Saturday, April 6, 2013

Taking Down the Take Down – Facts Matter in Disability Discussion

We recently addressed the sensationalism and mischaracterizations offered by This American Life from WBEZ in their March 2013 broadcast Trends with Benefits.  Along with Media Matters, many individuals and groups who actually understand the disability program have steadily debunked the show’s assertions. To wit, Kathy Ruffing who has countered virtually every incorrect assertion the show so cavalierly alleged.  

Now, eight former SSA Commissioners have offered a take down. We could not agree more. And the entire statement is provided below. We would only offer a qualification and an additional note to the chorus. When the commissioners speak of the 17 percent of disabled who tried to work in 2007 with earnings generally very low (two-thirds of those who worked in 2007 earned less than $5,000 for the whole year) and mention only a small amount managed to earn enough to be self-sufficient to leave the DI and SSI programs;  a clarification is necessary.

We note that often simply returning to work  frequently removes or jeopardizes the benefits. TAL legitimately asked these questions at the end of their drama fest. Had they explored the need for real return to work protection and incentives, the show might have been relevant.  At present, if a beneficiary or recipient reports work - as they are required to do, it can begin a process of removal from benefits (often incorrectly, as SSA underpaid millions in 2012 alone). This is not due to the agency’s ire, although the front line workers must be weary at this point. There are many factors - a hiring freeze for SSA employees as workloads increase, staffing shortage etc.

Finally an additional note to the chorus.  When a show like This American Life attacks the program, perceptions can change the discussion.  For example, Ronald Regan as president changed the term “earned entitlements “to” entitlements” when addressing a gathering of business executives. That false moniker has held,  in relation to the majority of SSA benefits. After all, the very words entitlement and welfare appear in the constitution. Yet these facts did not make into the "6 months of research" TAL devoted to the take down job they attempted. All credit to the past Commissioners whose consensus takes down the take down TAL misguidedly attempted. Words matter and careless incorrect rhetoric has been countered in the past two weeks. We are all disabled eventually. Timing may change one's perspective. So too sloppy journalism. We applaud the response by these commissioners and others who have responded, standing up for the truth and for the most severely impaired amongst us, the disabled.

