Rural communities have strongest reliance on disability benefits
WARSAW, Mo. -- Around this rural county seat 100 miles southeast of Kansas City, 1 out of every 8 people of working age is home collecting disability checks from the Social Security Administration.
That compares to about 1 in 20 for the Kansas City area - which may sound low, but it’s climbing here, too.
Everywhere, Americans below retirement age are surviving on Social Security disability benefits and, with baby boomers aging in a slow economy, applications are exploding. Each year since the onset of the recession, more than 400,000 have been joining the system’s disability rolls, where they collect a monthly average of about $1,000.
But where are they most apt to collect it? A recent tabulation of data nationwide reveals the highest concentrations of communities subsisting on disability benefits, per capita, to be in historically poor, rural settings.
They’re often places where two-lane highways wind around wooded hills, where mining or manual farm labor once put food on the table, and access to medical care has long been limited.
Poverty begets bad health and greater rates of disability, experts say, and disabilities often lead to deeper poverty.
In Benton County, Mo., where city folk enjoy camping and shopping for antiques around Truman Lake, Becky Noland, 32, lives on little more than the $716 monthly allotment that Social Security provides. Both of her parents collect disability, and a fiancé is trying to after three back operations plus a stroke that weakened his right side.
Noland said she knows people who game the system. One bought a motorcycle with disability benefits awarded on a claim of being legally blind, she said.
“That makes me angry,” Noland said from her wheelchair. Muscular dystrophy has withered her legs and curled her fingers.
The maladies afflicting some of her countryside neighbors are far less visible - back pain, mood disorders, heart issues, the whole range of physical and emotional side effects from serving in Vietnam or the more recent theaters of war.
Not all of this region’s disabled grew up here. Many moved in from the cities because life is more affordable in a mobile home outside Warsaw or at an RV park lakeside.
In four contiguous west-central Missouri counties - Benton, Hickory, St. Clair and Morgan - the unemployment rate ranges between 9 percent and 12 percent. Add to those jobless rolls the 10 percent to 13 percent of residents between ages 15 and 64 collecting Social Security disability checks.
That’s according to an analysis of 2009 data by Mississippi State University researcher Roberto Gallardo and the nonprofit Center for Rural Strategies.
The per-capita rates of disability beneficiaries were higher yet in the Missouri Bootheel and rural parts of Alabama, Arkansas and the Appalachians. The website Daily Yonder reported that Buchanan County, Va., led the nation with 27 percent of working-age people on federal disability benefits in 2009.
The national average for working age but disabled?
It’s calculated at 4.6 percent, up from about 2.5 percent of the nonelderly adult population in the mid-1980s.
“You find higher rates in counties historically reliant on extraction industries - mining, agriculture, forestry,” said Tim Marema of the Center for Rural Strategies.
Where the mining has vanished, as in parts of west-central Missouri, generations of workers have been afflicted by struggling economies, low-paying jobs, poor access to health care and long, hilly drives to the nearest hospital.
Other experts say an array of factors - including the erratic, subjective system for determining who gets benefits and why - might figure into one community’s high reliance on disability income versus another’s low reliance.
In several rural and economically stressed counties in the Kansas outback, for example, the share of beneficiaries was calculated to be well below the national norm.
• • •
The trends in all corners of the country are rising, creating a backlog of disability claims and appeals that can take years to run their course.
While the political rhetoric this election year focuses on the retirement side of Social Security, many experts warn of even grimmer prospects for the side that funds disability benefits of younger Americans.
Analysts say that “out of control” growth in the disability rolls is creating a clogged system where undeserving but determined applicants win benefits, while many deserving applicants lose patience and opt to suffer without.
A white paper last month out of the National Bureau of Economic Research attributed much of the “unsustainable rise” in disability rolls to a swelling number of claims awarded for mental disorders and pain. Such conditions - difficult to diagnose and hard to assess their effects on work - are cited in more than half of the claims awarded.
Cancer and heart disease - the most common diagnoses a generation ago - now comprise only 20 percent of claims.
The number of disability beneficiaries has quadrupled since the early 1970s.
