BEYOND THE NUMBERS
In light of the Washington Post’s new profile of a Social Security Disability Insurance (SSDI) applicant in Lamar County, Alabama, let’s put the story in its proper context:
- The Post story highlights an atypical case: a young applicant in a county with an unusually high share of disability beneficiaries. Lamar County ranks in the top 5 percent of U.S. counties in the share of working-age residents receiving disability benefits. Its residents lag other parts of the country in terms of health outcomes, access to health care, and other risk factors, and they’re also older and less educated — making the odds of disability higher. Moreover, few younger workers, like the 39-year-old applicant featured in the Post’s story, qualify for DI. Overall, fewer than 4 in 10 applicants are ultimately awarded benefits.
Places with older, less educated, more blue-collar populations have higher disability rates. Places with higher rates — especially in the South and Appalachia — tend to have populations that are older, less educated, and more blue-collar, and to have fewer immigrants. More of their residents suffer from debilitating health problems and can no longer support themselves through work. That’s because the risk of disability rises sharply with age and falls with education level.
Local job market conditions are not a factor in deciding whether an applicant qualifies for benefits. The law requires workers to prove that they can’t earn substantial wages anywhere across the economy — regardless of whether such work exists where they live, whether a specific job vacancy exists, or whether they would be hired.
- The number of SSDI beneficiaries rose over the past two decades for reasons that are well understood and were largely foreseen, and it’s now shrinking. SSDI enrollment grew as the population grew, baby boomers aged into their peak years of disability, and more women earned SSDI coverage in case of disability by participating in the workforce and paying into Social Security. Also, Social Security’s retirement age rose, so workers who become disabled remain in SSDI for longer before switching to retirement benefits. As the demographic and economic pressures on the program have eased, the number of disabled-worker beneficiaries has fallen by 150,000 over the past two years. And the share of Americans receiving SSDI is expected to remain flat over the next 20 years.
Places like Lamar County, Alabama face dire problems — but high rates of disability receipt are a result of those problems, not the cause. Many rural communities have been hollowed out as younger, healthier, and better-educated residents leave for greater opportunities and the remaining population ages faster than the rest of the country. Residents often struggle to access the health care they need to stay healthy enough to work — particularly in states like Alabama, which did not adopt the Affordable Care Act’s Medicaid expansion.
These struggling rural communities deserve more attention from policymakers. But disability benefits provide residents of these communities — and others across the country who can no longer support themselves through work due to severe impairments — with badly needed support.