 April 4, 2013 
     As former Commissioners of the Social Security Administration (SSA), we write to express our significant concerns regarding a series recently aired on This American Life, All Things Considered, and National Public Radio stations across the U.S. ("Unfit for Work: The Startling Rise of Disability in America"). Our nation’s Social Security system serves as a vital lifeline for millions of individuals with severe disabilities. We feel compelled to share our unique insight into the Social Security system because we know firsthand the dangers of mischaracterizing the disability programs via sensational,anecdote-based media accounts, leaving vulnerable beneficiaries to pick up the pieces.           
     Approximately 1 in 5 of our fellow Americans live with disabilities, but only those with the most significant disabilities qualify for disability benefits under Title II and Title XVI of the Social Security Act. Title II Old Age, Survivors, and Disability Insurance (DI) benefits and Title XVI Supplemental Security Income (SSI) benefits provide critical support to millions of Americans with the most severe disabilities, as well as their dependents and survivors. Disabled beneficiaries often report multiple impairments, and many have such poor health that they are terminally ill: about 1 in 5 male DI beneficiaries and 1 in 7 female DI beneficiaries die within 5 years of receiving benefits. Despite their impairments, many beneficiaries at tempt work using the work incentives under the Social Security Act, and some do work part-time. For example, research by Mathematica and SSA finds that about 17 percent of beneficiaries worked in 2007. However,their earnings are generally very low (two-thirds of those who worked in 2007 earned less than $5,000 for the whole year), and only a small share are able to earn enough to be self-sufficient and leave the DI and SSI programs each year. Without Social Security or SSI, the alternatives for many beneficiaries are simply unthinkable. 
     The statutory standard for approval is very strict, and was made even more so in 1996. To implement this strict standard, Social Security Administration (SSA) regulations, policies, and procedures require extensive documentation and medical evidence at all levels of the application process. Less than one-third of initial DI and SSI applications are approved, and only about 40 percent of adult DI and SSI applicants receive benefits even after all levels of appeal. As with adults, most children who apply are denied SSI, and only the most severely impaired qualify for benefits. 
     Managing the eligibility process for the disability system is a challenging task, and errors will always occur in any system of this size.But the SSA makes every effort to pay benefits to the right person in the right amount at the right time. When an individual applies for one of SSA’s disability programs, the agency has extensive systems in place to ensure accurate decisions, and the agency is home to many dedicated public servants who take their ongoing responsibility of the proper stewardship of the programs very seriously. Program integrity is critically important and adequate funds must be available to make continued progress in quality assurance and monitoring. In the face of annual appropriations that were far below what the President requested in Fiscal Year 2011 and Fiscal Year 2012, the agency has still continued to implement many new system improvements that protect taxpayers and live up to Americans’ commitment to protect the most vulnerable in our society. 
     It is true that DI has grown significantly in the past 30 years.The growth that we’ve seen was predicted by actuaries as early as 1994 and is mostly the result of two factors: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 DI based on their own prior contributions. The increase in the number of children receiving SSI benefits in the past decade is similarly explained by larger economic factors, namely the increase in the number of poor and low-income children. More than 1 in 5 U.S. children live in poverty today and some 44 percent live in low-income households. Since SSI is a means-tested program, more poor and low-income children mean more children with disabilities are financially eligible for benefits. Importantly, the share of low-income children who receive SSI benefits has remained constant at less than four percent. 
     Yet, the series aired on NPR sensationalizes this growth, as well as 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  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. We are deeply concerned that the series “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. We fear that listeners may come away with an incorrect impression of the program — as opposed to an understanding of the program actually based on facts. 
     As former Commissioners of the agency, we could not sit on the sidelines and witness this one perspective on the disability programs threaten to pull the rug out from under millions of people with severe disabilities. Drastic changes to these programs would lead to drastic consequences for some of America's most vulnerable people. With the lives of so many vulnerable people at stake, it is vital that future reporting on the DI and SSI programs look at all parts of this important issue and take a balanced, careful look at how to preserve and strengthen these vital parts of our nation’s Social Security system. 

Kenneth S. Apfel 
Michael J. Astrue 
Jo Anne B. Barnhart 
Shirley S. Chater 
Herbert R. Doggette 
Louis D. Enoff 
Larry G. Massanari 
Lawrence H. Thompson

Wednesday, April 3, 2013

Drama vs. Moral Perspective - Response to This American Life's Report on SSA Disability

On March 23, 2013,   This American Life broadcast a show about the disabled. It was an unfortunate endeavor, full of errors and did little to examine the program. The focus was more sensationalism and less responsible reporting. We offered the following response to the reporter and producer. Comments to This American Life may be sent to

Our comments are included below. We received a response thanking us for taking the time to write in and expressing sorrow that we were disappointed with the show.

Dear Ms. Joffe-Walt and Mr. Glass, 

As a long time listener and admirer of This American Life, I was extremely disappointed with your recent show, Trends with Benefits.  Having worked for SSA 23 years and then starting a solo practice as a claimant representative for disability clients for an additional 9 years, I have been on both sides of the program. I participated in President Clinton's Welfare reform, by contributing in policy groups. As a claimant representative, I have represented clients in 35 states at initial levels and through Administrate Law Judge hearings and Appeals council reviews. Like the overwhelming numbers of fellow representatives, I have never “sued” the government and found your treatment a sensational approach, from the outset title to the, hey wanna know a secret? introduction.  Equally puzzling that Ms. Chana Joffe-Walt spent 6 months “researching” the problem without mentioning such basics as the payroll contributions workers make (i.e., pay) for SSDI  disability insurance should they encounter a disability in addition to the SSI program. Since Congress holds hearings on disability, virtually monthly, real research would have disclosed the whole program is under constant scrutiny. People get cancer, develop Alzheimer’s, break ankles, and yes rupture multiple discs in their backs after toiling 30 years in construction jobs. Hardly the common back pain you inferred. I won’t even go into Ms. Joffe-Walt’s   query about what jobs remain for people “without hands.”