One cause for that is the improved health of Americans. Medical advancements have helped beneficiaries live much longer than they did when Congress drafted the program in the 1950s.
The economy factors in, too. During the boom years of 1996 through 1999, the disability rolls climbed by less than 500,000; they grew by 1.4 million between 2007 and 2010.
Most initial claims - roughly 7 out of 10 in Kansas and Missouri - are denied. But when cases go to the Social Security administrative law judges who review appeals, the chances of success vary wildly, depending on the judge.
From state to state, “the inconsistencies are amazing,” said Alan L. Cowles of Lawrence, a physician and former Social Security consultant who assists claimants in need of benefits.
A 20-year-old U.S. worker today has a 30 percent chance of becoming disabled before reaching full retirement, the NBER report said. The Social Security Administration last year paid monthly benefits to about 10 million disabled workers, dependent spouses and children.
Still, obtaining disability benefits usually is not an easy, nor lucrative, process.
Appeals can drag on for many months - many years if a case is taken to federal court - during which an applicant cannot (or should not) be gainfully employed.
While acknowledging that “disability by nature is a very subjective concept,” the chief actuary for the Social Security Administration, Steve Goss, told Congress in December that the agency “meets this challenge effectively and efficiently.”
Timothy Harlan, a Missouri lawyer who represents applicants statewide said the typical applicant of the last few years was in ill shape to work in better times, but did so because the jobs were there.
“Nobody wants to be disabled,” he said. “It’s embarrassing for them to come in and apply.”
Then unemployment hit, doctor appointments and prescriptions were skipped, and hopes of landing work languished - especially if an applicant lacked a high school degree, Harlan said.
In regions where disability benefits are most common, “one issue is going to be education,” he said. “If the general education level is lower, it’s easier to meet disability requirements…”
Also, “we find a lot of people who wouldn’t be disabled except for the fact they couldn’t get medical care … In a place that lacks public transportation, it’s harder to see the doctor” or to commute to a job that suits the disabled, he said.
Benton County reflects the perfect storm.
• • •
A 2011 survey by the West Central Missouri Community Action Agency, which serves the needy in Benton and eight other counties, cited more than 30,000 residents, or 16 percent of the regional population, without health insurance.
Benton County - population 19,000, with more than 1,300 qualifying for the disability benefits - had the area’s lowest high-school graduation rate, 81 percent. Average hourly wage in the region, at $12.47, is almost $7 below the statewide average.
For most residents, the nearest hospital is in Sedalia, and many military veterans drive two hours to VA hospitals in Kansas City or Columbia.
Unlike many rural counties, Benton County’s population has grown by 10 percent since 2000, as retirees moved in to enjoy the recreational amenities of Truman Lake.
But the lake also draws younger people on disability benefits; some can live in a motor-home resort for $70 a month.
Noland and her fiancé, John Hale, share a home in a Lincoln, Mo., trailer park.
The acronym OATS - or Older Adults Transportation System - marks the wheelchair-accessible van that transports Noland to a Warsaw clinic and back. But it is serving many younger adults, “all shapes and sizes, too,” said driver Shirlane Foster.
“Monday I was in Warrensburg. Tuesday, in Bolivar. Wednesday, Columbia. Today, here,” Foster said. “They be-bop us around, baby.”
Noland’s muscular dystrophy qualified her for benefits from her father’s Social Security insurance when she was a young teen. She earns a few bucks here and there selling Avon products. Hale, 38, tinkers in Web design.
He said back pain and limited movement in one arm keep him out of the cooking jobs he once held. But years of appeals to receive Social Security benefits have been unsuccessful.
“I know this guy in St. Joe who qualified in his late 20s, but he’ll still lift car engines, replace a transmission, work on his house,” Hale said. “People like that make it harder for people like me to get Social Security.”
Among the non-beneficiaries around Benton County, it’s a common observation.
“There are more people on disability here than I’ve ever seen,” said William McKinney, who installs satellite TV systems and moves furniture. “I grew up in Independence, lived in Butler, spent time in Oklahoma, in Springfield. Nothing like here…
“I think some of them are disabled just enough to be labeled that way so they feel they don’t have to work.”
