Host: If you are disabled and you are not working, and you are getting this benefit, what if you work a little bit? Does the benefit go down, stay the same? Or are you not allowed to work at all because you are disabled?
Autor: So, there is what is called a Substantial Gainful Activity (SGA) threshold, which a couple of years ago was $1000/month. And essentially what it means is that if you earn more than SGA, you are in theory not disabled from the perspective of the Social Security Administration. They typically will reduce your benefits. You may lose your benefits for a month if you work above SGA. If you do it frequently, your benefits will be reviewed and you may lose access to the program. You can be viewed as having recovered. ... So, you have to basically be making money under the table. The thing is not by intention but the program creates a very strong incentive against meaningfully participating in the formal labor market. ... [It appears that Dr. Autor has never heard of the Trial Work Period, the Extended Period of Eligibility or Expedited Reinstatement, all of which are Social Security work incentives, not to mention Ticket to Work or the Vocational Rehabilitation exception to the medical improvement standard. Since his basic point is that there are serious disincentives to return to work, lack of knowledge of the work incentives that do exist is a major issue. There is no evidence that under the table employment by Social Security disability recipients is a significant problem.] ...
Autor: So, the definition of disability used by the SSA [Social Security Administration] adopted by Congress in 1956 is one based on employment more than health. The substance of the definition is that you are unable to engage in substantial gainful activity in the U.S. economy for a reason of health or disability. But what it really means is that you are not able to work; and you have to demonstrate to the SSA that you are unable to work; and the reason you are unable to work has to have something to do with your health. It could be your physical health or your mental health. So, it's a very elastic definition. For example, when the unemployment rate is high, there are very few jobs; you may be unable to work because the type of health limitation you have means that the type of job you would be able to do is not available at present. And that would qualify as a disability. ... [It appears that Dr. Autor has not read the part of the Social Security Act that says "An individual shall be determined to be under a disability only if ... he is not only unable to do his previous work but cannot ... engage in any other kind of substantial gainful work which exists in the national economy, regardless of whether such work exists in the immediate area in which he lives, or whether a specific job vacancy exists for him, or whether he would be hired if he applied for work."]
Autor: At present more than half of all awards are for mental disorders and musculoskeletal disorders. Mental disorders are things like nervous disorders, schizophrenia, and musculoskeletal disorders are basically back disorders.
Host: Carpal tunnel.
Guest: Yes. And those disorders are very difficult to verify. So, soft-tissue pain is difficult to prove or disprove; not observable. Obviously if you have a damaged disc in your back, that's observable. Soft tissue pain is not. ... [Musculoskeletal disorders are "basically back disorders?" I think that arthritis in the knees and broken bones and rheumatoid arthritis also qualify as musculoskeletal disorders. Damaged disks are easy to verify but schizophrenia isn't? Does Dr. Autor have any idea how ridiculous a statement that is medically? I'm pretty sure he wouldn't dismiss schizophrenia so quickly if he had any schizophrenics in his family or even in the families of any of his close friends.]
Autor: Even if population health were holding constant, there ought to be fewer and fewer people who are effectively disabled because of course the types of jobs they need to do require less and less physical capability. So, it is indeed quite surprising from that perspective that we should see an epidemic of disability. ... [Autor entirely misses the point that as the physical demands of some types of employment have decreased, the cognitive demands of almost all types of employment have increased, causing more disability for individuals who have cognitive limitations or who suffer chronic mental illness.]
Autor: ... And I believe it was 21 U.S. State Supreme Courts [who] ordered their Social Security Field Offices to stop complying with the continuing disability review process [in the early 1980s when Social Security has terminating the disability benefits of huge numbers of people]... [This is seriously fractured history. State governors ordered Disability Determination Services (DDS's) to stop doing continuing disability reviews for Social Security. A young Arkansas governor by the name of Bill Clinton was the first to do this. This was how he first drew national attention. But I digress. The DDS's are state agencies doing work under contract with Social Security. The state Supreme Courts ordered nothing. No part of any state government ordered Social Security field offices to do anything. If they had, the field offices would have ignored them. To think that State Supreme Courts could order Social Security field offices to do or not to do something is to misunderstand a fundamental principle of constitutional law, the sort of thing that I think that someone with a Ph.D. in public policy should know.]
I understand that Autor was speaking off the cuff, but come on! There's every appearance that there are serious gaps in Autor's knowledge that go to the core of what he's talking about. Not what you would expect from an MIT economist.
