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Notes -
Copying over a post from the ssc subreddit because I found it interesting. (Hope this is allowed.)
In the mid 2010s there was a crisis around social security disability. Things were so dire that estimates placed the DI reserves to run out by 2016.
And yet as we know, this didn't happen. Part of it was thanks to the Bipartisan Budget Act of 2015, which temporarily reallocated payroll tax revenues from the OAS fund to the DI trust fund but that was temporary and ran out in 2022. And as far as I can tell (and as far as my double checks with the chatbots can find), it wasn't extended.
And now with the upcoming social security crisis the DI reserves are the only part to not be facing any expected issues.
Another piece of the disability crisis, 14 million people were on disability in 2013 and the number was expected to keep rising and rising. And yet it didn't happen, the trend reversed and as of 2024, only around 7 million are on disability It was halved! Substantial drop! We're back to levels from two decades ago.
Why? How did things change so radically so fast?
Covid. I don't know how much of an impact Covid had, but it was disproportionately impacting the disabled both directly and indirectly (by using up hospital resources) and that likely lead to some deaths but it doesn't seem to be that much, we were already trending downwards before the pandemic. [Edit: See edit below, it's quite possible that Covid had a greater impact than I thought]
The social security admin changed up their policies a bit and got more pressure on appeal judges to make denials. This had an impact, but the changes to denial rates don't seem to be that drastic to explain a 50% drop. And since then that small trend downwards has actually reversed too, the overall final award rate of 2024 applications seems to be higher than the mid 2010s average.
I don't think those are the main reasons why it changed.
What do I propose was the main reason? The economy got stronger and the disabled got older.
You can see for yourself how disability applications correspond pretty heavily with the unemployment rate.
Unemployment has a selection bias, it mostly impacts the older, sicker and less educated. Those are people who in a good economy with low unemployment might be able to get jobs, but in a weaker economy they are too old and disabled to find something compared to their healthier younger peers.
You can see a huge surge in disability applications around the time of the great recession. These people were largely in their late 50s and early 60s, too young for early retirement but too old in the recession environment to compete well.
An NPR article from the time reveals this in an example of [in 2009] 56 year old Scott Birdsall and what an employee at a retraining center told him after a local mill closed down and the aging workers were left finding other jobs
A 56 year old in 2009 is what age in 2024? 71. They are past retirement age, and would have transitioned off of disability and onto normal retirement pay.
This is what I think solved a significant portion of the disability crisis. Overall disability in the late aughts and early 2010s was being used as a makeshift early retirement program for uneducated middle aged and senior workers who didn't yet quality for their benefits, but were functionally unemployable already in the post recession economy.
And while I came up with this idea for myself, during research I stumbled onto an analysis that suggests the same thing. Their analysis ended at 2019, where there was still roughly 9.8 million on the rolls, and found that about half the explanation is the business cycle/aging and half is ALJ retraining. The trend from 2019-2024 is likely explained in a similar way, and given the increased final award rates we've tended back towards, this is likely explained even more heavily by the aging explanation.
There are some factors that help support this explanation more. SSDI in general tends to go to older, poorer, more rural and sicker (at least given death rates are 2-6x higher than peers) individuals.
While this does not explain why the 2010s surge itself happened since those factors are relatively stable, it does explain why the surge was so temporary.
This also leads to an interesting question, what happens in the next period of high unemployment? How do we plan to address mass AI based layoffs if they occur?
Many people may be able to find a new job, but many won't and we will likely be facing a new disability crisis if it is forced to served as a early retirement program again.
Edit:
Thinking about it, one weirdness here is Covid unemployment which didn't seem to increase disability rates and in fact the trend downwards continued despite that. But we did see a huge surge in early retirement with about 2.6 million excess retirees. So maybe something changed in how early retirement works since? Or maybe Covid era unemployment mostly impacted younger healthier people or the jobs market for furloughed workers wasn't as bad. Or heck, maybe it's just coincidence that the downward trend was already happening and Covid really did have a major impact on the total number of beneficiaries.
My guess would be in the recovery, Covid unemployment surged higher but recovered really fast so we probably just didn't see as many Scott Birdsall situations.