Chris Stewart of the Katy Trail Community Health Centers disagreed: “I don’t think that’s anywhere near the norm.”
She attributed the region’s high reliance on disability benefits to factors linked to poor general health: Poverty, low graduation rates, geographic isolation and higher than normal levels of drug and alcohol abuse.
As for assessing their patients’ ability to work, Katy Trail physicians don’t get involved, Stewart said:
“They’ve said it puts them in a difficult situation in terms of advocacy or non-advocacy … We provide medical records and let others make that decision,” meaning the medical advisers and administrative judges employed by the Social Security Administration.
Local health practitioners and social-service groups note that abusers of government programs lurk wherever benefits are offered - and that’s all over the country.
At any given time, state vocational rehabilitation services are assisting about 100 clients in Benton County who want to keep or return to their jobs, said Karri Wilson of the Missouri Division of Vocational Rehabilitation in Sedalia.
“We would be happy to see more clients, but some of them simply can’t work … or don’t realize we’re here to help. People just need to persevere and seek out the resources,” she said.
Toward the goal of better medical access, the Benton County Health Care Coalition recently broke ground in Warsaw for Harbor Village, which will place a medical clinic, mental-health services and a senior social center on one site.
“The good news is this area is addressing these issues and not pushing them under the carpet,” said Irv Jensen of the Benton County Development Corp.
Air Force veteran Nick Moorer, who was exposed to Agent Orange in Vietnam, has done OK working his own plan to receive the disability money he argues he’s owed.
The Warsaw man left truck driving in 1995 and was deemed eligible for Social Security benefits in just a few weeks.
But the VA, which also offers disability benefits, was slow to recognize that in addition to back pain linked to surgery while he was serving, Moorer has since suffered from diabetes, a couple of heart attacks and a severe, purplish swelling of his right calf - all conditions the military lists as potential side effects of Agent Orange exposure.
“I didn’t say, ‘Hey, VA, you need to consider these other conditions.’ They were already on their list,” Moorer said.
Only last year did the VA relent to Moorer’s petitioning, bringing the sum of his benefits past $5,000 a month.
“I’ve learned over time if you don’t apply, you don’t get anything,” he said.
source
That compares to about 1 in 20 for the Kansas City area - which may sound low, but it’s climbing here, too.
Everywhere, Americans below retirement age are surviving on Social Security disability benefits and, with baby boomers aging in a slow economy, applications are exploding. Each year since the onset of the recession, more than 400,000 have been joining the system’s disability rolls, where they collect a monthly average of about $1,000.
But where are they most apt to collect it? A recent tabulation of data nationwide reveals the highest concentrations of communities subsisting on disability benefits, per capita, to be in historically poor, rural settings.
They’re often places where two-lane highways wind around wooded hills, where mining or manual farm labor once put food on the table, and access to medical care has long been limited.
Poverty begets bad health and greater rates of disability, experts say, and disabilities often lead to deeper poverty.
In Benton County, Mo., where city folk enjoy camping and shopping for antiques around Truman Lake, Becky Noland, 32, lives on little more than the $716 monthly allotment that Social Security provides. Both of her parents collect disability, and a fiancé is trying to after three back operations plus a stroke that weakened his right side.
Noland said she knows people who game the system. One bought a motorcycle with disability benefits awarded on a claim of being legally blind, she said.
“That makes me angry,” Noland said from her wheelchair. Muscular dystrophy has withered her legs and curled her fingers.
The maladies afflicting some of her countryside neighbors are far less visible - back pain, mood disorders, heart issues, the whole range of physical and emotional side effects from serving in Vietnam or the more recent theaters of war.
Not all of this region’s disabled grew up here. Many moved in from the cities because life is more affordable in a mobile home outside Warsaw or at an RV park lakeside.
In four contiguous west-central Missouri counties - Benton, Hickory, St. Clair and Morgan - the unemployment rate ranges between 9 percent and 12 percent. Add to those jobless rolls the 10 percent to 13 percent of residents between ages 15 and 64 collecting Social Security disability checks.
That’s according to an analysis of 2009 data by Mississippi State University researcher Roberto Gallardo and the nonprofit Center for Rural Strategies.
