It hit me yesterday afternoon that critics of Social Security's disability determination process have little idea what is involved in the process. There seems to be an eagerness to jump to the conclusion that almost anyone who says they are disabled is found disabled. In the view of these critics, it's nothing but thinly disguised unemployment benefits. These critics are told this by experts at think tanks who produce impressive looking reports. This narrative fits in with the general worldview of a lot of people who work in white collar jobs, people who seldom interact in any meaningful way with those who hold down blue collar jobs, the kind of people who file most Social Security disability claims.
This hit me yesterday afternoon as I was reviewing the file that Social Security has on one of my clients. It runs to 1374 long, tedious pages, detailing this person's health problems over a time period of about seven years. It includes incredibly personal details of this client's life and a mind-numbing amount of detail about this client's medical history. Multiple health problems, multiple doctors, multiple hospitalizations, multiple emergency room reports and more medical tests than most people can imagine. There are duplicate copies of some records because Social Security doesn't have enough personnel to weed these out. Many of the records are hard to read because they were faxed or simply because Social Security stores the records in a low resolution digital format to save money on storage space and bandwidth. If you haven't tried to do it, you just can't imagine how complicated it is to try to follow such a complicated narrative over such a long period of time reading these sort of records. Some of the health problems sound serious at first but turn out to be minor. Others start out sounding minor but end up being major. A health problem may seem to have been resolved only to crop up later. Health problems interact with each other in complex ways, both medically and in how they relate to Social Security's rules. No, most files don't run to 1374 pages but a more typical length is still 500-600 pages and usually involves more than one impairment and possibly a red herring or two. How many of the experts at think tanks or the critics who listen to those supposed experts have ever tried to wade through files like this? I'll take an educated guess that the answer is exactly zero. How much can you know about the process if you haven't done this?
I may disagree with others who spend time reading these files but I respect them because I know they have a firm grounding in reality. The think tank "experts" and the critics who listen to them simply don't know what they're talking about. It's not easy to get on Social Security disability benefits. The process has plenty of flaws but every reasonable effort has been made to make it rigorous and maybe some of these efforts have been unreasonable. Social Security works hard at this. They're been trying to refine their processes for decades. You can't mull these problems over while drinking a cup of coffee and come up with some wonderful idea that no one has even though of. There aren't easy solutions.