Further Elaboration on Social Security Disability System



In response to Christine Michaels’ recent rebuttal of my article on the dysfunctional  Social Security Disability system, I would like to add several clarifications. Firstly, I did do not believe all mental health patients are scamming the system. Certainly, there are chronically ill individuals who cannot function normally no matter the treatments they receive. Perhaps this is the population Ms. Michaels deals with exclusively. However , to suggest she has never seen people “game” the system can only indicate one of two possibilities, and I have just indicated the more benign of the two. Since my article, I have heard from physicians, nurses, social workers, and, yes, some attorneys whose feedback has been a throaty “Right on! It’s about time someone gave voice to this issue.” One nurse who worked extensively with the chronically mentally ill in the hospital setting, where patients would be expected to be most impaired, estimated that perhaps 20% of this population are truly disabled from working.  Dr. Bastiaens, in his recent Letter to the Editor in the Post-Gazette, concurs that appropriate evaluations for mental disability are not currently being done. Most responses I have received have witnessed and confirmed the unacceptable abuse of this program.     


Several of those who rebutted my views insisted that recipients of Social Security Disability are regularly reevaluated to ensure that they continue to require disability funding. Yesterday I queried (only) 3 of my patients who are on Social Security Disability. Two of them, beneficiaries for the past 4 years, looked at me quizzically, unable to even comprehend the concept of reevaluation, which they had in fact never had heard of. The third, on Social Security Disability for 20 years, was last re-evaluated 3 years ago. The Social Security Disability system is simply not assertive enough or sensitive enough to detect those many who are receiving and continue to receive this entitlement inappropriately. If they do not have the tools to carry out their mandate properly, perhaps they should not do it at all.


Thirdly, at the risk of being accused of ad hominem argumentation, I would like to note that I have encountered but four responses which were not fully pleased with my arguments. Two of these were from lawyers whose sole income stems from getting people onto Social Security Disability. The airwaves are plastered with their commercials. Indeed, it is my understanding that these attorneys receive a full 25% of the “disability” benefits awarded to their clients. Thus, the Social Security Disability system has also managed to generate and to support a secondary industry which funnels a large chunk of its monies to lawyers! A third negative response was from Christine Michaels of NAMI, who may be well intentioned, but who may not be dealing with the same populations I treat, or who may be overly identified with her clients. The fourth response, on Facebook, was from a Bipolar woman who  sounds sincerely chronically impaired and in genuine need of financial help, which I would actively support. I would like,however,  to underline that I am a physician: I have no financial or other interest in this issue other than the health of my patients, as well as the natural concern as a citizen that our public monies be monitored extremely  meticulously and spent only on which yields  value.





On another note, I would like to cite the report of two individuals who contacted me to raise related issues I had not considered. One, a psychiatric nurse, herself a former disability recipient for a medical injury, railed on about her conviction that the Social Security Disability system is invested in fostering dependence. They helped her lose her self-confidence, and she doubted her ability to ever function again.  Recognizing this, she wisely pulled herself up by her bootstraps and forced herself to return to work in order to re-develop her self-assuredness and to escape the clutches of the system. She couldn’t get away fast enough. She now works full time as a clinic director. A gentleman from Pittsburgh concurred. In relation to the effects of Social Security Disability he writes, “Most tragic is the sapping of the spirit of the individuals who trade away their personal pride and feeling of self worth-and ultimately their self-confidence. The sum of those who are weakened and corrupted is paid for in our broader culture and demonstrated most in our daily lives. What we are experiencing is a new version of the adage “power corrupts”-not by threat … but by seduction. What you have described so eloquently is not a matter of bureaucratic sloth or incompetence, but rather a considered plan by government to make people dependent on it and its politicians and bureaucrats, resulting in increased power for them...Your piece is one that should be read by a much larger audience than those who see P-G. My hope is that one of the national news services will pick it up and make it available to a national audience.”



Lastly, the focus of my arguments is primarily on the Social Security Disability system itself and only secondarily on the clients who misuse the system. If the system is flawed and open to abuse, it will naturally encourage a large population of individuals to take advantage of this "path of least resistance." While I do not believe that the Social Security Disability system is the most important problem on the list of current national priorities, I would surmise that it serves as a microcosm for many Federal programs which do not purchase “value” and which have not attended sufficiently to their unintended destructive consequences.  Witness the recent reports from Iliinois, Wisconsin, and Indiana, among other  states, that the government has overpaid fourteen billion dollars in unemployment claims to people who quit work voluntarily, those who have already returned to work, and to prisoners! American citizens, no matter which party affiliation, need to demand loudly that such spending programs be intelligently overhauled until they are buying only  that which is of “value,” or extirpated entirely from the Federal budget.




                                                                                                                                                                                                                                                                                                                        C.

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