The per-capita rates of disability beneficiaries were higher yet in the Missouri Bootheel and rural parts of Alabama, Arkansas and the Appalachians. The website Daily Yonder reported that Buchanan County, Va., led the nation with 27 percent of working-age people on federal disability benefits in 2009.
The national average for working age but disabled?
It’s calculated at 4.6 percent, up from about 2.5 percent of the nonelderly adult population in the mid-1980s.
“You find higher rates in counties historically reliant on extraction industries - mining, agriculture, forestry,” said Tim Marema of the Center for Rural Strategies.
Where the mining has vanished, as in parts of west-central Missouri, generations of workers have been afflicted by struggling economies, low-paying jobs, poor access to health care and long, hilly drives to the nearest hospital.
Other experts say an array of factors - including the erratic, subjective system for determining who gets benefits and why - might figure into one community’s high reliance on disability income versus another’s low reliance.
In several rural and economically stressed counties in the Kansas outback, for example, the share of beneficiaries was calculated to be well below the national norm.
• • •
The trends in all corners of the country are rising, creating a backlog of disability claims and appeals that can take years to run their course.
While the political rhetoric this election year focuses on the retirement side of Social Security, many experts warn of even grimmer prospects for the side that funds disability benefits of younger Americans.
Analysts say that “out of control” growth in the disability rolls is creating a clogged system where undeserving but determined applicants win benefits, while many deserving applicants lose patience and opt to suffer without.
A white paper last month out of the National Bureau of Economic Research attributed much of the “unsustainable rise” in disability rolls to a swelling number of claims awarded for mental disorders and pain. Such conditions - difficult to diagnose and hard to assess their effects on work - are cited in more than half of the claims awarded.
Cancer and heart disease - the most common diagnoses a generation ago - now comprise only 20 percent of claims.
The number of disability beneficiaries has quadrupled since the early 1970s.
One cause for that is the improved health of Americans. Medical advancements have helped beneficiaries live much longer than they did when Congress drafted the program in the 1950s.
The economy factors in, too. During the boom years of 1996 through 1999, the disability rolls climbed by less than 500,000; they grew by 1.4 million between 2007 and 2010.
Most initial claims - roughly 7 out of 10 in Kansas and Missouri - are denied. But when cases go to the Social Security administrative law judges who review appeals, the chances of success vary wildly, depending on the judge.
From state to state, “the inconsistencies are amazing,” said Alan L. Cowles of Lawrence, a physician and former Social Security consultant who assists claimants in need of benefits.
A 20-year-old U.S. worker today has a 30 percent chance of becoming disabled before reaching full retirement, the NBER report said. The Social Security Administration last year paid monthly benefits to about 10 million disabled workers, dependent spouses and children.
Still, obtaining disability benefits usually is not an easy, nor lucrative, process.
Appeals can drag on for many months - many years if a case is taken to federal court - during which an applicant cannot (or should not) be gainfully employed.
While acknowledging that “disability by nature is a very subjective concept,” the chief actuary for the Social Security Administration, Steve Goss, told Congress in December that the agency “meets this challenge effectively and efficiently.”
Timothy Harlan, a Missouri lawyer who represents applicants statewide said the typical applicant of the last few years was in ill shape to work in better times, but did so because the jobs were there.
“Nobody wants to be disabled,” he said. “It’s embarrassing for them to come in and apply.”
Then unemployment hit, doctor appointments and prescriptions were skipped, and hopes of landing work languished - especially if an applicant lacked a high school degree, Harlan said.
In regions where disability benefits are most common, “one issue is going to be education,” he said. “If the general education level is lower, it’s easier to meet disability requirements…”
Also, “we find a lot of people who wouldn’t be disabled except for the fact they couldn’t get medical care … In a place that lacks public transportation, it’s harder to see the doctor” or to commute to a job that suits the disabled, he said.
Benton County reflects the perfect storm.
• • •
A 2011 survey by the West Central Missouri Community Action Agency, which serves the needy in Benton and eight other counties, cited more than 30,000 residents, or 16 percent of the regional population, without health insurance.
