true, as I have explained (although I seem to have missed that apology for 'misreading' my post).

No, I'm laboring under your delusion: the current costs of the program are worthwhile and that the fraud effect is probably overstated. In other words, it's another fine government program.

To your points:

In 1960, when vastly more Americans were involved in physical labor of some kind, 0.65 percent of workforce participants between the ages of 18 and 64 were receiving Social Security disability-insurance payments. Fifty years later, in a much healthier America, that number has grown nearly nine-fold to 5.6 percent.

In 1960, 134 Americans were working for every officially recognized disabled worker. Five decades later that ratio fell to roughly 16 to 1.

Some defenders of the status quo say these numbers can be explained by the entry of women into the U.S. workforce, the aging of baby boomers, and the short-term spike in need that came with the recession.

No doubt those are significant factors. But not nearly so significant as to explain why the number of people on disability has been doubling every 15 years (while the average age of recipients has gone down) or why such a huge proportion of claim injuries can’t be corroborated by a doctor.

Nicholas Eberstadt of the American Enterprise Institute and the Harvard School of Public Health notes in his recent book A Nation of Takers: America’s Entitlement Epidemic that 29 percent of the 8.6 million Americans who received Social Security disability benefits at the end of 2011 cited injuries involving the “musculoskeletal system and the connective tissue.” Fifteen percent claimed “mood disorders.”

It’s almost impossible, Eberstadt writes, “for a medical professional to disprove a patient’s claim that he or she is suffering from sad feelings or back pain.” And that’s assuming a doctor wants to disprove the claim.

In an illuminating and predictably controversial exposé for This American Life, NPR’s Planet Money team tried to figure out why, since 2009, nearly 250,000 people have been applying for disability every month (while we’ve averaged only 150,000 new jobs every month).

The answers fall on both sides of the gray middle.

One factor has to do with what correspondent Chana Joffe-Walt calls the “Vast Disability Industrial Complex.” These are the sometimes shady, sometimes well-intentioned lawyers who fight to fatten the rolls of disability recipients. These lawyers get a cut of every winning claimant’s “back pay.” The more clients, the bigger the take. That’s why they run ads on TV shouting, “Disabled? Get the money you deserve!”

DF, tis you who are deluded. If I thought it was all fine and dandy, why would I propose changes?

What I have done is to question the extent of the problem, and how much of the increase is down to what you call fraud (which seems to include actual fraud, which could be very low, but also playing the system's rules for advantage), and how much is due to other factors. I do not argue that those otuer factors explain all of the increase (indeed I stated that I thought otherwise), and I am not seeking to minimise it, but to quantify it. I have no idea whether it is worth a crackdown (even though I can see ways to do one), but if you are arguing that a problem needs fixing, it would be useful from a Cost-Benefit Analysis perspective to be clearer on the true extent.

As requested before, please stop arguing against a straw man version of my position. It's no worse than when ricky twists the argument.

To your suggestions,
1. Having States pay it only moves it to another governmental agency and does little to correct the problem of too many taking advantage of the problem. Yes, it is an easy fix since the federal government can't seem to do anything well and it would then force each state to do better enforcement, I don't see this fixing anything and for me, I live in New York State, they can't do anything well either! Yeah, nobody scams New York State?
2. The government should hire an attorney, ok, that may help some but again, it doesn't really correct the problem. The attorney would need to fight a doctors recommendation, the problem seems to be it is far too easy for a doctor to suggest a person is incapable of working, not that work is difficult but rather impossible. The attorney would certainly help police the system but not correct it.
3. Monitoring program, again, it helps but is not a fix, I am not familiar with the system but I have to think something is in place like this already...not working obviously, but something has to be in place already.
4. State Program ...already stated in number 1. States already are overburdened with Federal mandates, and moving the program helps the Feds but not our tax money from being squandered.
5. Second opinion, hey! probably not a bad idea!!! But again, if it's up to a doctors "opinion" we are in a bit of trouble, something a bit more concrete needs to be in order.
6. an alternate to disability. not a fix, just another handout supported by our taxes and still getting taken advantage of.
7. Different levels, this seems to only enforce further abuse of the system. Disability is there because you can not work, not because of some sort of degree of not working, thinking further about it...if I can't work my 40 hour week, say I can work 20 hours only, do I get half disability? OK, but my employer would fire me for only working half my job! I don't see this working at all but it is a good idea any way.
8. In-work disability, seems to me no answer, still taking advantage of the system and if they can work ...why are they getting any benefits?
9. Encouragement, sounds so nice, not an answer in the least