Rather than a balanced review, which is long overdue and would have been the high ground, the show focused on outliers -a small town in remote area, or a singing representatives or advocates who make millions of dollars. Advocate fees by the way are overwhelmingly paid for by the disabled individual - not “by the government” – and are limited to 25 percent of back due benefits with a limit of $6000, only if they win the case.  Nor was the fact that representatives pay “user fees” that is the right to have SSA send their fees directly if they obtain benefits for claimants. Most representatives do not sing jingles or wear cowboy hats. In addition, advocates are encouraged to include pro bono work. In my small firm, during the last 10 years I have maintained at least 10  percent pro bono case load because  disability includes everyone from chronic schizophrenics without housing  to CEOs who  paralyzed from a stroke, spend down their savings, lose their homes and have a great deal of difficulty finding help when they apply for benefits. In fact, the majority of people who lose homes do so after working and becoming disabled, thus unable to pay their mortgage and then ending up on the street with health declining. 

Fraud in SSA (one of the largest programs in the world) has always been comparatively low and has been studied excessively for the last 30 plus years. Additionally while SSA does make over payments, they also underpaid millions of dollars of benefits in 2012 alone .  This is due in part to the fact that the agency has had a diminished budget, is losing employees, and faced with increased workloads. How is that for a lead story? These are only a few of the observations I would offer.

Media Matters within a day of your broadcast came out with additional accurate, reality based factual retorts to the glossy statistic speed sheets that you both gasped about on the air.  Now you have backtracked on your Planet Monday site with multiple corrections. Then, on March 29, 2013, Ms. Joffe-Walt back tracked on NPR and leaned into advocacy and away from her sensationalism. A less than altruistic shift, but a start. Since the show prides itself on the accuracy of your reporting and in this show the charming love of numbers; perhaps you can spend another 6 months and contribute to reporting real answers to valid questions.

A hard look at the program could clearly improve efforts to get people back to work. However, most individuals who are eventually allowed and draw their 13 K a year are so ill they either die or cling to the meager existence left.  Of course, some disabled individuals could return to work, but that takes programs and the willingness to provide real rehabilitation with support as the beneficiary tries to return to work. That also means money from taxpayers and more programs. Having done this for 32 years, I can safely say most who come to me have done everything they can to keep the dignity that comes from working. 

Your question about what we do with this economy and those who are disabled is an important one. Too important for a skewed perspective composed in large part of  blatant  and erroneous exceptions (mom keeps kid home to “pull” 700 dollars, doctor who “makes” the disability decision )- omitting the DDSs – state agency examiners who make decisions and the extremely complex medical  and vocational criteria required to review claims and appeals, the Administrative Law Judges who make decisions, SSA’s oversight of attorneys and non-attorneys who are required to complete comprehensive testing and continuing education if they wish to practice and review direct pay etc. etc. Reporting on the disabled may increase your ratings at the expense of the most vulnerable amongst us. Indeed, WSJ and FOX diatribes about the “dramatic” growth of free loaders – inaccurate publicity, have decreased allowance rates in the last two years. One would hope the quality of TAL could accurately and substantively engage the reality that in hard times the weakest are easy to attack. They should be more than fodder for a sensational scoop.  This vast and complicated program should have the public interest. But without working for facts, you are just another drive by op- ed. The disabled and those involved in their lives deserve more. FDR’s vision for protecting the disabled remains as does the integrity of his advocacy echoed by Hubert Humphrey. Mr. Humphrey stated that the moral test of government is how that government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; and those who are in the shadows of life, the sick, the needy, and the handicapped. If This American Life wishes to report on the disabled, I respectfully suggest you keep such moral perspective and an accurate grasp of real facts in mind when you break your next dramatic story.