...But disability has also become a de facto welfare program for people
without a lot of education or job skills. But 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. Fewer than 1 percent of those who were on the federal
program for disabled workers at the beginning of 2011 have returned to
the workforce since then, one economist told me.
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.
But going on disability means you will not work, you will
not get a raise, you will not get whatever meaning people get from work.
Going on disability means, assuming you rely only on those disability
payments, you will be poor for the rest of your life. That's the deal.
And it's a deal 14 million Americans have chosen for themselves.
...Part of Clinton's welfare reform plan pushed states to get people on
welfare into jobs, partly by making states pay a much larger share of
welfare costs. The incentive seemed to work; the welfare rolls shrank.
But not everyone who left welfare went to work.
A person on welfare costs a state money. That same resident on
disability doesn't cost the state a cent, because the federal government
covers the entire bill for people on disability. So states can save
money by shifting people from welfare to disability. And the Public
Consulting Group is glad to help.
PCG is a private company that states pay to comb their
welfare rolls and move as many people as possible onto disability. "What
we're offering is to work to identify those folks who have the highest
likelihood of meeting disability criteria," Pat Coakley, who runs PCG's
Social Security Advocacy Management team, told me.
The company has an office in eastern Washington state
that's basically a call center, full of headsetted women in cubicles who
make calls all day long to potentially disabled Americans, trying to
help them discover and document their disabilities:
"The high blood pressure, how long have you been taking
medications for that?" one PCG employee asked over the phone the day I
visited the company. "Can you think of anything else that's been
bothering you and disabling you and preventing you from working?"
The PCG agents help the potentially disabled fill out
the Social Security disability application over the phone. And by help, I
mean the agents actually do the filling out. When the potentially
disabled don't have the right medical documentation to prove a
disability, the agents at PCG help them get it. They call doctors'
offices; they get records faxed. If the right medical records do not
exist, PCG sets up doctors' appointments and calls applicants the day
before to remind them of those appointments.
PCG also works very, very hard to make the people who
work at the Social Security happy. Whenever the company wins a new
contract, Coakley will personally introduce himself at the local Social
Security Administration office, and see how he can make things as easy
as possible for the administrators there.
"We go through even to the point, frankly, of do you
like things to be stapled or paper-clipped?" he told me. "Paper clips
wins out a lot of times because they need to make photocopies and they
don't want to be taking staples out."
There's a reason PCG goes to all this trouble. The
company gets paid by the state every time it moves someone off of
welfare and onto disability. In recent contract negotiations with
Missouri, PCG asked for $2,300 per person. For Missouri, that's a deal
-- every time someone goes on disability, it means Missouri no longer
has to send them cash payments every month. For the nation as a whole,
it means one more person added to the disability rolls.
...In the past few decades, an entire disability-industrial complex has
emerged. It has just one goal: Push more people onto disability. And,
sometimes, it seems like the government is outmatched. This is
especially true in the legal system.
Daytime TV in many places is full of ads from lawyers
who promise to fight the government and win the disability benefits you
deserve. There are tons of YouTube videos about getting disability --
one lawyer, one webcam. The standard form is a let's-get-real chat about
how to win this thing.
There is one man who takes much of the credit for this
industry: Charles Binder. "When we started," Binder told me, "I don't
think anybody else was advertising." What's more, most people who
applied for disability were denied and never had a hearing. Binder, and
the lawyers who followed him, changed that. "I've created some of the
problems for the government because so many people appeal," Binder says.
When he started in 1979, Binder represented fewer than
50 clients. Last year, his firm represented 30,000 people. Thirty
thousand people who were denied disability appealed with the help of
Charles Binder's firm. In one year. Last year, Binder and Binder made
$68.7 million in fees for disability cases.
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