so, I am sorry I missed those suggestions (they were several pages ago) but they simply do nothing (ok, very little) to correct the problem.

Re #2, if the government were to hire an attorney, presumably that attorney would bring in his own expert witenss doctor. That's how most trials work. Each side has their own expert witnesses in trials.

Tom, what are your suggestions?

danivon wrote:

Ray Jay wrote:In response to Danivon's question on what we should do about it:

There are a few obvious things that we should do right away:

1. If the states are making decisions on disability, then they need to have skin in the game and pay some of the cost. Otherwise incentives are not properly aligned.
2. The government should hire an attorney to represent itself. Right now, the individual on disability has an attorney whereas the federal government does not. The poor judge often decides with the attorney because there isn't adequate rebuttal of the point. (Ironically, the government pays for the individual's attorney, but doesn't hire its own.) I've been in several court hearings where either side's attorney can make it seem like they are 100% correct. It's quite amazing how good some lawyers can be.
3. Once people go on disability, there should be monitoring of the program to see whether they can stay on disability.
4. I would consider turning it into a state program. I know that's something that Paul Ryan has suggested.

1. It makes no sense to take a program run under the auspices of Social Security and had it over to the States. The program itself would have to be scrapped, new legislation written, etc. Worse: States already bend under the unfunded mandates of the Federal government. One can only imagine the lard this program would soon have.

1a/4. I would have to see Ryan's proposal, but on the face of it, this seems unworkable. On the potential positive side: it would eliminate (or at least reduce) the practice of moving people from Welfare to Disability.

2. This is the case with local disability issues and it seems reasonable that the Feds should do it too.

3. The problem is this: a bureaucracy which is charged with enforcing standards that could erase its own need to exist. In other words, if this agency did a "great" job, they would all get furloughed or fired.

and..

danivon wrote:I also have a few other suggestions:

5. Evidence from a doctor to be verified by a second opinion, preferably through an independent/court appointed doctor
6. Making sure that people who are out of work and can't get it have an alternative to claiming disability
7. Different levels of disability benefits depending on the severity (not sure if this already happens or not)
8. In-work disability benefits, so that there is less of a disincentive to getting a job, and also to enable people to get to work
9. Encouragement for employers to make it easier for people with disabilities to work

5. Over time, there is no such thing as an "independent" doctor. They will trend toward being "anti" or "pro" disability and get hired based on the trends.

6. More State-sponsored programs? Sigh.

Here's the problem: if someone has an option of something for nothing or an alternative that entails work, how many will choose work? The answer, sadly, is fewer and fewer.

7. Oh, the howling that will ensue. "It's not fair to discriminate against depression!"

8. Not sure what that means.

9. You can't get much more than the ADA, which makes it illegal to discriminate and lowers the bar so much that it can get a bit ridiculous.

Danivon,
I asked a question about the British system, and how the survey of all on disability need to be checked by a doctor and 55% didn't even try. Could you shed some light on why. My post is before DF's. Perhaps that is where you missed it.