Back to my thoughts, I'm extremely skeptical that the disability numbers could halve over such a relatively short period without some sort of accounting trickery. I could definitely see Covid having an impact, especially since the vast majority are older people. But the drop in numbers is just too great for me to take them at face value.
We've seen it before with disability, social security, etc, but often times the medicalized benefits system will just shuffle large amounts of people from one category to another once political pressure comes to bear on a label like "disability."
This also reminds me of the old post by Alone on how SSI is basically medicalizing political problems - can't seem to find it but if anyone knows what I'm talking about and has the link that would be great.
Just to get the convo started... wow. I'm reading this NPR article on disability and this is a direct quote:
Ok great, so disability is basically just handouts for people who didn't have the intelligence or wherewhithal to complete college. Got it.
On the one hand I don't think it's necessarily a bad idea to help low IQ folks or those who made poor life choices to some degree - but lets at least make it clear. Hiding it behind this medical idea that they are unable to work is wrong.
Didn’t complete college and can’t do manual labor. Unless the good doctor is rubber-stamping disability for healthy young farm boys?
What work are they able to do?
There's an entire list of unskilled sedentary jobs as they appear in the Dictionary of Occupational Titles that "exist in significant numbers in the national economy". As long as someone is able to do one of these jobs, they aren't disabled (assuming they're under 50 and thus can be expected to adjust to new work). Most of these are obscure specialized jobs that involve some kind of industrial assembly that con be done entirely sitting down. An example:
The relevant symbols below are that the strength is listed as sedentary, defined as:
And the Specific Vocational Preparation is 2, meaning that for the specific job, the typical worker would be able to achieve an average level of proficiency in less than 1 month. There are a ton of jobs like this you've never heard of, though whether or not they are actually realistic options for the claimant is irrelevant. From what I recall, the law specifically states that it doesn't matter whether such a job is actually available or whether they'd actually be able to get the job if it were available. A lot of people think this is ridiculous, but it underscores the point that disability is for people who physically can't work at any job they are qualified to do, not for people who physically can't work available jobs that they have a chance of actually getting. Saying "but there aren't any jobs as a label pinker" is basically saying that the reason you don't have a job is because you can't find one, not because you can't do one.
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What about babysitting? Or cleaning people's houses?
I'm also of the opinion that most of these issues are psychosomatic, so I will admit I'm a bit biased here. Not that psychosomatic disorders don't need care and compassion, but I'm skeptical that they actually cannot ever work again.
The exact jobs I've seen arguments about on here that are too low-skill and 'anyone can do them' to charge high wages so the cost of childcare is scandalous compared to the labour done.
You can't have it both ways: either that kind of labour is a job and is paid accordingly (not sky high but enough), or it's paid peanuts because "my sixteen year old niece will mind my two kids after school" and thus isn't going to support an adult (let alone one with a family).
And yeah, even for babysitting/childminding, you do need to be able to lift and bend and carry, and it's a job where you can put out your back over time.
Suggesting that disabled coal miners go into childcare might be on par with that Ben Shapiro bit about selling houses.
Well now we need to encourage more men into the industry as it's pretty much female-dominated, do you have something against equality or what? 😁
I’m ready for the Pacifier sequel where Vin Diesel takes on his toughest parenting challenge yet: the opioid epidemic.
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What could possibly go wrong?
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Ahh yes. Cleaning - such a gentle load on a person's back.
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How did you form that opinion, and how confident are you in it?
It's a bit personal, but I am quite confident in it. Read this article on Sarno if you're curious to start going down the chronic pain rabbit hole.
Which of his falsifiable claims hasn't been disproven?
Most of the claims of the mechanisms are likely not spot on I'll admit, but the 'psychological' effect is absolutely real. Make of that what you will.
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My wife also had a chronic health issue for a few years before she stumbled on Sarno and it went away in 2 months by doing (basically) nothing.
Mentioned this to other friends as well and those that "tried it" had similar success stories (tiny sample but still).
So I think this is vastly underestimated. I tried starting a conversation years ago on a comment post on Scott's blog but nothing came of it iirc.
Yeah the typical rationalist mind is allergic to this sort of thing. It's a shame.
