The American Association for Disability Policy Reform

— rehabilitation first —

The Case for Disability Policy Reform

Our treatment of disabled and impaired persons in the United States is much in need of reform. For its entire history, the Social Security disability program has been plagued by problems:

The cost has been high and growing rapidly. For 2018, with Medicare and Medicaid obligations included, it was about $555 billion (details). That's about $3,544 per employed person.
Applicants often spend years waiting for decisions on their applications, without income or medical care, sometimes losing their homes or dying during the wait (details).
Decision-making is unpredictable, making the program the largest and longest-running lottery in the world (details).
The program discriminates heavily against the poor (details).

The principal cause of these problems is simple: except in extreme cases, there is no reliable method for evaluating a person's motivation (effort) or claims of pain, fatigue, depression, anxiety and the other subjective factors which determine whether or not a person can work (details). The Social Security Administration's attempts to create rules for determining the presence or absence of disability have failed badly (details) and the Administration makes matters worse by doing a very poor job of collecting information on most applicants (details), misclassifying their previous occupations, and using occupational data which was unreliable when it was collected and now is 25 or more years out of date (details).

Meanwhile, we are missing some of our best opportunities to help those who are unemployed and want to return to work. Vocational rehabilitation is badly neglected, with less than 1% of what we spend for disability benefits being spent for vocational rehabilitation (details). As a result, many who are unemployed, have no marketable skills, and are threatened with homelessness and would like to return to work see no other option than to apply for disability benefits.

Surely we can do better than to submit our disabled and impaired citizens to the current disability lottery. On learning that a person is not working our first step should be to have trained individuals visit the person to determine why he or she is not working and what might be done to help him or her return to work. Once that has been done,

for those who are potentially able to work, we could provide far better assistance in returning to work (details), including good workplace accommodation (details) and
for those who are extremely disabled, we could provide far better support than we now provide (details).

For $555 billion a year, we could do much better than we are doing now. Reform is badly needed.

Special Topics

Vocational Rules and Cats and Dogs that Answer the Phone	For Physicians and Psychologists
Quality vs. QUANTITY - which almost always wins?	A Pension for Life (need it or not)
The Destruction of Evidence by the Social Security Administration	Discrimination Against the Poor
Fireworks: Padro vs. Astrue	Social Security Advisory Board Recommendations
Examinations: Almost Worthless	Overcoming Disability
Playing the Disability Lottery to WIN
Contact Us	Send Additional Information

Check this web site from time to time for corrections and additions, particularly to the Special Topics (above). We are committed to factual accuracy and making recommendations which will help both the disabled and the taxpayer. We strive for accuracy. If you see something that doesn't look right, contact us. Please report any problems and suggestions by sending us a message. We will try to respond promptly.

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Last reviewed on 2/1/2021.