Trials are expensive, attorneys are expensive, getting a person examined now by two doctors is expensive, this is not an answer to the problem. This would certainly help no doubt, but it is not an answer. The root of the problem is in what is or is not allowed to claim disability. We had the story that showed this one county where what was it, 1 in 4? were on disability, we then had some people here try to defend this sort of insane percentage of claims as possibly correct and those same want us to think of disability as some sort of "option". What needs to be done is to beef up the requirements, just look at the stats and you see the two skyrocketing reasons for the rise in claims is due to Back pain and mental issues ...the two that require almost no concrete "proof" one can not work. (easier said than done I know!) the social stigma of not working used to work in the governments favor, that is now gone, there is absolutely no "shame" in being on disability, being on welfare, food stamps, etc, scamming the government is also accepted to a great degree, "hey, get what you can, good for you!" is all too common, I have heard it myself (though never agreed with it).

As described the benefits for a disabled person versus an person on welfare proper aren't vastly different. $2,000 a year. The advantage seems to be immediate inclusion on Medicaid.
Is the climb in disability claims a huge contributors to government expense?

Welfare spending started out at the beginning of the 20th century at 0.2 percent of Gross Domestic Product (GDP). It was not until crisis of the Great Depression that welfare expenditures began their rise, reaching 2 percent of GDP by 1940.
During World War II, welfare expenditures declined to about one percent of GDP per year, and fluctuated between one and two percent per year, depending on the business cycle. Health care expenditure amounted to about one percent of GDP. By the early 1960s, welfare cost about two percent of GDP, and health cost about one percent of GDP.
The Great Society programs started welfare on an upward path, so that after 1980 welfare spending fluctuated between 3 and 4 percent of GDP. The joint federal-state Medicaid program, health care for the poor that began in the 1960s grew steadily, reaching one percent of GDP in the recession year of 1991. By 2005 Medicaid exceeded 2 percent and is expected to reach 3 percent of GDP by 2015. Other state and local health care expenditures cost about one percent of GDP, so that in the recession year of 2010 total expenditures on welfare, including all health care expenditures, reached over 8 percent of GDP

source: http://www.usgovernmentspending.com/welfare_spending
Since Medicaid is around 2 percent of GDP, it doesn't seem to indicate that there is an unnatural bump in welfare due to increased use of disability.
The root cause of welfare use is unemployment and poverty Period.
Disability is just a specific reason for receiving a specific set of welfare benefits.
The reason that someone might choose to specifically apply for disability? Immediate access to medicaid. The additional $2,000 a year seems like a pittance against access to health care. Especially for people who are probably not in good health, hence their claim.

all the solutions offered to reduce disability use or fraud, come with attendant costs... And as DF noted, the ability to recoup fraudulently received disability is probably not going to be a huge net benefit if it only comes at the expense of high and soon entrenched legal costs and other enforcement costs...

SImplifying how people receive medical insurance coverage, would eliminate a lot of the applications for disability. If everyone receives a minimal medical insurance without regard to anything but citizenship the chief motivation to draw disability is eliminated.
After that a sensible welfare/employment insurance system that allows people to work as much as they can ....without costing them net income when they work ...
This eliminates the situation where someone has to choose between working 40 hours a week, and getting only a few more dollars than not working. Those working should always be better off no matter how much they work. But their net income should include less assistance as they improve their income levels ....
Essentially this is a tax program ...not a welfare program. And it will also be subject to some fraud. Everything is... Although I think the IRS would have an easier time prosecuting someone for sheltering income then a lawyer would have proving a back injury was fraudulent.
Encouraging some work over no work through a system like that would eliminate a lot of the costly litigation and enforcement that doesn't work anyway.
I don't know if something like that has been effectively rolled out anywhere... But we do know that universal health insurance is far more efficiently managed than private insurance. And I'm certain that the bureaucracy that seems to evolve from a system where people need to apply and prove need .... is even less efficient.. Even conservatives here can't envision enforcement provisions that would save much in the current system...

Wow, I am beginning to see why Danivon is sick of my response of a flat tax to every problem. We come back to universal health care response to every problem from RickyP. We can't stop fraud, but we can give everyone what they are committing fraud for.

Sounds like the 2 year old (unemployed) is screaming for candy (money) that the other kids (working class) are having because they finished their dinner (have a job). So let's give everyone the dessert candy regardless.