Benton County - population 19,000, with more than 1,300 qualifying for the disability benefits - had the area’s lowest high-school graduation rate, 81 percent. Average hourly wage in the region, at $12.47, is almost $7 below the statewide average.
For most residents, the nearest hospital is in Sedalia, and many military veterans drive two hours to VA hospitals in Kansas City or Columbia.
Unlike many rural counties, Benton County’s population has grown by 10 percent since 2000, as retirees moved in to enjoy the recreational amenities of Truman Lake.
But the lake also draws younger people on disability benefits; some can live in a motor-home resort for $70 a month.
Noland and her fiancé, John Hale, share a home in a Lincoln, Mo., trailer park.
The acronym OATS - or Older Adults Transportation System - marks the wheelchair-accessible van that transports Noland to a Warsaw clinic and back. But it is serving many younger adults, “all shapes and sizes, too,” said driver Shirlane Foster.
“Monday I was in Warrensburg. Tuesday, in Bolivar. Wednesday, Columbia. Today, here,” Foster said. “They be-bop us around, baby.”
Noland’s muscular dystrophy qualified her for benefits from her father’s Social Security insurance when she was a young teen. She earns a few bucks here and there selling Avon products. Hale, 38, tinkers in Web design.
He said back pain and limited movement in one arm keep him out of the cooking jobs he once held. But years of appeals to receive Social Security benefits have been unsuccessful.
“I know this guy in St. Joe who qualified in his late 20s, but he’ll still lift car engines, replace a transmission, work on his house,” Hale said. “People like that make it harder for people like me to get Social Security.”
Among the non-beneficiaries around Benton County, it’s a common observation.
“There are more people on disability here than I’ve ever seen,” said William McKinney, who installs satellite TV systems and moves furniture. “I grew up in Independence, lived in Butler, spent time in Oklahoma, in Springfield. Nothing like here…
“I think some of them are disabled just enough to be labeled that way so they feel they don’t have to work.”
Chris Stewart of the Katy Trail Community Health Centers disagreed: “I don’t think that’s anywhere near the norm.”
She attributed the region’s high reliance on disability benefits to factors linked to poor general health: Poverty, low graduation rates, geographic isolation and higher than normal levels of drug and alcohol abuse.
As for assessing their patients’ ability to work, Katy Trail physicians don’t get involved, Stewart said:
“They’ve said it puts them in a difficult situation in terms of advocacy or non-advocacy … We provide medical records and let others make that decision,” meaning the medical advisers and administrative judges employed by the Social Security Administration.
Local health practitioners and social-service groups note that abusers of government programs lurk wherever benefits are offered - and that’s all over the country.
At any given time, state vocational rehabilitation services are assisting about 100 clients in Benton County who want to keep or return to their jobs, said Karri Wilson of the Missouri Division of Vocational Rehabilitation in Sedalia.
“We would be happy to see more clients, but some of them simply can’t work … or don’t realize we’re here to help. People just need to persevere and seek out the resources,” she said.
Toward the goal of better medical access, the Benton County Health Care Coalition recently broke ground in Warsaw for Harbor Village, which will place a medical clinic, mental-health services and a senior social center on one site.
“The good news is this area is addressing these issues and not pushing them under the carpet,” said Irv Jensen of the Benton County Development Corp.
Air Force veteran Nick Moorer, who was exposed to Agent Orange in Vietnam, has done OK working his own plan to receive the disability money he argues he’s owed.
The Warsaw man left truck driving in 1995 and was deemed eligible for Social Security benefits in just a few weeks.
But the VA, which also offers disability benefits, was slow to recognize that in addition to back pain linked to surgery while he was serving, Moorer has since suffered from diabetes, a couple of heart attacks and a severe, purplish swelling of his right calf - all conditions the military lists as potential side effects of Agent Orange exposure.
“I didn’t say, ‘Hey, VA, you need to consider these other conditions.’ They were already on their list,” Moorer said.
Only last year did the VA relent to Moorer’s petitioning, bringing the sum of his benefits past $5,000 a month.
“I’ve learned over time if you don’t apply, you don’t get anything,” he said.
source