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Totally willing to believe most people claiming ‘chronic pain’ are faking it for either 1) a medical marijuana scrip or 2) a disability diagnosis. That doesn’t mean they’re in good health/can take jobs with any arbitrary physical demands.
At the end of the day, blue collar laborers in their fifties are not going to be able to do much if they lose their jobs. Fake disabilities reflect the underlying reality that these people cant adjust to a new set of physical demands.
I think the point is not that they fake it but that they meme themselves into being retarded. The pain is real, the cause is not. Or something like this is the saying.
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@hydroacetylene
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(I legitimately don’t remember who’s a parent or not, don’t get offended) uhh, have you ever watched a toddler? There’s some picking kids up(that may not want to be) involved, and running after them and the like. And cleaning houses is similar- lots of bending over, moving things out of the way. Neither one is conducive to poor-health based physical unfitness, although they don’t need a power lifter.
How dare you??? I have 11 youngins you whippersnapper!!!
Nah, don't have kids yet. I am largely unsympathetic to people with chronic health issues as I've said elsewhere. I'll tag you.
Look, I do a sedentary office job as administrative support. The heaviest things I carry are a bunch of files. I use my hands and arms for typing.
And I had a upper spinal disc problem (yes it showed up on x-ray so no I wasn't imagining or pretending) that meant I had terrible pain that started in my neck, gradually went down my arm, and ended up at the knuckles every single day and night for a prolonged period of time. It genuinely felt like my arm was on fire and I couldn't sleep because of the pain. My doctor didn't put me on painkillers (no idea why, unless it was 'don't want to facilitate addiction') so I was dosing myself up with over-the-counter analgesics (I sincerely believe I may have borked my liver the amounts I was taking for relief, plus I managed through other means to source tablets containing codeine which did permit me to sleep by reducing the pain to a dull roar) and I genuinely feared I wouldn't be able to work, because the pain made it impossible to use my hands.
Fortunately, the trapped nerve or whatever eventually untrapped itself or died or something so the pain stopped.
And that was just for a damn "sit at a desk and type emails etc." job. Imagine if I was doing anything even a bit more labour-intensive requiring dexterity or strength.
So just wait until you get old enough, or over-exert yourself enough, to run into a chronic health issue then come back with the same opinion.
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Sure. If they can do those things, then they’re less disabled. How do you get from there to “handouts for people who didn’t have the intelligence or wherewithal”?
Imagine a more extreme case where a guy loses his legs and, thus, his lifelong job at the widget-stomping factory. If he gets disability, it’s not because he couldn’t make it in college.
Now say a doctor asks him, “hey, do you have any skills that could get you a different job? One that doesn’t require jumping up and down?” Here a college degree would be a mitigating factor for his existing, factual disability. The handout was never for failing college. It was for not having legs.
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Cashier. Delivery driver. Maybe a waiter, probably the guy in the aisle at Home Depot.
These are not ‘good jobs’ but they do pay better than disability.
I figured those were ruled out by the “back problem.”
I agree that, if they are doable, someone might well prefer them to scraping by on disability.
What I don’t get is where “IQ and wherewithal” come into it. Either the guy is able to do jobs or he’s disabled. A college degree adds some set of jobs, so it can take him out of the disabled category, but not put him in.
Cashiers and DoorDash drivers don’t do much heavy lifting, at least. Waiters it varies. The guy in the aisle at Home Depot doesn’t need to lift stuff but needs to be on his feet all day.
Plus if you genuinely have a bad back, standing on your feet all day can put strain on it which causes pain.
If anyone has ever put their back out by lifting something too heavy or the wrong way, you soon find out how every little action somehow involves the muscles of the lower back so that even trying to get out of bed is a production.
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More importantly, they provide actual economic value and give the employee the dignity and a forcing function to get out of bed, have a routine, socialize, et cetera. Work is good for us. Most people on disability, from what I've seen, end up mostly rotting away via endless entertainment.
What have you seen, and how confident are you that it is representative of the broader phenomena it purportedly represents?
I'm not that confident! I also believe from my own personal experiences with chronic pain though, that taking disability is not a good way out for the majority.
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