(yes, this happened last night at my house. No, he did not get the dessert, he got the lesson instead)

...good for you!
Teach the lad a lesson the hard way, the only way!
But the funny thing is few of us would argue what you did was anything but correct, why oh why is it suddenly different when we talk about the poor (or in this case, the lazy)????

and Ricky, I honestly do not follow your logic, to me, it would seem like you are actually supporting our position.
According to your own facts posted, welfare grew from 2% in 1940 (not gonna count the incredibly low percent before that time) to over 8%. This is total "welfare" including health care. But it does not include disability that has skyrocketed the past decade or two (and what this topic had to do with), you seem to assume disability is included in this total, it is NOT (spending on the poor, not on those unable to work) this makes the total just tremendous! How can you support such a position as justifiable in the least???

rickyp wrote:As described the benefits for a disabled person versus an person on welfare proper aren't vastly different. $2,000 a year. The advantage seems to be immediate inclusion on Medicaid..

Wait. Whuh?

$2000 a year?

Is that a typo?

bbauska wrote:Danivon,
I asked a question about the British system, and how the survey of all on disability need to be checked by a doctor and 55% didn't even try. Could you shed some light on why. My post is before DF's. Perhaps that is where you missed it.

Well, that's not strictly what happened...

There is churn in the system, and ours recognises that disability may not be permanent. So there will be those whose conditions improve and don't need to maintain the claim, and so don't need to be assessed.

There are also other reasons why people come off disability benefits, for example - just as in the US - when you reach retirement age, you are no longer entitled to working-age benefit, and so your claim would lapse. So there'd be no need to be reassessed.

The figures I've seen suggest that its not 55%, but more like 35% who drop off, and it's been pretty constant (falling slightly in fact) since 2008 when we had the previous major shake up.

The assessments are apparently getting tougher than they used to, and there is a concern that Atos who are being paid by the government to carry them out are being overzealous (and less than observant) in marking people as fit for work. As a measure of this, the appeal success rate is very high (basically when there's an assessment of all medical evidence, rather than a cold interview and basic notes.

The current government are talking big about cracking down. My view is that the last government was actually starting that already, and we are seeing the results of that coming through - so I don't think it's a good idea to accelerate until we are pretty clear that the problem of the system 5 years ago are really still around.

well, Bbbauska, what is disability insurance other than a way to provide a person in poverty with medical care and a minimal income with which to feed themselves?
The article that Fate linked says

People who leave the workforce and go on disability qualify for Medicare, the government health care program that also covers the elderly. They also get disability payments from the government of about $13,000 a year. This isn't great. But if your alternative is a minimum wage job that will pay you at most $15,000 a year, and probably does not include health insurance, disability may be a better option

If people don't have the motivation of gaining Medicare, since they already have it, you've eliminated a lot of the people who choose disability primarily for medical security.
Since Universal health Care insurance is delivered in every jurisdiction in the world more efficiently than private insurance in the US, you've eliminated waste. (There are a lot of reasons the US is at 17% GDP on Health care and every one else in the world at 9 to 12% but one factor is the wasteful beareucracy of private insurance in the US)

The US already cares for people without insurance anyway. Only in the most expensive way possible. At emergency departments when their conditions are worse...
So, if you stop kidding yourselves - and provide universal insurance in a more appropriate fashion, you also improve the cost equation that way.
The United States is not going to stoop to allowing poor people to starve to death, or force them out on the curb of hospitals if they don't come with a Blue Cross card. So the question isn't how do you reduce fraud, the question is how do we deliver services efficiently and effectively.


fate

Is that a typo?

No. Someone on welfare in the US gets around $11,000 in the most generous jurisdictions. A lot less in some states..
I know you've quoted all kinds of programs and ridiculous amounts, but the real world is that few people qualify for more than basic assistance and maybe one targeted benefit... As your article states above, the federal disability Benefit is $13,000.